Risk Management and Healthcare Policy最新文献

Background: Hand hygiene is a critical preventive measure for controlling infections, particularly in underdeveloped nations.

Materials and methods: A cross-sectional study was conducted in a hospital in Mogadishu, Somalia, from January to March 2024. This study aimed to assess compliance with hand hygiene practices and related factors among healthcare professionals.

Results: The study population comprised 52% men and 47.3% women. Most participants held bachelor's degrees, with the majority being nurses or midwives. A significant proportion had over five years of work experience. Almost all participants were knowledgeable about hand hygiene. Most reported cleaning and drying their hands before, during, and after contact with bodily fluids during aseptic procedures. Age, gender, educational status, marriage, working experience, type of occupation, receiving hand hygiene training and knowledge, and having the availability of water, soap, alcohol, and gloves significantly affected the overall uptake of infection control measures in Mogadishu (p<0.05).

Conclusion: The findings highlight an urgent need for targeted interventions to enhance hand hygiene practices in Somalia. Addressing training gaps and resource shortages is crucial for reducing infection rates and safeguarding patient health in this high-risk setting.

Background: Bell's Palsy (BP) is an acute lower motor nerve impairment of the facial nerve, causing sudden paralysis on one side of the face and significantly affecting the patient's quality of life. Physiotherapy is critical for rehabilitation after BP, aiding functional recovery. Various physical therapy interventions, such as dry needling, taping, and nerve mobilization, have proven effective in treating BP. However, different rehabilitation approaches and knowledge levels among therapists can result in varying treatment outcomes. Therefore, understanding rehabilitation specialists' knowledge and attitudes towards BP is essential for ensuring effective treatment. To date, no studies have examined the knowledge and attitudes of rehabilitation professionals in Saudi Arabia regarding BP.

Objective: This study aims to evaluate the knowledge and attitudes of physical therapists in Saudi Arabia regarding the rehabilitation of BP.

Methods: A cross-sectional observational study was conducted with 150 licensed physical therapists in Saudi Arabia, selected via convenience sampling. Participants completed an anonymous online survey covering demographics, knowledge of, and attitudes toward BP rehabilitation techniques. Descriptive and inferential statistics were used to analyze the data.

Results: The participants had a mean age of 33.13 ± 6.85 years, with 68.7% being female. Most held Bachelor's degrees (65.3%) and worked in general hospitals (72.7%). The average knowledge score was 8.99 ± 1.95, indicating moderate knowledge levels. Attitudes towards BP rehabilitation were positive, particularly regarding early intervention, emotional support, and coordination exercises. Significant differences in knowledge and attitudes were observed based on gender, experience, and practice location.

Conclusion: Physical therapists in Saudi Arabia demonstrate moderate knowledge and positive attitudes toward BP rehabilitation. Continued professional education and collaboration are recommended to improve clinical standards in treating BP.

Purpose: Understanding that the complexity and dynamic nature of the nursing care setting creates diverse conditions for teamwork is important when developing tools to measure nursing unit team effectiveness. The Team Effectiveness Scale for Nursing Units (TES-NU), based on the Integrated Team Effectiveness Model, was developed without confirmatory factor analysis and only tested on one nursing organization. It needs further research to prove its validity and reliability. This study aims to refine and validate the TES-NU in various nursing organizations.

Methods: We designed this methodological study to refine the TES-NU by establishing its validity and reliability. The study included 330 clinical nurses from six general hospitals in South Korea, selected via convenience sampling. The TES-NU's refinement process includes item analysis, exploratory factor analysis, confirmatory factor analysis, item analysis, and convergent validity.

Results: The KMO of 22 preliminary items was 0.89, the cumulative variance of the five factors was 67.58%, and the commonality was >0.40. Confirmatory factor analysis indicated the revised model fit well with better indices: CMIN/DF = 1.687, CFI = 0.936, TLI = 0.924, RMSEA = 0.059, and SRMR = 0.057. We simplified the refined scale to 22 items in 5 subdomains: "head nurses leadership", "job satisfaction", "cohesion", "work performance", and "nurses competence". Convergent validity (r = 0.69, p < 0.001) and reliability (Cronbach's alpha = 0.92) were validated for the revised TES-NU.

Conclusion: A refined TES-NU has tested their validity and reliability. Nursing managers can use this tool to manage the performance of individual nurses as well as nursing units, which will contribute to improving the work performance of the nursing organization.

The global spread of the Mpox virus represents a significant public health challenge, particularly for regions with fragile healthcare systems. Afghanistan, already grappling with severe healthcare deficits, faces the added threat of Mpox, a zoonotic disease caused by the monkeypox virus. The recent emergence of Clade Ib, a new strain associated with rising outbreak cases, exacerbates concerns as Afghanistan's healthcare infrastructure continues to deteriorate due to reduced international aid, healthcare worker shortages, and an ongoing socio-political crisis. This commentary underscores the urgent need for international intervention to avert a potential public health crisis that could devastate Afghanistan's already weakened healthcare system. It calls for immediate support to enhance disease surveillance, improve healthcare infrastructure, and address the pressing challenges of malnutrition and access to medical services.

Objective: To analyze the trends of lung cancer incidence and mortality in Xiamen from 2011 to 2020 and provide some clues for the lung cancer prevention and control.

Methods: The data was obtained from the Xiamen City Cancer Register in Fujian Province, China. The data was updated on Sep 30, 2023. The codes of C33-C34 were used to identify the lung cancer. The newly diagnosed lung cancer patients during the period of 2011-2020 in Xiamen City were included in the evaluation of incidence and mortality and Cox analysis.

Results: A total of 11408 lung cancer patients were enrolled. The crude incidence rate was 52.78 per 100000 and the age-standardized incidence rate (ASIWR) was 40.67 per 100000 from 2011 to 2020. Both the crude incidence rate of lung cancer (AAPC =5.92, P value <0.001) and ASIWR (AAPC = 4.93, P value <0.001) showed increasing trends. The crude incidence rate in female increased 4.90 times faster as that in male (AAPC: 12.34/2.52). The crude mortality rate and the age-standardized mortality rate (ASMWR) were 37.25 per 100000 and 28.30 per100000. The 5-year age-standardized relative survival rate (ARS) was 18.62% (95% CI: 17.63-19.67%). The 5-year ARS was higher in women than men (26.35% vs 15.28%) and higher in urban than rural areas (21.44% vs 11.96%). Patients with lower education levels had significantly lower ARS than those with higher education (14.66% vs 31.53%). The 5-year ARS improved notably from 2016-2020 compared to 2011-2015 (22.23% vs 13.21%). Farmers had the lowest ARS among occupations [13.34% (95% CI:11.93-14.92%)]. There were all increasing trends in 1-year, 3-year, 5-year, and 10-year ARS rates between 2011 and 2020 (all P values of AAPC<0.05).

Conclusion: Lung cancer incidence in Xiamen increased, while mortality decreased with improved survival. Developing more perfect need to consider the differences in the social environment and other factors.

Background: Patients in Intensive Care Units (ICUs) face high risks of physical, functional, cognitive, and mental impairments. Early rehabilitation activities are crucial for reducing mortality and complication rates. This survey investigates the characteristics, current implementation, and detailed status of early rehabilitation activities in ICUs across Central China.

Methods: A cross-sectional survey was conducted involving 158 hospitals, with 131 responding. Data on institutional characteristics and early rehabilitation activities were collected through questionnaires. Descriptive statistical analysis described the current status, and a univariate regression model identified factors associated with the implementation of early rehabilitation measures.

Results: A total of 131 ICUs completed the survey, with a response rate of 82.91% (131/158). Results indicated that 82.44% (108/131) of ICUs implemented early rehabilitation activities, but only 65 (49.62%) had explicit early rehabilitation exercise protocols or standards/procedures. Before implementing early rehabilitation activities, approximately 89.97% (110/131) of ICUs conducted assessments, and 46.56% (61/131) regularly held structured interdisciplinary rounds to discuss early activity measures and goals. More than half of the participating adult ICUs reported screening patients for swallowing function (64.89%; 85/131), and 55.73% (73/131) of adult ICUs reported having a nutrition therapy specialist conduct regular consultations/visits. Only 26.72% (35/131) of adult ICUs reported having a speech therapist conduct consultations/visits. A total of 81.68% (107/131) of ICUs believed that the current implementation of early rehabilitation activities was insufficient. In the analysis of influencing factors, the presence of rehabilitation therapists in the ICU was a significant factor for the implementation of early rehabilitation activities (P<0.05).

Conclusion: The majority of ICUs in hospitals in central China have implemented early rehabilitation activities; however, less than half have explicit early rehabilitation exercise protocols or standards/procedures. The presence of professional rehabilitation therapists in the ICU is a key factor in the implementation of early rehabilitation activities in ICUs in hospitals in Central China.

Background: Despite control efforts, including mass drug administration (MDA), neglected tropical diseases (NTDs) continue to pose a significant public health threat, particularly in rural Ethiopia. Integrating social and behavior change communication (SBCC) into MDA is essential for success. This study aimed to evaluate the effectiveness of tailored SBCC integrated into MDA campaigns to enhance community knowledge, perception, and preventive behaviors regarding targeted NTDs in the Jimma, Ethiopia.

Methods: A community-based study was conducted using a pre-test post-test design. A multistage sampling technique was employed for surveys, while for qualitative insights, purposive sampling was employed. SBCC interventions tailored to local needs were implemented. Changes in knowledge, perception, and practices were evaluated using Cohen's d. Additionally, a score for key outcome variables comparisons were made to examine variations based on socio-demographic factors, employing suitable statistical tests. Qualitative data were analyzed thematically using Atlas.ti 7.1.5.

Results: The prevalence of SBCC exposure was 88.8%. The intervention had a more significant impact on improving knowledge and preventive practices related to Onchocerciasis (OC) compared to Soil-transmitted helminthes (STH). Specifically, most OC outcomes showed moderate to large effect sizes. In contrast, the effect on STH was more limited, with only knowledge of consequences improving moderately and preventive practices showing a small effect size. The mean score for OC preventive practices varied by educational level and sex, while the median score for STH perception varied among educational level and marital status. Additionally, score variation was observed across districts for all key outcome variables.

Conclusion: The majority of the population was exposed to SBCC resulting in improvements in knowledge, perception, and preventive behaviors regarding OC and knowledge of consequences of STH and its prevention behavior. This highlights the importance of incorporating well-designed SBCC activities in to MDA campaigns to optimize the control and eventual elimination of targeted NTDs.

Background: Clinical guidelines emphasize the use of standardized outcome measures (SOMs) in post-stroke rehabilitation. However, the extent of SOM utilization among physiotherapists in this context in Saudi Arabia remains unclear.

Aim: 1) assess the current use of SOMs by physiotherapists involved in stroke rehabilitation in Saudi Arabia and 2) identify facilitators and barriers influencing the use of SOMs.

Methods: An online survey was administered using a three-section questionnaire designed for this study. The first section collected demographic data, the second evaluated the use of SOMs recommended by the American Physical Therapy Association, and the third explored factors facilitating or hindering SOM use in clinical practice. Only highly recommended outcome measures capturing the three levels of the International Classification of Functioning, and Disability (ICF) model were considered: body structure and function, activities, and participation. Poisson regression analysis was used to investigate the association between SOMs utilization and educational level, work experience, type of work facility, and the number of patients treated per week.

Results: A total of 138 physiotherapists responded. Most participants (98.5%) used at least one outcome measure in clinical practice. Regression analysis showed that number of strokes treated per week and facility type were associated with the likelihood of using higher number of SOMs. Physiotherapists managing more than 10 stroke patients per week and working in private sector had significantly higher odds of using a greater number of SOMs. The most pronounced barriers were time restrictions and limited resources.

Conclusion: Physiotherapists working with stroke patients in Saudi Arabia demonstrate a high awareness and positive attitude toward SOM utilization. Addressing barriers such as time management and resource allocation is crucial to enhancing SOM integration in clinical practice.

Clinical rehabilitation impact: Organizational support in terms of adequate time and resources is needed to enhance the use of SOMs among physiotherapists.

Purpose: The study aims to understanding the mental health literacy level of urban and rural residents in Guangdong Province, the first major province in China, and its influencing factors is crucial.

Methods: A multi-stage stratified equal-volume random sampling method was adopted in October-December 2022 to select permanent residents aged 18 years and above in Guangdong Province for the questionnaire survey, which consisted of a general demographic information questionnaire and a national mental health literacy questionnaire. Rao-Scott χ²-test with correction based on sampling design, independent samples t-test and binary multivariate logistic regression analysis were performed.

Results: A total of 51744 individuals completed the questionnaire, including 31822 urban residents and 19200 rural residents. The rate of achievement of mental health literacy was 13.6% among urban residents, which was significantly higher compared to the rate of 8.6% among rural residents. Logistic regression analysis showed that female, higher education, being mental worker, being a retiree, having a higher monthly household income, maintaining a regular diet, and using electronic products for 2-6 hours per day were protective factors for mental health literacy attainment in urban residents, while having chronic diseases, being a smoker and having a history of drinking were identified as risk factors in urban residents. Among in rural residents, married, younger, higher education, being mental worker and using electronic products for 2-6 hours per day, maintaining a regular diet, and engaging in regular exercise were protective factors for achieving mental health literacy, while previous smoking was a risk factor.

Conclusion: The study revealed a low level of mental health literacy among urban and rural residents of Guangdong Province, with a significant disparity between the two areas. These findings highlight the need for continuing efforts to increase the dissemination of mental health knowledge in rural communities and improve levels of mental health literacy.

Background and objective: Inadequate risk assessment and a lack of risk monitoring are common deficiencies in clinical laboratory, and are also the main causes of biosafety incidents. Therefore, we summarized the experience of implementing adequate risk assessment and maintaining risk monitoring, and established a procedure for continuously improving biosafety management.

Methods: Learning from our laboratory's experience in implementing risk assessment, risk response, and risk monitoring before and during the COVID-19 epidemic, we summarized the procedures for fully identifying risks, accurately evaluating risks, maintaining risk monitoring, establishing and regular reviewing safety indicators. On this basis, we established a system for continuously improving biosafety management through risk monitoring and reviewing safety indicator.

Results: We identified a total of 30 unacceptable risks prior to the COVID-19 pandemic, and developed and implemented appropriate risk control measures. After risk control, residual risks were acceptable, and no biosafety incidents have occurred. During the COVID-19 pandemic, after multiple risk monitoring, we identified ten new risks, three ineffective risk control measures, and multiple control measures for excessive protection. Then, we timely adjusted risk control measures to avoid laboratory personnel infection and excessive protection. Meanwhile, We established eight safety indicators and identified two improvement opportunities through regular reviews.

Conclusion: Adequate risk identification and accurate risk assessment are particularly important for effectively controlling biosafety risks. Biosafety management should be continuously improved to deal with ineffective and excessive protection caused by various changes in experimental activities. Continuous improvement of biosafety management can be achieved through risk monitoring, regular review of safety indicators, and management reviews. This study will help laboratory managers to fully and accurately assess risks, as well as update risks and their control measures through risk monitoring, and the continuous improvement procedure established in the study has certain reference value for laboratories to effectively respond to emerging infectious diseases and avoid excessive protection.