Risk Management and Healthcare Policy最新文献

Background: Occupational hazards among healthcare workers (HCWs) present serious risks, from infectious diseases to physical and chemical dangers, along with psychological stress, all of which threaten their health and safety. This study aims to identify the unique challenges and hazards encountered by radiology technologists in in Saudi Arabia by assessing the key factors contributing to these risks.

Methods: A descriptive questionnaire study was conducted in January-February 2023, targeting 75 radiology technologists at King Abdulaziz Medical City (KAMC), Jeddah, with participants recruited via non-probability convenience sampling and invited to complete a widely recognized questionnaire previously used among radiographers. Descriptive statistics were calculated, and the Kruskal-Wallis H-test was conducted to examine the relationships between demographic factors and different aspects of occupational hazards.

Results: Of the 75 technologists contacted, 63 responded, resulting in an 84% participation rate. Workload, work shifts, and patient-related factors are major contributors to occupational hazards, surpassing technologist-specific and organizational elements. Additionally, 68.3% cited rigid leadership and unequal treatment as aggravating factors, while insufficient staffing, inadequate protective devices, and patient interaction were also significant concerns. Over 60% identified bending, lifting heavy patients, prolonged radiation exposure, and frequent walking as major hazard sources.

Conclusion: Key occupational hazards factors facing radiology technologists include high workloads, work shifts, and patient-related issues, with 68.3% citing rigid leadership and unequal treatment as exacerbating risks. Insufficient staffing and protective devices, along with demanding work conditions, further heighten these hazards. This study emphasizes the need for targeted interventions in staffing, resources, and culture to improve radiology technologists' safety.

Objective: We aimed to analyze the clinical characteristics and prognostic factors of patients with severe hyperkalemia in the emergency department.

Methods: This retrospective cohort study included adult patients diagnosed with severe hyperkalemia who sought medical care at the emergency department of Aerospace Center Hospital between January 2018 and May 2022. Clinical data, including demographics, comorbidities, laboratory findings, and outcomes, were systematically collected. Patients were categorized into survival and deceased groups based on in-hospital mortality. Comparative analysis between these groups identified significant differences, highlighting key clinically covariates. Binary logistic regression was employed to determine the primary factors influencing patient outcomes.

Results: Of 90 patients diagnosed with severe hyperkalemia, 64 were in the survival group, and 26 in the deceased group. Binary logistic regression identified several significant predictors of mortality, including higher APACHE II scores (odds ratio [OR] 1.41, P = 0.02), widened QRS wave on electrocardiogram (ECG) (OR 79.39, P = 0.04), and elevated serum potassium levels (OR 1.3, P = 0.04). In contrast, emergency blood purification was associated with a reduced mortality rate (OR 0.29, P = 0.03).

Conclusion: Key risk factors for mortality in patients with severe hyperkalemia include widened QRS wave on ECG, elevated APACHE II score, and high serum potassium level. Timely correction of hyperkalemia through emergency blood purification significantly improves patient outcomes.

Objective: Atrial fibrillation (AF) is known to increase the risk of thromboembolic events and major adverse cardiovascular events (MACE). The impact of paroxysmal atrial tachycardia (PAT) on these risks remains unclear.

Methods: This retrospective cohort study was conducted involving 889 patients diagnosed with PAT and 1106 control patients without PAT, all of whom underwent their initial 24-hour ECG monitoring between 2015 to 2020. Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the association between PAT and the study endpoints, including thromboembolic events and MACE.

Results: Over a mean follow-up period of 50.3 months, the incidence of thromboembolic events and MACE was significantly higher in the PAT group compared to the control group (6.5% vs 1.7% and 19.1% vs 9.9%, respectively). After adjusting for common risk factors and baseline imbalances, the PAT group exhibited a significantly elevated risk of thromboembolic events (hazard ratio [HR] 3.782, 95% confidence interval [CI] 2.212-6.467; P <0.001) and MACE (HR 1.795, 95% CI 1.398-2.305; P <0.001). However, the frequency of PAT episodes, heart rate, and maximum heart rate were not significantly associated with these outcomes. Within the PAT group, a history of stroke, transient ischemic attack, and chronic renal failure were identified as independent risk factors for thromboembolic events, while hypertension, coronary heart disease, heart failure, and chronic renal failure were independently associated with MACE.

Conclusion: PAT, as detected by 24-hour dynamic ECG, is associated with an increased risk of thromboembolic events and MACE.

Objective: To investigate the current status of elderly health services in medical institutions at all levels within Guangxi Province, China.

Methods: Using a purposeful sampling method, a questionnaire survey was conducted from July 24, 2023 to October 24, 2023 on the general situation, human resources, rehabilitation medicine, nursing services, and the development of hospice care at 1305 medical institutions in Guangxi.

Results: Among the surveyed 1305 medical institutions in Guangxi, 172 (13.18%) had established departments of geriatrics, while 293 (22.45%) boasted departments of rehabilitation medicine. Furthermore, 909 (69.66%) of these institutions offered annual free physical examination services to individuals aged 65 and above. Notably, a total of 362 medical institutions, encompassing both comprehensive hospitals and grassroots hospitals, were recognized as elderly-friendly institutions, accounting for 31.4% of the surveyed sample.The highest demand for talents in medical institutions at all levels included specialized physicians/general practitioners (74.6%), traditional Chinese medicine practitioners (63.1%), rehabilitation therapists (56.1%), and specialized nurses for the elderly (41.7%). A total of 1038 medical institutions conducted popular science activities on elderly health, accounting for 79.5% of the total, focusing mainly on disease prevention (89.21%), nutritional diets (84.68%), rational medication use (79.77%), physical exercise (68.21%), and mental health (60.79%). Only 88 medical institutions provided hospice care services, accounting for 6.7% of the total.

Conclusion: Guangxi medical institutions' elderly services are inadequate. Geriatrics and rehab departments are scarce, talent is lacking, and hospice care is underdeveloped. As aging accelerates, the country and society must support elderly care. Governments should introduce talent incentives, and medical institutions should enhance services, foster a positive work environment, and advance Guangxi's elderly health agenda.

Background: Pharmacovigilance (PV) is an essential part of the healthcare system's framework. In Saudi Arabia, pharmacovigilance is still a relatively new concept though it is well established in many countries.

Study aim: In this study, we aim to evaluate knowledge, attitude, and practice regarding pharmacovigilance and barriers to reporting adverse drug reactions (ADRs) among the general public in Saudi Arabia.

Methods: This is a cross-sectional study that used a self-administered online questionnaire to assess knowledge, attitude, and practice of PV and ADRs. The study included only the adult population in Saudi Arabia. A scoring system was generated with a scale from 0 to 100, where 80% was set as a cut-off point, as any higher score resembled adequate knowledge, a positive attitude, and good practice. We used the Statistical Package for Social Sciences (SPSS) version 26 for performing the statistical analysis, where para-normal tests were used to associate scores with the socio-demographic characteristics of participants.

Results: The study collected 1098 complete responses. The mean age (±SD) of participants was 37.9±11.2 years. Females comprised 68.9% of the participants. The average knowledge score among participants was 37.8±18.5, where only 4.3% of respondents had adequate knowledge. The average attitude score was 90.1±19.2, where 83.4% had a positive attitude. The average practice score was 70.4±18, and 34.5% of participants had good practice.

Conclusion: The study found that the majority of participants had inadequate knowledge, a positive attitude, and poor practice. Individuals holding a master's degree or higher and those working in the healthcare sector had the highest knowledge scores, whereas the group aged 31 to 50 years old, participants from the Al Jawf region, participants who are married with children, holders of a master's degree or higher, and healthcare workers had the best attitude scores. Higher practice scores were seen among married individuals with children and those who work in the healthcare sector.

Background: Depression, a prevalent mental health issue, can significantly impact healthcare workers (HCWs), leading to decreased productivity, increased turnover, and high medical errors. However, there is a dearth of information regarding depression among healthcare professionals in Somalia. Therefore, this study aimed to assess the magnitude and risk factors associated with depressive symptoms among healthcare professionals in Mogadishu, Somalia.

Methods: A hospital-based cross-sectional study was conducted among HCWs at Erdogan Hospital, in the capital city of Somalia. Data was collected using questionnaires on socio demographic, work-related characteristics and Patient Health Questionnaire-9 (PHQ-9). Bivariate and multivariate logistic regression analyses were conducted to identify variables associated with depressive symptoms. A p-values of 0.05 as a cutoff for a significant association.

Results: The prevalence of depressive symptoms among healthcare professionals was 48.9% (95% CI: 45.4-56.9%). In multivariable analysis, being female (AOR = 2.05; 95% CI: 1.17-3.60), being a nurse (AOR = 3.11; 95% CI: 1.14-8.48), unmarried (AOR = 1.83; 95% CI: 1.04-3.21), having insufficient sleep (AOR = 2.61; 95% CI: 1.45-4.70), a family history of mental illness (AOR = 3.31; 95% CI: 1.49-7.36), lack of physical activity (AOR = 2.59; 95% CI: 1.19-5.62), and having low social support (AOR = 3.06; 95% CI: 1.17-7.98) were all associated with increased odds of experiencing depressive symptoms.

Conclusion: The study showed that nearly half of healthcare professionals experienced depressive symptoms. The study underscores the importance of efficient screening methods for identifying psychological symptoms in healthcare professionals, which is essential for enhancing their mental health and patient care. Therefore, we recommend that healthcare institutions and policymakers develop and implement screening measures to identify and improve the mental health well-being of HCWs, as well as provide high-quality patient care.

Background: Intimate partner violence, is a major public and clinical health issue. Health institutions are one of the institutions to which a violence victim applies first. That is why the attitude of future health professionals is important. Hope is a concept that supports well-being and mental health. The aim of this study was to determine the relationship between attitudes towards intimate partner violence and hope levels of university students studying in the field of health.

Methods: The research was a descriptive cross-sectional study. The research was carried out in December 2021 with 934 students. Data were collected using the sociodemographic data form, the acceptance of couple violence scale, and the trait hope scale.

Results: %65 have a date or an ex-date, and %3.1 of them have experienced dating violence. 2.1% of the female students and 6.9% of the male students reported having experienced dating violence, and this was significantly higher in male students. Acceptance of couple violence among students are low in all dimensions. Acceptance of violence by men was significantly higher in all dimensions. Acceptance of male violence was significantly higher in those who use cigarettes and alcohol, and those who have experienced domestic or dating violence. The hope scale scores were close to high in all dimensions.

Conclusion: The findings of the study showed the attitudes of students studying in health fields against violence. Students have dating relationships, are exposed to any violence in dating relationships, had low levels of acceptance of couple violence and high levels of hope. Students will start working with hope.

Purpose: To explore the value of different inflammatory markers in predicting the severity of coronavirus disease 2019 (COVID-19) in patients with type 2 diabetes mellitus (T2DM).

Patients and methods: A total of 116 patients with COVID-19 in patients with T2DM were collected from December 2022 to March 2023 and were divided into a mild case group (77 cases) and a severe case group (39 cases). The ratio of neutrophil to lymphocyte (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil to lymphocyte × platelet ratio (NLPR), lymphocyte ratio to monocyte (LMR), systemic inflammatory response index (SIRI), systemic inflammatory index (SII), systemic inflammatory composite index (AISI), procalcitonin (PCT), C-reactive protein (CRP) and lactate dehydrogenase (LDH) were compared between the two groups. The screening effect of each variable on the progression of the disease was analyzed using receiver operating characteristic (ROC) curves.

Results: NLR, PLR, NLPR, MLR, SIRI, SII, AISI, LDH, CRP and PCT in severe case group were higher than those in mild case group (P<0.05), and LMR was lower than those in mild case group (P<0.05). ROC curve analysis further demonstrated the diagnostic performance of these biomarkers, with PCT having the largest area under the ROC curve (AUC^ROC) of 0.83.

Conclusion: NLR, PLR, NLPR, SIRI, SII, LDH, CRP and PCT demonstrate greater reliability in diagnostic value and clinical utility for predicting the severity of COVID-19 in patients with T2DM.

Purpose: This study aimed to identify distinct trends among Chinese residents based on their health-related quality of life (HR-QoL) outcomes and to analyze the demographic characteristics that contribute to these trends.

Materials and methods: The study conducted latent class analysis using baseline data obtained from a survey of health service utilization behaviors (from July to December 2016) among residents of Hubei Province, China (N = 1517). Latent classes were used to implement the HR-QoL grouping of different trends among the respondents. Multinomial logistic regression analysis was used to identify demographic characteristic factors affecting HR-QoL in the trend groups.

Results: A three-class model emerged as the most suitable grouping classification for HR-QoL among Chinese residents: the low HR-QoL class, exhibiting a downward trend (5.5%); the medium HR-QoL class, exhibiting an upward trend (12.1%); and the stable HR-QoL class, exhibiting high HR-QoL (82.4%). Participants in the medium class were more likely to be without chronic diseases, aged 45-64 years, and employed than those in the low class. Conversely, urban participants had a higher likelihood of belonging to the low class. Participants in the stable class were more likely to be without chronic diseases, aged 15-44 years or 45-64 years, and employed than those in the low class. Conversely, urban participants had a higher likelihood of belonging to the low class.

Conclusion: Three latent trend classes of HR-QoL were observed, which exhibited distinct characteristics. Residents without chronic diseases, residents under 65 years of age, and employed residents had better HR-QoL than individuals in other classes, while urban residents had poorer HR-QoL than individuals in other classes.

Background: Non-communicable diseases emerge as major public health challenges with increasing prevalence and mortality. The armed conflict in Sudan has resulted in the displacement of 6.8 million people, putting a significant strain on the health sector in the displacement areas. This study aimed to explore the prevalence of non-communicable diseases and access to healthcare services among internally displaced people in Northern Sudan.

Methods: A cross-sectional study was conducted among randomly selected internally displaced people in accommodation shelters at Dongola locality. Data were collected by face-to-face interviews using a questionnaire adapted from relevant studies. For data analysis descriptive statistics and chi-square tests were utilized using SPSS-27.

Results: 374 participated in the study with a 96.1% response rate. 70% of respondents were 18-49 years old. 70.9% of respondents were females, and 92.8% of them had no source of financial income. The prevalence of non-communicable diseases was 42.5%, with hypertension (44.7%), diabetes mellitus (24.7%), and thyroid disorders (15.2%) predominating. About 45.7% of patients interrupted their medication, and 38.6% could not access healthcare services, while 57.2% of respondents received free medical care. The study found a statistically significant association between the type of disease and age, gender, residence before displacement, and the Length of displacement.

Conclusion: 42.5% of the internally displaced suffer from non-communicable diseases, with hypertension, diabetes mellitus, and thyroid disorders predominating. About 45.3 and 38.6% of them respectively have interrupted their medications and lost regular follow up. The urgent need for improved healthcare services is recommended.