scholarly journals Managing violence against healthcare personnel in the emergency settings of Pakistan: a mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044213
Author(s):  
Muhammad Naseem Khan ◽  
Ikram Khan ◽  
Zia Ul-Haq ◽  
Mirwais Khan ◽  
Faryal Baddia ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Focus Group ◽  
Emergency Departments ◽  
Tertiary Care ◽  
Scale Up ◽  
Healthcare Personnel ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Intervention Hospital

ObjectivesThe primary objective of this study was to evaluate the effectiveness of a half-day training on de-escalation of violence against healthcare personnel regarding prevention and management of violence incidents versus a similar tertiary-level hospital with no such training. Secondary objectives were to compare the overall satisfaction, burnout, fear of violence and confidence in coping with patients’ aggression of the healthcare personnel in the two hospitals.DesignMixed method design, with a comparative cross-sectional (quantitative) and focus group discussions (qualitative) components.SettingEmergency departments of the two tertiary care hospitals in district Peshawar over 6 months starting from May 2018.ParticipantsHealthcare personnel in the emergency departments of the two hospitals (trained vs untrained).Outcome measuresViolence exposure (experienced/witnessed) assessed through a previously validated tool in the past 5 months. Burnout, confidence in coping with patient aggression and overall job satisfaction were also assessed through validated tools. The qualitative component explored the perceptions of healthcare personnel regarding the management of violence and the importance of training on de-escalation of violence through focus group discussions in the two hospitals.ResultsThe demographic characteristics of the healthcare personnel within the two hospitals were quite similar. The de-escalation training did not lead to a reduction in the incidences of violence; however, confidence in coping with patient aggression and the overall satisfaction were significantly improved in the intervention hospital. The de-escalation training was lauded by the respondents as led to an improvement in communication skills, and the healthcare personnel suggested for scale-up to all the cadres and hospitals.ConclusionThe study found significant improvements in the confidence of healthcare personnel in coping with patient aggression, along with better job satisfaction and less burnout in the intervention hospital following the de-escalation training.

scholarly journals Perspectives of future pharmacists on the potential for development and implementation of pharmacist prescribing in Qatar

2020 ◽  
Vol 42 (1) ◽  
pp. 110-123
Author(s):  
Mohammad Issam Diab ◽  
Angham Ibrahim ◽  
Oraib Abdallah ◽  
Alla El-Awaisi ◽  
Monica Zolezzi ◽  
...  
Keyword(s):  
Focus Group ◽  
Treatment Options ◽  
Developed Countries ◽  
Focus Group Discussions ◽  
Cross Sectional Survey ◽  
Group Discussions ◽  
Cross Sectional ◽  
Pharmacist Prescribing ◽  
Barriers To Implementation ◽  
Special Training Program

AbstractBackground Pharmacists in many developed countries have been granted prescribing authorities under what is known as “non-medical prescribing” or “pharmacist prescribing”. However, such prescribing privileges are not available in many developing countries. Objective The objective of this study was to determine the perspectives of future pharmacists (recent pharmacy graduates and pharmacy students) on pharmacist prescribing and its potential implementation in Qatar. Methods A convergent parallel mixed-methods design was used: (1) a cross-sectional survey using a pre-tested questionnaire and; (2) focus group discussions to allow for an in-depth understanding of the issue, with a focus on pharmacists prescribing competencies as well as barriers for its implementation. Main outcome measures Future pharmacists’ perspectives and attitudes towards pharmacist prescribing in Qatar. Results The majority of the respondents (94.4%) indicated awareness of the prescribing competency related to selecting treatment options. Furthermore, the majority (92.4%) believed that pharmacists should undergo prescribing training and accreditation before been legally allowed to prescribe, a point that was reiterated in the focus group discussions. Participants generally expressed support for collaborative and supplementary prescribing models when developing prescribing frameworks for Qatar. Four categories emerged under the theme barriers to implementation of pharmacist prescribing: lack of prescribing competency, pharmacist mindset, lack of accessibility to patient records and counseling rooms, and diversity of education and training background. Conclusion The majority of recent pharmacy graduates and students were in favor of pharmacist prescribing been implemented in Qatar. However, a special training program was deemed necessary to qualify pharmacists to prescribe safely and effectively.

scholarly journals ‘Sometimes you are forced to play God…’: a qualitative study of healthcare worker experiences of using continuous positive airway pressure in newborn care in Kenya

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034668
Author(s):  
Helen M Nabwera ◽  
Jemma L Wright ◽  
Manasi Patil ◽  
Fiona Dickinson ◽  
Pamela Godia ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Focus Group ◽  
Airway Pressure ◽  
Healthcare Workers ◽  
Positive Airway Pressure ◽  
Scale Up ◽  
Newborn Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant

​ObjectiveTo explore the experiences of using continuous positive airway pressure (CPAP) in newborn care among healthcare workers in Kenya, and to identify factors that would promote successful scale-up.​Design and settingA qualitative study using key informant interviews and focus group discussions, based at secondary and tertiary level hospitals in Kenya.​ParticipantsHealthcare workers in the newborn units providing CPAP.​Primary and secondary outcome measureFacilitators and barriers of CPAP use in newborn care in Kenya.​Results16 key informant interviews and 15 focus group discussions were conducted across 19 hospitals from September 2017 to February 2018. Main barriers reported were: (1) inadequate infrastructure to support the effective delivery of CPAP, (2) shortage of skilled staff rendering it difficult for the available staff to initiate or monitor infants on CPAP and (3) inadequate knowledge and training of staff that inhibited the safe care of infants on CPAP. Key facilitators reported were positive patient outcomes after CPAP use that increased staff confidence and partnership with caregivers in the management of newborns on CPAP. Healthcare workers in private/mission hospitals had more positive experiences of using CPAP in newborn care as the relevant support and infrastructure were available.​ConclusionCPAP use in newborn care is valued by healthcare workers in Kenya. However, we identified key challenges that threaten its safe use and sustainability. Further scale-up of CPAP in newborn care should ensure that staff members have ready access to optimal training on CPAP and that there are enough resources and infrastructure to support its use.EthicsThis study was approved through the appropriate ethics committees in Kenya and the UK (see in text) with written informed consent for each participant.

scholarly journals Job Satisfaction of Midwives in the Context of a Midwife-Led Project – A Repeat Measure Mixed Methods Study

2020 ◽  
Author(s):  
Susanne Grylka-Baeschlin ◽  
Regula Aeberli ◽  
Barbara Guenthard-Uhl ◽  
Barbara Meier Kaeppeli ◽  
Vanessa Leutenegger ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Focus Group ◽  
Models Of Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Policy Makers ◽  
Work Related ◽  
Before And After ◽  
Related Stress ◽  
The One

Abstract Background: Job satisfaction of midwives is important to prevent skill shortage. Those working in midwife-led models of care were more satisfied than those working in standard care. Job satisfaction in the context of a midwife-led project was not researched previously. The aim of this study was to investigate job satisfaction before and after the implementation of a midwife-led intervention.Methods: Longitudinal observational study at three time points using quantitative and qualitative methods. A total of 43 midwives working in the labour ward participated in the online surveys and 5-7 in the focus group discussions. The surveys comprised questions from validated instruments. Descriptive and multivariable time series analysis were used for quantitative and content analysis for qualitative data.Results: Adjusted predicted scores decreased between t0 and t1 and subsequently increased at t2 without reaching baseline values (e.g ‘professional support subscales’: between t0 and t1: (0.65, 95% CI [0.45, 0.86] versus 0.26, 95% CI [0.08, 0.45], p=0.005) and t0 and t2 (0.65, 95% CI [0.45, 0.86] versus 0.29, 95% CI [0.12, 0.47], p=0.004). Focus group discussions revealed three themes: “Job satisfaction”, “Challenges with the implementation” and “Continuity of care”. Midwives perceived the additional tasks as stressors. Conclusion: The implementation of new interventions might increase work related stress and decrease job satisfaction in an early phase. This effect was stronger than the one of acquiring more autonomy and responsibility. Heads of institutions and policy makers should recognise the needs of support and additional resources for staff when planning new projects.

scholarly journals Promoting traditional foods for human and environmental health: lessons from agroecology and Indigenous communities in Ecuador

2019 ◽  
Author(s):  
Ana Laura Deaconu ◽  
Geneviève Mercille ◽  
Malek Batal
Keyword(s):  
Focus Group ◽  
Indigenous People ◽  
Scale Up ◽  
Indigenous Communities ◽  
Traditional Food ◽  
Traditional Foods ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Dietary Practices ◽  
Production Diversity

Abstract Background: The displacement of traditional dietary practices is associated with negative nutritional consequences for rural Indigenous people, who already face the brunt of both nutritional inadequacies and excesses. Traditional food (TF) consumption and production practices can improve nutritional security by mitigating disruptive dietary transitions, providing nutrients and improving agricultural resilience. Meanwhile, traditional agricultural practices regenerate biodiversity to support healthy ecosystems. In Ecuador, Indigenous people have inserted TF agricultural and dietary practices as central elements of the country’s agroecological farming movement. This study assesses factors that may promote TF practices in rural populations and explores the role of agroecology in strengthening such factors. Methods: Mixed methods include a cross-sectional comparative survey of dietary, food acquisition, production and socioeconomic characteristics of agroecological farmers (n=61) and neighboring reference farmers (n=30) in Ecuador’s Imbabura province. Instruments include 24-hour dietary recall and a food frequency questionnaire of indicator traditional foods. We triangulate results using eight focus group discussions with farmers’ associations. Results: Compared to their neighbors, agroecological farmers produce and consume more TFs, and particularly underutilized TFs. Farm production diversity, reliance on non-market foods and agroecology participation act on a pathway in which TF production diversity predicts higher TF consumption diversity and ultimately TF consumption frequency. Age, income, market distance and education are not consistently associated with TF practices. Focus group discussions corroborate survey results and also identify affective (e.g. emotional) and commercial relationships in agroecological spaces as drivers of stronger TF practices. Conclusions: Traditional food practices in the Ecuadorian highlands are not relics of old, poor and isolated populations but rather an established part of life for diverse rural people. However, many TFs are underutilized. Sustainable agriculture initiatives may improve TF practices by integrating TFs into production diversity increases and into consumption of own production. Agroecology may be particularly effective because it is a self-expanding global movement that not only strengthens productive pathways toward TF promotion, but also intensifies affective sentiments toward TFs and inserts them in commercial spaces. Understanding how to promote TFs is necessary in order to scale up their potential to strengthen nutritional health.

scholarly journals Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1949
Author(s):  
Mat Lowe ◽  
Mamsamba Joof ◽  
Bomar Mendez Rojas
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Rural Areas ◽  
The Gambia ◽  
Early Marriage ◽  
Rural Settlements ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Key Informant

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%), however this rate is still high. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies to decrease early marriages. Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents, focus group discussions with 16 male and female parents, and eight key informant interviews with community-based decision makers. Focus group discussions and key informant interviews were transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: The study finds that ethnicity and the fear that girls may engage in premarital sex are two important factors associated with early marriage in rural Gambia. In addition, lack of meaningful alternatives to marriage including work opportunities in rural areas may also limit the options and resources available to girls, resulting in early wedlock. Conclusions: These findings suggest that in order to decrease early marriages in rural Gambia, future efforts should focus on understanding and addressing the role of ethnicity in determining marriage patterns and allaying the fear around premarital sex.The findings also suggest a need to provide girls with employment-oriented education including vocational skills which may result into more empowerment and a delay in marriage.

scholarly journals Aetiological factors and perception of anaemia in Tunisian women of reproductive age

2008 ◽  
Vol 11 (7) ◽  
pp. 729-736 ◽  
Author(s):  
Jalila El Ati ◽  
Pierre Lefèvre ◽  
Chiraz Béji ◽  
Chiheb Ben Rayana ◽  
Sadok Gaigi ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Focus Group ◽  
Reproductive Age ◽  
Sufficient Information ◽  
Women Of Reproductive Age ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Perceptions And Attitudes ◽  
Major Factors

AbstractObjectivesTo identify aetiological factors in anaemia and to explore knowledge, perceptions and attitudes towards anaemia.DesignTwo cross-sectional surveys and sixteen focus group discussions.SettingThe two regions with the highest prevalence of anaemia in Tunisia, Greater Tunis (GT) and the South West (SW).SubjectsTwo representative samples of 687 (GT) and 729 (SW) women of reproductive age; 108 women were included in focus group discussions.ResultsAmong anaemic women, 63·4 % in the GT region and 80·2 % in the SW displayed iron deficiency (ID). Genetic haemoglobinopathies accounted for 10·0 % and 3·6 % of the cases of anaemia in the two regions, respectively. After adjustment for confounders, the major factors for iron-deficiency anaemia were low dietary Fe intake (OR = 5·0, 95 % CI 3·0, 8·4), drinking tea after eating (OR = 3·4, 95 % CI 2·0, 5·7) and pica (OR = 2·1, 95 % CI 1·1, 3·9). Most of the women related anaemia to the following causes: malnutrition, lack of hygiene, and their heavy workload and responsibilities in the household. Many women connected anaemia with hypotension. Few established a relationship between ID and anaemia. They had confidence in their doctor for treatment, but many complained they were not given sufficient information. Low dietary Fe intake, inappropriate food practices and inadequate perceptions contribute to the aetiology of anaemia in women.ConclusionsThese results point out to the need for a strategy combining food fortification, Fe supplementation for pregnant women, nutritional education for the general public and at-risk specific target groups, and training of health professionals.

scholarly journals “Our culture prohibits some things”: Qualitative inquiry into how sociocultural context influences the scale up of community-based injectable contraceptives in Nigeria

2019 ◽  
Author(s):  
Oluwaseun Akinyemi ◽  
Bronwyn Harris ◽  
Mary Kawonga
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Health Workers ◽  
Scale Up ◽  
Community Members ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Injectable Contraceptives ◽  
Depth Interviews

AbstractObjectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.DesignA qualitative study based on a grounded theory approach was conducted through in-depth interviews and focus group discussions.SettingMost participants lived in Gombe State, North East Nigeria. Other participants were from Ibadan (South West) and Abuja (Federal capital territory).ParticipantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.MethodsThis study, conducted in 2016 was part of a larger study on scale up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.ResultsSociocultural challenges to scale up included patriarchy and men’s fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are ‘divine blessings’ and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale up process as active, although they also identified scope for further involvement and recognition.ConclusionScale up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. This requires the health system and those who work in it, to move beyond a narrow health ‘comfort zone’ by actively engaging with, and learning from, those who are leading, caring for and living in, the community.Strengths and limitations of this studyThe study participants represented a range of stakeholders - users of injectable contraceptives, community members, providers and health system managers.Our results highlighted that scale up is influenced by several socio-cultural factors; thus, showing the importance of paying attention to complex contextual issues during innovation uptake.The findings of our study emphasized how health systems and communities should interact in order to ensure successful scale up of health innovations.As with any qualitative study, the findings of this study are not statistically generalizable.FundingThis research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No:54100113), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z) and Deutscher Akademischer Austauschdienst (DAAD). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the authors.Declarations of interestNone.

scholarly journals Assessment of Chlorhexidine use for cord care at Kangundo level 4 Hospital

2019 ◽  
Author(s):  
Clarice Ambale ◽  
Brian Ngatia ◽  
Jonathan Nthusi
Keyword(s):  
Focus Group ◽  
Data Collection ◽  
Standard Operating Procedure ◽  
Cross Sectional Study ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Ethical Approval ◽  
Hospital Cleaning ◽  
First Time

Abstract Background: Sepsis continues to be an important cause of morbidity and mortality in neonates. One of the most important portals of entry for infections is the umbilical cord. Proper care of the cord can prevent many of these cases of sepsis and hence reduce neonatal mortality rates. In Kenya, the use of chlorhexidine digluconate (CHX) gel was introduced to scale in 2016 and received with mixed reactions in some hospitals with reports of medication errors and ineffectiveness being received. This study sought to find out the knowledge, practices and attitude on its use in Kangundo Level 4 hospital. Methodology: The study was carried out at Kangundo level 4 hospital between June and August 2019. It was a descriptive cross-sectional study with both quantitative and qualitative components. A questionnaire was used for the quantitative data collection while focus group discussions were held for the qualitative data collection. Ethical approval was sought prior to commencement of data collection. Results: A total of 19 clients and 24 healthcare workers were interviewed and two focus group discussions held. All the 19 clients had delivered in the hospital and only three were first-time mothers. Education on how to use chlorhexidine (CHX) was given to 16/19 (84%) of the clients interviewed. Duration of application varied among clients; 4 days 5/19(26%), 7 days, 12/19 (64%) and until the stump falls off, 2/19 (10%). Twenty of the 24 HCWs (83%) interviewed advised the patients on cleaning the cord prior to application of CHX, frequency of application varied from OD 15/24 ( 62%), BD 3/24 (13%) and TID 6/24( 25%). Two FGDs were held for HCW; lack of training and clear instructions on how to use the gel as major contributors to ineffectiveness of CHX. Conclusion and recommendation: There was poor understanding on the use of CHX among both clients and HCWs at Kangundo level 4 hospital. Cleaning of the stump prior to gel application is important to prevent accumulation of the dry gel and allow contact with the wound. There is need for training and development of a standard operating procedure on use of CHX.

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