scholarly journals General hospital specialists’ attitudes toward psychiatry: a cross-sectional survey in seven countries

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054173
Author(s):  
Inoka Koshali Wimalaratne ◽  
Jane McCarthy ◽  
Birit F P Broekman ◽  
Klaas Nauta ◽  
Samudra Kathriarachchi ◽  
...  

ObjectivePsychiatric comorbidities are common in physical illness and significantly affect health outcomes. Attitudes of general hospital doctors toward psychiatry are important as they influence referral patterns and quality of care. Little is known about these attitudes and their cultural correlates. The aim of this study was to identify attitudes toward psychiatry among general hospital specialists in relation to culture of the practice setting and other clinician factors (gender, age, seniority and specialty).MethodsA cross-sectional, descriptive study was carried out in seven countries (New Zealand, China, Sri Lanka, Russia, Israel, Brazil, the Netherlands). Data were collected from senior medical staff of various disciplines using an updated version of Mayou and Smith’s (1986) self-administered questionnaire.ResultsA total of 889 hospital doctors participated. While favourable attitudes toward both psychiatric consultation and management were endorsed by a majority, significant differences were also observed between countries. Subgroup differences were mostly confined to gender, acuity of practice setting and specialty. For example, female doctors in Russia (χ2=7.7, p=0.0056), China (χ2=9.2, p=0.0025) and the Netherlands (χ2=5.7, p=0.0174) endorsed more positive attitudes compared with their male counterparts, but this gender effect was not replicated in the total sample. Chronic care specialists were overall more inclined to manage patients’ emotional problems compared with those working in acute care (χ2=70.8, p (adjusted)<0.0001), a significant finding seen also in individual countries (China, New Zealand, the Netherlands, Russia). Physicians were more favourably disposed toward psychiatry compared with other specialists, especially surgeons, in all countries except Israel.ConclusionsThis study adds to evidence for the association of medical attitudes with individual clinician factors and demonstrates that the influence of these factors varies by country. Understanding these issues may help to overcome barriers and improve quality of care provided to general hospital patients.

BMJ Open ◽  
2016 ◽  
Vol 6 (3) ◽  
pp. e010632 ◽  
Author(s):  
Anthony K Mbonye ◽  
Esther Buregyeya ◽  
Elizeus Rutebemberwa ◽  
Siân E Clarke ◽  
Sham Lal ◽  
...  

2020 ◽  
Author(s):  
Ettamba Agborndip ◽  
Benjamin Momo Kadia ◽  
Domin Sone Majunda Ekaney ◽  
Lawrence Tanyi Mbuagbaw ◽  
David C Rees ◽  
...  

AbstractBackgroundSickle Cell Disease (SCD) affects two in 100 Cameroonian new-borns, with 50-90% of affected children dying before their fifth birthday. Despite this burden, there is no national SCD programme in Cameroon. This study aimed to assess parents’ and physicians’ knowledge of SCD, their satisfaction with the quality of care and their recommendations to improve the treatment of SCD in Cameroon.MethodsA multi-centre cross-sectional survey was conducted in English and French, using structured questionnaires distributed in electronic format to physicians throughout Cameroon. Paper-based questionnaires were also administered to parents in the West and North West regions of Cameroon. Data were entered into Microsoft Excel and analysed using the SPSS statistical software.ResultsFifty-four parents and 205 physicians were recruited. We found that 72.2% of parents had good knowledge of SCD, 72.2% of parents were satisfied with the quality of care. Attending a sickle cell clinic (AOR 22, 95% CI 17.70-250) was significantly associated with having good knowledge. Just 14.2% of physicians had good knowledge and 23.3% of physicians were satisfied with the available management standards of SCD. Seeing more than five patients per month (AOR 3.17, 95% CI 1.23-8.20) was significantly associated with having good knowledge. Sickle cell clinics, national guidelines and subsidised treatment were the top three measures proposed by physicians and parents to improve the management of SCD.ConclusionKnowledge of SCD and satisfaction with care were poor among Cameroonian physicians. There is a need for a national programme and a comprehensive system of care for SCD in Cameroon.


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025740 ◽  
Author(s):  
Karin Hekkert ◽  
Ine Borghans ◽  
Sezgin Cihangir ◽  
Gert P Westert ◽  
Rudolf B Kool

ObjectivesReadmissions are used widespread as an indicator of the quality of care within hospitals. Including readmissions to other hospitals might have consequences for hospitals. The aim of our study is to determine the impact of taking into account readmissions to other hospitals on the readmission ratio.Design and settingWe performed a cross-sectional study and used administrative data from 77 Dutch hospitals (2 333 173 admissions) in 2015 and 2016 (97% of all hospitals). We performed logistic regression analyses to calculate 30-day readmission ratios for each hospital (the number of observed admissions divided by the number of expected readmissions based on the case mix of the hospital, multiplied by 100). We then compared two models: one with readmissions only to the same hospital, and another with readmissions to any hospital in the Netherlands. The models were calculated on the hospital level for all in-patients and, in more detail, on the level of medical specialties.Main outcome measuresPercentage of readmissions to another hospital, readmission ratios same hospital and any hospital and C-statistic of each model in order to determine the discriminative ability.ResultsThe overall percentage of readmissions was 10.3%, of which 91.1% were to the same hospital and 8.9% to another hospital. Patients who went to another hospital were younger, more often men and had fewer comorbidities. The readmission ratios for any hospital versus the same hospital were strongly correlated (r=0.91). There were differences between the medical specialties in percentage of readmissions to another hospital and C-statistic.ConclusionsThe overall impact of taking into account readmissions to other hospitals seems to be limited in the Netherlands. However, it does have consequences for some hospitals. It would be interesting to explore what causes this difference for some hospitals and if it is related to the quality of care.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Chiarenza ◽  
D Domenig ◽  
S Cattacin

Abstract Background Several sets of standards aiming at improving access and quality of care for service users have been published in recent years. Certain standards focused on improving healthcare providers’ responsiveness to specific target groups. The general goal of this research was to improve organisations’ awareness of equity standards that are not focused on specific groups, but on all contributing factors that put vulnerable groups at risk of exclusion. The specific objective was to evaluate the degree of compliance with a set of equity standards in 52 health care organisations from 16 countries. Methods A self-assessment tool (SAT) was developed to allow healthcare organisations to measure their capacity to provide equitable care for service users. The SAT indicates the main areas that should be addressed: equity in policy; equitable access and utilisation; equitable quality of care; equity in participation; promoting equity. A cross-sectional survey addressing participants from pilot-organisations was used for data collection, concerning both the self-reported compliance score with the standards, as well as the additional information provided to support the score assigned. Data were analysed quantitatively as well as qualitatively. Results The findings confirm that healthcare providers do invest in improving equity in the access and delivery of services to vulnerable groups. However, many health organisations have inadequate strategies to address inequities and are insufficiently engaged in improving equity in participation and promoting equity outside the organisation. Conclusions The participating organisations reported a significant impact from use of the self-assessment tool: some received the support from regional/national authorities to continue working on improving equity in healthcare; others linked the equity standards to existing performance-measurement strategies; others invested in new frameworks to improve service users engagement. Key messages The implementation of the SAT contributes to a self-reflective process, involving health professionals and managers, in which gaps and potential improvements are identified. Pilot organisations utilised the SAT as part of a process of increasing their awareness of equity issues and changing their organisational culture.


2021 ◽  
Author(s):  
sarah idriss ◽  
walaa alasaadi ◽  
abdullah Aldhuhayyan ◽  
Ahmed alenzi ◽  
Reem alharbi ◽  
...  

BACKGROUND The use of communication technologies to deliver health care remotely is known as telemedicine. The coronavirus disease 2019 (COVID-19) pandemic had a variety of consequences for health-care delivery in 2020. As a result, it was necessary to adapt and deliver high-quality care to patients while limiting possible viral exposure for both patients and health-care workers. During the pandemic, physicians employed video visits, phone visits, and electronic written visits (e-consultations), all of which have the ability to provide a comparable quality of care while removing social barriers. OBJECTIVE The study’s aim is to assess physicians’ perspectives and attitudes concerning the usage of telemedicine in Riyadh hospitals during the COVID-19 pandemic. The main domains of the assessment are physicians’ overall experience with telemedicine use before and during COVID-19, future adaptability to using telemedicine, perceptions about patients’ experience, and the influence of telemedicine on burnout. METHODS Methods: An anonymous 28-question cross-sectional survey was developed using SurveyMonkey and distributed to all physicians from all specialty disciplines across Riyadh city hospitals. RESULTS A total of 362 doctors were included in the study. Among them, 28.7% were consultants, 30.4% were specialists, and 40.9% were residents. Male doctors formed the majority (56.1%). When asked about the frequency of using telemedicine, 41.4% answered “frequently,” 26% responded “occasionally,” and 32.6% said “never.” Thirty one percent of doctors agreed and somewhat agreed that the “quality of care during telemedicine is comparable with face-to-face visits.” About 55% doctors believed that telemedicine consultation is a cost-effective way, compared to face-to-face visits. Most of the doctors were skilled (70%) at telemedicine, and they were also able to solve technology issues during telemedicine visits (54%). Overall, the physicians felt that their patients liked telemedicine: 68% said they felt comfortable using telemedicine and 76% said theyfound that it saved time. As per the burnout question, 4.1% of doctors felt burnout every day, 7.5% felt burnout a few times a week, and 27.3% felt burnout a few times per month. CONCLUSIONS Physicians had a generally favorable attitude toward telemedicine, believing that the quality of health-care delivery using it was comparable to that of in-person care. Future research is needed to investigate how physicians’ attitudes toward telemedicine have changed since the pandemic, as well as how this virtual technology might be used to improve their professional and personal well-being.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Dug Yeo Han ◽  
Bruce Arroll ◽  
Michael Leveritt ◽  
...  

Throughout the world, medical students and doctors report inadequate nutrition education and subsequently lack of knowledge, attitude, and skills to include nutrition in patient care. This study described New Zealand’s students’ attitudes to and self-perceived skills in providing nutrition care in practice as well as perceived quantity and quality of nutrition education received in training. 183 medical students from New Zealand’s largest medical school (response rate 52%) completed a 65-item questionnaire, partially validated, using 5-point Likert scales. Students believed incorporating nutrition care into practice is important, yet they were less confident patients improve nutrition behaviours after receiving this care. Students were confident in skills related to nutrition in health and disease but less confident in skills related to general food knowledge. Greater quantity and quality of nutrition education received was associated with greater self-perceived skills in providing nutrition care to patients but not with attitudes towards incorporating nutrition care into practice. This cohort of New Zealand medical students places similarly high importance on nutrition care as students and doctors from other countries. Further investigations beyond graduation are required to inform whether additional nutrition education is warranted for these doctors.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nathalie Möckli ◽  
Michael Simon ◽  
Carla Meyer-Massetti ◽  
Sandrine Pihet ◽  
Roland Fischer ◽  
...  

Abstract Introduction The persistent fragmentation of home healthcare reflects inadequate coordination between care providers. Still, while factors at the system (e.g., regulations) and organisational (e.g., work environment) levels crucially influence homecare organisation, coordination and ultimately quality, knowledge of these factors and their relationships in homecare settings remains limited. Objectives This study has three aims: [1] to explore how system-level regulations lead to disparities between homecare agencies’ structures, processes and work environments; [2] to explore how system- and organisation-level factors affect agency-level homecare coordination; and [3] to explore how agency-level care coordination is related to patient-level quality of care. Design and methods This study focuses on a national multi-center cross-sectional survey in Swiss homecare settings. It will target 100 homecare agencies, their employees and clients for recruitment, with data collection period planned from January to June 2021. We will assess regulations and financing mechanisms (via public records), agency characteristics (via agency questionnaire data) and homecare employees’ working environments and coordination activities, as well as staff- and patient-level perceptions of coordination and quality of care (via questionnaires for homecare employees, clients and informal caregivers). All collected data will be subjected to descriptive and multi-level analyses. Discussion The first results are expected by December 2021. Knowledge of factors linked to quality of care is essential to plan and implement quality improvement strategies. This study will help to identify modifiable factors at multiple health system levels that might serve as access points to improve coordination and quality of care.


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