High-dose benzodiazepine dependence among health-care professionals: A neglected phenomenon

2021 ◽  
Vol 61 (1_suppl) ◽  
pp. 42-45
Author(s):  
Laura Morbioli ◽  
Fabio Lugoboni

Chronic use of benzodiazepines (BDZs) is a widespread phenomenon which can lead to side effects such as tolerance, dependence and cognitive impairment, as well as resulting in accidents at work. High-dose BDZ dependence (HD-BDZ) is little studied, and it is mainly attributed to major psychiatric disorders and polydrug abuse. To date, few studies have investigated HD-BDZ among active workers, with none among health-care professionals (HPs). Tapering from high doses of BDZs can cause severe withdrawal symptoms, including seizures. The Addiction Unit of the University Hospital in Verona uses a protocol based on flumazenil slow infusion (FLU-SI), the safest and most effective treatment for HD-BDZ. Since 2003, 1281 patients have been detoxified from long-term use of high doses of BDZ using FLU-SI. The sample includes 139 (10.8%) HPs. Mean daily doses were 336 mg diazepam equivalent among HPs and 365 mg diazepam equivalent among non-HPs (no statistically significant difference). HPs are at higher risk of sleep disorders and work-related stress. Most of these HPs experience difficulties at work due to cognitive impairment, but they are often afraid of the potential legal implications and too ashamed to ask for help. It is important to study the prevalence of HD-BDZ among HPs and to investigate the impact on their working skills and working eligibility.

2020 ◽  
Vol 8 (B) ◽  
pp. 779-783
Author(s):  
Olivera Kalajdžić ◽  
Jelena Pavlović

BACKGROUND: Psychological support for patients and their families is of great importance at times when they go through shock, stress, and fear at moments when confronted with diagnosis and treatment. AIM: Aim to this study was to examine the influence of family attitudes on psychosocial adaptation and the effect of treatment of patients with malignancies to preserve the integrity of the diseased person in Bosnia and Herzegovina. METHODS: The cross-sectional study included 100 patients who were hospitalized at Foca University Hospital, Department of Oncology between September 2019 and December 2019. The survey used a sociodemographic questionnaire as well as a standardized questionnaire to evaluate communication with patients with malignant diseases for the patient and family (CCAT-PF). RESULTS: More than half of the respondents (69%) accepted the malignancy. When it comes to communication between health-care professionals and patients, 51% are satisfied with the communication and 49% are not satisfied. Most respondents (62%) hesitate to talk about side effects during treatment with health-care professionals, with a statistically significant difference observed between male and female respondents (χ2 = 6,014; p = 0.014). CONCLUSION: The time devoted to the subjects by the physicians as well as the willingness to listen to the patient is important aspects that influence the adaptation of the disease as well as the treatment.


Author(s):  
Salmeen D. Babelgaith ◽  
Mansour Almetwazi ◽  
Syed Wajid ◽  
Saeed Alfadly ◽  
Ahmed M Shaman ◽  
...  

Background: This study aimed to evaluate the Impact of diabetes continuing education on knowledge and practice of diabetes care among health care professionals in Yemen. Methods: A quasi-experimental study was carried out among health care professionals. The original questionnaire consisted of 22 multiple choice questions. A total of 73 HCPs received continuing education (CE) intervention.  Knowledge attitude and practice (KAP) was assessed using a validated questionnaire.  Results: The result showed that majority of the HCPs has a good general knowledge on diabetes and its managements prior to the CE program. Evaluation of the general knowledge score of the HCPs found some improvement in the knowledge score, however the improvement was not significant (p=0.31). The result of this study found that HCPs has good knowledge on monitoring the sign, symptoms and laboratory parameters. Conclusion: Evaluation of the knowledge score on Goal of Diabetes Management of HCPs found significant (p=0.024) improvement in the knowledge score. The results indicated that the lab values were rated as the most important in the goal for the treatment of diabetes patients.  The study also found no significant difference in practice score after CE program among HCPs.


2020 ◽  
Vol 31 (2) ◽  
pp. 179-190 ◽  
Author(s):  
Katherine Reed ◽  
Kathryn L. Cochran ◽  
Anthony Edelblute ◽  
Daniel Manzanares ◽  
Hillary Sinn ◽  
...  

The delivery of health care is undergoing a rapid evolution that is dramatically changing the way health care professionals perform their job responsibilities. In this increasingly stressful work environment, professionals are experiencing alarming rates of burnout. Recent efforts to enhance wellness have been directed toward organizations. However, because of the nature of the work performed in intensive care units, interventions to develop individual resilience are also needed. Currently, medical centers are environments in which the emotional impact of work-related trauma is often minimized and rarely processed. Some individuals may struggle to describe or express the impact of those traumas. Through nonverbal interventions, creative arts therapy can help people access, explore, and share authentic emotion in visual, musical, physical, or written form. By reconstructing meaning through transformative methods, participants may confront, reflect, and better cope with traumatic experiences while catalyzing social support networks and deepening relational bonds in the workplace.


2020 ◽  
Vol 16 (1) ◽  
pp. 165-173 ◽  
Author(s):  
Claudia Carmassi ◽  
Carlo Antonio Bertelloni ◽  
Maria Teresa Avella ◽  
Ivan Cremone ◽  
Enrico Massimetti ◽  
...  

Background: PTSD and burnout are frequent conditions among emergency healthcare personnel because exposed to repeated traumatic working experiences. Increasing evidence suggests high comorbidity between PTSD and mood symptoms, particularly depression, although the real nature of this relationship still remains unclear. The purpose of this study was to investigate the relationship between PTSD, burnout and lifetime mood spectrum, assessed by a specific scale, among health-care professionals of a major University Hospital in Italy. Methods: N=110 Emergency Unit workers of the Azienda Ospedaliero-Universitaria Pisana (Pisa, Italy) were assessed by the TALS-SR, MOODS-SR lifetime version and the ProQOL R-IV. Results: Approximately 60% of participants met at least one PTSD symptom criterion (criterion B, 63.4%; criterion C, 40.2%; criterion D 29.3%; criterion E, 26.8%), according to DSM-5 diagnosis. Almost sixteen percent of the sample reported a full symptomatic DSM-5 PTSD (work-related) diagnosis, and these showed significantly higher scores in all MOODS-SR depressive domains, as well as in the rhythmicity domain, compared with workers without PTSD. Further, mood-depressive and cognition-depressive MOODS-SR domains resulted to be predictive for PTSD. Significant correlations emerged between either PTSD diagnosis and criteria or ProQOL subscales and all the MOOD-SR domains. Conclusion: A significant association emerged among PTSD, burnout and lifetime MOOD Spectrum, particularly the depressive component, in emergency health care operators, suggesting this population should be considered at-risk and undergo regular screenings for depression and PTSD.


CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S79-S80
Author(s):  
M. A. Hasan ◽  
L. Snell ◽  
P. Nugus

Introduction: Over the last few decades, health care facility design has been studied to look at its effect on many patient-centred outcomes. However, limited data exists on the impact that specific physical features of a clinical space may have on learning and the educational experience. The aim of this study is to develop a set of characteristics which clinicians, clinical teachers and residents believe should be present in a clinical space to maximize trainees learning, using an emergency department (ED) as a context. Methods: A qualitative methodology used semi- structured interviews with a purposive sample of twelve attending physicians and residents who work in EDs of varying age and design at several sites of a quaternary university hospital. We explored their perceptions of the physical features in the clinical and learning environment that supported or impeded teaching and learning. The interviews were transcribed and thematically analyzed. Results: Preliminary results show that many physical characteristics of the clinical space are perceived to have an impact on trainees learning experience. A design with separation between clinician-learner dyads and the patients, with a visual access; shared clinical space among different health care professionals within a reasonable distance; availability of enough clinical space for specific emergency presentations; features such as adequate size, appropriate light, and control of sound were all perceived to enhance and augment clinical learning. Not surprisingly, non-design factors such as the presence of a functioning team and the availability of adequate equipment and technology was considered as important as the characteristics of physical space to optimize learning. Conclusion: This study demonstrates the importance and the impact of physical space design on trainees learning in a dynamic clinical environment. It provides teachers and policy-makers with a basis for developing criteria of the physical characteristics of a healthcare facility to maximize learning.


Author(s):  
Peter Memiah ◽  
Tristi Ah Mu ◽  
Shreya Madhavaram ◽  
Caroline Kingori ◽  
Courtney Cook ◽  
...  

The objective of the study was to investigate the gap between data and evidence-based decisions among healthcare professionals considering the enormous amount of individual and aggregate data collected. Our study assessed the capacity, skills, and knowledge of the Ministry of Health leadership staff to understand data management, analysis, utilization, and dissemination. Three key components were assessed: 1) Knowledge through true/false questions, 2) Level of Skill (and Competency) using a Likert scale, and 3) Understanding of Key Concepts and Tools based on a Likert scale. The 183 study respondents were diverse healthcare professionals from Kenya, Tanzania, and Rwanda. Majority of respondents had not received any training on data management, analysis, interpretation, and utilization techniques, further there was a significant difference between those who had received training versus those who had not(p=0.005). The respondents were competent in work-related experiences but lacked skills and knowledge on: data concepts and tools, study designs, and types of data analysis. These findings explain the gap between data management, analysis, utilization, and dissemination among health professional’s cadre. To enhance service delivery and optimal provision of health care, it is imperative to have all health care professionals receive a well-designed training on data management, analysis, interpretation, and utilization.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.


2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.


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