Tetrahydrocannabinol and Cannabidiol Use in an Outpatient Palliative Medicine Population

2020 ◽  
Vol 37 (8) ◽  
pp. 589-593 ◽  
Author(s):  
Bridget H. Highet ◽  
Elizabeth R. Lesser ◽  
Patrick W. Johnson ◽  
Judith S. Kaur
Keyword(s):  
Palliative Care ◽  
Chronic Illness ◽  
Side Effects ◽  
Patient Population ◽  
Palliative Medicine ◽  
Daily Basis ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample

Background: Palliative medicine physicians are challenged by lack of guidance regarding effectiveness and dosing of cannabis products in the setting of their emerging popularity. Objective: The aim of this study was to describe early patterns of tetrahydrocannabinol (THC) and cannabidiol (CBD) use in Florida following passage of the state’s first medical marijuana law. We describe here the perceived benefits, side effects, and beliefs expressed by patients in a single outpatient academic palliative medicine practice. Methods: A cross-sectional survey was performed of a sequential convenience sample of patients who presented to an outpatient academic palliative medicine clinic over a 3-month period. Results: In all, 24% (14/58) of respondents reported THC use, with half using THC on a daily basis. Patients reported improvements in pain, appetite, and nausea. In all, 71% (10/14) began using THC after the diagnosis of their chronic illness, and the most common form of usage was vaping. In all, 24% (14/58) of patients reported CBD use. Patients reported improvements in pain, and the most common form of usage was topical application. None of the patients had used CBD prior to the onset of their chronic illness. In all, 21% (3/14) of THC users and 21% (3/14) of CBD users thought that their substance was helping to cure their illness. Individual reported side effects in both groups were minimal. Conclusions: Approximately a quarter of outpatient palliative care patients use THC or CBD, often on a daily basis. Palliative care providers should be aware of the frequency, diverse usage, and beliefs behind cannabis product use in this patient population.

scholarly journals Nursing students' knowledge and attitudes regarding brominated flame retardants

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Krešimir Jakšić ◽  
Marijana Matek Sarić ◽  
Jelena Čulin
Keyword(s):  
Nursing Students ◽  
Health Care Providers ◽  
Flame Retardants ◽  
Brominated Flame Retardants ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Content Type ◽  
Knowledge And Attitudes

PurposeThis study explored Croatian nursing students' knowledge and attitudes regarding brominated flame retardants (BFRs) as indicators of their predisposition to educate future patients. The purpose of the study was to identify knowledge gaps and barriers and to propose possible remedies.Design/methodology/approachThe cross-sectional survey was conducted on a convenience sample of 114 nursing students at undergraduate and graduate levels from three Croatian universities during the winter semester in the academic year 2018–2019. Descriptive and inferential statistical  analyses were performed using STATISTICA 13 software.FindingsSlightly over half of the students (58.49%) were knowledgeable of BFR health effects and 45.28% showed knowledge about its presence in the environment. Only 33.02% of students identified prenatal exposure effects and 24.53% answered correctly about legislative actions. Participants expressed modest interest in the topic (M = 3.15, SD = 1.35). Although informing the public on the health consequences of BFRs was important to them (M = 4.18, SD = 1.03), they did not perceive health-care providers as primarily responsible for communicating that information.Originality/valueThere is a need to enhance related content in the curriculum to improve students' knowledge. Raising students' awareness regarding the role of nurses in clinical and policy arenas is proposed to facilitate active participation in improving environmental health.

Graduating nurses' knowledge of palliative and end-of-life care

2020 ◽  
Vol 26 (1) ◽  
pp. 5-12
Author(s):  
Ann Selena Cleary
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Baccalaureate Nursing ◽  
Survey Design ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Eol Care ◽  
Care Course ◽  
Nurses Knowledge

Background: Generalist nurses frequently care for people who have advanced chronic diseases in decline, or who are dying. Few studies have measured graduating nurses' knowledge about end-of-life (EoL) care. Aims: To measure and compare knowledge about EoL care using the palliative care quiz for nurses among two cohorts of graduating nurses in a baccalaureate nursing programme. Methods: A quantitative cross-sectional survey design using a convenience sample of two cohorts of students. Findings: Total mean scores were low at 44.5% and 46.5% for the cohorts, respectively; this was not statistically significant. Misconceptions related to presentation and symptom management of the dying patient and integration of palliative with acute care. Palliative care knowledge was higher among the cohort who completed the dedicated EoL care course. Conclusion: Significant misconceptions about EoL care exist among these graduating nurses; this information provides direction for curriculum revision.

scholarly journals Perception of Inappropriate Use of Proton Pump Inhibitors Among Community-Dwelling Older Adults

2020 ◽  
Author(s):  
Mohammad Rababa ◽  
Abeer Rababa'h
Keyword(s):  
Older Adults ◽  
Side Effects ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Primary Care Providers ◽  
Community Dwelling ◽  
Care Providers ◽  
Cross Sectional ◽  
Convenience Sample

Abstract Background Long-term use of proton pump inhibitors (PPIs) in older adults is a prevalent issue and associated with adverse health outcomes. There is limited evidence about older adults’ perception of PPI use and its associated side effects. This study aimed to examine the knowledge and awareness of older adults about PPI use and its side effects and willingness to stop PPI and its associated factors. Methods This cross-sectional study was conducted on a convenience sample of 120 older adults from three local healthcare centers located in Irbid, Jordan. Older adults’ perception of PPI use was measured by Patients’ Perceptions of Proton Pump Inhibitor Risks and Attempts at Discontinuation Survey. Results The majority of older adults were not familiar with any report linking PPI use with side effects, reported no concern related to the chronic side effects of PPI, and had not discussed the benefits and risks of PPI with their primary care providers (PCPs). Although a majority did not try to stop PPI, most older adults were willing to stop PPI due to its side effects, particularly if recommended by PCPs. Factors associated with long-term use of PPI included age, indication for gastrointestinal reflux disease (GERD), improvement of GERD symptoms, and being comfortable to reduce or stop PPI. Recommendations by PCPs to stop PPI (p = 0.049) and a greater level of concern about long-term side effects of PPI (p < 0.0001) were the only two statistically significant predictors of previous attempts to stop PPIs. Conclusions Concern about PPIs is associated with attempts to stop PPI, particularly with PCPs’ recommendation. The risks and benefits of PPIs should be discussed with PCPs to avoid making inappropriate decisions regarding PPI therapy. The Long-term use of PPIs should be carefully evaluated.

scholarly journals Oral Health Status, Knowledge, and Behaviours of People with Diabetes in Sydney, Australia

2021 ◽  
Vol 18 (7) ◽  
pp. 3464
Author(s):  
Prakash Poudel ◽  
Rhonda Griffiths ◽  
Amit Arora ◽  
Vincent W. Wong ◽  
Jeff R. Flack ◽  
...  
Keyword(s):  
Health Status ◽  
Oral Health ◽  
Diabetes Care ◽  
Health Knowledge ◽  
Oral Health Status ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Oral Health Knowledge ◽  
Sydney Australia

This study assessed self-reported oral health status, knowledge, and behaviours of people living with diabetes along with barriers and facilitators in accessing dental care. A cross sectional survey of 260 patients from four public diabetes clinics in Sydney, Australia was undertaken using a 35-item questionnaire. Data were analysed using SPSS software with descriptive and logistic regression analyses. More than half (53.1%) of respondents reported having dental problems which negatively impacted their related quality of life. Less than half (45%) had adequate oral health knowledge. Only 10.8% reported receiving any oral health information in diabetes care settings, which had higher odds of demonstrating adequate oral health knowledge (AOR, 2.60; 95% CI, 1.06–6.34). Similarly, 62.7% reported seeing a dentist in the last 12 months. Having private health insurance (AOR, 3.70; 95% CI, 1.85–7.40) had higher odds of seeing a dentist in the past 12 months. Dental costs were a major contributor to avoiding or delaying dental visit. Patients living with diabetes have unmet oral health needs particularly around the awareness of its importance and access to affordable dental services. Diabetes care providers can play a crucial role in this area by promoting oral health to their patients.

scholarly journals Prevalence, risk factors and sources of anxiety among Emergency Department healthcare workers in Pakistan during COVID-19 pandemic: A single center survey

2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Work Performance ◽  
Nonparametric Tests ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frontline Workers

Summary COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

2021 ◽  
pp. 104990912110186
Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Fast Track ◽  
Hospice Care ◽  
Cannabis Use ◽  
Care Plan ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

A survey of Cambodian health-care providers' HIV knowledge, attitudes and intentions to take a sexual history

2009 ◽  
Vol 20 (5) ◽  
pp. 346-350 ◽  
Author(s):  
G Webber ◽  
N Edwards ◽  
I D Graham ◽  
C Amaratunga ◽  
I Gaboury ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theory Of Planned Behaviour ◽  
Sexual History ◽  
People Living With Hiv ◽  
Care Providers ◽  
Hiv Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Planned Behaviour

Cambodia has one of the highest prevalence rates of HIV in Asia and is scaling up HIV testing. We conducted a cross-sectional survey with 358 health care providers in Phnom Penh, Cambodia to assess readiness for voluntary testing and counselling for HIV. We measured HIV knowledge and attitudes, and predictors of intentions to take a sexual history using the Theory of Planned Behaviour. Over 90% of health care providers correctly answered knowledge questions about HIV transmission, but their attitudes were often not positive towards people living with HIV. The Theory of Planned Behaviour constructs explained 56% of the variance in intention to take a sexual history: the control providers perceive they have over taking a sexual history was the strongest contributor (51%), while social pressure explained a further 3%. Attitudes about taking a sexual history did not contribute to intention. Interventions with Cambodian health care providers should focus on improving skills in sexual history-taking.

scholarly journals Assessment of U.S. health care personnel (HCP) attitudes towards COVID-19 vaccination in a large university health care system

2021 ◽  
Author(s):  
Jana Shaw ◽  
Telisa Stewart ◽  
Kathryn B Anderson ◽  
Samantha Hanley ◽  
Stephen J Thomas ◽  
...  
Keyword(s):  
Health Care ◽  
Vaccine Development ◽  
Direct Care ◽  
Healthcare Personnel ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Vaccination Programs ◽  
To Receive

Abstract Background As a priority group, healthcare personnel (HCP) will be key to success of COVID-19 vaccination programs. The purpose of this study was to assess HCP willingness to get vaccinated and identify specific concerns that would undermine vaccination efforts. Methods We conducted a cross-sectional survey of HCP, including clinical and non-clinical staff, researchers, and trainees between November 23 rd ,2020 and December 5 th ,2020. The survey evaluated attitudes, beliefs and willingness to get vaccinated. Results A total of 5287 respondents had a mean age of 42.5 years (SD=13.56), and were 72.8% female (n=3842). Overall 57.5 % of individuals expressed intent to receive COVID-19 vaccine. 80.4% were physicians and scientists representing the largest group. 33.6% of registered nurses, 31.6% of allied health professionals, and 32% of master’s level clinicians were unsure they would take the vaccine (p&lt;.001). Respondents who were older, males, White, or Asian were more likely to get vaccinated compared to other groups. Vaccine safety, potential adverse events, efficacy and speed of vaccine development dominated concerns listed by participants. Fewer (54.0%) providers of direct care vs. non-care providers (62.4%), and 52.0% of those who had provided care for COVID-19 patients (vs. 60.6% of those who had not) indicated they would take the vaccine if offered (p&lt;.001). Conclusions We observed that self-reported willingness to receive vaccination against COVID-19 differs by hospital roles, with physicians and research scientists showing the highest acceptance. These findings highlight important heterogeneity in personal attitudes among HCPs around COVID-19 vaccines and highlight a need for tailored communication strategies.

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