scholarly journals Factors affecting the manual linking of clinical progress notes to problems in daily clinical practice: A retrospective quantitative analysis and cross sectional survey

2021 ◽  
Vol 27 (2) ◽  
pp. 146045822110075
Author(s):  
Felix Cillessen ◽  
Pieter de Vries Robbé ◽  
Hans Bor ◽  
Marion Biermans
Keyword(s):  
Work Experience ◽  
Mixed Model ◽  
Univariate Analysis ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Added Value ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Specialties ◽  
Progress Notes

This cross sectional study examines how patient characteristics, doctor characteristics, and doctors’ education and attitudes affect the extent to which doctors link progress notes to clinical problems. The independent effects of patient characteristics on the linking of notes was examined with a mixed model logistic regression. The effects of doctor characteristics and doctors’ education and attitudes on the link ratio was analyzed with univariate analysis of variance. A survey was used to obtain arguments and attitudes on linking notes. For “patient characteristics”, the odds of linking increased with an increase in the number of problems or hospital days, decreased, with an increase in the number of involved doctors, medical specialties or the number of notes. For “doctor characteristics”, the link ratio increased with more work experience. For “doctors’ education and attitudes”, the link ratio increased with more familiarity in linking notes and belief in the added value of problem oriented charting. “Overview” was the most cited reason for linking; “I don’t know how” the most cited reason for not linking. There is a huge variation within and between all disciplines. Important arguments, for and against, are found. Recommendations for policymakers and medical leadership are given to maximize the benefits.

scholarly journals Sex-Based Differences in the Association between Nutrition Label Awareness and the Prevalence of Atopic Dermatitis: A Cross-Sectional Survey

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 210
Author(s):  
Soo Jin Kwon ◽  
Yoonjung Kim
Keyword(s):  
Atopic Dermatitis ◽  
Food Selection ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Nutrition Label ◽  
Cross Sectional ◽  
Nutrition Labels ◽  
Men And Women ◽  
The Relationship

Atopic dermatitis is a chronic allergic disease with multifactorial causation. Although its association with diet has been demonstrated, it remains unclear whether the prevalence of atopic dermatitis among adults is associated with nutrition label awareness. Nutrition label awareness indicates knowledge of the existence of nutrition labels on processed food, and the use of them for food selection. In this cross-sectional study, we analyzed the relationship between nutrition label awareness and the prevalence of atopic dermatitis among men and women using data from the Korean National Health and Nutrition Examination Survey VI (2013–2015), including a nationally representative sample of 13,505 Korean adults (aged > 19 years). The relationship between the prevalence of atopic dermatitis and nutrition label awareness was evaluated using t-tests, χ2 tests and multivariate adjusted logistic regression analysis. Although univariate analysis showed that atopic dermatitis was associated with nutrition label awareness in both men and women, after adjustment for covariates, there was no significant association among men. The significant association between the prevalence of atopic dermatitis and nutrition label awareness among women reveals a sex-based difference in this relationship in adults, and atopic dermatitis may be managed and prevented among women by targeted education regarding nutrition labels and diet.

scholarly journals Specialty Physician Designation in Referrals from a Vertically Integrated PCMH

2019 ◽  
Vol 6 ◽  
pp. 233339281985038
Author(s):  
Andrew D. Schreiner ◽  
Keri T. Holmes-Maybank ◽  
Jingwen Zhang ◽  
Justin Marsden ◽  
Patrick D. Mauldin ◽  
...  
Keyword(s):  
Medical Home ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Cross Sectional ◽  
Medical Specialties ◽  
The Individual

Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% ( P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.

scholarly journals Attitudes on euthanasia among medical students and doctors in Sri Lanka: a cross sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
H. M. M. T. B. Herath ◽  
K. W. S. M. Wijayawardhana ◽  
U. I. Wickramarachchi ◽  
Chaturaka Rodrigo
Keyword(s):  
Medical Students ◽  
Sri Lanka ◽  
Work Experience ◽  
Assisted Suicide ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Undergraduates

Abstract Background Euthanasia is a topic of intense ethical debate and it is illegal in most countries at present, including Sri Lanka. The aim of this descriptive cross-sectional study of medical students and practicing doctors was to explore the acceptance of euthanasia and physician assisted suicide (PAS), and factors influencing this opinion. Methods A customised online questionnaire which explored opinions on euthanasia was administered to first and final year medical undergraduates in University of Colombo and practicing doctors with more than 5 years of work experience at The National Hospital of Sri Lanka. Attitudes on euthanasia and PAS were also assessed with the attitudes towards euthanasia (ATE) Scale, which is a 10-item questionnaire. Results A total of 425 individuals responded (males: 178, 42%, age: median – 27 years), which included 143 (33.6%) first-year medical undergraduates, 141 (33.2%) final-year medical undergraduates and 141 (33.2%) practicing doctors. More participants (200, 47.1%) favoured legalizing euthanasia than those directly opposing it (110, 25.9%), but a significant proportion (27%) remained undecided. The mean scores of ATE questionnaire from the whole sample were generally unfavourable towards euthanasia/PAS. Accepting euthanasia as an option for oneself (p =  < 0.001) was the strongest predictor of favouring euthanasia/PAS or supporting its legalization. Conclusion In this cross-sectional survey, more respondents supported legalisation of euthanasia in Sri Lanka than those openly opposing it. Yet, a significant minority that responded as “undecided” for legalisation, were more likely to have unfavourable ATE.

scholarly journals Healthcare workers preparedness for COVID-19 pandemic in the occupied Palestinian territory: a cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Osaid Alser ◽  
Heba Alghoul ◽  
Zahra Alkhateeb ◽  
Ayah Hamdan ◽  
Loai Albarqouni ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Gaza Strip ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Occupied Palestinian Territory ◽  
Governmental Institutions ◽  
Palestinian Territory

Abstract Background The COVID-19 pandemic threatens to overwhelm the capacity of a vulnerable healthcare system in the occupied Palestinian territory (oPt). We aimed to evaluate the availability of personal protective equipment (PPE) and the level of preparedness among HCWs in the oPt. Methods A cross-sectional study was conducted using a validated online questionnaire distributed through convenient sampling between March 30, 2020 and April 12, 2020. Outcomes were availability of PPE, healthcare workers (HCWs) preparedness in oPt for COVID-19 pandemic, and regional and hospital differences in oPt in terms of availability of PPE and HCWs preparedness. Descriptive statistics and univariate analysis were used in this study. Results Of 138 respondents, only 38 HCWs (27.5%) always had access to facemasks and 15 (10.9%) always had access to isolation gowns. Most HCWs did not find eye protection (n = 128, 92.8%), N95 respirators (n = 132, 95.7%), and face shields (n = 127, 92%) always available. Compared to HCWs in West Bank, those in the Gaza Strip were significantly less likely to have access to alcohol sanitizers (p = 0.03) and gloves (p < 0.001). On average, governmental hospitals were significantly less likely to have all appropriate PPE than non-governmental institutions (p = 0.001). Only 16 (11.6%) surveyed felt confident in dealing with a potential COVID-19 case, 57 (41.3%) having received any COVID-19-related training, and 57 (41.3%) not having a local hospital protocol. Conclusion HCWs in oPt appear to be underprepared and severely lacking adequate PPE provision. The lack of PPE provision will exacerbate spread of COVID-19 and deepen the crisis, whilst putting HCWs at risk.

scholarly journals Satisfaction of Physicians Working in Polish Hospitals—A Cross-Sectional Study

2018 ◽  
Vol 15 (12) ◽  
pp. 2640 ◽  
Author(s):  
Alicja Domagała ◽  
Juan Peña-Sánchez ◽  
Katarzyna Dubas-Jakóbczyk
Keyword(s):  
Work Experience ◽  
Online Survey ◽  
Career Satisfaction ◽  
Working Hours ◽  
Cross Sectional Study ◽  
Physician Satisfaction ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Level Of Satisfaction

Physician satisfaction is a multidimensional concept associated with numerous factors. The objectives of the study were to evaluate the satisfaction of physicians practicing in hospitals in Poland and to identify factors associated with higher levels of satisfaction. A quantitative, cross-sectional survey of Polish hospitals was conducted between March and June 2018. All doctors working in the hospitals invited to the study were asked to fill in an online survey. Fifteen hospitals were included: seven general, five specialist, and three university ones. The total number of questionnaires analyzed was 1003. The questionnaire included 17 items to measure the level of satisfaction, classified into four dimensions: personal, professional, performance, and inherent. The statistical analyses included: assessment of association between levels of career satisfaction and basic demographic and work-related variables; and multivariable logistic regressions, conducted to determine which variables were associated with higher levels of career satisfaction. The mean level of career satisfaction, on a scale from 1 to 6, was 4.1 (SD = 0.69). Respondents reported high levels of inherent satisfaction: mean = 4.4 (SD = 0.66) and a low personal satisfaction: mean = 3.78 (SD = 0.98). 56.6% of respondents reported being satisfied, but only 8.2% reported a higher level of satisfaction (≥5). The satisfaction of Polish physicians is moderate. Gender, numbers of working hours/week, years of work experience, type of hospital, and stage of professional development were the identified factors associated with higher levels of career satisfaction.

scholarly journals Determinants of physicians’ online medical services uptake: a cross-sectional study applying social ecosystem theory

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048851
Author(s):  
Xueqing Peng ◽  
Zhiguang Li ◽  
Chi Zhang ◽  
Rui Liu ◽  
Yongzhi Jiang ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Administrative Positions ◽  
Cross Sectional ◽  
Ecosystem Theory ◽  
Basic Characteristics ◽  
Laws And Policies ◽  
Multistage Sampling

ObjectiveTo investigate the determinants of willingness and practice of physicians’ online medical services (OMS) uptake based on social ecosystem theory, so as to formulate OMS development strategies.DesignCross-sectional survey.SettingResearch was conducted in two comprehensive hospitals and two community hospitals in Jiangsu, China, and the data were gathered from 1 June to 31 June 2020.ParticipantsWith multistage sampling, 707 physicians were enrolled in this study.Outcome measureDescriptive statistics were reported for the basic characteristics. χ2 test, Mann-Whitney U test and Spearman’s correlation analysis were used to perform univariate analysis. Linear regression and logistic regression were employed to examine the determinants of physicians’ OMS uptake willingness and actual uptake, respectively.ResultsThe mean score of the physicians’ OMS uptake willingness was 17.33 (range 5–25), with an SD of 4.39, and 53.3% of them reported having conducted OMS. In the micro system, factors positively associated with willingness included holding administrative positions (b=1.03, p<0.05), OMS-related awareness (b=1.32, p<0.001) and OMS-related skills (b=4.88, p<0.001); the determinants of actual uptake included holding administrative positions (OR=2.89, 95% CI 1.59 to 5.28, p<0.01), OMS-related awareness (OR=1.90, 95% CI 1.22 to 2.96, p<0.01), OMS-related skills (OR=2.25, 95% CI 1.35 to 3.74, p<0.01) and working years (OR=2.44, 95% CI 1.66 to 3.59, p<0.001). In the meso system, the hospital’s incentive mechanisms (b=0.78, p<0.05) were correlated with willingness; hospital advocated for OMS (OR=2.34, 95% CI 1.21 to 4.52, p<0.05), colleagues’ experiences (OR=3.81, 95% CI 2.25 to 6.45, p<0.001) and patients’ consultations (OR=2.93, 95% CI 2.02 to 4.25, p<0.001) were determinants of actual uptake. In the macro system, laws and policies were correlated with willingness (b=0.73, p<0.05) and actual uptake (OR=1.98, 95% CI 1.31 to 2.99, p<0.01); media orientation was also associated with willingness (b=0.74, p<0.05).ConclusionMultiple determinants influence physicians’ OMS application. Comprehensive OMS promotion strategies should be put forward from multidimensional perspectives including the micro, meso and macro levels.

scholarly journals What is the perception of biological risk by undergraduate nursing students?

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Mª Carmen Moreno-Arroyo ◽  
Montserrat Puig-Llobet ◽  
Anna Falco-Pegueroles ◽  
Maria Teresa Lluch-Canut ◽  
Irma Casas García ◽  
...  
Keyword(s):  
Nursing Students ◽  
Work Experience ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Practical Training ◽  
Cross Sectional ◽  
Undergraduate Nursing Students ◽  
Biological Risk ◽  
Sociodemographic Variables ◽  
Undergraduate Nursing

Abstract Objective: to analyze undergraduate nursing students' perception of biological risk and its relationship with their prior practical training. Method: a descriptive cross-sectional study was conducted among undergraduate nursing students enrolled in clinical practice courses in the academic year 2013-2014 at the School of Nursing at the University of Barcelona. Variables: sociodemographic variables, employment, training, clinical experience and other variables related to the assessment of perceived biological risk were collected. Both a newly developed tool and the Dimensional Assessment of Risk Perception at the worker level scale (Escala de Evaluación Dimensional del Riesgo Percibido por el Trabajador, EDRP-T) were used. Statistical analysis: descriptive and univariate analysis were used to identify differences between the perception of biological risk of the EDRP-T scale items and sociodemographic variables. Results: students without prior practical training had weaker perceptions of biological risk compared to students with prior practical training (p=0.05 and p=0.04, respectively). Weaker perceptions of biological risk were found among students with prior work experience. Conclusion: practical training and work experience influence the perception of biological risk among nursing students.

Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Christian-Alexander Behrendt ◽  
Tilo Kölbel ◽  
Thea Schwaneberg ◽  
Holger Diener ◽  
Ralf Hohnhold ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Invasive Treatment ◽  
Cross Sectional ◽  
Hospital Outcomes ◽  
Vascular Intervention ◽  
Medical Specialties ◽  
Team Decision ◽  
The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

MORBIDITY PATTERN AMONG ADOLESCENT SCHOOL GIRLS IN RURAL AND URBAN SCHOOL OF JHANSI (U.P.)- A COMPARATIVE CROSS-SECTIONAL SURVEY

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Shubhanshu Gupta ◽  
Sanjeev Kumar ◽  
Piyush D Swami ◽  
Anjana Niranjan
Keyword(s):  
Health Status ◽  
Adolescent Girls ◽  
Low Socioeconomic Status ◽  
Optimal Level ◽  
Cross Sectional Study ◽  
World Health ◽  
World Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rural And Urban

Background: According to World Health Organization, adolescents constitute about one fifth of the world population, and in India they constitute about 21% of the total population. Most of the surveys show that health status of adolescent girls is at sub-optimal level. Objectives: To assess nutritional status and morbidity pattern among the adolescent girls and to suggest measures for improvement of health status of adolescent girls.  Method: A community based cross-sectional study was carried out among 250 adolescent schoolgirls in Rural and urban field practice area of Jhansi school from January 2017 to July 2014. Results: Among the various morbidities eye problem was seen in maximum no of adolescent girls. Eye problem was present in 44.8% of adolescent girls followed by respiratory 14.7% and ear 13.06% disease. Skin disease was present in 3.2% of adolescent girls, which was more in rural girls 6.7% than in urban girls 1.7%, may be due to better hygienic practice in urban schoolgirls. Conclusions: Rural background, low socioeconomic status, illiteracy, birth rate and order, income and number of members in a family have shown to be significant determinants of morbidity pattern in the adolescent girls. Keywords: Adolescent, anemia, morbidity, vaginal discharge.

Comparison of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondyltis from a Single Rheumatology Hospital in Morocco

2020 ◽  
Vol 16 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nessrine Akasbi ◽  
Siar Nihad ◽  
Zoukal Sofia ◽  
El Kohen Khadija ◽  
Harzy Taoufik
Keyword(s):  
Disease Burden ◽  
Axial Spondyloarthritis ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Low Back ◽  
New Classification ◽  
Cross Sectional ◽  
Asas Criteria ◽  
History Of ◽  
High Level

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.

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