Language diversity and challenges to communication in Indian emergency departments

Abstract Background Communication in emergency departments (ED) in India is complicated by the country’s immense language diversity. Prior research has revealed challenges in language and communication as barriers to care. Our objective was to quantify language diversity among clinicians in Indian EDs and better understand issues related to clinician-clinician and clinician-patient communication. Methodology A cross-sectional survey of ED clinicians was conducted. Survey participants were recruited in-person and through email at six partner sites in India. ANOVA and binary logistic regression were used for subgroup analysis. Semi-structured interviews were conducted with ED clinicians. Interview data was analyzed using the rapid assessment process to determine predominant themes. Results 106 clinicians completed the survey. On average, clinicians spoke 3.75 languages. Seventy-one percent used a non-English language to speak to fellow clinicians most of the time, and 53% reported at least one critical incident over the last year where poor communication played a part. Interviews revealed challenges including low health literacy, high patient volume, and workplace hierarchy. Conclusions This study is the first to document the impact of language diversity and communication barriers in Indian EDs. The results highlight the need for effective strategies to improve communication between the multiple languages spoken by clinicians and patients.

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Language Diversity and Challenges to Communication in Indian Emergency Departments

10.21203/rs.3.rs-154113/v1 ◽

2021 ◽

Author(s):

Katherine Douglass ◽

Lalit Narayan ◽

Rebecca Allen ◽

Jay Pandya ◽

Zohray Talib

Keyword(s):

Emergency Departments ◽

Critical Incident ◽

English Language ◽

Rapid Assessment ◽

Assessment Process ◽

Language Diversity ◽

Structured Interviews ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Impact

Abstract BackgroundCommunication in emergency departments (ED) in India is complicated by the country’s immense language diversity. Prior research has revealed challenges in language and communication as barriers to care. Our objective was to quantify language diversity among clinicians in Indian EDs and better understand issues related to clinician-clinician and clinician-patient communicationMethodologyA cross-sectional survey of ED clinicians was conducted. Survey participants were recruited in-person and through email at six partner sites in India. ANOVA and binary logistic regression were used for subgroup analysis. Semi-structured interviews were conducted with ED clinicians. Interview data was analyzed using the rapid assessment process to determine predominant themes.Results 106 clinicians completed the survey. On average, clinicians spoke 3.75 languages. 71% used a non-English language to speak to fellow clinicians most of the time. 53% reported at least one critical incident over the last year where poor communication played a part. Interviews revealed challenges including low health literacy, high patient volume,and workplace hierarchy.Conclusions This study is the first to document the impact of language diversity and communication barriers in Indian EDs. The results highlight the need for effective strategies to improve communication that account for the multiple languages spoken by clinicians and patients.

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Physiotherapists perceived role in managing anxiety in patients with Relapsing-Remitting Multiple Sclerosis: a mixed-methods study.

10.1101/2021.04.06.21254964 ◽

2021 ◽

Author(s):

Lauren Lucas ◽

Jack Parker

Keyword(s):

Mixed Methods ◽

Clinical Supervision ◽

Management Practices ◽

Training Needs ◽

Outpatient Rehabilitation ◽

Structured Interviews ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Physiotherapy Practice ◽

The Impact

ABSTRACT Objectives: To explore how physiotherapists manage anxiety in patients with RRMS in community and outpatient settings. To identify further training and research to better develop physiotherapy practice. Design: A mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists. Participants: Sixteen UK-registered physiotherapists: 11 in the survey, 5 in the interviews. Methods: To inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety, physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively. Results: The survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills. Conclusion: Physiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.

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Physiotherapists perceived role in managing anxiety in patients with relapsing-remitting multiple sclerosis: a mixed-methods study

Archives of Physiotherapy ◽

10.1186/s40945-021-00124-z ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Lauren Lucas ◽

Jack Parker

Keyword(s):

Multiple Sclerosis ◽

Mixed Methods ◽

Training Needs ◽

Structured Interviews ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rehabilitation Process ◽

Relapsing Remitting ◽

Outpatient Settings ◽

The Impact

Abstract Background Anxiety is common for people with Multiple Sclerosis (PwMS) and is higher in those with relapsing-remitting MS (RRMS) and in community-based samples. Anxiety can impact self-efficacy, pain, fatigue, engagement in physical activity and treatment adherence, all of which influence the rehabilitation process. Little is known about how physiotherapists manage anxiety in PwMS and the challenges associated with anxiety throughout the rehabilitation process, in community and outpatient settings. Methods A mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists, was used to answer the research question. To inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety in PwMS in community and outpatient settings, identified perceived physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively. Results The survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills. Conclusion Physiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.

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Assessment Challenges & Impact of Formative Portfolio Assessment (FPA) on EFL Learners’ Writing Performance: A Case Study on the Preparatory English Language Course

English Language Teaching ◽

10.5539/elt.v12n7p161 ◽

2019 ◽

Vol 12 (7) ◽

pp. 161

Author(s):

Md. Jahangir Alam ◽

Tahmina Aktar

Keyword(s):

English Language ◽

Portfolio Assessment ◽

Assessment Process ◽

Assessment Practices ◽

Intensive English ◽

Structured Interviews ◽

Writing Performance ◽

Efl Learners ◽

The Impact

Present study aimed to explore the impact of formative portfolio assessment on Saudi EFL learners’ overall writing performance. The study reviewed literature of prevailing assessment challenges including the formative role of portfolio assessments to develop an understanding of the nature of assessments and various issues related to assessment practices. The current research applied formative portfolio assessment (FPA) technique as an intervention material in the ongoing preparatory Intensive English Language course and utilized semi-structured interviews to elicit qualitative data from students. The findings of the study suggest: formative portfolio assessment inspires autonomous learning among students by empowering them taking more control of the learning and assessment process.

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Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

10.2196/preprints.24776 ◽

2020 ◽

Author(s):

Khanh Ngoc Cong Duong ◽

Tien Nguyen Le Bao ◽

Phuong Thi Lan Nguyen ◽

Thanh Vo Van ◽

Toi Phung Lam ◽

...

Keyword(s):

Psychological Distress ◽

General Population ◽

Psychological Health ◽

Online Survey ◽

Survey Study ◽

Limited Information ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Event Scale ◽

The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

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COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116076 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6076

Author(s):

Hasan S. Alamri ◽

Wesam F. Mousa ◽

Abdullah Algarni ◽

Shehata F. Megahid ◽

Ali Al Bshabshe ◽

...

Keyword(s):

Health Care ◽

Saudi Arabia ◽

Health Care Workers ◽

Psychological Impact ◽

Psychological Outcomes ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Care Workers ◽

The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

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Are e-learning Webinars the future of medical education? An exploratory study of a disruptive innovation in the COVID-19 era

Cardiology in the Young ◽

10.1017/s1047951120004503 ◽

2020 ◽

pp. 1-10

Author(s):

Colin J. McMahon ◽

Justin T. Tretter ◽

Theresa Faulkner ◽

R. Krishna Kumar ◽

Andrew N. Redington ◽

...

Keyword(s):

Deep Learning ◽

Carbon Footprint ◽

Quantitative Research ◽

Survey Design ◽

Hybrid Approach ◽

Disruptive Innovation ◽

Cross Sectional Survey ◽

Cross Sectional ◽

E Learning ◽

The Impact

Abstract Objective: This study investigated the impact of the Webinar on deep human learning of CHD. Materials and methods: This cross-sectional survey design study used an open and closed-ended questionnaire to assess the impact of the Webinar on deep learning of topical areas within the management of the post-operative tetralogy of Fallot patients. This was a quantitative research methodology using descriptive statistical analyses with a sequential explanatory design. Results: One thousand-three-hundred and seventy-four participants from 100 countries on 6 continents joined the Webinar, 557 (40%) of whom completed the questionnaire. Over 70% of participants reported that they “agreed” or “strongly agreed” that the Webinar format promoted deep learning for each of the topics compared to other standard learning methods (textbook and journal learning). Two-thirds expressed a preference for attending a Webinar rather than an international conference. Over 80% of participants highlighted significant barriers to attending conferences including cost (79%), distance to travel (49%), time commitment (51%), and family commitments (35%). Strengths of the Webinar included expertise, concise high-quality presentations often discussing contentious issues, and the platform quality. The main weakness was a limited time for questions. Just over 53% expressed a concern for the carbon footprint involved in attending conferences and preferred to attend a Webinar. Conclusion: E-learning Webinars represent a disruptive innovation, which promotes deep learning, greater multidisciplinary participation, and greater attendee satisfaction with fewer barriers to participation. Although Webinars will never fully replace conferences, a hybrid approach may reduce the need for conferencing, reduce carbon footprint. and promote a “sustainable academia”.

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Population-based cross-sectional prevalence survey of diabetes and diabetic retinopathy in Sohag—Egypt, 2019

BMJ Open ◽

10.1136/bmjopen-2020-047757 ◽

2021 ◽

Vol 11 (6) ◽

pp. e047757

Author(s):

Heba AlSawahli ◽

Caleb D Mpyet ◽

Gamal Ezzelarab ◽

Ibrahim Hassanin ◽

Mohammad Shalaby ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Rapid Assessment ◽

Good Control ◽

Population Based ◽

Secondary Outcome ◽

Public Health Approach ◽

Eye Care ◽

Cross Sectional Survey ◽

Prevalence Survey ◽

Cross Sectional

ObjectivesTo determine the prevalence of diabetes mellitus (DM), prevalence of diabetic retinopathy (DR) and sight-threatening conditions among persons with DM aged 50 years and older in Sohag governorate in Upper Egypt.DesignPopulation-based, cross-sectional survey using the standardised Rapid Assessment of Avoidable Blindness with the addition of the Diabetic Retinopathy module methodology.SettingsSohag governorate in Egypt where 68 clusters were selected using probability proportional to population size. Households were selected using the compact segment technique.Participants4078 people aged 50 years and older in 68 clusters were enrolled, of which 4033 participants had their random blood sugar checked and 843 examined for features of DR.Primary and secondary outcomesThe prevalence of DM and DR; secondary outcome was the coverage with diabetic eye care.ResultsThe prevalence of DM was 20.9% (95% CI 19.3% to 22.5%). The prevalence in females (23.8%; 95% CI 21.4% to 26.3%) was significantly higher than in males (18.9%; 95% CI 17.1% to 20.7%) (p=0.0001). Only 38.8% of persons diagnosed with diabetes had good control of DM. The prevalence of DR in the sample was 17.9% (95% CI 14.7% to 21.1%). The prevalence in females was higher (18.9%; 95% CI 14.0% to 23.8%) than in males (17.1%; 95% CI 13.0% to 21.2%). Up to 85.3% of study participants have never had eye examination. Sight-threatening DR (R4 and/or M2) was detected in 5.2% (95% CI 3.4% to 7.0%) with only 2.3% having had laser treatment.ConclusionThe prevalence of uncontrolled DM in Sohag governorate in Egypt is higher than the national prevalence. There is a high prevalence of sight-threatening retinopathy and/or maculopathy with few people having access to diabetic eye care. A public health approach is needed for health promotion, early detection and management of DR.

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