Somatic health care professionals’ stigmatization of patients with mental disorder: a scoping review

Abstract Background Patients with mental disorders have an increased risk of developing somatic disorders, just as they have a higher risk of dying from them. These patients often report feeling devaluated and rejected by health professionals in the somatic health care system, and increasing evidence shows that disparities in health care provision contribute to poor health outcomes. The aim of this review was to map and synthesize literature on somatic health professionals’ stigmatization toward patients with mental disorders. Methods We conducted a scoping review using Arksey and O’Malley’s framework and carried out a systematic search in three databases: Cinahl, MEDLINE, and PsycINFO in May–June 2019. Peer-reviewed articles published in English or Scandinavian languages during 2008–2019 were reviewed according to title, abstract and full-text reading. We organized and analyzed data using NVivo. Results A total of 137 articles meeting the eligibility criteria were reviewed and categorized as observational studies (n = 73) and intervention studies (n = 64). A majority of studies (N = 85) focused on patients with an unspecified number of mental disorders, while 52 studies focused on specific diagnoses, primarily schizophrenia (n = 13), self-harm (n = 13), and eating disorders (n = 9). Half of the studies focused on health students (n = 64), primarily nursing students (n = 26) and medical students (n = 25), while (n = 66) focused on health care professionals, primarily emergency staff (n = 16) and general practitioners (n = 13). Additionally, seven studies focused on both health professionals and students. A detailed characterization of the identified intervention studies was conducted, resulting in eight main types of interventions. Conclusions The large number of studies identified in this review suggests that stigmatizing attitudes and behaviors toward patients with mental disorders is a worldwide challenge within a somatic health care setting. For more targeted interventions, there is a need for further research on underexposed mental diagnoses and knowledge on whether specific health professionals have a more stigmatizing attitude or behavior toward specific mental disorders.

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Somatic health care professionals’ stigmatization of patients with mental disorder: a scoping review

10.21203/rs.3.rs-701770/v1 ◽

2021 ◽

Author(s):

Ida Nielsen Sølvhøj ◽

Amalie Oxholm Kusier ◽

Pia Vivian Pedersen ◽

Maj Britt Dahl Nielsen

Keyword(s):

Health Care ◽

Mental Disorders ◽

Scoping Review ◽

Health Professionals ◽

Health Care Professionals ◽

Intervention Studies ◽

Eligibility Criteria ◽

Somatic Health ◽

Targeted Interventions ◽

Increased Risk

Abstract Background Patients with mental disorders have an increased risk of developing somatic disorders, just as they have a higher risk of dying from them. These patients often report feeling devaluated and rejected by health professionals in the somatic health care system, and increasing evidence shows that disparities in health care provision contribute to poor health outcomes. The aim of this review was to map and synthesize literature on somatic health professionals’ stigmatization toward patients with mental disorders. Methods We conducted a scoping review using Arksey and O’Malley’s framework and carried out a systematic search in three databases: Cinahl, MEDLINE, and PsycINFO in May-June 2019. Peer-reviewed articles published in English or Scandinavian languages during 2008–2019 were reviewed according to title, abstract and full-text reading. We organized and analyzed data using NVivo. Results A total of 137 articles meeting the eligibility criteria were reviewed and categorized as observational studies (n = 73) and intervention studies (n = 64). A majority of studies (N = 85) focused on patients with an unspecified number of mental disorders, while 52 studies focused on specific diagnoses, primarily schizophrenia (n = 13), self-harm (n = 13), and eating disorders (n = 9). Half of the studies focused on health students (n = 64), primarily nursing students (n = 26) and medical students (n = 25), while (n = 66) focused on health care professionals, primarily emergency staff (n = 16) and general practitioners (n = 13). Additionally, seven studies focused on both health professionals and students. A detailed characterization of the identified intervention studies was conducted, resulting in eight main types of interventions. Conclusions The large number of studies identified in this review suggests that stigmatizing attitudes and behaviors toward patients with mental disorders is a worldwide challenge within a somatic health care setting. For more targeted interventions, there is a need for further research on underexposed mental diagnoses and knowledge on whether specific health professionals have a more stigmatizing attitude or behavior toward specific mental disorders.

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A Scoping Review of Interventions Aimed at Improving Knowledge, Detection Practices and Management of Dementia among Health Professionals (Preprint)

10.2196/preprints.20587 ◽

2020 ◽

Author(s):

Krishna Krishna Prasad Pathak

Keyword(s):

Health Care ◽

Scoping Review ◽

Health Professionals ◽

Educational Program ◽

Best Practice ◽

Intervention Studies ◽

Educational Interventions ◽

Learning Activities ◽

Inclusion Criteria ◽

Improving Health Care

BACKGROUND Health professionals (HPs) play a key role in dementia management and detection. However, there is a gap in the literature as to what represents best practice with regard to educating HPs to improve their dementia detection practices and management. OBJECTIVE The objective of this scoping review is to synthesize the aggregated studies aimed at improving health care knowledge, detection practices and management of dementia among HPs. METHODS We searched electronically published relevant articles with inclusion criteria; (1) intervention studies aimed at improving HPs practices concerning dementia care and (2) educational interventions focused on nurses and doctors’ knowledge, detection practice and management of dementia. Twenty-five articles fit the inclusion criteria. RESULTS Collaborative programs of practice based workshops, interactive learning activities with community and multi-faced educational program were the most effective. CONCLUSIONS HPs should be supported to improve their knowledge, tackle behavioural problems associated with dementia, be made aware of services and be enabled to engage in more early diagnosis. CLINICALTRIAL no applicable

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Patient safety challenges in primary health care: a scoping review

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2019-0209 ◽

2020 ◽

Vol 73 (5) ◽

Author(s):

Carlise Rigon Dalla Nora ◽

Mariur Gomes Beghetto

Keyword(s):

Health Care ◽

Patient Safety ◽

Primary Health Care ◽

Scoping Review ◽

Health Professionals ◽

Health Care Professionals ◽

Improve Patient Safety ◽

Policy Makers ◽

Primary Health ◽

Enhancing Resources

ABSTRACT Objectives: to identify the patient safety challenges described by health professionals in Primary Health Care. Methods: a scoping review was conducted on the LILACS, MEDLINE, IBECS, BDENF, and CINAHL databases, and on the Cochrane, SciELO, Pubmed, and Web of Science libraries in January 2019. Original articles on patient safety in the context of Primary Health Care by health professionals were included. Results: the review included 26 studies published between 2002 and 2019. Four categories resulted from the analysis: challenges of health professionals, administration challenges of health services, challenges with the patient and family, and the potential enhancing resources for patient safety. Conclusions: patient safety challenges for Primary Care professionals are multiple and complex. This study provides insight into resources to improve patient safety for health care professionals, patients, administrators, policy makers, educators, and researchers.

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A Scoping Review of Interventions Aimed at Improving Knowledge, Detection Practices and Management of Dementia among Health Professionals (Preprint)

10.2196/preprints.20585 ◽

2020 ◽

Author(s):

◽

Keyword(s):

Health Care ◽

Scoping Review ◽

Health Professionals ◽

Best Practice ◽

Intervention Program ◽

Intervention Studies ◽

Educational Interventions ◽

Learning Activities ◽

Inclusion Criteria ◽

Improving Health Care

BACKGROUND Health professionals (HPs) play a key role in dementia management and detection. However, there is a gap in the literature as to what represents best practice with regard to educating HPs to improve their dementia detection practices and management. The objective of this scoping review is to synthesize the aggregated studies aimed at improving health care knowledge, detection practices and management of dementia among HPs. OBJECTIVE To synthesize the aggregated studies aimed at improving health care knowledge, detection practices and management of dementia among HPs by the intervention program METHODS We searched electronically published relevant articles with inclusion criteria; (1) intervention studies aimed at improving HPs practices concerning dementia care and (2) educational interventions focused on nurses and doctors’ knowledge, detection practice and management of dementia. Twenty-five articles fit the inclusion criteria. RESULTS Collaborative programs of practice based workshops, interactive learning activities with community and multi-faced educational program were the most effective. CONCLUSIONS HPs should be supported to improve their knowledge, tackle behavioural problems associated with dementia, be made aware of services and be enabled to engage in more early diagnosis. CLINICALTRIAL none

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Disaster Management in Rural and Remote Primary Health Care: A Scoping Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000200 ◽

2021 ◽

Vol 36 (3) ◽

pp. 362-369

Author(s):

Katie A. Willson ◽

Gerard J. FitzGerald ◽

David Lim

Keyword(s):

Mental Health ◽

Health Care ◽

Primary Health Care ◽

Mental Health Care ◽

Disaster Management ◽

Scoping Review ◽

Health Care Professionals ◽

Disaster Preparedness ◽

Rural And Remote ◽

Primary Health

AbstractObjective:This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.Introduction:Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.Methods:A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol.Results:Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations’ planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care.Conclusion:Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.

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The effect of multimodal comprehensive care methodology training on oral health care professionals’ empathy for patients with dementia

BMC Medical Education ◽

10.1186/s12909-021-02760-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Masaki Kobayashi ◽

Mio Ito ◽

Yasuyuki Iwasa ◽

Yoshiko Motohashi ◽

Ayako Edahiro ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Professionals ◽

Health Care Professionals ◽

Dental Treatment ◽

Oral Care ◽

Training Programme ◽

Comprehensive Care ◽

Dental Hygienists ◽

People With Dementia

Abstract Background The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. Methods This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). Results The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. Conclusions The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. Trial registration UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586

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Are antiretrovirals prescribed according to the recommended prescribed daily doses in the private healthcare sector in South Africa

Health SA Gesondheid ◽

10.4102/hsag.v16i1.604 ◽

2011 ◽

Vol 16 (1) ◽

Author(s):

Norah L. Katende-Kyenda ◽

Martie Lubbe ◽

Juan H.P. Serfontein ◽

Ilse Truter

Keyword(s):

South Africa ◽

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Health Care Sector ◽

Hiv And Aids ◽

Healthcare Sector ◽

Private Health Care ◽

Care Providers ◽

Increased Risk

Current antiretroviral treatment (ART) guidelines recommend different combinations that have led to major improvements in the management of HIV and AIDS in the developed and developing world. With the rapid approval of many agents, health care providers may not be able to familiarise themselves with them all. This lack of knowledge leads to increased risk of dose- prescribing errors, especially by non-HIV and AIDS specialists. The purpose of this retrospective non-experimental, quantitative drug utilisation study was to evaluate if antiretrovirals (ARVs) are prescribed according to the recommended prescribed daily doses (PDDs) in a section of the private health care sector in South Africa (SA). Analysed ARV prescriptions (49995, 81096 and 88988) for HIV and AIDS patients were claimed from a national medicine claims database for the period 1 January 2005 through to 31 December 2007. ARV prescriptions prescribed by general practitioners (GPs) with PDDs not according to the recommended ARV dosing increased dramatically, from 12.33% in 2005 to 24.26% in 2007. Those prescribed by specialists (SPs) increased from 15.46% in 2005 to 35.20% in 2006 and decreased to 33.16% in 2007. The highest percentage of ARV prescriptions with PDDs not according to recommended ARV dosing guidelines was identified in ARV regimens with lopinavir−ritonavir at a PDD of 1066.4/264 mg and efavirenz at a PDD of 600 mg prescribed to patients in the age group of Group 3 (19 years > age ≤ 45 years). These regimens were mostly prescribed by GPs rather than SPs. There is a need for more education for all health care professionals and/or providers in the private health care sector in SA on recommended ARV doses, to avoid treatment failures, development of resistance, drug-related adverse effects and drug interactions.OpsommingHuidige riglyne vir behandeling met antiretrovirale middels beveel verskillende kombinasies aan wat tot groot verbetering in die beheer van MIV en VIGS in die ontwikkelde en ontwikkelende wêreld gelei het. Met die vinnige goedkeuring van talle nuwe middels kan dit gebeur dat verskaffers van gesondheidsorg nie kan bybly om hulle hiermee op hoogte te hou nie. Hierdie gebrek aan kennis lei tot ‘n hoër risiko vir foute in die voorgeskrewe dosis en veral deur persone wat nie spesialiste in MIV en VIGS is nie. Die doel van hierdie nie-eksperimentele, retrospektiewe, kwantitatiewe studie van die gebruik van geneesmiddels was om te bepaal of antiretrovirale middels in ‘n deel van die privaat gesondheidsorgsektor in Suid-Afrika (SA) volgens die aanbevole voorgeskrewe daaglikse dosisse (VDD) voorgeskryf word. Voorskrifte van antiretrovirale middels (49995, 81096 en 88988) aan pasiënte met MIV en VIGS wat in die periode van 1 Januarie 2005 tot 31 Desember 2007 van ‘n nasionale medisyne databasis geëis is, is ontleed. Voorskrifte van antiretrovirale middels deur algemene praktisyns (APs) met VDDs wat nie volgens die aanbevole dosisse vir antiretrovirale middels was nie, het dramaties van 12.33% in 2005 tot 24.26% in 2007 toegeneem. Die wat deur spesialiste (SPs) voorgeskryf is, het van 15.46% in 2005 tot 35.20% in 2006 toegeneem en in 2007 tot 33.16% gedaal. Die hoogste persentasie van voorskrifte vir antiretrovirale middels met VDDs wat nie volgens die riglyne was nie, was in die regimens met lopinavir−ritonavir met ‘n VDD van 1066.4/264 mg en efavirens met ‘n VDD van 600 mg wat aan pasiënte in die ouderdomsgroep van ouer as 19 tot en met 45 jaar voorgeskryf is. Hierdie regimens is meer deur APs as deur SPs voorgeskryf. Daar is ‘n behoefte aan nog opleiding van alle gesondheidsprofessies en/of voersieners in die privaat gesondheidsorgsektor in SA oor die aanbevole antiretrovirale middel-dosisse om mislukking van behandeling, ontwikkeling van weerstand, nadelige effekte vanweë geneesmiddels en geneesmiddel interaksies te voorkom.

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Post-stroke memory deficits and barriers to seeking help: views of patients and carers

Family Practice ◽

10.1093/fampra/cmy109 ◽

2018 ◽

Vol 36 (4) ◽

pp. 506-510 ◽

Cited By ~ 3

Author(s):

Eugene Y H Tang ◽

Christopher Price ◽

Blossom C M Stephan ◽

Louise Robinson ◽

Catherine Exley

Keyword(s):

Health Professionals ◽

Health Care Professionals ◽

Organizational Level ◽

Stroke Survivors ◽

Ageing Population ◽

Family Carers ◽

Post Stroke ◽

North East ◽

Increased Risk ◽

Seeking Help

Abstract Background Memory and cognitive deficits post stroke are common and associated with increased risk of future dementia. Rehabilitation tends to focus on physical recovery; however, once in the community, it is unclear what happens in the longer term to the stroke-survivor with new memory difficulties. Objective The aim of this qualitative study was to examine in stroke-survivors what factors influence contact with health professionals. Method Semi-structured interviews were conducted with stroke-survivors and their family carers where memory difficulties were reported at 6 months post stroke. A topic guide was used which sought to critically examine participants care experience following their stroke diagnosis. All participants were interviewed at baseline (around 6 months post stroke) and offered an interview at around 12 months post stroke. All interviews were conducted in the North East of England. All transcripts were coded and thematically analysed. Results Ten stroke-survivors (age range 72–84 years) were interviewed alongside five carers at baseline; eight stroke-survivors and four carers agreed to a follow-up interview. Three main barriers were identified: (i) fear of a dementia diagnosis; (ii) denial or minimization of symptoms leading to adaptation and (iii) obstacles to seeking help in the community. Conclusions With an ageing population and increase in stroke-survival, the burden of post-stroke cognitive impairment and dementia will only increase. Stroke-survivors and their family carers in this study have identified issues that may hinder their presentation to health care professionals at a personal and organizational level. Health professionals need to be aware of these potential issues when planning services for stroke-survivors.

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Assessing Apps for Patients with Genitourinary Tumors Using the Mobile Application Rating Scale (MARS): Systematic Search in App Stores and Content Analysis (Preprint)

10.2196/preprints.17609 ◽

2019 ◽

Author(s):

Miguel Ángel Amor-García ◽

Roberto Collado-Borrell ◽

Vicente Escudero-Vilaplana ◽

Alejandra Melgarejo-Ortuño ◽

Ana Herranz-Alonso ◽

...

Keyword(s):

Prostate Cancer ◽

Health Care ◽

Health Professionals ◽

Health Care Professionals ◽

Mobile Application ◽

Rating Scale ◽

Cross Sectional ◽

Cancer Symptoms ◽

Genitourinary Cancers

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (P<.001 and P=.01, respectively), but not for cost (P=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.

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Smart Glasses for Caring Situations in Complex Care Environments: Scoping Review

JMIR mhealth and uhealth ◽

10.2196/16055 ◽

2020 ◽

Vol 8 (4) ◽

pp. e16055

Author(s):

Charlotte Romare ◽

Lisa Skär

Keyword(s):

Health Care ◽

Intensive Care ◽

Scoping Review ◽

Health Care Professionals ◽

Qualitative Content Analysis ◽

High Tech ◽

Anesthesia Care ◽

Complex Care ◽

Smart Glasses

Background Anesthesia departments and intensive care units represent two advanced, high-tech, and complex care environments. Health care in those environments involves different types of technology to provide safe, high-quality care. Smart glasses have previously been used in different health care settings and have been suggested to assist health care professionals in numerous areas. However, smart glasses in the complex contexts of anesthesia care and intensive care are new and innovative. An overview of existing research related to these contexts is needed before implementing smart glasses into complex care environments. Objective The aim of this study was to highlight potential benefits and limitations with health care professionals' use of smart glasses in situations occurring in complex care environments. Methods A scoping review with six steps was conducted to fulfill the objective. Database searches were conducted in PubMed and Scopus; original articles about health care professionals’ use of smart glasses in complex care environments and/or situations occurring in those environments were included. The searches yielded a total of 20 articles that were included in the review. Results Three categories were created during the qualitative content analysis: (1) smart glasses as a versatile tool that offers opportunities and challenges, (2) smart glasses entail positive and negative impacts on health care professionals, and (3) smart glasses' quality of use provides facilities and leaves room for improvement. Smart glasses were found to be both a helpful tool and a hindrance in caring situations that might occur in complex care environments. This review provides an increased understanding about different situations where smart glasses might be used by health care professionals in clinical practice in anesthesia care and intensive care; however, research about smart glasses in clinical complex care environments is limited. Conclusions Thoughtful implementation and improved hardware are needed to meet health care professionals’ needs. New technology brings challenges; more research is required to elucidate how smart glasses affect patient safety, health care professionals, and quality of care in complex care environments.

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