scholarly journals Clinical Oncology Workload in Sri Lanka: Infrastructure, Supports, and Delivery of Clinical Care

2021 ◽  
pp. 1703-1710
Author(s):  
Sanjeeva Gunasekera ◽  
Sanjeewa Seneviratne ◽  
Matthew Jalink ◽  
Nuradh Joseph ◽  
Yasantha Ariyarathna ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Patient Care ◽  
Clinical Oncology ◽  
Care Delivery ◽  
Clinical Care ◽  
Hematologic Malignancies ◽  
Noncommunicable Diseases ◽  
Cross Sectional ◽  
Middle Income ◽  
Quality Patient Care

PURPOSE Sri Lanka is a lower middle-income country undergoing a demographic transition with an increasing aging population. This has given rise to a higher burden of noncommunicable diseases including cancer. A well-trained oncology workforce is essential to address this growing public health challenge. Understanding the baseline status of the clinical oncology workforce is an essential step to improving cancer care delivery in Sri Lanka. METHODS In this cross-sectional study, we distributed a web-based survey to all clinical oncologists in Sri Lanka. The survey captured data regarding clinical workload, demographic details, practice setting, and perceived barriers to quality patient care. RESULTS A total of 41 of 54 oncologists responded to the survey, and all participants had training in clinical oncology. Thirty-seven (90%) of 41 oncologists treated both solid and hematologic malignancies, and the median duration of independent practice was 5 years. Almost two thirds of the oncologists (26 of 41, 63%) work at an academic center, and two thirds of the oncologists (27 of 41, 66%) work in both public and private sectors. A majority of the oncologists (26 of 41, 63%) were on-call 7 days per week. More than half of the oncologists saw over 400 new patient consults per year. With regard to barriers to quality patient care, most of the concerns relate to the scarcity of resources. CONCLUSION This study sheds significant light about the clinical oncology workload landscape in Sri Lanka. Compared with other low- and middle-income countries, Sri Lankan clinical oncologists are faced with a very high workload, which may affect delivery or care.

Inter-professional physician-nurse collaboration in Lebanon

2020 ◽  
Vol 25 (1) ◽  
pp. 34-45
Author(s):  
Hala Ahmadieh ◽  
Ghali H. Majzoub ◽  
Faraj M. Abou Radi ◽  
Areej H. Abou Baraki
Keyword(s):  
Patient Care ◽  
Care Delivery ◽  
Postgraduate Education ◽  
Local Context ◽  
Cross Sectional ◽  
Content Type ◽  
Study Results ◽  
Significant Difference ◽  
Nurses And Physicians

PurposeA physician–nurse relationship is a complex, professional and shared-decision-making process, which is an important predictor of high-quality patient care. The purpose of this paper is to explore the attitude of the physician–nurse relationship in Southern Lebanon hospitals.Design/methodology/approachA descriptive institutional cross-sectional study was conducted among different departments of three hospitals in Southern Lebanon using a validated Jefferson Scale of Attitude.FindingsIn sum, 89 physicians and 245 nurses accepted to participate. The nurses’ mean age was 32 and the physicians’ was 44. The mean score was found to be 46 for all participants, with significantly higher scores noted among nurses compared to physicians (48 vs 43, respectively) and higher scores among females compared to males (48 vs 46, respectively). However, the study scored no significant difference in relation to the degrees attained by nurses and the participants’ years of experience. The majority had agreed that the shortage in the nurses’ staff affects proper patient care delivery. One fourth of the physicians disagreed that nurses should be considered as a collaborator and colleague. Therefore, more work is required to improve this collaboration.Research limitations/implicationsThere is a complex relationship normally displayed by physicians and nurses, which cannot be easily interpreted and analyzed. Physicians and nurses may have given socially desirable responses while filling the questionnaire. Even more, this study was conducted in Hospitals in Southern Lebanon, and it would be nice to extend this study to include further hospitals in other regions in Lebanon as well.Practical implicationsNurses had higher scores toward collaboration, with females scoring higher than males. However, overall scores are considered to be lower compared to other countries. Thus, more efforts should be done on improving this communication among nurses and physicians, through promoting inter-professional undergraduate and postgraduate education training toward more effective communication.Social implicationsQuality of patient care would be improved if more work is done on improving the collaboration between physicians and nurses, and this was shown to be required as per study results.Originality/valueThere is a gap in literature assessing this important topic which is the collaboration and attitude of nurses and physicians toward their relationship in Lebanon. It is extremely important that efforts should be taken in order to determine the type of nurse–physician relationship in every local context as this relationship affects quality of patients’ care.

scholarly journals Prevalence of Hyperhomocysteinaemia and Associated Factors among Ethiopian Adult Population in a 2015 National Survey

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Feyissa Challa ◽  
Tigist Getahun ◽  
Meron Sileshi ◽  
Bikila Nigassie ◽  
Zeleke Geto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Vegetable Consumption ◽  
Adult Population ◽  
Noncommunicable Diseases ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Steps Survey ◽  
Associated Risk Factors

Hyperhomocysteinaemia (HHcy) is an independent risk factor for major cardiovascular diseases, but data on the prevalence and predictors of HHcy in low- and middle-income countries like Ethiopia are scant. The aim of this study was to estimate the prevalence of HHcy and associated risk factors in the Ethiopian adult population. A cross-sectional survey on risks of noncommunicable diseases (NCDs) using the STEPwise approach to surveillance (STEPS) survey was conducted between April and June 2015. A total of 4,175 study participants were surveyed. Serum homocysteine (Hcy) and metabolic profile were determined using Cobas Integra 400 Plus and CardioChek PA analyzer, respectively. Factors associated with HHcy were determined using logistic regression. The mean serum tHcy concentration was 14.6 μmol/L, with 16.4 μmol/L in males and 13.4 μmol/L in females. Overall, 38% had HHcy, with figures in males (49%) higher than females (30%). Increased age, being male, and high blood pressure and/or taking blood pressure medication, as well as low consumption of fruit and/or vegetables, were independent risk factors for HHcy. In conclusion, the prevalence of HHcy among the adult Ethiopian population is alarmingly high. Improving diets through the promotion of fruit and vegetable consumption is needed to reduce the risk of NCDs.

scholarly journals Impact of COVID-19 on Cancer Care Delivery in Africa: A Cross-Sectional Survey of Oncology Providers in Africa

2021 ◽  
pp. 368-377
Author(s):  
Yehoda M. Martei ◽  
Tara J. Rick ◽  
Temidayo Fadelu ◽  
Mohammed S. Ezzi ◽  
Nazik Hammad ◽  
...  
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
Clinical Care ◽  
Small Sample ◽  
Treatment Modalities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Income Groups ◽  
Oncology Providers

PURPOSE The COVID-19 pandemic has disrupted cancer care globally. There are limited data of its impact in Africa. This study aims to characterize COVID-19 response strategies and impact of COVID-19 on cancer care and explore misconceptions in Africa. METHODS We conducted a web-based cross-sectional survey of oncology providers in Africa between June and August 2020. Descriptive statistics and comparative analysis by income groups were performed. RESULTS One hundred twenty-two participants initiated the survey, of which 79 respondents from 18 African countries contributed data. Ninety-four percent (66 of 70) reported country mitigation and suppression strategies, similar across income groups. Unique strategies included courier service and drones for delivery of cancer medications (9 of 70 and 6 of 70, respectively). Most cancer centers remained open, but > 75% providers reported a decrease in patient volume. Not previously reported is the fear of infectivity leading to staff shortages and decrease in patient volumes. Approximately one third reported modifications of all cancer treatment modalities, resulting in treatment delays. A majority of participants reported ≤ 25 confirmed cases (44 of 68, 64%) and ≤ 5 deaths because of COVID-19 (26 of 45, 58%) among patients with cancer. Common misconceptions were that Africans were less susceptible to the virus (53 of 70, 75.7%) and decreased transmission of the virus in the African heat (44 of 70, 62.9%). CONCLUSION Few COVID-19 cases and deaths were reported among patients with cancer. However, disruptions and delays in cancer care because of the pandemic were noted. The pandemic has inspired tailored innovative solutions in clinical care delivery for patients with cancer, which may serve as a blueprint for expanding care and preparing for future pandemics. Ongoing public education should address COVID-19 misconceptions. The results may not be generalizable to the entire African continent because of the small sample size.

scholarly journals Nurses’ Awareness on Patient Safety Culture in A Newly Established University Hospital

2020 ◽  
Vol 23 (2) ◽  
pp. 119-127
Author(s):  
Mohd Said Nurumal ◽  
Najwatul Madihah Sabran ◽  
Siti Hazariah Abdul Hamid ◽  
Muhammad Kamil Che Hasan
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Safety Culture ◽  
Care Delivery ◽  
Medical Center ◽  
Patient Safety Culture ◽  
University Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Post Hoc

As a vital part of patient care delivery, patient safety culture contributes to the quality of care provided by nurses. Safe patient care is positively linked to the attitudes of nurses. This study aimed to assess the perception of nurses working in a newly established teaching hospital. A cross-sectional study involving 194 nurses from three different units was conducted by using a 24-item Hospital Survey of Patient Safety Culture. Data on gender, working unit, age, years of working, and attendance in workshops on patient safety were also collected. The majority of the nurses had a positive total score of patient safety culture. The lowest score was 76 (63%), and the highest score was 120 (96%). The awareness on patient safety culture significantly differed between gender, years of working, and working units. Post-hoc comparisons using Tukey’s HSD test yielded a significant difference between nurses from critical care units and those from medical and surgical units. The mean score and total positive score on awareness on patient safety culture of the former were higher than those of the latter. Overall, the majority of the staff nurses in International Islamic University Malaysia Medical Center had a positive total score on awareness on patient safety culture. Awareness on patient safety, which is considered crucial worldwide, should be enhanced to influence the development of a positive patient safety culture within hospitals. This implementation would directly develop high-quality care to patients and positively impact health organizations.Abstrak  Kesadaran Perawat terhadap Budaya Keselamatan Pasien di Rumah Sakit Universitas yang Baru Dibangun. Sebagai bagian penting dari pemberian perawatan pasien, budaya keselamatan pasien berkontribusi pada kualitas perawatan yang diberikan oleh perawat. Perawatan pasien yang aman secara positif terkait dengan sikap perawat. Penelitian ini bertujuan untuk menilai persepsi perawat yang bekerja di rumah sakit pendidikan yang baru dibangun. Sebuah studi cross-sectional yang melibatkan 194 perawat dari tiga unit yang berbeda dilakukan dengan menggunakan Survei Rumah Sakit Budaya Keselamatan Pasien. Data tentang jenis kelamin, unit kerja, usia, tahun kerja, dan kehadiran dalam lokakarya tentang keselamatan pasien juga dikumpulkan. Mayoritas perawat memiliki skor total positif dari budaya keselamatan pasien. Skor terendah adalah 76 (63%), dan skor tertinggi adalah 120 (96%). Kesadaran tentang budaya keselamatan pasien berbeda secara signifikan antara jenis kelamin, tahun kerja, dan unit kerja. Perbandingan post-hoc menggunakan uji HSD Tukey menghasilkan perbedaan yang signifikan antara perawat dari unit perawatan kritis dan mereka dari unit medis dan bedah. Skor rata-rata dan skor total positif pada kesadaran tentang budaya keselamatan pasien dari yang pertama lebih tinggi daripada yang terakhir. Secara keseluruhan, mayoritas staf perawat di International Islamic University Malaysia Medical Center memiliki skor total positif pada kesadaran tentang budaya keselamatan pasien. Kesadaran akan keselamatan pasien, yang dianggap penting di seluruh dunia, harus ditingkatkan untuk memengaruhi perkembangan budaya keselamatan pasien yang positif di rumah sakit. Implementasi ini secara langsung akan mengembangkan perawatan berkualitas tinggi kepada pasien dan berdampak positif bagi organisasi kesehatan.Kata Kunci: budaya, perawat, keselamatan pasien, rumah sakit

scholarly journals Should male doctors in Sri Lanka wear a necktie to be recognized and respected?

2019 ◽  
Vol 13 (05) ◽  
pp. 445-448
Author(s):  
Prabath K Abeysundara ◽  
Nilanga Nishad ◽  
Karthiha Balendran ◽  
Manod Pabasara ◽  
Poornima K Bandara ◽  
...  
Keyword(s):  
Secondary Education ◽  
Sri Lanka ◽  
Patient Care ◽  
Cross Sectional Study ◽  
Cultural Norms ◽  
Sectional Study ◽  
National Hospital ◽  
Cross Sectional ◽  
Almost All

Introduction: European cultural norms have influenced physicians’ attire in Sri Lanka. The necktie is one such item of clothing which is worn to be recognized and respected as professionals. This study was carried out to assess the perceptions of doctors and patients towards male doctors wearing neckties while providing patient care. Methododology: A descriptive cross-sectional study was carried out at the National Hospital of Sri Lanka. An interviewer-administered questionnaire was used to collect data from doctors and patients. Results: The study included 105 doctors (57% males) and 333 patients (54% males). Mean ages of the doctors and patients were 37 years (95% C.I. 36-39) and 47 years (95% C.I. 45-49) respectively. Sixty-nine percent of the patients had completed secondary education or above. None of the patients were aware of the risk of spreading infections by wearing a necktie. Of the 41% of doctors who thought it was unnecessary to wear a necktie, 95% believed the necktie can spread infections. Ninety-five percent of patients believed doctors should wear neckties to be identified and respected and to maintain trustworthiness. Conclusions: None of the patients were aware of the possible risk of spreading infections by wearing a necktie, while most of the doctors who thought neckties were unnecessary also believed neckties can spread infections. Almost all patients thought that doctors should wear a necktie to be recognized and respected. Therefore, implementing a change in dress policy for doctors is a challenging task in Sri Lanka.

scholarly journals Evaluating capacity at three government referral hospital emergency units in the Kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool

2020 ◽  
Author(s):  
Jennifer Pigoga ◽  
Anjni Patel Joiner ◽  
Phindile Chowa ◽  
Jennifer Luong ◽  
Masitsela Mhlanga ◽  
...  
Keyword(s):  
Emergency Care ◽  
Assessment Tool ◽  
Care Delivery ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Emergency Unit ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Middle Income ◽  
Entry Points

Abstract Background The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results All sites provided some level of emergency care 24 hours a day, seven days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.

scholarly journals Colorectal Cancer Epidemiology in Tanzania: Patterns in Relation to Dietary and Lifestyle Factors

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 3s-3s
Author(s):  
L. Katalambula ◽  
P. Petrucka ◽  
J. Buza ◽  
T. Ngoma
Keyword(s):  
Colorectal Cancer ◽  
Alcohol Consumption ◽  
Tobacco Smoking ◽  
Noncommunicable Diseases ◽  
Lifestyle Behaviors ◽  
Chart Audit ◽  
Cross Sectional ◽  
Middle Income ◽  
Survey Tool ◽  
Local Risk

Background: Chronic noncommunicable diseases are increasingly captured as contributing to morbidity and mortality in low and middle income countries. Aim: This study aimed to investigate the epidemiology of colorectal cancer and the potential modifiable local risk factors in Tanzania. Methods: A cross sectional retrospective chart audit study was conducted to establish the pattern and distribution of colorectal cancer, The Food Frequency Questionnaire and the Step® survey tool were used to collect data. Descriptive statistics, χ2 tests, and regression analysis were used and augmented by data visualization to display risk variable differences. Results: Tanzania's colorectal cancer incidence has increased six times in the last decade in which major towns and cities of Dar es Salaam (20.2 per 100,000), Pwani (7.2 per 100,000), Kilimanjaro (4.4 per 100,000), Arusha (4.2 per 100,000), and Morogoro (3.6 per 100,000) had the highest percentage. This study reported that, almost 45% of the participants were hypertensive. Two major dietary patterns, namely “healthy” and “western”, existed among the study sample. Obesity was found in 25% of participants, whereas overweight was present in 28%; of note, the prevalence was higher in females (26.9%) than in males (23.6%) respectively. The prevalence of alcohol consumption was 21.5%, with a significantly lower rate of smoking (12.2%) noted within the study subjects. Both alcohol consumption and tobacco smoking were more common in men than women (22.7 vs. 20.6% and 24.5 vs. 3.2%, respectively). The prevalence of vigorous, moderate, and low physical activity for both sexes was 18.6%, 54.1% and 42.3%, respectively. Conclusion: Evidence from this study demonstrate that, like other NCDs CRC is increasing in Tanzania. Colon cancer is increasing at higher rate than rectal cancer seeming to align with change in lifestyle. Major towns and cities had the highest share of CRC patients. Diet, obesity, tobacco smoking, alcohol consumption, and sedentary behavior have potential role to play in the rising trend of CRC and other NCDs. We recommend a large longitudinal study with robust methodology which can establish cause and effect relationships between specific lifestyle behaviors and the incidence of colorectal cancer.

scholarly journals Usage of Cloud Storage Facilities by Medical students in a low-middle income country, Sri Lanka: A cross sectional study

2019 ◽  
Author(s):  
Samankumara Hettige ◽  
Eshani Dasanayaka ◽  
Dileepa Senajith Ediriweera
Keyword(s):  
Medical Students ◽  
Sri Lanka ◽  
Cloud Storage ◽  
Cross Sectional Study ◽  
Security And Privacy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Google Drive ◽  
Storage Facilities

Abstract Introduction Cloud storage facilities (CSF) has become popular among the internet users. There is limited data on CSF usage among university students in low middle-income countries including Sri Lanka. In this study we present the CSF usage among medical students at the Faculty of Medicine, University of Kelaniya. Methods We undertook a cross sectional study at the Faculty of Medicine, University of Kelaniya, Sri Lanka. Stratified random sampling was used to recruit students representing all the batches. A self-administrated questionnaire was given. Results Of 261 (90.9%) respondents, 181 (69.3%) were females. CSF awareness was 56.5% (95%CI: 50.3% - 62.6%) and CSF usage was 50.8% (95%CI: 44.4 - 57.2%). Awareness was higher in males (P=0.003) and was low in senior students. Google Drive was the commonest CSF followed by Dropbox and OneDrive. There was no association between CSF awareness and pre-university entrance or undergraduate examination performance. Inadequate knowledge, time, accessibility, security and privacy concerns limited CSF usage. 69.8% indicated that they would like to undergo training on CSF as an effective tool for education. Conclusion CSF awareness and usage was nearly 50% among the students and Google drive is the most popular CSF. Lack of knowledge, accessibility, concerns on security and privacy limited CSF usage among students. Majority were interested to undergo training on CSF and undergraduate ICT curricula should introduce CSF as effective educational tools.

scholarly journals Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study

2020 ◽  
Author(s):  
Anita Gadgil ◽  
Geetu Bhandoria ◽  
Monty Khajanchi ◽  
Bhakti Sarang ◽  
Deepa Kizhakke Veetil ◽  
...  
Keyword(s):  
Health Care Services ◽  
Emergency Services ◽  
Care Delivery ◽  
Surgical Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Care Services ◽  
Research Consortium

Abstract Background The ongoing COVID-19 pandemic and subsequent lockdown have adversely affected global health care services to varying extent. Emergency Services were also affected along with elective surgeries, which were deferred to accommodate the added burden of COVID 19 affected patients, on the healthcare systems. We aimed to assess the change in delivery of essential and emergency surgeries due to the pandemic.Methodology A research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low- and Middle-Income countries (LMIC), India, conducted this retrospective cross-sectional study with 12 recruited centers. All surgeries performed during the months of April 2020 were compared with those performed in April 2019. These surgeries were stratified into emergency and elective, and further categorized based on NHS surgery prioritization documents. Results A total of 4396 surgeries were performed at these centers in April 2019 and 1216 surgeries were performed in same month during 2020, yielding a fall of 72.3% (1216 /4396).We found a 54% reduction in emergency surgeries and a 91% reduction in the elective surgeries. Number of cesarean sections reduced by 29.7% and fracture surgeries declined by 85.3% Laparotomies and surgeries for local soft tissue infections with necrotic tissue reduced by 71.7% and 69.5% respectively.Conclusion Our study quantifies the effects of COVID 19 pandemic on surgical care delivery in India and documents that the overall surgical volume reduced by three fourths in the pandemic period. Emergency surgeries reduced to half when compared with pre-pandemic period. Cesarean section surgeries were affected the least by pandemic, whereas the fracture surgeries and laparotomies were affected the most.

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