Talking With Children About Prognosis: The Decisions and Experiences of Mothers With Metastatic Cancer

PURPOSE: Parents with metastatic cancer report unique concerns and challenges when discussing their illness with their minor children. Greater understanding of parents’ communication experiences can facilitate these discussions. This study aimed to describe the challenges, approaches, and decisions related to discussing prognosis among a sample of mothers with metastatic cancer. METHODS: We conducted a web-based cross-sectional survey assessing the psychosocial concerns of 224 women with metastatic cancer who had minor children. This analysis focused on participant responses to structured and open-ended questions addressing communication with their children. We used descriptive statistics to summarize responses to the structured questions and qualitative content analysis for responses to open-ended questions. RESULTS: Nearly 80% (n = 176) reported they had discussed their prognosis with at least one of their children; 79% identified at least one barrier to these discussions. The most common obstacles were participants’ uncertainty about their illness trajectory (43%) and emotional distress associated with these conversations (41%). Qualitative analyses revealed three principles that guided mothers’ communication decisions: commitment to honesty and protection; child developmental readiness; and beliefs about the right time. Approaches to discussing prognosis included total honesty, using the language of chronic illness, gradual disclosure, waiting for questions, and emphasizing hope, love, and reassurance. CONCLUSION: This study provides further evidence of the complexity and challenges of parental communication with their children about metastatic cancer. There is a need for both clinicians and researchers to identify, test, and implement evidence-based strategies to assist ill parents with their communication concerns.

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A gap between Law and Practice: A Community’s Perception of Unmarried Women’s Abortion Options in Nepal

Health Prospect ◽

10.3126/hprospect.v12i2.9869 ◽

2014 ◽

Vol 12 (2) ◽

pp. 24-30

Author(s):

Simone Christensen Hald ◽

Ditte Aagaard Sondergaard

Keyword(s):

Cross Sectional Survey ◽

Cross Sectional ◽

Safe Abortion ◽

Community Attitudes ◽

Abortion Law ◽

Premarital Sexual Activity ◽

Premarital Sexual ◽

The Right ◽

Changing Attitudes ◽

Depth Interviews

Background In 2002, the Nepalese abortion law went from being highly restrictive to fully liberal. This study aimed to explore a local community’s perception of the situation for unmarried Nepalese women wanting to practice their legal right to abortion.Methods The study comprised a cross-sectional survey and in-depth interviews with men and women above the age of 16 years living in the Makwanpur District, Nepal. The final data included 55 questionnaires and 16 interviews. The questionnaire data was univariate analysed, while a condensation of meaning analysis was carried out on the interviews.Results The overall awareness of abortion being legal was high, although the extent of knowledge of the specific legal grounds varied. Unmarried women were believed to have access to abortion services, although they risked stigmatisation due to their marital status. The community attitude towards these women having abortions was very negative, hence it differed from the legal acceptance of all women having the right to abortion. This was explained by societal norms on premarital sexual activity. Generally, the participants felt that changing attitudes would be difficult but possible over time.Conclusion A considerable gap exists between the legal acceptance of abortion and community attitudes when it comes to unmarried women as this group encounters barriers when wanting to practice their right. Therefore, these barriers need to be addressed to allow unmarried Nepalese women access to safe abortion services without the risk of being stigmatised.One possible alternative is educational initiatives such as disseminating information vigorously through mass media to create awareness.DOI: http://dx.doi.org/10.3126/hprospect.v12i2.9869 Health Prospect Vol.12(2) 2013: 24-30

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Assessment of Knowledge, Attitudes, and Practices Regarding Dengue among Physicians: A Web-Based Cross-Sectional Survey

Behavioral Sciences ◽

10.3390/bs11080105 ◽

2021 ◽

Vol 11 (8) ◽

pp. 105

Author(s):

Kranthi Swaroop Koonisetty ◽

Ubydul Haque ◽

Rajesh Nandy ◽

Nasrin Aghamohammadi ◽

Tamanna Urmi ◽

...

Keyword(s):

Dengue Fever ◽

Viral Infections ◽

Diagnosis And Treatment ◽

Cross Sectional Survey ◽

Accurate Identification ◽

Cross Sectional ◽

Web Based ◽

Attitudes And Practices ◽

Aedes Mosquitoes ◽

Knowledge Attitudes And Practices

Dengue fever is one of the most important viral infections transmitted by Aedes mosquitoes and a major cause of morbidity and mortality globally. Accurate identification of cases and treatment of dengue patients at the early stages can reduce medical complications and dengue mortality rate. This survey aims to determine the knowledge, attitude, and practices (KAP) among physicians in dengue diagnosis and treatment. This study was conducted among physicians in Turkey as one nonendemic country and Bangladesh, India, and Malaysia as three dengue-endemic countries. The dosing frequencies, maximum doses, and contraindications in dengue fever were examined. The results found that physicians from Bangladesh, India, and Malaysia have higher KAP scores in dengue diagnosis and treatment compared to physicians in Turkey. This may be due to a lack of physician’s exposure to a dengue patient as Turkey is considered a nonendemic country. This assessment may help establish a guideline for intervention strategies among physicians to have successful treatment outcomes and reduce dengue mortality.

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The Impact of the COVID-19 Pandemic on Breast Reconstruction: A Canadian Perspective

Plastic Surgery ◽

10.1177/22925503211030017 ◽

2021 ◽

pp. 229255032110300

Author(s):

Caroline F. Illmann ◽

Christopher Doherty ◽

Margaret Wheelock ◽

Joshua Vorstenbosch ◽

Joan E. Lipa ◽

...

Keyword(s):

Breast Reconstruction ◽

Care Delivery ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Reconstructive Procedures ◽

Surgical Access ◽

Canadian Perspective ◽

Canadian Provinces ◽

The Impact

Background: The COVID-19 pandemic has led to unprecedented challenges and restrictions in surgical access across Canada, including for breast reconstructive services which are an integral component of comprehensive breast cancer care. We sought to determine how breast reconstructive services are being restricted, and what strategies may be employed to optimize the provision of breast reconstruction through a pan-Canadian evaluation from the providers’ perspective. Methods: This was a cross-sectional survey of Canadian plastic and reconstructive surgeons who perform breast reconstruction. The 33-item web-based questionnaire was developed by a pan-Canadian working group of breast reconstruction experts and disseminated via email to members of the Canadian Society of Plastic Surgery. The questionnaire queried respondents on the impact of the COVID-19 pandemic and associated restrictions on surgeons’ breast reconstruction practice patterns and opinions on strategies for resource utilization. Results: Responses were received from 49 surgeons, who reported practicing in 8 of 10 Canadian provinces. Restrictions on the provision of breast reconstructive procedures were most limited during the First Wave of the COVID-19 pandemic, where all respondents reported at least some reduction in capacity and more than a quarter reporting complete cessation. Average reported reduction in capacity ranged from 31% to 78% across all 3 waves. Autologous, delayed, and prophylactic reconstructions were most commonly restricted. Conclusion: This study provides a pan-Canadian impact assessment on breast reconstructive services during the COVID-19 pandemic from the providers’ perspective. To uphold the standards of patient-centred care, a unified approach to strategically reorganize health care delivery now and in the future is needed.

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Perceptions on the right to adequate food after a major landslide disaster: a cross-sectional survey of two districts in Uganda

BMC International Health and Human Rights ◽

10.1186/s12914-015-0047-x ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 2

Author(s):

Peter M Rukundo ◽

Per O Iversen ◽

Bård A Andreassen ◽

Arne Oshaug ◽

Joyce Kikafunda ◽

...

Keyword(s):

Cross Sectional Survey ◽

Cross Sectional ◽

Adequate Food ◽

The Right ◽

Landslide Disaster

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Breast-feeding promotion in hospitals and prospective breast-feeding rates during the first year of life in two national surveys 1997–1998 and 2017–2019 in Germany

Public Health Nutrition ◽

10.1017/s1368980021001099 ◽

2021 ◽

pp. 1-13

Author(s):

Nele Hockamp ◽

Constanze Burak ◽

Erika Sievers ◽

Silvia Rudloff ◽

Anja Burmann ◽

...

Keyword(s):

Breast Feeding ◽

Infant Nutrition ◽

Feeding Habits ◽

First Year ◽

Feeding Rates ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Phone Calls ◽

First Year Of Life

Abstract Objectives: The present study aimed to assess the current state of breast-feeding promotion in hospitals and the prevalence of breast-feeding during the first year of life in Germany and to compare the results with a study 20 years earlier. Design: In the studies on ‘breast-feeding and infant nutrition in Germany’ named ‘SuSe’, a cross-sectional survey in hospitals was combined with a subsequent prospective survey of breast-feeding and infant nutrition during the first year of life (0·5, 2, 4, 6 and 12 months after birth) in mother–infant pairs who were recruited in the hospitals. Written questionnaires and phone calls were used in SuSe I and web-based questionnaires in SuSe II. Breast-feeding promotion and prevalence were evaluated using recommendations from the WHO and the UNICEF. Setting: Two nationwide surveys SuSe I (1997–1998) and SuSe II (2017–2019). Participants: In SuSe I, 177 hospitals and 1717 mother–infant pairs and in SuSe II 109 hospitals and 962 mother–infant pairs were included. Results: In SuSe II, hospitals implemented seven of the WHO ‘Ten Steps to Successful Breastfeeding’ to a greater extent than the hospitals in SuSe I. More mothers exclusively breastfed for 4 months (57 % v. 33 %) and continued breast-feeding until 6 (78 % v. 48 %) and 12 months (41 % v. 13 %). In both studies, exclusive breast-feeding decreased between 4 and 6 months of age due to the introduction of complementary feeding. Conclusions: In Germany, breast-feeding habits have come closer to the recommendations over the last 20 years.

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Corona virus fear among health workers during the early phase of pandemic response in Nepal: a web-based cross-sectional study

10.1101/2020.11.04.367912 ◽

2020 ◽

Author(s):

Pratik Khanal ◽

Navin Devkota ◽

Minakshi Dahal ◽

Kiran Paudel ◽

Shiva Raj Mishra ◽

...

Keyword(s):

At Risk ◽

Family Member ◽

Chronic Diseases ◽

Early Phase ◽

Health Workers ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Factors Associated

AbstractBackgroundHealth workers involved in COVID-19 response might be at risk of developing fear and psychological distress. This study aimed to identify factors associated with COVID-19 fear among health workers in Nepal during the early phase of pandemic.MethodsA web-based cross-sectional survey was conducted in the month of April-May 2020 among 475 health workers directly involved in COVID-19 management. The Fear Scale of COVID 19 (FCV-19S) was used to measure the status of fear. Scatter plots were used to observe the relationship between fear and other psychological outcomes: anxiety, depression and insomnia. Multivariable logistic regression was done to identify factors associated with COVID fear.ResultsCOVID-19 fear score was moderately correlated with anxiety and depression, and weakly correlated with insomnia (p<0.001). Nurses (AOR=2.29; 95% CI: 1.23-4.26), health workers experiencing stigma (AOR=1.83; 95% CI: 1.12-2.73), those working in affected district(AOR=1.76; 95% CI: 1.12-2.77) and presence of family member with chronic diseases (AOR=1.50; 95% CI: 1.01-2.25) was associated with higher odds of developing COVID-19 fear as compared to other health workers, health workers not experiencing stigma, working in non-affected district and not having family member with chronic diseases respectively.ConclusionNurses, health workers facing stigma, those working in affect district and having family member with chronic diseases were more at risk of developing COVID-19 fear. It is thus recommended to improve work environment to reduce fear among health workers, employ stigma reduction interventions, and ensure personal and family support for those having family member with chronic diseases.

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Knowledge, Attitude and Perception towards COVID-19 Pandemic among Veterinary Professionals and Impacts: A Cross-Sectional Nationwide-Based Survey

COVID ◽

10.3390/covid1030053 ◽

2021 ◽

Vol 1 (3) ◽

pp. 645-665

Author(s):

Olubukola Adenubi ◽

Oluwawemimo Adebowale ◽

Hezekiah Adesokan ◽

Abimbola Oloye ◽

Noah Bankole ◽

...

Keyword(s):

Best Practices ◽

Physical Status ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Postgraduate Qualification ◽

Level Of Knowledge ◽

Policy Measures ◽

Household Members ◽

Good Attitude

This study evaluated the knowledge, attitude and perception (KAP) towards COVID-19 pandemic control among veterinarians in Nigeria. A nation-wide web-based cross-sectional survey was conducted. Information on KAP towards the COVID-19 pandemic was gathered (April 23 and May 31, 2020) and multivariate logistic regression was performed to identify associated factors. A total of 368 veterinarians participated in the study. The majority of respondents were males (72.8%), between the ages of 30–39 years (39.7%). Generally, respondents displayed a good level of knowledge about COVID-19 (72.4% ± 9.9%, range 44.1–91.2%), while the general attitude level was poor (65.4% ± 10.8, range 35.3–94.1%). Various determinants for good attitude among respondents were: if they were above 60 years old (aOR = 4.49, 95% CI: 1.379–14.594, p = 0.013), possessed postgraduate qualification (aOR = 1.63, 95 CI: 1.045–2.553, p = 0.031), worked over 30 years post DVM (aOR = 5.63, 95% CI: 1.966–16.100, p = 0.001), had household members between five and 10 (aOR = 1.73, 95% CI: 1.130–2.641, p = 0.012), and if respondents’ residence was on total lockdown (aOR = 1.66, 95% CI: 1.070–2.590, p = 0.024). The pandemic had moderate impacts on social, financial and physical status of the participants. Stricter policy measures and educational programs should be implemented to keep veterinarians and the populace informed about the best practices recommended for COVID-19 management.

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Sleep disturbance and anxiety symptom among public during the second wave of COVID-19 in Beijing: A web-based cross-sectional survey

Journal of Affective Disorders ◽

10.1016/j.jad.2021.10.068 ◽

2021 ◽

Author(s):

Yanan liu ◽

Xi Wang ◽

Pengfei Sun ◽

Qi Zhang ◽

Cheng Zhang ◽

...

Keyword(s):

Sleep Disturbance ◽

Anxiety Symptom ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Second Wave

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Bedside ultrasound education in Canadian medical schools: A national survey

Canadian Medical Education Journal ◽

10.36834/cmej.36646 ◽

2016 ◽

Vol 7 (1) ◽

pp. e78-e86 ◽

Cited By ~ 16

Author(s):

Peter Steinmetz ◽

Octavian Dobrescu ◽

Sharon Oleskevich ◽

John Lewis

Keyword(s):

Medical School ◽

Undergraduate Curriculum ◽

Medical Schools ◽

School Curriculum ◽

Bedside Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Ultrasound Education ◽

Current Characteristics

Background: This study was carried out to determine the extent and characteristics of bedside ultrasound teaching in medical schools across Canada.Methods: A cross-sectional, survey-based study was used to assess undergraduate bedside ultrasound education in the 17 accredited medical schools in Canada. The survey, consisting of 19 questions was pilot-tested, web-based, and completed over a period of seven months in 2014.Results: Approximately half of the 13 responding medical schools had integrated bedside ultrasound teaching into their undergraduate curriculum. The most common trends in undergraduate ultrasound teaching related to duration (1-5 hours/year in 50% of schools), format (practical and theoretical in 67% of schools), and logistics (1:4 instructor to student ratio in 67% of schools). The majority of responding vice-deans indicated that bedside ultrasound education should be integrated into the medical school curriculum (77%), and cited a lack of ultrasound machines and infrastructure as barriers to integration.Conclusions: This study documents the current characteristics of undergraduate ultrasound education in Canada.

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