scholarly journals What do young doctors know of Palliative Care; how do they expect the concept to work?

2019 ◽  
Author(s):  
GVM Chamath Fernando ◽  
Shamini Prathapan

Abstract Objectives Discipline of palliative care is still evolving in developed parts of the world while it remains at an infantile stage in Sri Lanka which has not been formally assessed as of today. We aimed at evaluating the level of palliative care knowledge and opinions among young medical graduates. A descriptive cross-sectional study was carried out among pre-residency medical graduates of Sri Lanka through a social media based on-line survey. The pre-tested questionnaire assessed the level of knowledge on general principles, service organization, clinical management and ethical considerations while it also evaluated their opinions. Results Response rate was 35.8% (n=351). The average score among the respondents was 37.25% (standard deviation (SD) = 11.975). Specific knowledge on “general principles” was adequate (score>=50%) with an average of 62.61%, SD=24.5 while “ethics” was observed to be the area with poorest knowledge (average score=19.55%, SD=22). Average scores for “service organization” and “managerial aspects” were 34.54%, SD=17.6 and 32.26%, SD=22.3 respectively. The majority (>90%) believed that de-novo establishment of hospice, hospital and community-based palliative services would sustainably improve holistic patient care. Measures must be taken to optimize basic palliative care knowledge among the undergraduates in view of achieving Universal Health Coverage in the long term.

2019 ◽  
Author(s):  
GVM Chamath Fernando ◽  
Shamini Prathapan

Abstract Objectives Discipline of palliative care is still evolving in developed parts of the world while it remains at an infantile stage in Sri Lanka which has not been formally assessed as of today. We aimed at evaluating the level of palliative care knowledge and opinions among young medical graduates. A descriptive cross-sectional study was carried out among pre-residency medical graduates of Sri Lanka through a social media based on-line survey. The pre-tested questionnaire assessed the level of knowledge on general principles, service organization, clinical management and ethical considerations while it also evaluated their opinions. Results Response rate was 35.8% (n=351). The average score among the respondents was 37.25% (standard deviation (SD) = 11.975). Specific knowledge on “general principles” was adequate (score>=50%) with an average of 62.61%, SD=24.5 while “ethics” was observed to be the area with poorest knowledge (average score=19.55%, SD=22). Average scores for “service organization” and “managerial aspects” were 34.54%, SD=17.6 and 32.26%, SD=22.3 respectively. The majority (>90%) believed that de-novo establishment of hospice, hospital and community-based palliative services would sustainably improve holistic patient care. Measures must be taken to optimize basic palliative care knowledge among the undergraduates in view of achieving Universal Health Coverage in the long term.


Author(s):  
Bernard Hope Taderera

The study of healthcare personnel migration in Ireland reports that most medical graduates plan to leave the country’s health system. It may be possible to address this challenge by understanding and addressing the reasons why young doctors plan to leave. Future studies should contribute to the retention of early career doctors in highincome countries such as Ireland. This will help reduce the migration of doctors from low- and middle-income countries in order to address the global health workforce crisis and its impact on the attainment of universal health coverage in all health systems.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041214
Author(s):  
Kevin Glynn ◽  
Frank McKenna ◽  
Kevin Lally ◽  
Muireann O’Donnell ◽  
Sandeep Grover ◽  
...  

ObjectivesTo investigate whether delirium motor subtypes differ in terms of phenomenology and contributory aetiology.DesignCross-sectional study.SettingInternational study incorporating data from Ireland and India across palliative care, old age liaison psychiatry and general adult liaison psychiatry settings.Participants1757 patients diagnosed with delirium using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM IV).Primary and secondary outcome measuresHyperactive, mixed and hypoactive delirium subtypes were identified using the abbreviated version of the Delirium Motor Subtype Scale. Phenomenology was assessed using the Delirium Rating Scale Revised. Contributory aetiologies were assessed using the Delirium Aetiology Checklist (DEC), with a score >2 indicating that the aetiology was likely or definitely contributory.ResultsHypoactive delirium was associated with dementia, cerebrovascular and systemic infection aetiologies (p<0.001) and had a lower overall burden of delirium symptoms than the other motor subtypes. Hyperactive delirium was associated with younger age, drug withdrawal and the DEC category other systemic aetiologies (p<0.001). Mixed delirium showed the greatest symptom burden and was more often associated with drug intoxication and metabolic disturbance (p<0.001). All three delirium motor subtypes had similar levels of impairment in attention and visuospatial functioning but differed significantly when compared with no subtype (p<0.001).ConclusionsThis study indicates a pattern of aetiology and symptomatology of delirium motor subtypes across a large international sample that had previously been lacking. It serves to improve our understanding of this complex condition and has implications in terms of early detection and management of delirium.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046694
Author(s):  
Jiani Mao ◽  
Feng Chen ◽  
Dianguo Xing ◽  
Huixian Zhou ◽  
Ling Jia ◽  
...  

ObjectiveTo evaluate knowledge of cardiopulmonary resuscitation (CPR) among Chinese college students and their attitude towards participating in CPR training and willingness to perform bystander CPR.DesignA cross-sectional study.ParticipantsA total of 1128 college students were selected through a multistage stratified random sampling method from 12 universities in Chongqing, China.Primary and secondary outcomesPrimary outcomes included CPR knowledge and willingness to participate in training and perform bystander CPR; secondary outcomes included CPR training experience and obstacles to training and performing CPR.ResultsThe average score on CPR knowledge was 2.078 (±1.342). Only 45.5% of the respondents were willing to participate in CPR training. Women, respondents who were postgraduate or above, with liberal arts as major and with high CPR knowledge level were more willing to participate in CPR training. A total of 47.2% of the respondents were willing to provide simple assistance, such as checking the consciousness and breathing of the patient and dialling 120 (medical emergency call). Only 34.1% indicated their willingness to perform bystander CPR on strangers. Perceived behavioural control, behavioural attitudes and subjective norms are positive predictors of willingness to provide bystander CPR.ConclusionsCPR knowledge and training rate were low among Chongqing college students. Willingness to participate in training and perform bystander CPR was also low. Improving legislation, strengthening training programmes, incorporating CPR training into the school curriculum and reshaping the social and public culture of offering timely help to those in need are recommended strategies to improve bystander CPR performance.


Author(s):  
Ana A. Esteban-Burgos ◽  
María José Lozano-Terrón ◽  
Daniel Puente-Fernandez ◽  
César Hueso-Montoro ◽  
Rafael Montoya-Juárez ◽  
...  

Background: Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new indicators for the establishment of the resident’s advanced chronic condition. Methods: Cross-sectional study conducted in 149 nursing homes Complex Chronic residents evaluated by trained professionals. Palliative Care Needs, assessed by the NECPAL ICO-CCOMS© tool, and fragility, case and palliative complexity and prognosis were evaluate through a comprehensive assessment. Descriptive analyses and association measures were performed setting the statistical significance at 0.05. Results: More than 50% of the residents had positive Surprise Question and other Palliative Needs and were classified as Advanced Chronic Patients. Distress and/or Severe Adaptative Disorder was the most frequent need shown by the residents and significant differences in levels of frailty and other characteristics, were found between the Positive and the Negative Surprise Question Groups. Statistically significant correlations were also found between aspects of both groups. Conclusions: Nursing homes residents show Palliative Needs regardless of the response to the Surprise Question of the NECPAL tool. Other characteristics such as presence of an intermediate level of frailty are suggested as a new perspective to identify advanced chronic patients among nursing homes residents.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Janaka Weragoda ◽  
Rohini Seneviratne ◽  
Manuj C. Weerasinghe ◽  
Mandika Wijeyaratne ◽  
Anil Samaranayaka

2021 ◽  
Vol 8 (1) ◽  
pp. 30-33
Author(s):  
Sujit Kumar Sarker ◽  
Geethanjali Bhas ◽  
Priyanka Moitra ◽  
Ratna Paul ◽  
Md. Abdullah Yusuf ◽  
...  

Background: Periodic students’ feedback ensures and enhances the effectiveness of the curriculum of medical subject. Objective: This study was designed to obtain students appraisal of the undergraduate pharmacology curriculum and teaching methodology. Methodology: This cross-sectional study was conducted in the Department of Pharmacology at Colonel Malek Medical College, Manikganj, Bangladesh from May to June, 2019 for a period of two months. Questionnaire-based data were collected from students of both sexes who had completed 3rd Professional examination. Likert Scale was applied to collect students’ feedback on pharmacology. Results: A total number of 40 students were recruited for this study of which 60.0% students were strongly agreed about organized teaching. About 47.5% students were agreed that the course was appropriate at their level and achieved their goals in Pharmacology. However, 55% of them strongly agreed that teacher provided clear constructive feedback during class. Total 60%, were agreed that the course improved their problem-solving skills. Overall, 55% students were agreed regarding their satisfaction on Pharmacology course delivery and conduction. Conclusion: In conclusion, periodic appraisal from students regarding evaluation of the student-centric undergraduate pharmacology curriculum is vital in developing efficient medical graduates. Journal of Current and Advance Medical Research, January 2021;8(1):30-33


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