scholarly journals Ultrasonography in assessing suspected bone fractures: a cross-sectional survey amongst German general practitioners

2019 ◽  
Author(s):  
Gordian Lukas Schmid ◽  
Beatrice Kühnast ◽  
Marcus Heise ◽  
Tobias Deutsch ◽  
Thomas Frese

Abstract Background: Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs) to assess their knowledge, attitudes, and utilization of US for the diagnosis of suspected fractures. Methods: Notification of the study, a self-designed questionnaire, and a reminder were mailed to 600 randomly selected GPs in Saxony and Saxony-Anhalt. Results: The response rate was 47.7% ( n = 286), and respondents did not differ from the population of all GPs in respect to sex and practice type. Among GPs surveyed, 48.6% used an US device in their practice. On average, GPs diagnosed six patients with suspected fractures per month, yet only 39.3% knew about the possibility of ultrasonographic fracture diagnosis, and only 4.3% of GPs using US applied it for this purpose. Among participants, 71.9% believed that US is inferior to conventional X-rays for the diagnosis of bony injuries. Users of US were better informed of and more commonly used US for fracture diagnosis compared to non-users. Conclusion: The need to rule out possible fractures frequently arises in general practice, and US devices are broadly available. Further efforts are needed to improve the knowledge and attitudes of GPs regarding the accuracy of US for fracture diagnosis. Multicenter controlled trials could explore the safety, usefulness, and effectiveness of this still seldom used diagnostic approach for suspected fractures.

2019 ◽  
Author(s):  
Gordian Lukas Schmid ◽  
Beatrice Kühnast ◽  
Marcus Heise ◽  
Tobias Deutsch ◽  
Thomas Frese

Abstract Background: Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the conditions for integrating this usage of US into general practice need to be specified. In this study, we surveyed German general practitioners (GPs) to assess their knowledge, attitudes, and utilization of US for the diagnosis of suspected fractures. Methods: Notification of the study, a self-designed questionnaire, and a reminder were sent by mail to 600 randomly selected GPs in Saxony and Saxony-Anhalt. Results: The response rate was 47.7% (n=286), and respondents did not differ from the population of all GPs in respect to sex and practice type. Of all GPs surveyed, 48.6% used an US device in their practice. On average, GPs diagnosed six patients with suspected fractures per month, yet only 39.3% knew about the possibility of ultrasonographic fracture diagnosis, and only 4.3% of GPs using US utilized it for this purpose. Among participants, 71.9% believed that US is inferior to conventional X-rays for the diagnosis of bony injuries. Users of US were better informed of and used this imaging modality more often for fracture diagnosis than non-users. Conclusion: The need to rule out possible fractures frequently arises in general practice, and US devices are broadly available. Further efforts are needed to improve the knowledge and attitudes of GPs regarding the accuracy of US for fracture diagnosis. Multicenter controlled trials could explore the usefulness and effectiveness of this seldom used diagnostic approach.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022101 ◽  
Author(s):  
Emily A Karanges ◽  
Anastasia Suraev ◽  
Natalie Elias ◽  
Ramesh Manocha ◽  
Iain S McGregor

ObjectivesTo examine the knowledge and attitudes of Australian general practitioners (GP) towards medicinal cannabis, including patient demand, GP perceptions of therapeutic effects and potential harms, perceived knowledge and willingness to prescribe.Design, setting and participantsA cross-sectional survey completed by 640 GPs (response rate=37%) attending multiple-topic educational seminars in five major Australian cities between August and November 2017.Main outcome measuresNumber of patients enquiring about medicinal cannabis, perceived knowledge of GPs, conditions where GPs perceived it to be beneficial, willingness to prescribe, preferred models of access, perceived adverse effects and safety relative to other prescription drugs.ResultsThe majority of GPs (61.5%) reported one or more patient enquiries about medicinal cannabis in the last three months. Most felt that their own knowledge was inadequate and only 28.8% felt comfortable discussing medicinal cannabis with patients. Over half (56.5%) supported availability on prescription, with the preferred access model involving trained GPs prescribing independently of specialists. Support for use of medicinal cannabis was condition-specific, with strong support for use in cancer pain, palliative care and epilepsy, and much lower support for use in depression and anxiety.ConclusionsThe majority of GPs are supportive or neutral with regards to medicinal cannabis use. Our results highlight the need for improved training of GPs around medicinal cannabis, and the discrepancy between GP-preferred models of access and the current specialist-led models.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Gordian Lukas Schmid ◽  
Beatrice Kühnast ◽  
Marcus Heise ◽  
Tobias Deutsch ◽  
Thomas Frese

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020605 ◽  
Author(s):  
Xiaojun Liu ◽  
Anran Tan ◽  
Samuel D Towne Jr ◽  
Zhaoxun Hou ◽  
Zongfu Mao

ObjectiveGeneral practitioners (GPs) are highly underutilised in China with many patients going directly to hospitals when seeking routine care. Multiple countries around the world have successfully used GPs in routine care, and as such, China may benefit from the use of GPs. This study examines the status of, and factors associated with, knowledge related to GPs among outpatient populations from China’s tertiary hospitals.DesignThis is a cross-sectional survey study.Study setting and participantsThe questionnaires were completed by 565 outpatients from four tertiary hospitals in China during 2016. Convenience sampling on different floors and throughout the outpatient building was carried out.Primary outcome measuresWe used the logistic regression models to identify GP-related knowledge among different populations.ResultsOverall, 50.27% of respondents said they had never heard of GPs. This was also true among females (adjusted OR (AOR)=1.57, 95% CI 1.43 to 2.71), older adults (AOR46–65=1.61, 95% CI 1.39 to 2.98; AOR>65=2.01, 95% CI 1.62 to 3.59), those with lower education level (AORBachelor’s degree=0.61, 95% CI 0.20 to 0.81; AOR≥Master’s degree=0.49, 95% CI 0.23 to 0.76), rural residents (AOR=1.51, 95% CI 1.35 to 2.82) and those with chronic disease (AORwithout chronic disease=0.61, 95% CI 0.22 to 0.71). What is more, less than one-in-ten (9.03%) outpatients were able to accurately describe what a GP was, with less than 30% accurately describing a GP among those receiving GPs’ services.ConclusionsOutpatients who could have received less costly health services from GPs in primary medical institutions were more likely to choose costlier specialist physicians in tertiary hospitals, which is likely linked to limited knowledge about GPs. Policy makers should invest in outreach efforts to improve public awareness of GPs, while at the same time conducting continued surveillance of these efforts to evaluate progress towards this goal.


2020 ◽  
Author(s):  
Shuma Gosha Kanfe ◽  
Nebyu Demeke Mengiste ◽  
Mohammedjud Hassen Ahmed ◽  
Gebiso Roba Debele ◽  
Berhanu Fikadie Endehabtu

BACKGROUND Evidence based practice is a key to increase effectiveness and efficiency of quality health services. To achieve this, utilization of health facility data (DHIS2 data) is required which is determined by knowledge and attitudes of health professionals. Thus, this study aimed to assess knowledge and attitudes of health professionals to use DHIS2 data for decision making. OBJECTIVE This study aimed to assess the knowledge, attitudes and its associated factors among health professionals to use DHIS2 data for decision making at South west of Ethiopia 2020 METHODS Cross sectional quantitative study methods was conducted to assess Knowledge and Attitudes of health professionals to use DHIS2 data. A total of 264 participants were approached. SPSS version 22 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done RESULTS Overall 130(49.2%) of the respondents had good knowledge to use DHIS2 data (95% CI: [43, 55.3]), whereas over 149 (56.4%) of the respondents had favorable attitudes towards the use of DHIS2 data for decision making purpose (95% CI: [53.2, 59.8]). Skills [AOR=2.20,95% CI:(1.16, 4.19)], Age [AOR= 1.92, 95% CI: (1.03, 3.59)] ,Resources[AOR=2.56, 95% CI:(1.35,4.86)], Staffing[AOR= 2.85, 95% CI : (1.49, 5.48)] and Experiences[AOR= 4.66, 95% CI: (1.94, 5.78)] were variables associated with knowledge to use DHIS2 data whereas Training [AOR= 5.59, 95% CI: (2.48, 5.42)], Feedback [AOR= 4.08, 95% CI: (1.87, 8.91)], Motivation [AOR=2.87, 95% CI: (1.36, 6.06)] and Health need [AOR=2.32, 95% CI: (1.10-4.92)] were variables associated with attitudes of health professionals to use DHIS2 data CONCLUSIONS In general, about half of the study participants had good knowledge of DHIS2 data utilization whereas more than half of respondents had favorable attitudes. Skills, resources, ages, staffing and experiences were the most determinant factors for the knowledge to use DHIS2 data whereas health need, motivation, feedback and training were determinant factors for attitudes to use DHIS2 data


Author(s):  
Musaab Elzain ◽  
Ahmed Bashir ◽  
Noreen Moloney ◽  
Colum P. Dunne ◽  
Brendan D. Kelly ◽  
...  

Objectives: To investigate the frequency, characteristics and impact of death threats by patients towards psychiatrists. Methods: A cross-sectional survey of psychiatrists (n = 60) was undertaken to investigate the frequency, characteristics and impact of death threats by patients in one Irish healthcare region serving a mixed urban–rural population of 470,000. Results: Forty-nine responses (82%) were received. Thirty-one per cent of respondents experienced death threats by patients during their careers. Victims were more likely to be male and in a consultant role. Patients making the threats were more likely to be males aged 30–60 with a history of violence and diagnosis of personality disorder and/or substance misuse. A majority of threats occurred in outpatient settings and identified a specific method of killing, usually by stabbing. Prosecution of the perpetrator was uncommon. Of the victimised psychiatrists, 53% reported that such threats affected their personal lives, and 67% believed their professional lives were impacted. In half of the incidents, there were adverse incidents subsequent to the threats, involving either the patient or the clinician. Conclusions: Death threats by patients have significant psychological and professional impacts on psychiatrists. Early liaison with employers and police and transferring the care of the patient to another clinician may be useful measures.


2001 ◽  
Vol 12 (2) ◽  
pp. 98-100 ◽  
Author(s):  
B Craig Lee

PURPOSE:To evaluate training in infectious diseases, determining which components of the training program best prepare residents for their career choices and where improvements are needed.METHOD:A cross-sectional survey was mailed to all 14 physicians who had graduated from both the Adult and Paediatric Infectious Diseases Training Program at the University of Calgary from 1985 to 1998. Responses about the adequacy of training were measured using a Likert-type scale and a qualitative questionnaire.RESULTS:Of 14 mailed questionnaires, nine responses were received (64%). Two-thirds of respondents were in an academic setting, and seven (78%) graduates obtained postfellowship training. The specialists in academic settings were all engaged in multiple nonclinical activities. The clinical and diagnostic microbiological components of training received the highest scores in terms of adequacy of training.CONCLUSION:Graduates of the University of Calgary training program indicated an overall satisfaction with their training. However, improvements are needed in career counselling, health administration, antibiotic utilization, infection prevention and specialized outpatient clinics. Potential strategies for addressing these issues include didactic lectures, enhanced exposure to clinical outpatient settings and provision of designated faculty mentors.


2021 ◽  
Vol 7 (6) ◽  
pp. 6609-6626
Author(s):  
Shuyuan Li

This study is a cross-sectional survey of the satisfaction of postoperative patients its relationship to the knowledge and attitudes of Chinese nurses on pain management. Data were sourced out from two groups of respondents participated in the study, 75 post-operative patients and 97 in-service nurses from the health institutions China. The study was conducted for five-months. Ethics protocols were observed before and after the conduct of the study. Findings showed that post-operative pain management program among the participating medical institutions in China were assessed to have moderate level of satiation by the patients. All the components namely pain relief experience, care provided by the nurses, education provided as to pain management, and therapeutic dialogue provided by the nurses were all assessed by postoperative Chinese patients at a fair level. Meanwhile, gender and education of post-operative patients can be considered as factors in the planning and implementation of pain management program. Consequently, similar to studies conducted worldwide, Chinese nurses do not establish yet an optimal level of knowledge and attitude towards pain management. Meanwhile age, experience, education are factors on the knowledge and attitude on pain management among nurses. Finally, positive moderate relationship is established between patient satisfaction and knowledge and attitudes of nursing staff towards pain management. The findings of these study call for action and reform in the implementation of pain management program focusing on the major role and development of 21st century nurses. Practical implications of the study are discussed.


BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022730 ◽  
Author(s):  
Rachel C Forcino ◽  
Renata West Yen ◽  
Maya Aboumrad ◽  
Paul J Barr ◽  
Danielle Schubbe ◽  
...  

ObjectiveIn this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.SettingWe administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.Participants272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.ResultsWe found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.ConclusionsRecent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.


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