PedHITSS: A Screening Tool to Detect Childhood Abuse in Clinical Settings

Background and Objectives: Though child abuse is prevalent and detrimental, health care providers fail to screen for abuse at sufficient rates to detect or preempt events. Current child abuse screening tools lack brevity and usefulness in clinical settings. To validate the Pediatric Hurt-Insult-Threaten-Scream-Sex (PedHITSS) screening tool, a 5-item questionnaire designed to detect and prompt provider investigation into child abuse in clinical settings, the PedHITSS was compared to the Conflict Tactics Scale: Parent-Child Version (CTSPC) screening measure. Methods: Participants included 422 pediatric patients (n=242 nonabused; n=180 abused subsample) recruited from an ambulatory care setting, a medical center at-risk referral clinic, or homeless shelter clinic. Parents were asked to complete a cross-sectional survey, including PedHITSS and CTSPC questionnaires. Concurrent validity of PedHITSS was tested with 242 participants identified as nonabused. Construct validity was assessed with 180 participants previously identified as victims of child abuse. Results: Concurrent validity between the CTSPC and PedHITSS was strong, rs=.70 (P<.01). Sensitivity and specificity for correctly identifying abuse victims (≤12 years) was optimal at a cutpoint of one or greater. There was no significant difference in sensitivity and specificity of HITSS and CTSPC in correctly identifying victims of child abuse. Conclusions: This study indicates that PedHITSS performs as well as CTSPC in identifying and differentiating victims and nonvictims of child abuse. PedHITSS allows health care providers to confidently screen and report suspected cases of child abuse and serves as a mechanism to confirm abuse status through validated means.

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Implementation of Mobile Audiometry During the COVID-19 Pandemic

Otolaryngology ◽

10.1177/01945998211051588 ◽

2021 ◽

pp. 019459982110515

Author(s):

Alejandro Garcia ◽

Divya A. Chari ◽

Konstantina M. Stankovic ◽

Daniel J. Lee ◽

Elliott D. Kozin ◽

...

Keyword(s):

Health Care ◽

Emergency Department ◽

Hearing Loss ◽

Sensitivity And Specificity ◽

Health Care Providers ◽

Screening Tool ◽

Care Providers ◽

Air Conduction

During the COVID-19 pandemic, the utility of portable audiometry became more apparent as elective procedures were deferred in an effort to limit exposure to health care providers. Herein, we retrospectively evaluated mobile-based audiometry in the emergency department and outpatient otology and audiology clinics. Air conduction thresholds with mobile audiometry were within 5 dB in 66% of tests (95% CI, 62.8%-69.09%) and within 10 dB in 84% of tests (95% CI, 81.4%-86.2%) as compared with conventional audiometry. No significant differences were noted between mobile-based and conventional audiometry at any frequencies, except 8 kHz ( P < .05). The sensitivity and specificity for screening for hearing loss were 94.3% (95% CI, 91.9%-96.83%) and 92.3% (95% CI, 90.1%-94.4%), respectively. While automated threshold audiometry does not replace conventional audiometry, mobile audiometry is a promising screening tool when conventional audiometry is not available.

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A comparison of women’s expectations of labour and birth with the experiences in primiparas and multiparas with normal vaginal delivery

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v4i1.15024 ◽

2016 ◽

Vol 4 (1) ◽

pp. 16-25 ◽

Cited By ~ 1

Author(s):

Manijeh Pirdil ◽

Leila Pirdel

Keyword(s):

Health Care ◽

Vaginal Delivery ◽

Health Care Providers ◽

Normal Vaginal Delivery ◽

Care Providers ◽

Medical College ◽

Childbirth Experience ◽

Significant Difference ◽

Negative Expectations

Background: Maternal childbirth expectations play an important role in determining a woman’s response to her childbirth experience. Women need to be helped to develop realistic and positive expectations and identify the factors that influence these expectations.Objective: The aim of this study was to compare woman’s expectations and experiences of childbirth.Methods: This descriptive-comparative study was carried out in Tabriz Alzahra Hospital from 2006 to 2007. For this purpose, a total of 600 primiparas and multiparas women who were candidates for vaginal delivery, were randomly selected and interviewed. The data were collected by questionnaire.Results: Comparison of the means of mothers expectation and experience of labor and birth between the two groups demonstrated a statistically significant difference (p<0.05). The findings indicated a number of differences exist between primiparas and multiparas women in relation to expectations and experiences of birth when compare two groups. The majority of women had negative expectations and experiences of childbirth.Conclusion: The evaluation and understanding of birth expectations and experiences as positive and negative is priority of maternity system. Antenatal educators need to ensure that pregnant women are appropriately prepared for what might actually happen to limit this expectation-experience gap. Health-care providers should improve the quality of antenatal care which can change negative childbirth expectations and experiences of womenJournal of Kathmandu Medical College, Vol. 4(1) 2015, 16-25

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The Effect of "Pathway" to Diagnosis for Childhood ITP on Caregiver Quality of Life at Time of Diagnosis

Blood ◽

10.1182/blood-2019-125686 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 2174-2174

Author(s):

Michelle Neier ◽

Michele P. Lambert ◽

Rachael F. Grace ◽

Kerry Hege ◽

Stephanie Chiu ◽

...

Keyword(s):

Health Care ◽

Health Care Provider ◽

Health Care Providers ◽

Care Provider ◽

Research Funding ◽

Care Providers ◽

Significant Difference ◽

Time To Diagnosis ◽

The Impact

Background: Immune thrombocytopenia (ITP) is an immune mediated bleeding disorder characterized by isolated thrombocytopenia. ITP can have a variety of presentations from asymptomatic to life threatening bleeding. Although childhood ITP is most often a self-resolving illness which can be closely observed without intervention, it can be associated with significant impact on quality of life (QoL). Prospective studies of QoL in ITP patients show that there is not always a correlation with treatment or disease severity. The pathway from initial presentation to final diagnosis varies and may include encounters with emergency room, primary care or specialty providers. There have been no published studies to date showing the impact of factors prior to the diagnosis of ITP on treatment decision making and QoL. Objective: To identify the role of physician-patient and physician-caregiver interactions on the QoL and emotional well-being of patients and their families. Ascertaining the impact of pre-diagnosis factors may provide an opportunity to improve access and quality of care provided. Methods: The ITP Consortium of North America (ICON) "Pathways" study was a multicenter observational prospective cohort study focused on the pathways to diagnosis of ITP. The study was supported by a Foundation for Morristown Medical Center Research Fund Grant. Subjects were included if they had presumed primary ITP and were age >12 months to <18 years. Subjects were excluded if they had secondary ITP, including Evans syndrome. Treatment was determined by the physician. Subjects were consented and presented with questionnaires to be completed at the conclusion of the initial hematology visit. The hematologist also completed survey data at that time. Survey data forms included demographic form, physician form, Peds QL Family Impact Questionnaire, Kids ITP tools (KIT) Parent Impact Report and parent proxy report, and child (patient) KIT self-report. There was a parent questionnaire which included a question about worry with a scale from 0 to 10. Study data were collected and managed using REDCap electronic data capture tools hosted at Atlantic Health System. Correlation between variables were calculated using Pearson coefficient or Spearman's rho depending on the distribution of the data variables. Results: Sixty subjects and caregivers were enrolled at 6 ICON centers; 52 were eligible for inclusion. The majority (40%) had Grade 1 bleeding. Most patients (82%) were seen in outpatient hematology clinic by the hematologist and had been referred by the emergency room (73%). The median time to consultation with a hematologist from onset of symptoms was 7 days (1-199) and the median time to diagnosis by hematologist from initial contact with a health care provider was 5 days (0-154). Most subjects had seen 2 health care providers prior to the hematologist. KIT proxy report cumulative scores were a mean of 76.03 (SD 14.72). There was no significant difference between the time to diagnosis or the time from initial encounter with health care provider to hematologist and initial level of worry (p=0.70 and 0.90, respectively). There was also no significant difference between the time to diagnosis or the time from initial encounter with health care provider to hematologist and KIT proxy scores (p=0.96 and 0.50, respectively). However, there was a significant decline in level of worry (scale 0-10) prior to the hematologist visit (median 8, range 1-10) to after the visit (median 4, range 1-10). The association between number of medical providers encountered prior to diagnosis and KIT proxy scores was not significant (p=0.45) (Table). Conclusions: In this study at 6 teaching institutions, we were unable to detect a significant difference in proxy-reported KIT scores relative to the number of health care providers seen or time from diagnosis until the first encounter with the hematologist. We were, however, able to detect a significant change in the level of caregiver worry pre- and post- visit with the pediatric hematologist, supporting a benefit of specialist care to the caregivers of children with ITP. This study was limited by its small sample size and retrospective design. ITP is considered a benign disease but is associated with a significant amount of worry and impact on QoL for patients and caregivers which warrants further investigation. Disclosures Lambert: CSL Behring: Consultancy; Amgen: Consultancy, Other; Bayer: Other: Ad boards; Novartis: Other: Ad boards, Research Funding; Shionogi: Consultancy; Kedrion: Consultancy; Sysmex: Consultancy; AstraZeneca: Research Funding; PDSA: Research Funding. Grace:Agios Pharmaceuticals, Inc: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Research Funding.

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Health care provider’s experiences, practices, and recommendations for interventions and screening of cystic fibrosis patients with disordered eating: A qualitative analysis

Chronic Illness ◽

10.1177/1742395319881182 ◽

2019 ◽

pp. 174239531988118

Author(s):

Virginia Quick ◽

Grace Chang

Keyword(s):

Health Care ◽

Cystic Fibrosis ◽

Disordered Eating ◽

Health Care Providers ◽

Eating Behaviors ◽

Screening Tool ◽

Pancreatic Enzyme ◽

National Standard ◽

Care Providers ◽

Disordered Eating Behaviors

Objectives To investigate health care providers’ perspectives on their experiences and practices with cystic fibrosis patients exhibiting disordered eating behaviors and their recommendations for interventions and screening of this population. Methods Experienced health care providers (N = 17) were recruited from the Cystic Fibrosis Foundation listserv to participate in a semi-structured interview via phone. Two trained qualitative researchers independently coded audio-recorded interview scripts. Major themes were generated from questions inquiring health care providers’ perspectives on their experiences and practices with cystic fibrosis patients exhibiting disordered eating behaviors and their recommendations for better interventions and screening of disordered eating. Results The most prominent disordered eating behaviors observed by health care providers in cystic fibrosis patients were misusing pancreatic enzyme medication (53%), food restriction behaviors (47%), binge eating (29%), and skipping meals (29%). Over half (53%) of health care providers reported not having policies or procedures for disordered eating of cystic fibrosis patients. All health care providers thought it would be beneficial to have a cystic fibrosis-specific disordered eating screening tool. Recommendations by health care providers included developing a national standard protocol for cystic fibrosis disordered eating and educational training for health care providers. Discussion Ongoing development of evidence-based guidelines for screening and treating disordered eating among cystic fibrosis patients is warranted including development of a cystic fibrosis-specific disordered eating screening tool.

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Dignity and palliative end-of-life care

10.1093/med/9780199656097.003.0106 ◽

2015 ◽

Cited By ~ 1

Author(s):

Harvey Max Chochinov ◽

Susan E. McClement ◽

Maia S. Kredentser

Keyword(s):

Health Care ◽

End Of Life ◽

Health Care Providers ◽

End Of Life Care ◽

Vulnerable Groups ◽

Clinical Settings ◽

Life Care ◽

Care Providers ◽

Key Aspects ◽

To Receive

The concept of dignity continues to receive attention in health care, with particular implications for end-of-life care. This chapter reviews current conceptualizations of dignity, integrating medical, philosophical, and ontological perspectives. The centrality of dignity to palliative care is discussed, exploring empirical findings, which examine what dignity means to patients and families in the context of illness and end-of-life care. The chapter provides an overview of validated tools, evidence-based therapies, and practical ‘everyday’ communication skills that health-care providers in diverse clinical settings can use to enhance patient dignity. Suggestions are provided for extending existing research into the notion of dignity as it relates to vulnerable groups, and how interventions aimed at supporting patient dignity can impact family members. Dignity subsumes many key aspects of comprehensive care, which can guide health-care providers towards improving end-of-life experiences for patients and families.

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Factor structure of The Opening Minds Stigma Scale for Health Care Providers and psychometric properties of its Hungarian version

BMC Psychiatry ◽

10.1186/s12888-020-02902-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Dorottya Őri ◽

Sándor Rózsa ◽

Péter Szocsics ◽

Lajos Simon ◽

György Purebl ◽

...

Keyword(s):

Health Care ◽

Psychometric Properties ◽

Factor Structure ◽

Health Care Providers ◽

Concurrent Validity ◽

General Factor ◽

Care Providers ◽

Specific Factors ◽

Test Retest Reliability ◽

Hungarian Version

Abstract Background The Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a widely used questionnaire to measure the stigmatising attitudes of healthcare providers towards patients with mental health problems. The psychometric properties of the scale; however, have never been investigated in Hungary. We aimed to thoroughly explore the factor structure of the OMS-HC and examine the key psychometric properties of the Hungarian version. Methods The OMS-HC is a self-report questionnaire that measures the overall stigmatising attitude by a total score, and three subscales can be calculated: Attitude, Disclosure and Help-seeking, and Social Distance. Our study population included specialists and trainees in adult and child psychiatry (n = 211). Exploratory and confirmatory factor analyses were performed, and higher-order factors were tested. We calculated the test-retest reliability on a subgroup of our sample (n = 31) with a follow-up period of 1 month. The concurrent validity of the scale was measured with the Mental Illness: Clinician’s Attitudes-4 scale (MICA-4). Results Three factors were extracted based on a parallel-analysis. A bifactor solution (a general factor and three specific factors) showed an excellent model-fit (root mean square error of approximation = 0.025, comparative fit index = 0.961, and Tucker-Lewis index = 0.944). The model-based reliability was low; however, the general factor showed acceptable reliability (coefficient omega hierarchical = 0.56). The scale demonstrated a good concurrent validity with the MICA-4 [intraclass correlation coefficient (ICC) = 0.77]. The test-retest reliability was excellent for the general factor (ICC = 0.95) and good for the specific factors (ICC = 0.90, 0.88, and 0.84, respectively). Conclusions The three dimensions of the OMS-HC was confirmed, and the scale was found to be an adequate measure of the stigmatising attitude in Hungary. The bifactor model is more favourable as compared to the three correlated factor model; however, despite the excellent internal structure, its model-based reliability was low.

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Self-efficacy among patients with chronic diseases and its associated factors

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v7i3.22675 ◽

2018 ◽

Vol 7 (3) ◽

pp. 82-88

Author(s):

Dayana Shakya

Keyword(s):

Health Care ◽

Body Mass Index ◽

Chronic Disease ◽

Chronic Diseases ◽

Body Mass ◽

Health Care Providers ◽

Self Efficacy ◽

Care Providers ◽

Modifiable Factors ◽

Significant Difference

Background: Chronic diseases are in an increasing trend worldwide. Although, this rise may be due to a number of factors, one reason for the worldwide increase is due to better treatment protocols and higher awareness among patients. The management of chronic disease depends on the patient’s ability to alter the modifi able risk factors. The burden of disease can be decreased with better self- efficacy. Objectives: To assess the self-efficacy among patients with chronic diseases Methodology: In this descriptive, cross sectional study, data was collected purposively from 329 patients with chronic diseases presenting in the Medical outpatient department of Kathmandu Medical College. Face to face interview method was used to collect data using Chronic Disease Self-efficacy Scale and Patient Assessment Chronic Illness Care Questionnaire. Association with selected socio demographic variables were computed with Mann Whitney U and Kruskal Wallis H tests. Results: The mean age of the patients was 62±13 years. Males, those earning, those never admitted in the hospital for their disease and those who exercised were found to have better self-efficacy. There was significant difference in self-efficacy in terms of age, education, marital status, caregivers and body mass index. Self-efficacy showed significant positive correlation with monthly family income and health care provider score whereas significant negative correlation with age and monthly cost of treatment. Conclusion: Self-efficacy of patients with chronic disease can be improved with certain modifiable factors like daily exercise and appropriate body mass index. Younger patients, males, educated, employed and married patients were found to have better self-efficacy. Proper counselling by health care providers also improves self-efficacy.

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MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽

10.1017/cem.2019.169 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S54-S55

Author(s):

E. Mercier ◽

A. Nadeau ◽

A. Brousseau ◽

M. Emond ◽

J. Lowthian ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Emergency Department ◽

Physical Abuse ◽

Health Care Providers ◽

Scoping Review ◽

Elder Abuse ◽

Community Dwelling ◽

Screening Tools ◽

Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

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Educational Skills Evaluation among Health Care Providers (Behvarzan) in Educating of Clients Who Referred to the Health Care Homes

Global Journal of Health Science ◽

10.5539/gjhs.v9n1p112 ◽

2016 ◽

Vol 9 (1) ◽

pp. 112

Author(s):

Eshagh Ildarabadi ◽

Hamed Mortazavi ◽

Ali Talebi ◽

Toktam Kianian ◽

Saman Saber

Keyword(s):

Health Care ◽

Health Care Providers ◽

Study Data ◽

Internet Usage ◽

Care Providers ◽

Cross Sectional ◽

The Public ◽

Care Givers ◽

Significant Difference ◽

Health Homes

INTRODUCTION: Health care providers (Behvarzan) are the primary health care givers and their educational skills are an important factor to offer safe health care and promote the public health. So that this study was conducted to evaluate the educational skills among health care providers in educating the referrals to health homes.METHODS: This cross-sectional was conducted in health homes of Esfarayen health care network in 2015. By the method of enumeration 81 health care providers were included to the study. Data was collected by the questionnaire of evaluating the educational skills of Behvarz(s) designed by the researcher. Data were analyzed through descriptive statistics and analytical tests such as Pearson's correlation, independent T-test and ANOVA by the SPSS v.20.RESULTS: The results of this study had shown that 45.7% of subjects had good educational skills. Also the statistical calculation showed a significant difference between some variables such as internet usage (p=0.008) and internet usage in workplace (p=0.001) with Behvarz(s) educational skills.CONCLUSION: The educational skills of Behvarz(s) working in health homes was satisfactory. A significant relation was found between educational skills and some other factors. So then planning for upgrading the educational skills of Behvarz(s) and conducting much more studies to find effective factors on educational skills is recommended.

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Knowledge and attitudes of permanent chemotherapy-induced alopecia among health care providers.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.142 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 142-142

Author(s):

Jenna Rose Stoehr ◽

Cory Kosche ◽

Jennifer N. Choi

Keyword(s):

Health Care ◽

Health Care Providers ◽

Nurse Practitioners ◽

Care Providers ◽

Chi Square ◽

Hospital System ◽

Medical Specialties ◽

General Internal ◽

Correct Definition ◽

Significant Difference

142 Background: Reports of permanent chemotherapy-induced alopecia (PCIA) are increasing in the field of oncodermatology, but there is a dearth of information regarding how it is recognized and managed by health care providers (HCPs) across different medical specialties. Methods: An electronic survey was distributed to HCPs (resident physicians, attending physicians, and nurse practitioners) in the departments of dermatology, oncology, and general internal medicine (GIM) within one Midwestern hospital system. Results: Of the 62 participants (response rate: 13%), there were 19 from dermatology, 20 from oncology, and 23 from GIM. Responses were analyzed with descriptive statistics, and chi-square and ANOVA tests. There was a significant difference in the number of subjects that had heard of PCIA prior to starting the survey (Derm: 79%, Onc: 30%, GIM: 22%, p<0.05). A larger percentage of dermatology and oncology HCPs knew the correct definition of the condition (alopecia persisting >6 months) than GIM (42% and 45% vs. 17%) and significantly more had encountered patients with the condition (47% and 45% vs. 17%). More providers in dermatology and GIM knew how to diagnose PCIA compared to oncology (84% and 83% vs. 70%). Dermatology HCPs were the only participants who had attempted to treat patients with PCIA. Most providers across the three specialties believed that patients would accept PCIA treatment that was topical, oral, injectable, and required frequent administration or monitoring, but not treatment that was expensive or high risk. A majority of HCPs surveyed (94%) agreed that the diagnosis of PCIA is important. However, there was a significant difference in the confidence of HCPs in diagnosing and managing PCIA. A minority of dermatology providers (2/19) specified that they would refer to an alopecia or oncodermatology specialist, while the majority of oncology and GIM providers would refer to dermatology. Conclusions: The results of this survey identify knowledge gaps about PCIA amongst health care providers. Therefore, education and multidisciplinary engagement should be pursued in order to improve awareness, diagnosis, referral, and management of PCIA as part of survivorship care.

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