Nigerian physiotherapists’ perception of direct access and patients’ self-referral

Background: The global advocacy for Direct Access (DA) and Patients’ Self-Referral (PSR) to physiotherapy is consistent with the quest for promoting professional autonomy and recognition. It was hypothesized in this study that the attainment of this clarion call in Nigeria may be hamstrung by challenges similar or different from those reported in other climes. Objective: This study assessed the perception of DA and PSR among Physiotherapists (PTs) in South-West, Nigeria. Methods: One hundred PTs from ten purposely selected public-funded out-patient facilities from South-West, Nigeria responded in this cross-sectional study, yielding a response rate of 75% (100/150). A previously validated questionnaire for World Confederation of Physical Therapists (WCPT) on the global view of DA and PSR for physical therapy was used in this study. Data was analyzed using descriptive statistics. Results: There was a high awareness on legislation regulating practice (91%) and scope (84%) of the profession. Respondents assert that the extant legislation allows for DA (49%) and PSR (97%). However, 40% of the respondents opined that the baccalaureate qualification of PTs was inadequate for competence in DA and PSR; and a post-professional residency programme was mostly recommended (52%). Public support for DA and PSR to physiotherapy was rated more than the advocacy role of the Nigeria Society of Physiotherapy (60% vs. 40%). Physicians’ (71%) and politicians’ (65%) views were rated the major barrier to achieving DA and PSR status in physiotherapy. Similarly, physicians’ (90%) and politicians’ (88%) support was perceived as the major facilitator. Conclusion: Physiotherapy practice in Nigeria has the semblance of autonomy in DA and PSR but is devoid of legislative support. Most Nigerian physiotherapists assume professional autonomy but were not aware of the lack of legal support for DA and PSR. The current entry-level academic curricula were considered to be deficient and inadequate for autonomous practice in Nigeria. Physicians and politicians were the most important barrier or facilitator to achieving legal support for DA and PSR in physiotherapy in Nigeria.

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Cross-sectional study to assess the healthcare professionals’ knowledge, attitude and practices about probiotics use in Pakistan

BMJ Open ◽

10.1136/bmjopen-2020-047494 ◽

2021 ◽

Vol 11 (7) ◽

pp. e047494

Author(s):

Muhammad Subhan Arshad ◽

Muhammad Saqlain ◽

Abdul Majeed ◽

Imran Imran ◽

Hamid Saeed ◽

...

Keyword(s):

Positive Attitude ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Study Data ◽

Good Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Major Barrier ◽

Professional Health ◽

Training Programmes

ObjectivesThe study aimed to assess the knowledge, attitude and practices (KAP) of HCPs regarding the use of probiotics in different health conditions and to identify various barriers that are associated with their use.MethodsA cross-sectional study was conducted on 405 HCPs by using a validated self- administered questionnaire for assessing their KAP towards probiotic use. The study data were analysed using descriptive statistics, χ2 test and binary logistic regression (BLR).ResultsAmong the 405 participants, only 15.1 % of HCPs had good knowledge, while 15.6% had acceptable practices and 89.1% had a positive attitude towards probiotics. The professional position of HCPs was significantly associated with knowledge (p=0.001) and practice (p=0.001). Among all the HCPs, the pharmacists showed a significant association with good knowledge (p=0.016) and good practices (p=0.024) by using BLR. The lack of knowledge about probiotics was a major barrier to the utilisation of probiotics.ConclusionsThe poor knowledge and practices regarding the use of probiotics have been seen in the current study. While the participants showed a positive attitude towards the utilisation of probiotics. To transform HCPs’ positive attitude to their practices and to create awareness regarding probiotic use focused training programmes should be initiated by professional health organisations.

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Physiotherapists’ perspectives on barriers to implementation of direct access of physiotherapy services in the United Arab Emirates: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0253155 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253155

Author(s):

Arwa Alnaqbi ◽

Tamer Shousha ◽

Hamda AlKetbi ◽

Fatma A. Hegazy

Keyword(s):

United Arab Emirates ◽

Cross Sectional Study ◽

Demographic Variables ◽

Professional Autonomy ◽

Direct Access ◽

Professional Status ◽

Sectional Study ◽

General Physician ◽

Cross Sectional ◽

The Impact

Background There are two primary ways of accessing physiotherapy for service users around the world. The direct access, as opposed to the indirect access which requires a referral from a general physician, has several merits including better quality, timeliness, cost effectiveness of treatment and better probability of preventing acute conditions from turning into chronic ailments. Despite these benefits, several countries including the UAE, do not allow direct access to physiotherapists. This study aims to understand the level of awareness among practicing physiotherapists in the United Arab Emirates (UAE) about direct access and to determine whether any of their demographic variables influence the way they perceive the concept. Further, the study sought to explore the perceived barriers and benefits of direct access according to the participating physiotherapists. Subjects and methods An observational cross-sectional study was employed. The questionnaire survey developed by Bury and Stokes in 2013 was adapted and employed in this study. The instrument had six sections with close-ended items using a Likert five-point scale to rate them. Two hundred and sixty-four physiotherapists answered the questionnaire shared with them through a web link. Finally, MANOVA was employed to explore any influence of demographic variables on the opinions of the respondents. Results The findings showed that 70% of participants were aware about direct access while nearly 30% were completely unaware. Younger physiotherapists were more willing to endorse the practice whereas older ones were more apprehensive of the barriers. The main barriers reported were the limited support from the physicians and policy makers, professional autonomy, and the limited scope of practice for the physiotherapists, as well as evidence-based practice. The impact of demographic variables on direct access indicated that physiotherapists under the age of 23 endorsed direct access more strongly than other age groups. Conclusion More efforts are needed to implement direct access in the UAE, considering the benefits of improved professional status, cost savings, patient satisfaction, and higher efficiency. This study recommends leadership support, professional autonomy, and mentorship as possible ways to achieve this goal.

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Implementation of the surgical safety checklist in hospitals of Iran; operating room personnel’s attitude, awareness and acceptance

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa-03-2017-0051 ◽

2018 ◽

Vol 31 (6) ◽

pp. 609-618

Author(s):

Mobin Sokhanvar ◽

Edris Kakemam ◽

Narges Goodarzi

Keyword(s):

Operating Room ◽

Cross Sectional Study ◽

Study Data ◽

Operating Room Personnel ◽

Cross Sectional ◽

Content Type ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

Validated Questionnaire ◽

The Impact

Purpose The WHO Surgical Safety Checklist (SSC) has improved patient safety effectively. Despite the known benefits of applying the checklist before surgery, its implementation is less than universal in practice. The purpose of this paper is to determine the operating room personnel’s attitude, their awareness and knowledge of the SSC, and to evaluate staff acceptance of the SSC (including personal beliefs). Design/methodology/approach This cross-sectional study was conducted in eight tertiary general hospitals in Tehran, Iran. Some 145 operating room personnel (surgeons, anaesthetists and nurses) were selected for the study. Data collection was carried out via a validated questionnaire in three parts which included socio-demographic, attitude, awareness and acceptance. Data were then analysed using the Kruskal–Wallis and χ2 statistical test. Findings Out of the 145 participants in the study, 92 per cent were aware of the existence of the SSC and 73.9 per cent of them were aware of the objectives of SSC. Overall, the attitude to SSC was positive. The attitude of surgeons was positive towards the impact of the SSC on safety and teamwork. Surgeons were significantly more sensitive to the barriers of SSC application compared to nurses and anaesthetists (p=0.046). Among the three groups, nurses had the highest level of support for SSC (p=0.001). Practical implications Despite high acceptance of the checklist among staff, there is still a gap in knowledge about when exactly the checklist should be used. Therefore, involvement of all surgical team members to complete the checklist process, support of senior managers, on-going education and training and consideration of the barriers to its implementation are all key areas that need to be taken into account. Originality/value This is the first research to examine the operating room personnel’s attitude, awareness and acceptance about SSC in Iranian hospitals. The outcomes of this study provide documentation and possible justification for effective establishment of SSC in Iran and other countries.

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Studying and More: Part-Time Employment as an Educational Challenge?

Journal of Medical Psychology ◽

10.3233/jmp-200024 ◽

2020 ◽

Vol 1 (1) ◽

pp. 57-63

Author(s):

Silke Heuse ◽

Cathrin Dietze ◽

Daniel Fodor ◽

Edgar Voltmer

Keyword(s):

Health Care ◽

Perceived Stress ◽

Health Care Professionals ◽

Cross Sectional Study ◽

Study Data ◽

Future Health ◽

Cross Sectional ◽

Professional Students ◽

Educational Challenge ◽

Part Time

Background: Future health-care professionals face stress both during education and in later professional life. Next to educational trainings, many students are forced to assume part-time employment. Objective: Applying the Job Demands-Resources Model to the educational context, we investigate which role part-time employment plays next to health-care professional students’ education-specific demands and resources in the prediction of perceived stress. Method: In this cross-sectional study, data from N = 161 health-care students were analysed, testing moderation models. Results: Education-specific demands were associated with higher and education-specific resources with lower amounts of perceived stress. Part-time employment functioned as moderator, i.e. demands were less associated with stress experiences in students who were employed part-time. Conclusion: Identifying part-time employment as a resource rather than a demand illustrates the need to understand students’ individual influences on stress. Both educators and students will benefit from reflecting these resources to support students’ stress management.

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Knowledge of non-healthcare individuals towards cardiopulmonary resuscitation: a cross-sectional study in Riyadh City, Saudi Arabia

International Journal of Emergency Medicine ◽

10.1186/s12245-021-00335-y ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Reema M. Alhussein ◽

Mansoor M. Albarrak ◽

Abdulaziz A. Alrabiah ◽

Nawfal A. Aljerian ◽

Hashim M. Bin Salleeh ◽

...

Keyword(s):

Health Care ◽

Saudi Arabia ◽

Cardiopulmonary Resuscitation ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Major Barrier ◽

Riyadh City ◽

Resuscitation Training ◽

The Media

Abstract Background Most sudden cardiac arrests occur at home, with low rates of bystander cardiopulmonary resuscitation being performed. We aimed to assess knowledge of cardiopulmonary resuscitation among individuals in Riyadh City, Saudi Arabia, who are not involved in health care. Methods A community-based cross-sectional study was conducted between January and February 2020 in 4 different areas in Riyadh City: North, South, East, and West. The participants were surveyed using a validated self-administered questionnaire. The Statistical Package for Social Sciences version 25.0 was used for inferential statistics and binary logistic regression analysis. Results A total of 856 participants completed the questionnaire, 51.8% were unaware of cardiopulmonary resuscitation. Only 4.4% of the participants had attended a formal cardiopulmonary resuscitation training course, 5.1% were campaign attendees, and 38.7% acquired their experience through the media. Having a higher level of education was positively associated with having knowledge of cardiopulmonary resuscitation. The main concern among attendees of cardiopulmonary resuscitation training courses and campaigns was legal issues, whereas inadequate knowledge was the major barrier for those who had learned about cardiopulmonary resuscitation through the media. Conclusion The level of knowledge of cardiopulmonary resuscitation among non-health care individuals in Riyadh City was found to be insufficient. Therefore, coordinated efforts among different authorities should be considered to implement a structured strategy aiming to increase awareness and knowledge of cardiopulmonary resuscitation among non-health care individuals.

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Bedtime Oral Hygiene Behaviours, Dietary Habits and Children’s Dental Health

Children ◽

10.3390/children8050416 ◽

2021 ◽

Vol 8 (5) ◽

pp. 416

Author(s):

George Kitsaras ◽

Michaela Goodwin ◽

Michael P. Kelly ◽

Iain A. Pretty

Keyword(s):

Oral Hygiene ◽

Dietary Habits ◽

Dental Health ◽

Cross Sectional Study ◽

Study Data ◽

General Anaesthetic ◽

Dental Disease ◽

Cross Sectional ◽

Important Relationship ◽

Bedtime Routine

Background: Oral hygiene behaviours as well as dietary habits before bed can affect children’s dental health resulting in higher prevalence of dental disease. Dental disease can affect children’s health, development and even school performance. If left untreated, dental disease can progress and it can lead to extractions under general anaesthetic causing further distress for children and families. Consistent and appropriate oral hygiene behaviours and dietary habits can prevent dental diseases from occurring in the first place. Objective: This cross-sectional study examines the relationship between oral hygiene behaviours, dietary habits around bedtime and children’s dental health. Methods: A total of 185 parents with children between the ages of 3 and 7 years from deprived areas participated in the study. Data on bedtime routine activities were collected using an automated text-survey system. Children’s dental health status was established through examination of dental charts and dmft (decayed, missed, filled teeth) scores. Results: In total, 52.4% of parents reported that their children’s teeth were brushed every night. The majority of children (58.9%) had dmft scores over zero. In total, 51 (46.7% of children with dmft score over 0 and 27.5% of all children) children had active decay. The mean dmft score for those experiencing decay was 2.96 (SD = 2.22) with an overall mean dmft score of 1.75 (SD = 2.24). There were significant correlations between frequency of tooth brushing, frequency of snacks/drinks before bed and dmft scores (r = −0.584, p < 0.001 and r = 0.547, p = 0.001 respectively). Finally, higher brushing frequency was associated with a lower likelihood of a dmft score greater than 0 (Exp(B) = 0.9). Conclusions: Despite families implementing oral hygiene behaviours as part of their bedtime routines those behaviours varied in their consistency. Results of this study highlight the need for additional studies that consider bedtime routine-related activities and especially the combined effects of oral hygiene practices and dietary habits due to their potentially important relationship with children’s dental health.

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Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

Journal of Primary Care & Community Health ◽

10.1177/21501327211035088 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110350

Author(s):

Pasitpon Vatcharavongvan ◽

Viwat Puttawanchai

Keyword(s):

Primary Care ◽

Primary Care Clinic ◽

Clinical Decision ◽

Cross Sectional Study ◽

Study Data ◽

Patient Specific ◽

Potentially Inappropriate Medications ◽

Cross Sectional ◽

Care Clinic ◽

Inappropriate Medications

Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.

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980. Drexel Medicine Resident Knowledge, Practices and Attitudes Regarding Pre-exposure prophylaxis (PrEP)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1166 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S518-S518

Author(s):

Jen E Mainville ◽

Ed Gracely ◽

Zsofia Szep

Keyword(s):

Internal Medicine ◽

Male Partner ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Cross Sectional ◽

Major Barrier ◽

Medicine Resident ◽

Highly Effective ◽

Prevention Method ◽

Exposure Prophylaxis

Abstract Background Pre-exposure prophylaxis (PrEP) is a highly effective daily oral antiretroviral medication that was approved by the FDA in 2012 and has been shown to reduce the risk of HIV by 95% in real-world studies. Despite this, many healthcare providers are not offering PrEP to their patients who are at risk for HIV. Methods We performed a cross-sectional study among Drexel Internal Medicine, Family Medicine, and Obstetrics and Gynecology residents. The survey included questions about experience, knowledge, attitudes toward and barriers to using PrEP. The survey was adapted from previous studies regarding medical providers’ attitudes and knowledge about PrEP (Petroll, 2016; Seifman, 2016; Blumenthal, 2105). A Likert 5-point scale was used for attitude and barriers questions. Results Among 143 participants, 80% specialized in Internal Medicine. 43% of participants were in their first year of training and the mean age (+ SD) was 28.8 + 2. 76% reported never initiating a conversation about PrEP with a patient and only 18% reported ever prescribing PrEP to their patients. 92% reported being very or extremely willing to prescribe PrEP to a male with a current male partner known to be HIV positive. Only 43% of residents reported being moderately likely to prescribe PrEP to a patient coming in for a STI exposure. 68% of residents reported their knowledge about PrEP was a major barrier to prescribing PrEP. Conclusion We found that most residents have minimal experience with prescribing PrEP, and knowledge was identified as the largest barrier. Additional education and a better understanding of PrEP indications is necessary to ensure eligible PrEP patients have access to this highly effective HIV prevention method. Disclosures All Authors: No reported disclosures

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Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-040352 ◽

2021 ◽

Vol 11 (7) ◽

pp. e040352

Author(s):

Avinash Sharma ◽

Olusegun Isaac Alatise ◽

Kelli O'Connell ◽

Samson Gbenga Ogunleye ◽

Adewale Abdulwasiu Aderounmu ◽

...

Keyword(s):

Cancer Screening ◽

Cancer Care ◽

Healthcare Utilisation ◽

Cross Sectional Study ◽

Personal Income ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Potential Barriers ◽

South West

Background/aimsCancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.MethodsIn April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.ResultsWe enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists.ConclusionsDespite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.

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The prescription pattern and awareness about antibiotic prophylaxis and resistance among a group of Egyptian pediatric and general dentists: a cross sectional study

BMC Oral Health ◽

10.1186/s12903-021-01685-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mariam Mohsen Aly ◽

Marwa Aly Elchaghaby

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Prophylaxis ◽

Antibiotic Prescription ◽

Public Health Problem ◽

Cross Sectional Study ◽

Major Public Health Problem ◽

Eligibility Criteria ◽

Cross Sectional ◽

Validated Questionnaire ◽

General Dentists

Abstract Background The use of antibiotics in dentistry as prophylaxis and treatment is frequent. Their misuse has led to a major public health problem globally known as antibiotic resistance. This study aimed to assess the pattern of antibiotic prescription and its prophylactic use for systemic conditions. Besides, this study evaluated the awareness and adherence to antibiotic prescription guidelines and antibiotic prophylaxis guidelines along with awareness of antibiotic resistance across pediatric and general dentists. Methods An overall of 378 pediatric and general dentists meeting the required eligibility criteria, fulfilled a pre-designed validated questionnaire. Data were collected, tabulated, and statistically analyzed. Results A significant statistical difference was found among the pediatric and general dentists regarding antibiotics prescription for most of the oral conditions where Amoxicillin with clavulanic acid was the most frequently prescribed antibiotic among the two groups (53% pediatric dentist and 52% general dentist). The majority of pediatric and general dentists, on the other hand, were aware of antibiotic resistance and prescribing recommendations. Conclusions The present study showed a tendency to overprescribe and overuse antibiotics in certain dental conditions among the participants. The vast majority of dentists, especially general dentists do not have adherence to professional guidelines for antibiotics prescription in children despite their awareness of antibiotic resistance and prescription guidelines.

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