scholarly journals Learning needs of family physicians, pediatricians and obstetricians to support breastfeeding and inform physician education

2021 ◽  
Author(s):  
Krista Baerg ◽  
Juliet Smith-Fehr ◽  
Joshua Marko ◽  
Amanda Loewy ◽  
Jill Blaser Farrukh ◽  
...  
Keyword(s):  
Family Physicians ◽  
Informed Choice ◽  
Physician Education ◽  
Learning Needs ◽  
Breastfeeding Support ◽  
Cross Sectional Survey ◽  
Tertiary Institution ◽  
Cross Sectional ◽  
Mean Values ◽  
Breastfeeding Education

Background: Physicians require breastfeeding education appropriate to their roles. The aim of this survey was to determine physician learning needs and to inform development of breastfeeding education for physicians. Methods: A cross sectional survey was distributed to family physicians, pediatricians and obstetricians in a tertiary institution. Importance of knowledge to practice and confidence to manage was assessed for 18 learning topics proposed by a multi-specialty physician working group. Descriptive statistics, ANOVA and tests for equality of variances were calculated. Mean values of importance to practice and confidence to manage for each topic suggested learning priorities. Results: The study group included 75 physicians. The most important topics were “informed choice when supporting newborn feeding,” “analgesics, antidepressants and other medications while breastfeeding” and “community resources for breastfeeding support.”  Confidence to manage was lowest for “latch assessment,” “what mom can do during pregnancy to promote milk production,” and “risk factors for delayed lactogenesis.” Preferred learning formats were 15-minute online modules and grand rounds. Conclusions: Physicians acknowledged the importance of all topics but report lowest confidence to manage latch assessment, prenatal interventions to support lactogenesis and management of delayed lactogenesis.  Participants placed relatively low importance on learning about latch assessment despite the central nature of this skill in supporting early breastfeeding.

scholarly journals 31. Influenza Vaccination During Pregnancy: A Descriptive Cross-sectional Survey of the Knowledge, Beliefs, and Attitudes of Mexican Gynecologists and Family Physicians

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Erika Z Lopatynsky-Reyes ◽  
Sue Ann Costa-Clemens ◽  
Enrique Chacon-Cruz ◽  
Michael Greenberg
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Latin American ◽  
Vaccine Coverage ◽  
Family Physicians ◽  
Morbidity And Mortality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Beliefs And Attitudes ◽  
In Pregnancy

Abstract Background Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are both safe and effective in pregnancy, supporting routine use in this population. Even though influenza vaccination in Mexico is recommended for pregnant women, there are no publications of influenza vaccine coverage in pregnancy. This is the first Latin American survey done only in physicians aiming to assess the knowledge, beliefs, and attitudes that Mexican Obstetrics-Gynecologists (OBG) and Family Physicians (FP) have towards influenza and influenza immunization during pregnancy. Methods A cross-sectional survey was conducted, both paper-based and online. The questionnaire was composed of 35 questions, which addressed general knowledge of influenza, recommendations for vaccination during pregnancy, and beliefs and attitudes concerning the acceptability of the vaccine in pregnant women. Results A total of 206 completed surveys were available, 98 (47.6%) from OBG, 108 (52.4%) from FP. Regarding current practicing medical institutions, 76 (37%), 69 (34%), 31 (14.5%), 30 (14.5%) reported working for the Mexican Institute of Social Security, Private Sector, Secretariat of Health, or a combination of all respectively, representing an estimated 2,472 daily pregnancy consultations. About a quarter (26.2%) reported not having a notion that influenza is more severe among pregnant women. More than half (51.5%) ignored the potential side effects of influenza infection on the fetus. The majority (56.8%) did not know when vaccination during pregnancy should occur. Pregnancy as a risk factor for developing influenza complications was known only in 48.1%. Also, 46.1 % believed that vaccination only confers protection to the mother, but not to the fetus. Nevertheless, 96.1% considered that immunization against influenza during pregnancy is a safe and effective preventive intervention. A results’ summary is shown in Figure-1. Conclusion Based on this survey, current knowledge of OBG and FP for influenza morbidity and mortality during pregnancy, and the importance of influenza vaccination in pregnant women, is poor. Mandatory recommendations to educate medical providers regarding influenza vaccination during pregnancy in Mexico are necessary, even as imperative for CME credits. Disclosures All Authors: No reported disclosures

scholarly journals Breastfeeding support and barriers to women with gestational diabetes mellitus: a nationwide cross-sectional survey of hospitals in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mayumi Matsunaga ◽  
Yaeko Kataoka ◽  
Yumiko Igarashi ◽  
Toshiko Fukui ◽  
Masumi Imura ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
General Information ◽  
Breastfeeding Support ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Organizational Barriers

Abstract Background Despite the benefits of breastfeeding for women with Gestational Diabetes Mellitus (GDM) and their infants, breastfeeding is less likely to be performed by this group. This study aimed to examine the current levels of implementation of breastfeeding support to women with GDM in Japan and to clarify barriers to promoting breastfeeding among this population. Methods A 25-item questionnaire was developed by the authors to investigate the current levels of implementation of breastfeeding support for women with GDM provided in hospitals, and to explore barriers for promoting breastfeeding among these women. The questionnaire was sent to all 1046 hospitals facilitating childbirth in Japan. Descriptive statistics were used to analyze the quantitative data, and content analysis was used to analyze qualitative data from the open-ended questions. Results All 296 respondents were included in this study. Regarding breastfeeding support, 95.2% of the respondents provided general information on breastfeeding to GDM women during antenatal midwife consultations. However, the benefits of breastfeeding for preventing type 2 diabetes were addressed by only 48.0%. Likewise, although follow-up services (e.g., telephone support or breastfeeding consultations) were conducted in 88.9% of hospitals, only 50.7% of hospitals informed women that breastfeeding decreases the risk of developing type 2 diabetes after GDM. Regarding barriers, seven categories and 20 subcategories about promoting breastfeeding for women with GDM were extracted and abstracted into the following three themes: Barriers associated with mother and infant, Barriers associated with health professionals, and Organizational barriers. Conclusions In Japan, most hospitals that responded provided general breastfeeding support from the antenatal to postpartum periods. However, the benefits of breastfeeding in terms of preventing the incidence of type 2 diabetes following GDM were insufficiently communicated to women with GDM. Furthermore, there were numerous barriers to promoting breastfeeding among women with GDM.

scholarly journals Areas of Work Life as Predictors of Occupational Burnout of Nurses and Doctors in Operating Theaters in Poland—Multicenter Studies

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 26
Author(s):  
Piotr Jarzynkowski ◽  
Renata Piotrkowska ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Janina Książek
Keyword(s):  
Emotional Exhaustion ◽  
Maslach Burnout Inventory ◽  
Work Life ◽  
Personal Accomplishment ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Occupational Burnout ◽  
Multicenter Studies ◽  
Cross Sectional ◽  
Mean Values

Introduction: Researchers’ interest in occupational burnout results primarily from the dangerous and extensive consequences of this phenomenon. The aim of the study was to analyze the level of occupational burnout among nurses and doctors in operating theaters. Materials and Methods: A cross-sectional survey study conducted on 325 nurses and doctors of seven hospitals in Poland. The Maslach Burnout Inventory (MBI) and the Areas of Worklife Survey (AWS) by Michael Leiter and Christina Maslach. Results: The mean values for the level of occupational burnout for the entire sample according to the scale from the Maslach Burnout Inventory by C. Maslach amounted to 14.35 for emotional exhaustion, 8.56 for depersonalization, and 11.90 for personal accomplishment; when compared to reference levels, they classified emotional exhaustion at a low level, depersonalization at an average level, and personal accomplishment at a high level of burnout. Areas of work life are predictors of occupational burnout. The analysis showed a relationship between three of the six variables. As the workload increased, so did the level of burnout among participants, and the categories of honesty and values. Conclusions: The conducted research has shown that occupational burnout among nurses and doctors in operating theaters occurs in all dimensions of this phenomenon (emotional exhaustion, depersonalization, job satisfaction). It was also shown that the areas of work life (workload, control, community, rewards, fairness, values) are predictors of occupational burnout among the respondents. This article shows how important the problem of burnout among operating theater medical staff is. Perhaps it will allow nurses and doctors to recognize this syndrome and encourage them make changes to their work to prevent burnout.

SO005BARRIERS TO PERITONEAL DIALYSIS IN SASKATCHEWAN CANADA: RESULTS FROM A PROVINCE WIDE SURVEY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bhanu Prasad ◽  
Lucas Diebel ◽  
Maryam Jafari ◽  
Sachin Shah
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Option ◽  
Formal Education ◽  
Informed Choice ◽  
Patient Specific ◽  
Educational Strategies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Active Involvement

Abstract Background and Aims Peritoneal dialysis (PD) offers similar clinical outcomes to hemodialysis (HD) at a fraction of the cost. PD remains underutilized as remote HD patients in the province of Saskatchewan often relocate or travel hundreds of kilometers weekly in order to receive dialysis related care. Many barriers to patient uptake of PD have been described, but the scale of their impact on our patient population have not been quantified. To improve uptake of peritoneal dialysis in Saskatchewan, we need to address the most prominent barriers to patient access to PD to ensure that they truly have a choice in determining the modality with which they choose to dialyze. The purpose of this study was to determine the barriers to receiving PD in Saskatchewan Method We conducted a cross sectional survey of in-center HD patients across the province of Saskatchewan, Canada. A total of 740 in-center HD patients at two academic sites and 7 satellite units were approached by study coordinators. 421 patients (n=268 in the main units and n=153 in the satellite units) agreed to participate in the study. A questionnaire using a five-point Likert scale was created to identify barriers to PD with questions addressing PD awareness and knowledge, accessibility, and risks, fears, beliefs surrounding PD. Responses were anonymous and tabulated using a data collection tool. Survey data were summarized using descriptive statistics. Results 45.9% of participants had more than 12 years of formal education. 11% lived on farm, 19% on reserve, and 71% in town/city. The median (interquartile range=IQR) distance of home to in-center dialysis units was 10 (5-70) kilometers. Only 82% of patients were aware of PD as a treatment option. 35% of patients felt they had no understanding of the benefits or risks of PD. Despite only 13% of patients being told they were unsuitable for PD by their nephrologist, approximately half (47%) had ever considered it as a treatment option. Prominent barriers to PD that we identified were: excellent care in the HD unit (62%), proximity to dialysis unit (41%), unwilling to dialyze daily (36%), and unwilling to learn a new technique (34%). Beliefs held by patients that figured prominently in their decision to choose HD over PD included not wanting to take their disease home (32%), fear of being a burden on family (32%), lack of space (28%), risk of infection, issues with self-image while on PD, and PD being an inferior modality to HD (all approximately 24%). Conclusion Several barriers to PD were identified with a few consistent themes being identified, including deficiencies in knowledge, patient specific beliefs, poor patient education, and perceived benefits of in-center care (satisfaction with current care). The most frequently reported knowledge barrier was a lack of understanding of benefits and risks of PD. These findings suggest that not enough patients are receiving formal education, or active involvement in deciding which modality they would be most suitable for them when initiating dialysis. To improve uptake of PD in Saskatchewan, we will have to generate both increased awareness of PD as a treatment modality, alongside improved educational strategies to enable patients to make an informed choice about how they receive renal replacement therapy. While the study does not reflect the views of all patients, the information gained will be valuable in designing an educational program to improve adoption of PD within our province.

scholarly journals Physician Asthma Management Practices in Canada

2000 ◽  
Vol 7 (6) ◽  
pp. 456-465 ◽  
Author(s):  
Robert Jin ◽  
Bernard CK Choi ◽  
Benjamin TB Chan ◽  
Louise McRae ◽  
Felix Li ◽  
...  
Keyword(s):  
Management Practices ◽  
Behavioural Change ◽  
Asthma Management ◽  
Airflow Limitation ◽  
Physician Education ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Asthma Education ◽  
Consensus Recommendations ◽  
First Line Therapy

OBJECTIVES: To establish national baseline information on asthma management practices of physicians, to compare the reported practices with the Canadian Consensus recommendations and to identify results potentially useful for interventions that improve physician asthma management practices.DESIGN: National, stratified cross-sectional survey.SETTINGS: The 10 provinces and two territories of Canada, from 1996 to 1997.PARTICIPANTS: Questionnaires were sent to 4489 physicians stratified by province/territory and specialty group (family/general practice, respirology, internal medicine, pediatrics and allergy/immunology); 2605 responses were received.OUTCOME MEASURES: Methods for the diagnosis, treatment, education and follow-up of patients with asthma ('asthma management practices').RESULTS: Significant variations existed among the five specialty groups in asthma management practices. A low use of objective measures of airflow limitation to assist with diagnosis was found among some respondents (mostly family physicians). Up to 40% of physicians regarded the daily fixed dosing (three or four times a day) of inhaled, short acting beta2-agonist as 'first-line therapy' for moderate to severe asthma. A minority of physicians reported using written action plans for patients or referring them to other health professionals for asthma education. Insufficient time during appointments and a perceived lack of appropriate educational materials were frequently cited as reasons for not providing asthma education. The perceived knowledge of the Canadian Consensus recommendations varied among physicians but was lowest among nonspecialists.CONCLUSIONS: The survey showed variations in certain aspects of the management of asthma by physicians. The findings will help to target specific areas for future physician education programs and other behavioural change strategies.

scholarly journals Frequency, comprehension and attitudes of physicians towards abbreviations in the medical record

2018 ◽  
Vol 94 (1111) ◽  
pp. 254-258
Author(s):  
Uri Hamiel ◽  
Idan Hecht ◽  
Achia Nemet ◽  
Liron Pe’er ◽  
Vitaly Man ◽  
...  
Keyword(s):  
Medical Record ◽  
Medical Records ◽  
Online Teaching ◽  
Tertiary Hospital ◽  
Physician Education ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Online Lecture ◽  
Impact Patient Care

AimsAbbreviations are common in the medical record. Their inappropriate use may ultimately lead to patient harm, yet little is known regarding the extent of their use and their comprehension. Our aim was to assess the extent of their use, their comprehension and physicians’ attitudes towards them, using ophthalmology consults in a tertiary hospital as a model.MethodsWe first mapped the frequency with which English abbreviations were used in the departments’ computerised databases. We then used the most frequently used abbreviations as part of a cross-sectional survey designed to assess the attitudes of non-ophthalmologist physicians towards the abbreviations and their comprehension of them. Finally, we tested whether an online lecture would improve comprehension.Results4375 records were screened, and 235 physicians responded to the survey. Only 42.5% knew at least 10% of the abbreviations, and no one knew them all. Ninety-two per cent of respondents admitted to searching online for the meanings of abbreviations, and 59.1% believe abbreviations should be prohibited in medical records. A short online lecture improved the number of respondents answering correctly at least 50% of the time from 1.2% to 42% (P<0.001).ConclusionsAbbreviations are common in medical records and are frequently misinterpreted. Online teaching is a valuable tool for physician education. The majority of respondents believed that misinterpreting abbreviations could negatively impact patient care, and that the use of abbreviations should be prohibited in medical records. Due to low rates of comprehension and negative attitudes towards abbreviations in medical communications, we believe their use should be discouraged.

scholarly journals Reflecting on perceived failure of entrepreneurship development initiatives to help ignite economic development in Malawi

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Charles Mwatsika
Keyword(s):  
Economic Development ◽  
Limited Liability ◽  
Cross Sectional Survey ◽  
Size Category ◽  
Cross Sectional ◽  
Mean Values ◽  
Entrepreneurship Development ◽  
Development Initiatives ◽  
Economic Perspectives ◽  
Start Ups

AbstractThis study reflects on the perceived failure of entrepreneurship development initiatives to help ignite economic development in Malawi. A cross-sectional survey of 337 enterprises collected top-of-the-mind definitions of entrepreneurship, and innovations and their values carried out. Content analyses, comparison of mean values, 2 independent samples tests and multiple linear regression analyses showed that entrepreneurship is perceived as starting and managing one’s own business; being self-employed. Carrying out innovations is low and of low value, but enterprises which carried out innovations had higher median values than those that did not. The study found opportunity-motivated, growth-oriented, limited liability enterprises in the medium-to-large size category to be productive types of enterprises, but there were very few. It is argued that initiatives fail to help ignite economic development because knowledge which guides entrepreneurship development misses the essence of entrepreneurship—carrying out innovations. Secondly, there are no initiatives to support SME innovation and growth through product development, investments in modern production facilities and access to export markets. It is encouraged that key stakeholders adjust their understanding of entrepreneurship to neoclassical economic perspectives, encourage innovative start-ups and provide support to grow the numbers of productive enterprises.

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