Effect of cost sharing on utilization of general physician care: A cross-sectional survey from Shiraz, Iran

ABSTRACT:Background:An improved understanding of diagnostic and treatment practices for patients with rare primary mitochondrial disorders can support benchmarking against guidelines and establish priorities for evaluative research. We aimed to describe physician care for patients with mitochondrial diseases in Canada, including variation in care.Methods:We conducted a cross-sectional survey of Canadian physicians involved in the diagnosis and/or ongoing care of patients with mitochondrial diseases. We used snowball sampling to identify potentially eligible participants, who were contacted by mail up to five times and invited to complete a questionnaire by mail or internet. The questionnaire addressed: personal experience in providing care for mitochondrial disorders; diagnostic and treatment practices; challenges in accessing tests or treatments; and views regarding research priorities.Results:We received 58 survey responses (52% response rate). Most respondents (83%) reported spending 20% or less of their clinical practice time caring for patients with mitochondrial disorders. We identified important variation in diagnostic care, although assessments frequently reported as diagnostically helpful (e.g., brain magnetic resonance imaging, MRI/MR spectroscopy) were also recommended in published guidelines. Approximately half (49%) of participants would recommend “mitochondrial cocktails” for all or most patients, but we identified variation in responses regarding specific vitamins and cofactors. A majority of physicians recommended studies on the development of effective therapies as the top research priority.Conclusions:While Canadian physicians’ views about diagnostic care and disease management are aligned with published recommendations, important variations in care reflect persistent areas of uncertainty and a need for empirical evidence to support and update standard protocols.

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Levels and Determinants of Health Literacy in Bahrain’s Community Context

Oman Medical Journal ◽

10.5001/omj.2020.88 ◽

2020 ◽

Vol 35 (6) ◽

pp. e195-e195

Author(s):

G. V. Asokan ◽

Mohamed Yaqoob Ali Yusuf ◽

Richard Kirubakaran ◽

Abdulaziz Mohamed Muqbel Albadwi ◽

Ahmed Ebrahim Saad ◽

...

Keyword(s):

Social Skills ◽

Health Literacy ◽

Health Information ◽

Community Context ◽

Cross Sectional Survey ◽

Chi Square ◽

General Physician ◽

Cross Sectional ◽

Survey Tool ◽

Self Rating

Objectives: We sought to assess health literacy (HL) and its associated factors in the Bahraini community using a validated HL scale and address its deficient domains to inform policy. Methods: We carried out a conveniently sampled, cross-sectional survey using the All Aspects of Health Literacy Scale in the Bahraini community. The scale has three key aspects: basic or functional HL (FUN-4 items), which corresponds to basic reading and writing skills, and knowledge of health conditions and health systems; communicative or interactive HL (COM-3 items) on communicative and social skills to extract information from different forms of communication; and critical HL (CR-4 items), the advanced cognitive and social skills to critically analyze information and exert greater control over life events and situations relating to individual and community level wellbeing goals. We examined the association between sociodemographic and health information for the survey tool items using the chi-square test. The relationship between total scale score and subscale scores of the three domains of the survey tool to sociodemographic and health information was investigated using the t-test and ANOVA. Results: Of the 836 participants (mean age = 26.6 years), single (64.0%) and university students (76.6%) were predominant; 15.6% reported long-term sickness and visited the general physician often. The highest mean item scores were for empowerment (1.8) and lowest for functional HL (0.1). The significant domain-specific responses to the survey tool items were 12 for critical HL, 10 for functional HL, six for communicative HL, and five for empowerment. Participants aged < 30 years old, female, married, pursuing/completed Master’s program, employed, and whose self-rating of health was excellent had higher total HL scores. Conclusions: Older, less educated respondents with a poor self-rating of health had low HL scores. We recommend further studies to address the relative importance of functional, interactive, and critical HL in the community to promote health outcomes.

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Socio-demographic, clinical, hospital admission and oxygen requirement characteristics of COVID-19 patients of Bangladesh

10.1101/2020.08.14.20175018 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ratindra Nath Mondal ◽

Md. Abdur Razzak Sarker ◽

Anupom Das ◽

M. Ahsanul Kabir Ahsan ◽

Shah Md Sarwer Jahan ◽

...

Keyword(s):

Hospital Admission ◽

Family Members ◽

Disease Symptom ◽

Rt Pcr ◽

Cross Sectional Survey ◽

General Physician ◽

Cross Sectional ◽

Male Predominance ◽

Study Results ◽

Wide Range

Abstract Background: Clinical presentation hospital admission and outcome of COVID-19 pandemic are different from one country to another. So every country should have their own data regarding COVID-19. Subjects and Methods: This was an online cross-sectional survey carried out in RT-PCR positive COVID-19 adult patient. A preformed questionnaire adapted in Google form and circulated through online to collect data. Informed consent was ensured before participation in this study. Results: We have studied of 305 RT-PCR positive COVID-19 patients mean age was 36.32(+/-12.369) years with male predominance and majority were doctor 46.9%. 48.8% of the patients family members affected along with them. After COVID-19 pandemic 31.7% did not go out of their house. For prevention (72.4%)of the patients used mask and 38.8% used hand gloves during outing. 28.7% reported to be affected while working in hospital 21.8%were affected in their office. Fever (80.1%) cough (57.7%) pain in throat (50.8%) rhinitis (45.9%) and loss of smell (45%) and taste sensation (45.6%) were the most common symptoms. Sample was given average 3 (+/- 3.384) days after onset of the symptoms and report was delivered average 4.57 days after giving sample. After getting result 32.1% of the patients seek treatment in telemedicine and 23% directly consulted in Government hospital only 2% reported to be treated by the Government designated telephone number. 73.1% of the patient took both steam inhalation and warm water gargling. Paracetamol and antihistamine was the most commonly use drugs 69.8% and 71.5% respectively besides 47.5% took ivermectin 41.6% took azithromycin 35.1% steroid 34.8% took doxycyclin and 21.6% hydroxychloroquine. Among the patients only 20.3% needed hospital admission. The patients admitted in hospital average 5 (+/-3.922) days after onset of symptoms and hospital staying was 9.2 days (average). Breathless (54.83%) was the major cause of hospital admission and 19.35% patients admitted due to fear. 14% patients needed oxygen and average duration of oxygen was 4.84 days. 81.3% patients has taken oxygen in hospital and 18.8% at their home. Among the patient 2.2% needed ICU and artificial ventilation needed for 1.1% patients. The patients recovered after 17.74 days (average) from the onset of symptom. COVID-19 became negative (RT-PCR) at15th day from onset of symptom. 91.8%) were in mental stress to become the cause of infection spread to other family members 20.7%) reported that they were anxious that they would not get oxygen or ICU if required and 27.9% were suffering from fear of death. Weakness was the most common post disease symptom in 57.4% cases. Average time required for coming back to normal life was 21.59 days (+/-7.901) ranging a wide range from 5 to 60 days. Conclusion: COVID-19 patients were mostly male health worker. Fever cough pain in throat were most common symptoms. Hospital admission required in only one-fifth cases and ICU required for only 2% patients. Weakness was the most common post disease symptom. Keywords: COVID Bangladesh oxygen ivermectin Correspondence Dr. Ratindra Nath Mondal President Society of General Physician Founder-Daktarkhana (GP center) Rangpur Bangladesh Email [email protected].

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The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey

Journal of Medical Internet Research ◽

10.2196/19274 ◽

2020 ◽

Vol 22 (7) ◽

pp. e19274

Author(s):

Tania Tajirian ◽

Vicky Stergiopoulos ◽

Gillian Strudwick ◽

Lydia Sequeira ◽

Marcos Sanches ◽

...

Keyword(s):

Survey Methodology ◽

Perceived Usefulness ◽

Full Time ◽

Physician Burnout ◽

Cross Sectional Survey ◽

Related Factors ◽

General Physician ◽

Quality Health Care ◽

Cross Sectional ◽

Electronic Health

Background Physician burnout has a direct impact on the delivery of high-quality health care, with health information technology tools such as electronic health records (EHRs) adding to the burden of practice inefficiencies. Objective The aim of this study was to determine the extent of burnout among physicians and learners (residents and fellows); identify significant EHR-related contributors of physician burnout; and explore the differences between physicians and learners with regard to EHR-related factors such as time spent in EHR, documentation styles, proficiency, training, and perceived usefulness. In addition, the study aimed to address gaps in the EHR-related burnout research methodologies by determining physicians’ patterns of EHR use through usage logs. Methods This study used a cross-sectional survey methodology and a review of administrative data for back-end log measures of survey respondents’ EHR use, which was conducted at a large Canadian academic mental health hospital. Chi-square and Fisher exact tests were used to examine the association of EHR-related factors with general physician burnout. The survey was sent out to 474 individuals between May and June 2019, including physicians (n=407), residents (n=53), and fellows (n=14), and we measured physician burnout and perceptions of EHR stressors (along with demographic and practice characteristics). Results Our survey included 208 respondents, including physicians (n=176) and learners (n=32). The response rate was 43.2% for physicians (full-time: 156/208, 75.0%; part-time: 20/199, 10.1%), and 48% (32/67) for learners. A total of 25.6% (45/176) of practicing physicians and 19% (6/32) of learners reported having one or more symptoms of burnout, and 74.5% (155/208) of all respondents who reported burnout symptoms identified the EHR as a contributor. Lower satisfaction and higher frustration with the EHRs were significantly associated with perceptions of EHR contributing toward burnout. Physicians’ and learners’ experiences with the EHR, gathered through open-ended survey responses, identified challenges around the intuitiveness and usability of the technology as well as workflow issues. Metrics gathered from back-end usage logs demonstrated a 13.6-min overestimation in time spent on EHRs per patient and a 5.63-hour overestimation of after-hours EHR time, when compared with self-reported survey data. Conclusions This study suggests that the use of EHRs is a perceived contributor to physician burnout. There should be a focus on combating physician burnout by reducing the unnecessary administrative burdens of EHRs through efficient implementation of systems and effective postimplementation strategies.

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The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey (Preprint)

10.2196/preprints.19274 ◽

2020 ◽

Author(s):

Tania Tajirian ◽

Vicky Stergiopoulos ◽

Gillian Strudwick ◽

Lydia Sequeira ◽

Marcos Sanches ◽

...

Keyword(s):

Survey Methodology ◽

Perceived Usefulness ◽

Full Time ◽

Physician Burnout ◽

Cross Sectional Survey ◽

Related Factors ◽

General Physician ◽

Quality Health Care ◽

Cross Sectional ◽

Electronic Health

BACKGROUND Physician burnout has a direct impact on the delivery of high-quality health care, with health information technology tools such as electronic health records (EHRs) adding to the burden of practice inefficiencies. OBJECTIVE The aim of this study was to determine the extent of burnout among physicians and learners (residents and fellows); identify significant EHR-related contributors of physician burnout; and explore the differences between physicians and learners with regard to EHR-related factors such as time spent in EHR, documentation styles, proficiency, training, and perceived usefulness. In addition, the study aimed to address gaps in the EHR-related burnout research methodologies by determining physicians’ patterns of EHR use through usage logs. METHODS This study used a cross-sectional survey methodology and a review of administrative data for back-end log measures of survey respondents’ EHR use, which was conducted at a large Canadian academic mental health hospital. Chi-square and Fisher exact tests were used to examine the association of EHR-related factors with general physician burnout. The survey was sent out to 474 individuals between May and June 2019, including physicians (n=407), residents (n=53), and fellows (n=14), and we measured physician burnout and perceptions of EHR stressors (along with demographic and practice characteristics). RESULTS Our survey included 208 respondents, including physicians (n=176) and learners (n=32). The response rate was 43.2% for physicians (full-time: 156/208, 75.0%; part-time: 20/199, 10.1%), and 48% (32/67) for learners. A total of 25.6% (45/176) of practicing physicians and 19% (6/32) of learners reported having one or more symptoms of burnout, and 74.5% (155/208) of all respondents who reported burnout symptoms identified the EHR as a contributor. Lower satisfaction and higher frustration with the EHRs were significantly associated with perceptions of EHR contributing toward burnout. Physicians’ and learners’ experiences with the EHR, gathered through open-ended survey responses, identified challenges around the intuitiveness and usability of the technology as well as workflow issues. Metrics gathered from back-end usage logs demonstrated a 13.6-min overestimation in time spent on EHRs per patient and a 5.63-hour overestimation of after-hours EHR time, when compared with self-reported survey data. CONCLUSIONS This study suggests that the use of EHRs is a perceived contributor to physician burnout. There should be a focus on combating physician burnout by reducing the unnecessary administrative burdens of EHRs through efficient implementation of systems and effective postimplementation strategies.

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Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽

10.1027/0227-5910/a000604 ◽

2020 ◽

Vol 41 (2) ◽

pp. 82-88 ◽

Cited By ~ 1

Author(s):

Bob Lew ◽

Ksenia Chistopolskaya ◽

Yanzheng Liu ◽

Mansor Abu Talib ◽

Olga Mitina ◽

...

Keyword(s):

Social Support ◽

Suicidal Behavior ◽

Online Survey ◽

Perceived Social Support ◽

Strain Theory ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Psychological Strains ◽

Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conﬂicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

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Fit and Congruency

Journal of Personnel Psychology ◽

10.1027/1866-5888/a000233 ◽

2019 ◽

Vol 18 (3) ◽

pp. 148-156

Author(s):

Mary Hogue ◽

Lee Fox-Cardamone ◽

Deborah Erdos Knapp

Keyword(s):

Role Theory ◽

Social Role ◽

Gender Diversity ◽

Job Fit ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Working Adults ◽

Role Congruity ◽

Self Selection ◽

Selection Of

Abstract. Applicant job pursuit intentions impact the composition of an organization’s applicant pool, thereby influencing selection outcomes. An example is the self-selection of women and men into gender-congruent jobs. Such self-selection contributes to a lack of gender diversity across a variety of occupations. We use person-job fit and the role congruity perspective of social role theory to explore job pursuit intentions. We present research from two cross-sectional survey studies (520 students, 174 working adults) indicating that at different points in their careers women and men choose to pursue gender-congruent jobs. For students, the choice was mediated by value placed on the job’s associated gender-congruent outcomes, but for working adults it was not. We offer suggestions for practitioners and researchers.

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Oscillation between identities and Subjective psychological health objectives among an informed audience in therapeutic patient education

Education thérapeutique du patient - Therapeutic patient education ◽

10.1051/tpe/2018006 ◽

2018 ◽

Vol 10 (1) ◽

pp. 10202

Author(s):

Sandrine Roussel ◽

Alain Deccache ◽

Mariane Frenay

Keyword(s):

Patient Education ◽

Psychological Health ◽

Healthcare Professionals ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Therapeutic Patient Education ◽

French Speaking ◽

Health Objectives ◽

Self Administered Questionnaire

Introduction: The implementation of Therapeutic Patient Education (TPE) remains a challenge. An exploratory study highlighted two tendencies among practitioners of TPE, which could hamper this implementation: an oscillation between identities (as caregivers versus as educators) and an inclination towards subjective psychological health objectives. Objectives: To verify whether these tendencies can be observed among an informed audience in TPE. Next, to explore the variables associated with one or other of these tendencies. Method: A quantitative cross-sectional survey by a self-administered questionnaire was carried out among 90 French-speaking healthcare professionals. Statistical analyses (chi-square, logistic regression) were then conducted. Results: Sixty percent of respondents displayed identity oscillation, which was found to be linked to task oscillation, patient curability, scepticism towards medicine and practising in France. Fifty-six percent pursued subjective psychological health objectives, which was found to be associated with health behaviour objectives and a locus of power in the healthcare relationship distinct from those seen in the pre-existing health models (biomedical, global). This tendency seems to constitute an alternative model of TPE. Discussion & conclusion: Identity oscillation and subjective psychological health objectives can be both observed. This study stresses the need to deliberate on the form(s) of TPE that is/are desired.

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