Does the white coat influence satisfaction, trust and empathy in the doctor–patient relationship in the General and Family Medicine consultation? Interventional study

ObjectivesTo understand the influence of the white coat on patient satisfaction, opinions about medical clothing, perception about confidence, empathy and medical knowledge and the satisfaction and comfort level of physicians in consultation.SettingAn interventional study was conducted with a representative sample of the population attending primary care in central Portugal.ParticipantsThe sample was composed by 286 patients divided into two groups exposed or not to a doctor wearing a white coat. The first and last patients in consultation every day for 10 consecutive days were included.InterventionsEvery other day the volunteer physicians consulted with or without the use of a white coat. At the end of the consultation, a questionnaire was distributed to the patient with simple questions with a Likert scale response, the Portuguese version of the ‘Trust in physician’ scale and the Jefferson Scale of Patient Perceptions of Physician Empathy - Portuguese Version (JSPPPE-VP scale). A questionnaire was also distributed to the physician.OutcomesPlanned and measured primary outcomes were patient satisfaction, trust and perception about empathy and secondary outcomes were opinion about medical clothing, satisfaction and comfort level of physicians in consultation.ResultsThe sample was homogeneous in terms of sociodemographic variables. There were no statistically significant differences between the groups in terms of satisfaction, trust, empathy and knowledge perceived by the patients. There were differences in the opinion of the patients about the white coat, and when the physician was wearing the white coat this group of patients tended to think that this was the only acceptable attire for the physician (p<0.001). But when the family physician was in consultation without the white coat, this group of patients tended to agree that communication was easier (p=0.001).ConclusionsThere was no significant impact of the white coat in patient satisfaction, empathy and confidence in the family physician.Trial registration numberClinicalTrials.gov ID number: NCT03965416.

Air pollution perception in ten countries during the COVID-19 pandemic

As largely documented in the literature, the stark restrictions enforced worldwide in 2020 to curb the COVID-19 pandemic also curtailed the production of air pollutants to some extent. This study investigates the perception of the air pollution as assessed by individuals located in ten countries: Australia, Brazil, China, Ghana, India, Iran, Italy, Norway, South Africa and the USA. The perceptions towards air quality were evaluated by employing an online survey administered in May 2020. Participants (N = 9394) in the ten countries expressed their opinions according to a Likert-scale response. A reduction in pollutant concentration was clearly perceived, albeit to a different extent, by all populations. The survey participants located in India and Italy perceived the largest drop in the air pollution concentration; conversely, the smallest variation was perceived among Chinese and Norwegian respondents. Among all the demographic indicators considered, only gender proved to be statistically significant.

Psychometric Investigation of the Cultural Intelligence Scale Using the Rasch Measurement Model in South Korea

As the business environment and its workforce’s composition have become more diversified, more attention has been paid to cultural intelligence or the ability to effectively function in such an environment. Various attempts have been made to measure and develop leaders and staff members’ cultural intelligence. The Cultural Intelligence Scale (CQS) is the most representative tool for measuring cultural intelligence worldwide and has been frequently used in South Korea. Although CQS validity has been verified for each country and cultural region, it has been used without psychometric verification in South Korea and simply translates the original scale into Korean. This study’s objective was to test CQS validity when employed with the employees of South Korean companies. It applied the Rasch measurement model to confirm the validity in various aspects. First, this study calculated an item adequacy index and performed point biserial correlation analysis. The results showed that all values were above the appropriateness threshold. A Likert scale response test was conducted to check actual validity. The results confirmed that the 7-point rating scale was valid, and the item–subject map proved that the CQS items reflected the respondents’ ability distribution relatively well. Rasch factor analysis for confirming the internal structure’s validity revealed that CQS showed a multidimensional factor structure. Lastly, this study checked differential functioning items by position to secure evidence of generalization validity. It was confirmed that it has an appropriate level of generalization-related validity.

Minimal clinically important difference for chest discomfort in patients undergoing pleural interventions

RationaleTherapeutic thoracentesis is among the most frequently performed medical procedures. Chest discomfort is a common complication and has been associated with increasingly negative pleural pressure as fluid is withdrawn in the setting of non-expendable lung. Visual analogue scales (VASs) are commonly employed to measure changes in discomfort and dyspnoea related to pleural interventions. The minimal clinically important difference (MCID), defined as the smallest change in VAS score associated with patient report of significant change in a symptom, is required to interpret the results of studies using VAS scores and is used in clinical trial power calculations. The MCID for chest discomfort in patients undergoing pleural interventions has not been determined.MethodsProspectively collected data from two recent randomised trials of therapeutic thoracentesis were used for this investigation. Adult patients with symptomatic pleural effusions referred for therapeutic thoracentesis were enrolled across ten US academic medical centres. Patients were asked to rate their level of chest discomfort on 100 mm VAS before, during and following thoracentesis. Patients then completed a 7-point Likert scale indicating the significance of any change in chest discomfort from preprocedure to postprocedure. The mean difference between discomfort 5 min postprocedure and discomfort just prior to the start of pleural fluid drainage was categorised by Likert scale response.ResultsData from a total of 262 thoracenteses were included in the analysis. Thirty-four of 262 patients experienced a ‘small but significant increase’ or a ‘large or moderate increase’ in discomfort following thoracentesis. The mean increase in VAS score in those reporting a ‘small but significant increase’ in chest discomfort (n=23) was 16 mm (SD 22.44, 95% CI 6.87 to 25.21).ConclusionsThe MCID for thoracentesis-related chest discomfort measured by 100 mm VAS is 16 mm. This MCID specific to discomfort resulting from pleural fluid interventions can inform the design and analysis of future pleural intervention studies.

Impact of Parental Involvement on Pre-Tertiary Learners’ Academic Development and Performance in Ghana.

The purpose of this study was to investigate the impact of parental involvement on pre-tertiary learners’ academic performance and development in some selected pre-tertiary schools in the Ada East District of Greater Accra Region of Ghana. The study adopted the sequential explanatory mixed method approach. That is, quantitative data were initially gathered through a 3-point Likert Scale response set structured questionnaire followed by a qualitative interview data. The study made use of fifty (50) respondents who were randomly and judgmentally sampled. Both questionnaire and interview guide were developed to collect data on two formulated research questions after which they were descriptively and thematically analysed respectively. The study revealed that learners’ academic development and performance move along with parents’ financial commitment and other socioeconomic related characteristics, parents’ level of training, education and other sociocultural related characteristics as well as parents’ relationship and communication with teachers, school community and the community outside. It was concluded therefore that both socioeconomic and sociocultural statuses of parents affect academic development and performance of learners in pre-tertiary schools to a large extent. Conclusion was also drawn on how parents’ relationship and communication with the school community, teachers and the community outside contribute to pre-tertiary school learners’ development and performance. The study strongly recommended full parental, community and stakeholders’ commitment in all academic related activities of learners.

Motivators and its impacts on job satisfaction in FDI companies - A case study of Eurowindow Vietnam

This study investigates the factors motivating workers and their levels of job satisfaction at Eurowindow Vietnam – an FDI company in the furniture industry based in Hochiminh City, Vietnam. Data for this study were collected by a surveying 202 office workers of the company. A Likert-scale response format questionnaire was used to identify employment attitudes and job satisfaction. The research was carried out based on the theoretical aspects of job satisfaction. Cronbach’s alpha and exploratory factor analysis (EFA) were deployed to test the unidimensionality, reliability, and validity of measurement scales. Correlation analysis was carried out to estimate the relation between dependent and independent variables, and within the independent ones. Moreover, multiple regression analysis was adopted to test the hypotheses of the study. The level of job satisfaction was measured by seven dimensions, namely payment, promotion, supervisor, co-workers, work itself, benefits and work environment. The research results showed that work itself, promotion, payment, and supervisor have significant influences on job satisfaction. Findings of this study provide necessary knowledge for the leadership of Eurowindow Vietnam in boosting job satisfaction of their staff. Other FDI enterprises with the same development level may find these results applicable for their organizations. Recommendations for future research are also presented at the end of the study.

Fathers’ perception of child's weight and paternal feeding practices in relation to child's gender

The role of fathers in child rearing has changed in recent years due to an increase in maternal employment, which has increased the prevalence of co-parenting. It is important therefore to establish the role fathers have in feeding their child and how their attitudes and perceptions may influence the strategies they employ during mealtimes. In addition, research suggests that maternal and paternal feeding practices are associated with child's gender and weight status. Therefore, the aim of this research was to investigate the association between fathers’ perception of child's weight and paternal non-responsive and structure-related feeding practices, and the extent to which this is mediated by a child's gender.Cross-sectional data from an Irish sample of fathers, who completed an online survey based on one of their children aged 5–12 years old (n = 155). The Feeding Practices and Structure Questionnaire (FPSQ) assessed paternal feeding practices, and it was validated for use within this sample. A 5-point Likert scale response ranging from Very Underweight to Very Overweight to the question “Do you think your child is . . ?” assessed fathers’ perception of child's weight. Associations were assessed using multiple linear regressions.Fathers who perceived their sons as underweight reported higher levels of rewarding the child to eat (β = .24; p = 0.04) and overt restriction (β = .27; p = 0.03) than fathers who perceived their sons to be normal weight. Fathers who perceived their sons as overweight reported higher levels of overt restriction (β = .26; p = 0.04) than fathers who perceived their son to be normal weight. In relation to daughters, fathers who perceived them as underweight reported higher levels of both reward for behaviour (β = .28; p = 0.006) and reward for eating (β = .20; p = 0.04), while fathers who perceived their daughters as overweight reported lower levels of structured mealtimes (β = -.27; p = 0.012) compared to fathers who perceived their daughter as normal weight.Findings suggest that paternal perception of child's weight influences the type of feeding practices utilised by fathers, with the child's gender a mediating influence on reported specific feeding practices. Overall, fathers who perceive their son or daughter to be underweight or overweight appear to engage in more non-responsive and less structure-related feeding practices than fathers who perceive their child to be normal weight.

Nephrology Provider Surprise Question Response and Hospitalizations in Older Adults with Advanced CKD

Background: Older adults with advanced non-dialysis-dependent chronic kidney disease (NDD-CKD) face a high risk of hospitalization and related adverse events. Methods: This prospective cohort study followed nephrology clinic patients ≥60 years old with NDD-CKD stages 4-5. After an eligible patient’s office visit, study staff asked the patient’s provider to rate the patient’s risk of death within the next year using the surprise question (“Would you be surprised if this patient died in the next 12 months?”) with a 5-point Likert scale response (1, “definitely not surprised” to 5, “very surprised”). We used a statewide database to ascertain hospitalization during follow-up. Results: There were 488 patients (median age 72 years, 51% female, 17% black) with median estimated glomerular filtration rate 22 mL/min/1.73 m2. Over a median follow-up of 2.1 years, the rates of hospitalization per 100 person-years in the respective response groups were 41 (95% confidence interval [CI]: 34–50), “very surprised”; 65 (95% CI: 55–76), “surprised”; 98 (95% CI: 85–113), “neutral”; 125 (95% CI: 107–144), “not surprised”; and 120 (95% CI: 94–151), “definitely not surprised.” In a fully adjusted cumulative probability ordinal regression model for proportion of follow-up time spent hospitalized, patients whose providers indicated that they would be “definitely not surprised” if they died spent a greater proportion of follow-up time hospitalized compared with those whose providers indicated that they would be “very surprised” (odds ratio 2.4, 95% CI: 1.0–5.7). There was a similar association for time to first hospitalization. Conclusion: Nephrology providers’ responses to the surprise question for older patients with advanced NDD-CKD were independently associated with proportion of future time spent hospitalized and time to first hospitalization. Additional studies should examine how to use this information to provide patients with anticipatory guidance on their possible clinical trajectory and to target potentially preventable hospitalizations.

Linking governance qualities and stewardship attributes: findings from Malaysian takaful operators

Purpose As custodians of takaful contributors’ tabarru’ (donation) funds, takaful operators are expected to fulfil a stewardship role propagated under the precepts of Islam. The purpose of this paper is to analyse takaful operators’ stewardship, focusing on investment practices. Design/methodology/approach Structured interviews were conducted with senior investment staff from all of Malaysia’s takaful operators. Questions, developed using Delphi-style techniques, allowed a five-point Likert scale response addressing specific issues revolving around seven dimensions of governance quality – using the Malaysian Rating Corporation’s (MARC’s) governance rating guidelines for Islamic financial institutions (IFIs). Interviewees’ responses were assigned composite scores. Findings Malaysia’s takaful operators score well on most prescribed governance quality dimensions, although performance varies between operators and across dimensions. Areas for improvement are identified, especially regarding disclosure of information and contributor involvement in takaful operators’ management. Research limitations/implications Predetermined questions restrict flexibility in obtaining takaful operators’ information; however, end-of-interview, open-ended questions were asked to tap interviewee opinions on pertinent issues. A focus on takaful operators’ governance quality and stewardship of investments means findings may not be representative of all operational aspects of their businesses. Practical implications This study identifies governance quality guidelines which takaful operators may benchmark against and identifies where best to focus attempts to improve performance. These guidelines will also assist regulators assessing takaful operators’ stewardship performance. Originality/value This study uses governance quality as an indicator of stewardship, a concept aligned with the precepts of Shariah. It covers the opinion of the takaful industry in a country with a comprehensive Islamic financial system, Malaysia, extending understanding of takaful operators’ governance quality.

Differences between organic and conventional leafy green vegetables perceived by university students

Purpose The purpose of this paper is to evaluate perceived sensory differences of organic and conventional leafy green vegetables through three sensory tests – blind, informed and inverted and the willingness to buy (WTB) them, and associated factors of organic food consumption by these students. Design/methodology/approach The research had a cross-sectional design with university students. First, a questionnaire with 16 statements was presented to 233 consumers with a five-point Likert scale response. The assertions were categorized into five domains: trust in organic production; trust in conventional production; positive attitude to organic; affordable price; and perceived quality. Afterwards, a hedonic scaling was conducted with 150 consumers, 50 in each type of test with conventional and organic leafy green vegetables: lettuce (Lactuca sativa L.); kale (Brassica oleracea L.); common chicory (Cichorium intybus); and endive (Cichorium endivia). Visual aspect, taste, texture, bitterness and overall liking for all samples were evaluated on a nine-point hedonic scale. Findings In general, the participants did not perceive sensory differences during the blind test, but when the information about the vegetables was provided, higher scores were obtained by those products labelled as organic in the informed test and in the inverted test (conventional labelled as organic). This effect was higher for students with stronger attitudes towards organic food. These results indicated that the perceived differences between organic and conventional leafy green by university students tended to be attitudinal and, therefore, can be greatly influenced by the information provided with the product. Originality/value This research showed that university students were influenced by the organic label, revealing their sensory perception about vegetables. This study had multiple methodological approaches, including hedonic scaling and consumers’ WTB. This combination allowed identifying the students’ attitudinal tendency in relation to their sensory perceptions of organic green leafy green vegetables.