Reflections on the Concomitants of the Restrictive Visitation Policy During the COVID-19 Pandemic: An Ubuntu Perspective

Caregiving is a prominent concept in the Ubuntu philosophy, and caring and visitation of the sick is regarded as an example of Ubuntu. The restrictive visitation policy adopted in the hospitals during the coronavirus disease 2019 (COVID-19) pandemic affected the exhibition of this concept among patients, nurses, and families. The narrative inquiry was used to explore the reflections of the participants on the impact caused by the non-visitation policy experienced during the first and second waves of the COVID-19 pandemic in South Africa. The narrative inquiry approach allowed the participants to tell their story as it is unique to them. The study used purposive sampling technique to select five participants for the webinar. Three themes emerged from the narrated stories which are 1) moral anguish of the caregivers; 2) mental health instability, and 3) erosion of trust in health care practitioners (HCPs). The non-visitation hospital policy was intended to reduce the danger of spreading COVID-19 within and outside the hospital; however, the care provided was devoid of the values of Ubuntu such as mutual respect, relational, responsibility, reciprocity, and interconnectedness. In retrospect, a case-by-case application of the policy would reduce the non-desirable effect of the policy on the patients, nurses, and patients' family members.

Hesitancy towards the COVID-19 vaccine among health care practitioners in the Kingdom of Saudi Arabia: a cross-sectional study

Background: The coronavirus disease 2019 (COVID-19) pandemic is a major public health crisis worldwide. In less than 12 months since the World Health Organization declared the outbreak, several different COVID-19 vaccines have been approved and deployed mostly in developed countries since January 2021. However, hesitancy to accept the newly developed vaccines is a well-known public health challenge that needs to be addressed. The aim of this study was to measure willingness and hesitancy toward COVID-19 vaccines among health care practitioners' (HCPs) in Saudi Arabia. Methods: A cross-sectional study using an online self-reported survey was conducted among HCPs in Saudi Arabia between April 4th to April 25th 2021 using snowball sampling. Multivariate logistic regression was employed to identify the possible factors affecting HCPs’ willingness and hesitancy to receive COVID-19 vaccines. Results: Out of 776 participants who started the survey, 505 (65%) completed it and were included in the results. Among all HCPs, 47 (9.3%) either said “no” to receive the vaccine [20 (4%)] or were hesitant to receive it [27 (5.3%)]. Of the total number of the HCPs, 376 (74.5%) already received the COVID-19 vaccine, and 48 (9.50%) were registered to receive it. The main reason of agreement to receive the COVID-19 vaccine was “wanting to protect self and others from getting the infection” (24%). Conclusion: Our findings have shown that hesitancy toward receiving COVID-19 vaccines among HCPs in Saudi Arabia is limited and therefore may not be a serious issue. The outcomes of this study may help to understand factors that lead to vaccine hesitancy in Saudi Arabia and help public health authorities to design targeted health education interventions aiming to increase uptake of these vaccines.

Co-designing implementation strategies for the WALK-Cph intervention in Denmark aimed at increasing mobility in acutely hospitalized older patients: a qualitative analysis of selected strategies and their justifications

Background Selecting appropriate strategies to target barriers to implementing interventions represents a considerable challenge in implementation research and practice. The aim was to investigate what categories of implementation strategies were selected by health care practitioners and their managers in a co-design process and how they justified these strategies aimed at facilitating the implementation of the WALK-Cph intervention. Methods The study used a qualitative research design to explore what implementation strategies were selected and the justifications for selecting these strategies. Workshops were used because this qualitative method is particularly well suited for studying co-design processes that involve substantial attention to social interaction and the context. Data were 1) analyzed deductively based on the Proctor et al. taxonomy of implementation strategies, 2) categorized in accordance with the ERIC compilation of implementation strategies by Powell et al., and 3) analyzed to examine the justification for the selected strategies by the Proctor et al. framework for justifications of implementation strategies. Results Thirteen different types of implementation strategies were chosen across two hospitals. The deductive analysis showed that selection of implementation strategies was based on pragmatic and theoretical justifications. The contents of the two types of justifications were thematized into nine subthemes. Conclusion This study contributes with knowledge about categories and justification of implementation strategies selected in a co-design process. In this study, implementation strategies were selected through pragmatic and theoretical justifications. This points to a challenge in balancing strategies based on practice-based and research-based knowledge and thereby selection of strategies with or without proven effectiveness.

Acceptable Level of Professional Conducts from Health Sciences Students Perspective

Professionalism among health care practitioners is a critical value. This study aimed to determine the acceptable level of professional conduct from the perspective of undergraduate Health Sciences students of UiTM Puncak Alam and compare the difference of perspectives between the years of study. From 320 participants, the results showed the low level of acceptance towards poor scenarios and significant differences in perspectives between the year of study in scenarios 2,3 and 6; forging experimental results(χ²=18.66,p<0.01); intellectual dishonesty(χ2=11.11,p=0.01) and forging classmate’s signature(χ2=11.18,p=0.01). The findings provided faculty’s administrators with an acceptable level of professional conduct from the perspective of their students. Keywords: Professionalism, professional conduct, perspective, Health Sciences students eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i18.3077

A qualitative study to explore primary health care practitioners’ perceptions and understanding regarding the COVID-19 pandemic in KwaZulu-Natal, South Africa

Background: The coronavirus disease 2019 (COVID-19) is a novel virus that has rapidly spread across countries globally, and has been declared a pandemic by the World Health Organization (WHO). In South Africa, more that 1 million cases have been confirmed since case zero was detected in March 2020. South Africa is currently leading in the sub-Saharan African region in terms of COVID-19-related mortality and morbidity rates.Aim: The aim of this study was to explore primary health care practitioners’ perceptions and understanding regarding the COVID-19 pandemic in KwaZulu-Natal, South Africa.Setting: The study was conducted at two selected primary health care facilities (a community health centre and satellite clinic) within a low-income rural context in KwaZulu-Natal, South Africa.Methods: A qualitative study was conducted to explore and describe perceptions and understanding of primary health care practitioners regarding the COVID-19 pandemic in KwaZulu-Natal (KZN), South Africa. Data were collected from a purposive sample of 15 participants at two different clinics situated in rural KZN, South Africa. Participants comprised of nurses, physiotherapists, pharmacists, community care givers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. An audiotape was used to collect data, which were transcribed verbatim. Data were analysed manually by thematic analysis following Tech’s steps of data analysis.Results: Participants reported pre-pandemic and pandemic perceptions of fear, denial, expectancy and a perceived poor preparation for the COVID-19 outbreak. The findings also revealed participants’ misperceptions regarding the nature of the COVID-19 pandemic and unrealistic expectations of occupational compensations for working during the outbreak.Conclusion: The findings of this study suggest that primary health care practitioners generally have negative perceptions and understanding regarding the pandemic because of misinformation obtained from social media. Interventions to support health care practitioners are necessary to mitigate the potentially negative implications of health practitioners’ misconceptions on service delivery and their mental health.

Personalizing the BioPsychoSocial Approach: “Add-Ons” and “Add-Ins” in Generalist Practice

Generalist practitioners often find interacting with patients deeply satisfying and joyful; they also experience encounters that are challenging and complex. In both cases, they must be aware of the many issues that affect the processes and outcomes of patient care. Although using the BioPsychoSocial approach is an important, time-tested framework for cultivating one's awareness of patients' presenting concerns, recent developments suggest that additional frames of reference may enhance communication and relationships with patients. In this article, we describe several additions to the BioPsychoSocial approach, considerations we call “add-ons” and “add-ins”. We invite generalist practitioners and, indeed, all health care practitioners, to consider how they can improve their ongoing care of patients by personalizing these and other additions in their day-to-day work with patients.

Respiratory symptoms and respiratory deaths: A multi-cohort study with 45 years observation time

This study determined the association between respiratory symptoms and death from respiratory causes over a period of 45 years. In four cohorts of random samples of Norwegian populations with 103,881 participants, 43,731 persons had died per 31 December 2016. In total, 5,949 (14%) had died from respiratory diseases; 2,442 (41%) from lung cancer, 1,717 (29%) chronic obstructive pulmonary disease (COPD), 1,348 (23%) pneumonia, 119 (2%) asthma, 147 (2%) interstitial lung disease and 176 (3%) other pulmonary diseases. Compared with persons without respiratory symptoms the multivariable adjusted hazard ratio (HR) for lung cancer deaths increased with score of breathlessness on effort and cough and phlegm, being 2.6 (95% CI 2.1–3.2) for breathlessness score 3 and 2.1 (95% CI 1.7–2.5) for cough and phlegm score 5. The HR of COPD death was 6.4 (95% CI 5.4–7.7) for breathlessness score 3 and 3.0 (2.4–3.6) for cough and phlegm score 5. Attacks of breathlessness and wheeze score 2 had a HR of 1.6 (1.4–1.9) for COPD death. The risk of pneumonia deaths increased also with higher breathlessness on effort score, but not with higher cough and phlegm score, except for score 2 with HR 1.5 (1.2–1.8). In this study with >2.4 million person-years at risk, a positive association was observed between scores of respiratory symptoms and deaths due to COPD and lung cancer. Respiratory symptoms are thus important risk factors, which should be followed thoroughly by health care practitioners for the benefit of public health.

Australian Mental Health Care Practitioners’ Cultural Competence, Therapeutic Alliance, Desirable Responding and Racial/Ethnic Attitudes

Background Racial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country’s population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia’s population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners’ attitudes toward this diversity and their level of cultural competence. Aim Given the relationship between practitioner cultural competence and an effective therapeutic alliance with diverse clients, this study aimed to identify factors that influence non-White and White practitioner cultural competence and therapeutic alliance. Methods An online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Multicultural Counselling Inventory (MCI); the Color-blind Racial Attitudes Scale (CoBRAS); and the Balanced Inventory of Desirable Responding (BIDR). Descriptive statistics were used to summarise participants’ demographic characteristics. One-way ANOVA and Kruskal-Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence, therapeutic alliance, and racial and ethnic blindness. Correlation analyses were conducted to determine the effect of participants’ gender or age on cultural competence and therapeutic alliance. Hierarchical multiple regression analyses were conducted to predict cultural competence and therapeutic alliance. Results The study demonstrates that higher MCI total scores (measuring cultural competence and therapeutic alliance) were associated with being non-White, older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to have higher self-deceptive positive enhancement scores on the BIDR than those with lower MCI total scores. Conclusion The findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play in the therapeutic alliance. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners’ age, racial/ethnic background and professional experience.