Children’s contact with people with disabilities and their attitudes towards disability: a cross-sectional study

Purpose: To explore the association between children’s self-reported contact with people with disabilities and attitudes towards them, as well the potential mediating influence of anxiety about interacting with people with disabilities and empathy for them. Method: 1881 children, aged 7–16 years, from 20 schools in South West England completed a survey assessing their contact with people with disabilities and their attitudes towards them. Anxiety about interacting with people with disabilities and empathy towards them were examined as potential mediators. Gender, school year, perceived similarity between people with and without disabilities, proportion of children with additional needs at the school and socioeconomic status (SES) were assessed as moderators. A random effects (“multilevel”) regression model was used to test the contact–attitude association and moderation, and path analysis was used to test for mediation. Results: Participants with more self-reported contact reported more positive attitudes towards disability (p?Conclusions: Self-reported contact was observed to be associated with more positive attitudes towards disability, which was partially mediated by empathy and anxiety. Providing opportunities for contact with people with disabilities that reduces anxiety and increases empathy may improve attitudes to disability and merits evaluation in interventions.

• Implications for Rehabilitation

• Children who reported greater levels of contact with people with disabilities had more positive attitudes towards disability.

• Anxiety about interacting with people with disabilities and empathy towards them partially mediated the contact–attitude associations.

• Providing opportunities for contact with people with disabilities, reducing anxiety and increasing empathy may improve children’s attitudes to disability.

     

Clinicians’ attitudes towards escalation and management of deteriorating patients: A cross-sectional study

BackgroundInternationally, rapid response systems have been implemented to recognise and categorise hospital patients at risk of deterioration. Whilst rapid response systems have been implemented with a varying amount of success, there remains ongoing concern about the lack of improvement in the escalation, and management of the deteriorating patient. It also remains unclear why some clinicians fail to escalate concerns for the deteriorating patient.ObjectiveThe objective of this study was to explore clinicians’ attitudes towards the escalation, and management of the deteriorating patient.MethodsA cross-sectional online survey of conveniently sampled clinicians from the acute care sector in a regional health district in Australia was conducted. The Clinicians’ Attitudes towards Responding and Escalating care of Deteriorating patients scale, was used to explore attitudes towards the escalation and management of the deteriorating patient.ResultsSurvey responses were received from medical officers (n = 43), nurses (n = 677), allied health clinicians (n = 60), and students (n = 57). Years of experience was significantly associated with more confidence responding to deteriorating patients (p < .001) and significantly less fears about escalating care (p < .001). Nurses (M = 4.16, SD = .57) and students (M = 4.11, SD = .55) in general had significantly greater positive beliefs that the rapid response system would support them to respond to the deteriorating patient than allied health (M = 3.67, SD = .64) and medical (M = 3.87, SD = .54) clinicians, whilst nurses and medical clinicians had significantly less fear about escalating care and greater confidence in responding to deteriorating patients than allied health clinicians and healthcare students (p < .001).ConclusionNurses and medical officers have less fear to escalate care and greater confidence responding to the deteriorating patient than allied health clinicians and students. Whilst the majority of participants had positive perceptions towards the rapid response system, those with less experience lacked the confidence to escalate care and respond to the deteriorating patient.     

Organizational evaluation of an interprofessional study unit – Results from a Danish case study

This article presents results from an organizational evaluation of an interprofessional clinical study unit (ICS) in Denmark. The aim of this study was to test whether the ICS was based on a durable organizational concept and to identify the prerequisites for the unit to be successful. The evaluation framework was “theory-based evaluation”. A program theory was developed based on the concepts and expectations of the steering committee which initiated and designed the ICS. The program theory was tested for conflicts of interest among the stakeholders related to the ICS regarding prerequisites for the study unit to function organizationally. Further analysis examined whether these conditions had been present during the project period and whether all elements had been correctly implemented. The results suggested that although the ICS had taken into account stakeholders' requests, it was not possible to fully implement all the necessary conditions identified as essential for the unit to function successfully. The results generate a set of recommendations for future ICS units to function successfully.     

Rural GPs’ attitudes toward participating in emergency medicine: a qualitative study

Objective: Health authorities want to increase general practitioner (GP) participation in emergency medicine, but the role of the GP in this context controversial. We explored GPs’ attitudes toward emergency medicine and call outs.

Design: Thematic analysis of focus group interviews.

Setting: Four rural casualty clinics in Norway.

Participants: GPs with experience ranging from one to 32 years.

Results: The GPs felt that their role had changed from being the only provider of emergency care to being one of many. In particular, the emergency medical technician teams (EMT) have evolved and often manage well without a physician. Consequently, the GPs get less experience and feel more uncertain when encountering emergencies. Nevertheless, the GPs want to participate in call outs. They believed that their presence contributes to better patient care, and the community appreciates it. Taking part in call outs is seen as being vital to maintaining skills. The GPs had difficulties explaining how to decide whether to participate in call outs. Decisions were perceived as difficult due to insufficient information. The GPs assessed factors, such as distance from the patient and crowding at the casualty clinic, differently when discussing participation in call outs.

Conclusion: Although their role may have changed, GPs argue that they still play a part in emergency medicine. The GPs claim that by participating in call outs, they maintain their skills and improve patient care, but further research is needed to help policy makers and clinicians decide when the presence of a GP really counts.

Norwegian health authorities want to increase participation by general practitioners (GPs) in emergency medicine, but the role of the GP in this context is controversial.

• KEY POINTS

• The role of the GP has changed, but GPs argue that they still play an important role in emergency medicine.

• GPs believe that their presence on call outs improve patient care, but they find it defensible that patients are tended to by emergency medical technicians (EMTs) only.

• GPs offered different assessments regarding whether to participate in call outs in seemingly similar cases.

     

Doctor of physical therapy students’ attitudes towards people with disabilities: a descriptive study

Purpose To describe attitudes of doctoral physical therapy (DPT) students towards people with disability and examine predictive ability of demographic variables on those attitudes. Methods Two established surveys, Attitudes Towards Disabled Persons-Form O (ATDP-O) and Disability Attitudes in Health Care (DAHC) were completed by first (Y1) and third year (Y3) students in a DPT programme. Demographics and information about students’ contact experience with people with disabilities were collected through a brief questionnaire. Multiple linear regression models were constructed from predictor variables. Results Scores on the ATDP-O and the DAHC were not significantly different between the Y1 and Y3 DPT students. There was a modest correlation (r?=?0.342, p?Conclusion Attitudes of DPT students over the course of their education did not change. The DAHC is a more recently developed tool and should continue to be investigated for its usefulness in healthcare professional students. Faculty should consider measuring attitudes and developing specific educational strategies to improve attitudes with the goal to improve patient care.

• Implications for Rehabilitation

• Attitudes towards people with disability can impact their health care.

• Physical therapy students, in general, express positive attitudes towards people with disabilities and no differences in attitudes were determined in a group of Year 1 and Year 3 doctoral physical therapy students.

• Opportunities exist to intentionally thread educational strategies throughout a professional curriculum to facilitate further development of positive attitudes in doctoral physical therapy students.

     

Burden of chemotherapy-induced neuropathy��a cross-sectional study

Background  

Neuropathy is a common adverse effect of chemotherapy. However, the both the prevalence and the burden of this adverse effect have been poorly documented. The aim of the study was to assess the prevalence and discomfort caused by neuropathic symptoms in relation to other adverse effects of chemotherapy.     

Exploring the secondary clinical activities of emergency nurse practitioners – a prospective multicentre study

New drug therapy for hepatitis C (HCV) with section 85 authority for community prescribing has provided an opportunity to improve historically poor treatment rates.The Remote Consult Request Form (RCRF) is part of a collaborative approach coordinated by Liver Nurses to facilitate treatment by general practitioners (GPs) in consult with Liver Specialists.     

First-year nursing students’ attitudes towards artificial intelligence: Cross-sectional multi-center study

AimTo assess the attitudes of nursing students toward artificial intelligence.BackgroundPossible applications of artificial intelligence-powered systems in nursing cover all aspects of nursing care, from patient care to risk management. Although the final acceptance of artificial intelligence in practice will depend on positive 'nurses' attitudes toward artificial intelligence, those attitudes have gained little attention so far.DesignA cross-sectional multicenter study.MethodsThe study was performed at nursing schools of four Croatian universities, surveying a total of 336 first-year nursing students (response rate 69.7%) enrolled in 2021. A validated instrument, the General Attitudes towards Artificial Intelligence Scale, consisting of 20 Likert-type items, was chosen for the study. Where applicable, the items were contextualized for nursing. Four sub-scales were identified based on the outcomes of the factor analysis.ResultsThe average attitude score was (mean ± standard deviation) 64.5 ± 11.7, out of a maximum of 100, which was significantly higher than the neutral score of 60.0 (p < 0.001). The attitude towards AI did not differ across the universities and was not associated with students’ age. Male students scored slightly higher than their female colleagues. Scores on subscales “Benefits of artificial intelligence in nursing”, “Willingness to use artificial intelligence in nursing practice”, and “Dangers of artificial intelligence” were favorable of artificial intelligence-based solutions. However, scores on the subscale “Practical advantages of artificial intelligence” were somewhat unfavorable.ConclusionsFirst-year nursing students had slightly positive attitudes towards artificial intelligence in nursing, which should make it easier for the new generations of nurses to embrace and implement artificial intelligence systems. Reservations about artificial intelligence in daily nursing practice indicate that nursing students might benefit from education focused specifically on applications of artificial intelligence in nursing.     

Nursing students’ attitudes and experiences with mental illness: A cross-sectional study

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.     

Contact to the out-of-hours service among Danish parents of small children – a qualitative interview study

Objective: In Denmark, parents with small children have the highest contact frequency to out-of-hours (OOH) service, but reasons for OOH care use are sparsely investigated. The aim was to explore parental contact pattern to OOH services and to explore parents’ experiences with managing their children’s acute health problems.

Design: A qualitative study was undertaken drawing on a phenomenological approach. We used semi-structured interviews, followed by an inductive content analysis. Nine parents with children below four years of age were recruited from a child day care centre in Aarhus, Denmark for interviews.

Results: Navigation, information, parental worry and parental development appeared to have an impact on OOH services use. The parents found it easy to navigate in the health care system, but they often used the OOH service instead of their own general practitioner (GP) due to more compatible opening hours and insecurity about the urgency of symptoms. When worried about the severity, the parents sought information from e.g. the internet or the health care professionals. The first child caused more worries and insecurity due to less experience with childhood diseases and the contact frequency seemed to decrease with parental development.

Conclusion: Parents’ use of the OOH service is affected by their health literacy levels, e.g. level of information, how easy they find access to their GP, how trustworthy and authorized health information is, as well as how much they worry and their parental experience. These findings must be considered when planning effective health services for young families.

• Key points

• The main findings are that the parents in our study found it easy to navigate in the healthcare system, but they used the OOH service instead of their own general practitioner, when this suited their needs. The parents sought information from e.g. the internet or the health care professionals when they were worried about the severity of their children’s diseases. They sometimes navigated strategically in the healthcare system by e.g. using the OOH service for reassurance and when it was most convenient according to opening hours. The first child seemed to cause more worries and insecurity due to limited experience with childhood diseases, and parental development seems to decrease contact frequency.

• Overall, this study contributes with valuable insights into the understanding of parents’ help seeking behaviour. There seems to be a potential for supporting especially first-time parents in their use of the out of hours services.

     

The effects of interprofessional education – Self-reported professional competence among prehospital emergency care nursing students on the point of graduation – A cross-sectional study

The aim of the study was to investigate whether interprofessional education (IPE) and interprofessional collaboration (IPC) during the educational program had an impact on prehospital emergency care nurses’ (PECN) self-reported competence towards the end of the study program. A cross-sectional study using the Nurse Professional Competence (NPC) Scale was conducted. A comparison was made between PECN students from Finland who experienced IPE and IPC in the clinical setting, and PECN students from Sweden with no IPE and a low level of IPC. Forty-one students participated (Finnish n = 19, Swedish n = 22). The self-reported competence was higher among the Swedish students. A statistically significant difference was found in one competence area; legislation in nursing and safety planning (p < 0.01). The Finnish students scored significantly higher on items related to interprofessional teamwork. Both the Swedish and Finnish students’ self-reported professional competence was relatively low according to the NPC Scale. Increasing IPC and IPE in combination with offering a higher academic degree may be an option when developing the ambulance service and the study program for PECNs.     

General practitioners’ attitudes toward follow-up after cancer treatment: A cross-sectional questionnaire study

Objective An increasing number of cancer patients place a significant workload on hospital outpatient clinics, and health authorities are considering alternative follow-up regimens. It has been suggested that follow-up of cancer patients could be provided by GPs. This study aimed to explore GPs’ experiences with the provision of follow-up care for cancer patients, and their views on assuming greater responsibility in the future.

Design Electronic questionnaire study.

Subjects GPs in seven regions in Norway.

Results A total of 317 GPs responded. Many GPs reported experience in providing follow-up care to cancer patients, during the years following initial diagnosis primarily in collaboration with hospital specialists. More than half of the GPs were satisfied with their collaboration. Most GPs preferred to be involved at an early stage in follow-up care and, generally, GPs felt confident in their skills to provide this type of service. Fewer than 10% were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason.

Conclusions GPs acknowledged the importance of providing follow-up care to cancer patients, and the majority felt confident in their own ability to provide such care. However, they were hesitant to assume greater responsibility primarily due to fears of increased workload.

• Key Points

• It has been suggested that follow-up of cancer patients can be provided by general practitioners (GPs). The viewpoints and attitudes of GPs regarding such follow-up were investigated.

  • GPs reported broad experience in providing follow-up care to patients after active cancer treatment.

  • GPs acknowledged the importance of follow-up care, and they felt confident in their own ability to provide such care.

  • Fewer than 10% of GPs were willing to assume responsibility for additional cancer patients, citing potentially increased workload as the main reason.

     

A scale-development study: Exploration of intensive-care nurses’ attitudes towards futile treatments

The study was conducted to determine the validity and reliability of the tool used to assess nurses’ attitudes towards futility, and to explore intensive-care nurses’ attitudes towards futility. Principal components analysis revealed that 18item scale was made up of four subdimensions that assess Identifying(beliefs), Decision-Making, Ethical Principles and Law, and Dilemma and Responsibilities related to futile treatments. The internal consistency of the scale was in the acceptable range, with a total Cronbach’s alpha value of 0.72. Overall the results of study suggest that scale can be used as a valid and reliable assessment tool to assess nurses’ attitudes towards futility.