Challenges experienced by community health workers and their motivation to attend a self-management programme

Background: Community health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. However, they themselves have health risk behaviours, which predispose them to non-communicable diseases and thus need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours.Aim: This study aimed to explore the challenges experienced by CHWs in carrying out their daily duties and the motivating factors to join a self-management programme.Setting: The study was conducted in a low socio-economic urban area of the Western Cape, South Africa.Methods: This study used a qualitative exploratory design using in-depth interviews to obtain rich data about the personal and professional challenges that CHWs experience on a daily basis.Results: Five themes emerged with regard to professional challenges (social conditions, mental health of patients, work environment, patient adherence and communication). This cadre identified ineffective self-management as a personal challenge and two themes emerged as motivation for participating in a self-management programme: empowerment and widening perspective.Conclusion: The challenges raised by the CHWs have a direct impact on their role in communities. This study therefore highlights an urgent need for policymakers and leaders who plan training programmes to take intentional strategic action to address their health challenges and to consider utilising a self-management intervention model to improve their overall health status.

Learning from adversity: Occupational therapy staff experiences of coping during Covid-19

Introduction The Occupational Therapy profession is adaptable and flexible (Thorner (1991) and these characteristics have the potential to act as protective factors during the COVID-19 pandemic. Understanding the mechanisms that support coping during adversity can help promote future wellbeing. The aim of this study was to explore how Occupational Therapy staff felt and coped during the first peak of the pandemic. Method A questionnaire was developed to explore the experiences of Occupational Therapy staff during the first wave of the COVID-19 pandemic. The questions explored feelings, mechanisms of support and challenges to both practice and wellbeing. A total of 75 staff responded across one NHS Health Board and reflections were analysed using inductive content analysis. Findings Staff reflected on how their ability to adapt and remain flexible were protective factors. This combined with supportive family members, friends and colleagues led respondents to reflect on how well they coped. Barriers to coping included organisational challenges, personal challenges and professional challenges. Conclusion The importance of consistent communication, the need for staff to remain connected to their profession and the importance of engaging in meaningful occupations were highlighted as key to maintaining wellbeing during adversity.

Exploring the experiences of operating room health care professionals' from the challenges of the COVID-19 pandemic

Background The operating room nurses have encountered several challenges during the current COVID-19 Pandemic, which subsequently impact their clinical performance. The present study aimed to investigate the experiences of operating room health care professionals' regarding the COVID-19 pandemic challenges in southern Iran. Methods This is a descriptive qualitative study. The required data were collected using in-depth and semi-structured interviews. Accordingly, 19 operating room health care professions were included in this study through purposive sampling. The data were collected from February 2020 to August 2021 and then analyzed using the Granheim and Lundman’s method. Results Three main themes and 9 sub-themes were presented in this study. They included: 1- Challenges of applying protocols and standards of care in the COVID-19 pandemic in the operating room (lack of specific guidelines regarding care protocols and standards for crisis management of Covid-19 in the operating room and impossibility of keeping social distance in the operating room). 2- Professional challenges (tedious and hard work, professional burnout, lack of adequate support by the managers and lack of personal protective equipment). 3-Psychological crises (indescribable anxiety and worry, parenting stress, and weakened resilience). Conclusion Based on the findings of the present study, it was indicated that lack of a specific guideline in the COVID-19 pandemic led to a sense of indecision and confusion among operating room staff. In this regard, performing tedious tasks, feelings of tiredness and exhaustion, lack of support by the authorities, and lack of access to adequate facilities and equipment were reported as the professional challenges of the healthcare staff in the current COVID-19 pandemic, which consequently affected the quality of care and patient’s safety. It seems that hospital officials can use the results reported in this study for efficient planning and effective management during the COVID-19 pandemic.

Work readiness in rehabilitation medicine: a qualitative exploration and framework

Background/aims The skills and attributes that facilitate the transition from student to professional (also known as work readiness) have not been fully explored in rehabilitation medicine. The aim of this study was to develop a model of work readiness for new rehabilitation medicine professionals that allows for a successful transition to the workplace. Methods A qualitative approach was used to explore the perspectives of 26 clinicians, regulators and employers about work readiness in rehabilitation disciplines. Transcripts were coded and analysed using content analysis methods. Results At the core of work readiness for rehabilitation medicine professionals were three complex endeavours that were framed as professional challenges. Each endeavour integrated one or more foundational skills and could improve context-bound applied skills. Conclusions Work readiness in rehabilitation requires active and ongoing commitment from students, post-secondary programmes and employers.

Management of COVID-19-related challenges faced by EMS personnel: a qualitative study

Background As the first link in the chain of providing healthcare services in the frontline of the battle against COVID-19, emergency medical services (EMS) personnel are faced with various challenges, which affect their professional performance. The present study aimed to identify some strategies to manage the COVID-19-related challenges faced by the pre-hospital emergency care personnel in the south of Iran. Methods In this qualitative descriptive study, 27 pre-hospital emergency care personnel who were selected through the purposeful sampling method. Data were collected through 27 semi-structured, in-depth, individual interviews. The collected data were then analyzed based on the Granheim and Lundman’s method. Results Analysis of the data resulted in the identification of 3 main themes and eight sub-themes. These three main themes were as follows: comprehensive and systematic planning, provision of medical equipment, and reduction of professional challenges. Conclusion The findings of the present study showed that, during the COVID-19 crisis, emergency medical services personnel should be provided with a comprehensive and systematic protocol to provide pre-hospital care and their performance should be assessed in terms of a set of scientific standards. Due to lack of equipment and work overload in the current crisis, emergency medical services personnel are faced with many psychological challenges, which adversely affect their quality of pre-hospital emergency care. Furthermore, emergency care senior managers should develop comprehensive protocols, provide more equipment, and eliminate professional challenges to pave the ground for improving the quality and safety of the healthcare services in pre-hospital emergency care during the current COVID-19 crisis.

Literature as a Pedagogical Tool in Medical Education: The Silent Patient Case

The arts have seen increasing use in medical education over the last 4 decades. Literature in particular is now frequently used as an educational tool in different medical humanities programmes. This paper analyses Alex Michaelides’ novel The Silent Patient with the goal of examining the professional issues presented in this psychological thriller and how the novel’s themes can be used to prompt discussion among medical students about professionalism and ethics in psychiatric settings. Following Strauss and Corbin’s qualitative procedure for conventional content analysis, this study employs content analysis of the literary text. The process of analysis began with open coding in which codes were assigned to all relevant sentences and paragraphs addressing professionalism in working with silent patients in psychiatry. These codes were then analysed to identify five major themes: multidisciplinary teamwork; therapy for the therapist; patient-centred care for silent patients; communication with silent patients; professional challenges in working with silent patients. The paper concludes that The Silent Patient novel represents important issues related to ethics and professionalism in working with silent patients in psychiatric settings. The novel can be used as a creative tool to guide discussion surrounding these issues. The paper argues that although the impact of its use is short-term, literature can make a significant contribution by provoking thought and discussion about professional and ethical aspects of practising medicine and caring for patients.

A Multi-Country Survey on the Impact of COVID-19 on Dentists in Latin America

Background: The COVID-19pandemic has significantly impacted the dental sector worldwide.Methods: The impact of the pandemic on dentistsfrom Latin America was investigated by an online survey with professionals working in 11 Spanish-speaking countries in September–December 2020. The invitations were sent to registered professionals. An open campaign was promoted on social media. The questions investigated dental care routines, work practice changes, andfeelings about the pandemic, in addition toreasons for engaging in furthersurveys.Descriptive statistics were used to identify frequencies and distributions of variables. Proportions were compared using chi-square tests.Results: A total of 2,127 responses were collected from a samplewith diverse demographic, sex, work, and education characteristics. The impact of the pandemic was considered high/very high by 60% of respondents.The volume of patients assisted weekly was significantly lower compared with the pre-pandemic period (mean reduction=14 ±15 patients). A high rate of fear to contracting the COVID-19 at work was observed (85%); 4.9% of participants had a positive COVID-19 test. The mask most frequently worn was PFF2/N95 (42%). The main professional challenges faced by respondents were reduction in the number of patientsor financial gain (35%), fear of contracting COVID-19 (34%), and burden with or difficulty in purchasing new PPE (22%).The fear to contracting COVID-19 was influenced by the number of weekly appointments. A positive test by the dentists was associated with their reports of having assisted COVID-19 patients. The most cited feelings about the pandemic were uncertainty, fear, worry, anxiety, and stress. When asked about incentives to participating in further surveys, the most common responses were receiving articles that originated from the investigation (44%)and priority access to research data (15%). Conclusion:This multi-countrysurvey indicated a high impact of the pandemic on dental care routines in Latin American offices.