Studies of healthcare students report increased levels of stress, with academic pressures being the greatest source. The objective of this study was to examine the differences in the overall stress level, stressors, and reactions to stressors between physiotherapy students at the University of Gothenburg (GU) and those at the Hanze University of Applied Sciences (HUAS).
The Student-life Stress Inventory was used. The participants (n = 116) included physiotherapy students at GU and HUAS. The distribution of the questionnaire occurred during a regular lecture or in a lecture that was scheduled particularly for its distribution.
At GU, 13.7% of the students rated their level of stress as mild, whereas 72.5% of them rated it as moderate. The corresponding values for HUAS students were 43.9% and 43.9%, respectively. This difference between two universities was significant (p = 0.006). The total score of the subcategories indicated that the students at GU reported significantly higher levels of stressors (p = 0.027) and reactions to stressors (p = 0.003). However, there were no significant differences in the male participants between the universities.
Female students in their three-year educational program in Sweden experienced significantly more stress than Dutch female students in their four-year educational program.
Occupational therapy students need to develop self-efficacy for managing the therapeutic relationship in practice. This study examined the 10-month trajectories of Norwegian students' self-efficacy for use of self.
Eighty-nine students completed self-efficacy questionnaires related to the use of self after a workshop and at 3- and 10-month follow-up. Changes on the three outcome measures (self-efficacy for therapeutic mode use, for recognizing clients' interpersonal characteristics, and for managing interpersonal events) were analyzed with repeated measures ANOVA.
Across the follow-up period, the students improved their self-efficacy for therapeutic mode use (partial ?2 = 0.44, p
To determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England.
European primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013.
45 GP staff, 13 trainers and 18 stakeholders.
The iterative interview schedule explored participants' personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis.
Findings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country's health services.
A common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu.
Cites: Sex Transm Infect. 2014 May;90(3):188-94 PMID 24005256
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Cites: BMC Fam Pract. 2016 Mar 22;17 :33 PMID 27001608
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There are major gaps in the understanding of sexual and reproductive health in female renal transplant recipients.
In this Norwegian multicenter retrospective observational study, 118 female renal transplant recipients aged 22 to 49 years responded to a questionnaire on fertility, contraceptive use, and pregnancy.
More than one-third (37%) of patients reported that they did not receive advice on contraceptive methods from health care personnel in the early post-transplant phase. These women used effective contraceptive methods less often. Nearly half of the patients (45%) reported that they had not received any advice on timing of conception after transplant. From 95 pregnancies after renal transplant, 52 (55%) resulted in live births.
Counseling on contraceptive methods should be part of standard care in conjunction with transplantation. More than one-third of young female renal transplant recipients of reproductive age could not recall having received advice from health care personnel about contraceptive use, and nearly half of the patients did not receive preconceptional advice after transplant. Although the current study does not discriminate between lack of advice and recall bias, the findings signal the need for improved counseling on female sexual and reproductive health after renal transplant.
To describe the health-related quality of life (HRQOL) of patients with prostate cancer and their spouses in comparison with the Finnish general population, using the RAND 36-Item Health Survey. An additional purpose was to describe the associations between the background variables of the participants and their HRQOL.
The HRQOL of patients with prostate cancer and especially their spouses at the time of diagnosis is not well known.
A cross-sectional study.
Responses were received from 232 patients and 229 spouses at 5 central hospitals in Finland between October 2013 and January 2016.
Compared to the Finnish general population mean, the HRQOL of the patients and their spouses was, on average, better for all dimensions. Patients' age, the presence of disease, and the treatment method were associated with the dimensions of HRQOL. The dimensions of HRQOL were also associated with spouses' age, basic and vocational education, and the presence of disease.
The patients and their spouses experienced their HRQOL as very similar; however, on average, it is better than the general population mean. However, the evidence suggests that support from the nurses should focus on emotional well-being, the dimension that received the lowest scores in both groups.
To describe the factors pertaining to medication being administered to the wrong patient and to describe how patient identification is mentioned in wrong-patient incident reports.
Although patient identification has been given high priority to improve patient safety, patient misidentifications occur, and wrong-patient incidents are common.
A descriptive content analysis.
Incident reports related to medication administration (n = 1,012) were collected from two hospitals in Finland between 1 January 2013-31 December 2014. Of those, only incidents involving wrong-patient medication administration (n = 103) were included in this study.
Wrong-patient incidents occurred due for many reasons, including nurse-related factors (such as tiredness, a lack of skills or negligence) but also system-related factors (such as rushing or heavy workloads). In 77% (n = 79) of wrong-patient incident reports, the process of identifying of the patient was not described at all.
There is need to pay more attention to and increase training in correct identification processes to prevent wrong-patient incidents, and it is important to adjust system factors to support nurses.
Active patient identification procedures, double-checking and verification at each stage of the medication process should be implemented. More attention should also be paid to organisational factors, such as division of work, rushing and workload, as well as to correct communication. The active participation of nurses in handling incidents could increase risk awareness and facilitate useful protection actions.
Although digital technologies can mitigate the burdens of home healthcare services caused by an ageing population that lives at home longer with complex health problems, research on the impacts and consequences of digitalised remote communication between patients and caregivers is lacking. The present study explores how home healthcare professionals had experienced the introduction of digital medicine dispensers and their influence on patient-caregiver relationships.
The multi-case study comprised semi-structured interviews with 21 healthcare professionals whose home healthcare service involved using the digital medicine dispensers. The constant comparative method was used for data analyses.
Altogether, interviewed healthcare professionals reported three main technology-related impacts upon their patient-caregiver relationships. First, national and local pressure to increase efficiency had troubled their relationships with patients who suspected that municipalities have sought to lower costs by reducing and digitalising services. Participants reported having to consider such worries when introducing technologies into their services. Second, participants reported a shift towards empowering patients. Digital technology can empower patients who value their independence, whereas safety is more important for other patients. Healthcare professionals needed to ensure that replacing care tasks with technology implies safe and improved care. Third, the safety and quality of digital healthcare services continues to depend upon surveillance and control mechanisms that compensate for less face-to-face monitoring. Participants did not consider the possibility that surveillance exposes information about patients' everyday lives to be problematic, but to constitute opportunities for adjusting services to meet patients' needs.
Technologies such as digital medicine dispensers can improve the efficiency of healthcare services and enhance patients' independence when introduced in a way that empowers patients as well as safeguards trust and service quality. Conversely, the patient-caregiver relationship can suffer if the technology does not meet patients' needs and fails to offer safe and trustworthy services. Upon introducing technology, home healthcare professionals therefore need to carefully consider the benefits and possible disadvantages of the technology. Ethical implications for both individuals and societies need to be further discussed.
Cites: Sci Eng Ethics. 2013 Jun;19(2):389-406 PMID 22218998
Cites: J Med Internet Res. 2016 May 03;18(5):e98 PMID 27143097
To study the relation between body mass index (BMI) in young men and risk of early hospitalization with heart failure.
In a prospective cohort study, men from the Swedish Conscript Registry investigated 1968-2005 (n = 1 610 437; mean age, 18.6 years were followed 5-42 years (median, 23.0 years; interquartile range, 15.0-32.0), 5492 first hospitalizations for heart failure occurred (mean age at diagnosis, 46.6 (SD 8.0) years). Compared with men with a body mass index (BMI) of 18.5-20.0 kg/m2, men with a BMI 20.0-22.5 kg/m2 had an hazard ratio (HR) of 1.22 (95% CI, 1.10-1.35), after adjustment for age, year of conscription, comorbidities at baseline, parental education, blood pressure, IQ, muscle strength, and fitness. The risk rose incrementally with increasing BMI such that men with a BMI of 30-35 kg/m2 had an adjusted HR of 6.47 (95% CI, 5.39-7.77) and those with a BMI of =35 kg/m2 had an HR of 9.21 (95% CI, 6.57-12.92). The multiple-adjusted risk of heart failure per 1 unit increase in BMI ranged from 1.06 (95% CI, 1.02-1.11) in heart failure associated with valvular disease to 1.20 (95% CI, 1.18-1.22) for cases associated with coronary heart disease, diabetes, or hypertension.
We found a steeply rising risk of early heart failure detectable already at a normal body weight, increasing nearly 10-fold in the highest weight category. Given the current obesity epidemic, heart failure in the young may increase substantially in the future and physicians need to be aware of this.
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Cites: Eur Heart J. 2015 Jun 7;36(22):1371-6 PMID 25810456
Recent time trends and educational gradients characterizing out-of-hospital coronary deaths (OHCD) are poorly described.
We identified all deaths from coronary heart disease occurring outside the hospital in Norway during 1995 to 2009. Time trends were explored using Poisson regression analysis with year as the independent, continuous variable. Information on the highest achieved education was obtained from The National Education Database and classified as primary (up to 10 years of compulsory education), secondary (high school or vocational school), or tertiary (college/university). Educational gradients in OHCD were explored using Poisson regression, stratified by sex and age (
Cites: Circulation. 2014 Nov 18;130(21):1840-3 PMID 25274001
Cites: Tidsskr Nor Laegeforen. 2013 Apr 9;133(7):756-9 PMID 23588179
Background and aims The experience of pain may vary in accordance with personality traits and individual characteristics. Neuroticism is demonstrated to constitute a vulnerability factor among younger and middle-aged pain patients. The combination of openness and neuroticism is associated with high anxiety/depression scores among adult individuals with chronic conditions. The aim of this study was to investigate possible associations between pain and the personality dimensions of neuroticism, extroversion, openness, agreeableness and conscientiousness among persons aged 60 years and older. An additional aim was to explore whether such associations are equally gender expressed. Methods The Swedish National Study on Aging and Care includes a randomly selected sample from the National Population Register. The data collection was conducted at four research centres and was approved by the Ethics Committees of Lund University and the Karolinska Institutet, Stockholm, Sweden. The Blekinge sample includes 1402 individuals, aged 60-96 years, of whom 769 (55%) reported pain. A total of 2312 individuals had been invited to participate. The reason for non-participation was registered. Participants underwent medical examination and testing by research personnel, conducted in two sessions, each of which lasted about 3 h. A questionnaire was completed between the two sessions. Pain was self-reported and based on the question: Have you had ache/pain during the last 4 weeks? Information on personality traits was obtained by means of the personality SGC1 questionnaire; a 60-item Swedish version of Costa & McCrae's FFM questionnaire. Personality traits were then tested based on gender by means of multivariate forward logistic regression in models adjusted for age, insomnia, financial status and educational level. Results When adjusting for covariates among women, neuroticism had a small but significant odds ratio of experiencing pain (OR 1.05, CI 1.02-1.08). Insomnia had the highest odds ratio (OR 2.19, CI 1.52-3.15) followed by low education (OR 1.59, CI 1.07-2.36), while belonging to the younger part of the older adult cohort was also associated with pain (OR 1.02, CI 1.005-1.04). In men, neuroticism (OR 1.03, CI 1.002-1.06) followed by openness (OR 1.03 CI 1.001-1.07) had a small but significant odds ratio of experiencing pain. Insomnia had the highest odds ratio (OR 1.98, CI 1.24-3.15). Conclusions Personality traits and pain were related among the older adults but there were gender differences. The relationship between pain and neuroticism in women was about the same in strength as the relation between pain and neuroticism/openness in men. Both sexes suffer from insomnia. The relationship between personality traits and pain was only affected to a minor extent by insomnia. Implications There is a need to increase awareness of the impact of personality as well as to provide improved treatment for pain and insomnia in older people.
CommentIn: Scand J Pain. 2017 Dec 29;7(1):1-2 PMID 29911593