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  • Implementing seating guidelines into clinical practice and policy: A critical reflection and novel theory

    Samuriwo, Ray; Stephens, M.; Bartley, C.; Stubbs, N. (2022-11)
    Introduction: A significant proportion of healthcare that is delivered is wasteful, harmful and not evidence based. There are many wound care related guidelines, but their implementation in practice is variable. The Society of Tissue Viability (SoTV) published updated seating guidelines in 2017, but there is a lack of theoretical and conceptual clarity about how these guidelines are being utilised to inform clinical practice. Therefore, the aim of this paper is to generate a theory that can be used to incorporate the SoTV seating guidelines into policy and clinical practice. Methods: We critically reflected on data from an evaluation study utilising systems-thinking approach, informed by implementation and safety science using wider literature as well as our expertise to generate a guideline implementation theory. Discussion: Factors that facilitate or hinder the incorporation of the SoTV guidelines into policy and practice were characterised. We conceptualised the implementation of these guidelines into policy and practice into a Translation or Implementation into Policy or Practice (TIPP) theory with distinct stages, that we called liminal spaces. Knowledge of the guidelines, and the agency or authority to effect change, are key factors in the translation of these guidelines into clinical practice. Conclusion: Our theory is that there are liminal spaces in the implementation trajectory of these guidelines into practice, which have their own characteristics. This theory provides a framework that can be used to underpin guidelines strategies to embed skin and wound care guidelines into policy and clinical practice in order to improve patient care.
  • Perceptions of public health nursing Team Leaders (TLs) and Team Supervisors (TSs) on nurse's development in Fiji

    Singh, S.S.; Mohammadnezhad, Masoud; Tamani, L. (2022-12)
    Nurse team leaders are responsible for contributing to managing the quality of service delivery and facility output of their nurses to ensure there is a high quality of care delivered by the health system. This study aimed to explore the perceptions of public health nursing Team Leaders (TLs) and public health nursing Team Supervisors (TSs) on nurses' development in Fiji. A qualitative study was used to gather information using in-depth phone interviews among TLs and TSs comprising Chief Midwifery Nursing Officer (CMNO), Director of Nursing (DON), Sub-divisional Nursing Managers (SDNMs), acting SDNMs and Nursing Manager (NM) at Central health division in Fiji. The data was collected through semi-structured open-ended questionnaires and were audio recorded. The data was analyzed using manual thematic analysis process. The study comprised of 26 participants, which included 10 TSs and 16 TLs. Four themes were identified for the results amongst TSs and TLs: ethical development; professional development; psychological development; and recommendations. However, nine sub- themes were identified for TSs and eight sub-themes were identified for the result amongst TLs. This study highlighted that TLs and TSs elaborated on the need for the ethical, professional, psychological development, nursing development and also on the importance of policies and guidelines. Professional ethics should be integrated into the Continuous Profession Development (CPD) points that are used to renew yearly nursing licenses as well as exposing the need for having competencies on professional ethics in nurses' logbooks. Further research is needed to determine the in-depth barriers.
  • "Once you get cancer you die. There is no way to get saved from cancer." A qualitative exploration of patients' perceptions towards cancer in Fiji

    Kumar, K.; Mohammadnezhad, Masoud (2022-12)
    Understanding patients' perspective to get an insight into cancer, and how best the public health systems can battle with this disease is the way forward in this current world. This study aimed to explore patients' knowledge about common cancers, barriers to assessing cancer information and cancer preventative approaches in Fiji. The study used a qualitative method approach that was conducted among patients who attended Special Outpatients (SOPD) at the four selected health centres in Lautoka Subdivision, Fiji from 1st March to 30th April 2021. A semi-structured open-ended questionnaire was used to guide in-depth interviews. These audio recordings were transcribed and analysed using thematic analysis. All interview transcripts were read and similar words and phrases were assigned numbers which were grouped together to identify themes and sub themes. Twenty-eight patients took part in the in-depth interview and the responses were grouped into four themes including; cancer knowledge, diagnosis of cancer in a close friend/family, barriers of communication and optimizing cancer awareness. Patients' awareness about common cancers and cancer risk factors was low. Many barriers for cancer screening were highlighted including stigmatization, fear, worry, death, lack of information, herbal medicine use, lack of resources and delay in diagnosis. Awareness strategies highlighted by participants included community outreach programs, house to house visits, opportunistic screening, engagement of community health care workers and the concept of a cancer hub centre. It is evident that there is a range of views from patients towards cancer and it is important to understand these perceptions to better guide public health interventions concerning cancer. This puts more focus on the need to invest more in information, education, and communication material for public campaigns that target a variety of people for a wider reach.
  • Recruitment and retention of the health and social care digital workforce: A rapid review

    Prowse, Julie M.; Sutton, Claire; Randell, Rebecca (2022-12)
    The recruitment and retention of a digital health and social care workforce in the United Kingdom (UK) is challenging for several reasons that include the shortages of these employees in the National Health Service (NHS) and social care and the high demand for digital skills from other sectors (HEE, 2021a; NHS Providers, 2017). Brown (2022:7) notes that ‘high staff turnover rates, chronic recruitment and retention issues, and low morale are increasingly identified as major challenges for those working in social care’. Liu et al., (2019:5) in their report ‘NHS Informatics workforce in England: Phase 1 Project Report’ estimated that the size of the NHS informatics workforce in 2019 was between 40,640 Full Time Equivalents (FTEs) to 53,936 FTEs based on electronic staff records. However, significant shortages in digital and information technology staff in health and social care were identified that pose a challenge. This rapid review examines the strategies used to recruit and retain the health and social care digital workforce and potential solutions to issues raised.
  • Planning the Radiology Workforce for Cancer Diagnostics

    Prowse, Julie M.; Sutton, Claire; Faisal, Muhammad; Elshehaly, Mai; McVey, Lynn; Montague, Jane; Randell, Rebecca (2022-12)
    The publication of the Delivery plan for tackling the COVID-10 backlog of elective care (NHSE/I, 2022:5) contained a number of ambitions, including that, by March 2024, 75% of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have had cancer ruled out within 28 days. By March 2025, waits of longer than a year for elective care should be eliminated and 95% of patients needing a diagnostic test should receive it within six weeks. The report acknowledged the need to grow the workforce to achieve these ambitions and ensure a timely cancer diagnosis, while also proposing the use of digital technology and data systems to free up capacity. To assist West Yorkshire National Health Service (NHS) organisations to meet these ambitions, this report presents the findings of a ‘deep dive’ that focuses on the role of radiology in meeting the ambitions of providing timely cancer diagnosis. Aims 1. To understand current and projected demand for radiology expertise in cancer diagnosis in West Yorkshire. 2. To understand the current and projected radiology workforce in West Yorkshire and determine the gap between the projected radiology workforce and the required radiology workforce. 3. To identify possible solutions to assist in providing the radiology workforce required for West Yorkshire and explore their acceptability and potential impact. Methods A range of sources of data and methods were utilised. We examined publicly available quantitative data concerning cancer waiting times and diagnostic waiting times and activity and used this to forecast future cancer waiting times and diagnostic waiting times and activity. We examined data from Health Education England (HEE) regarding radiologists’ and radiographers’ workforce profile data for West Yorkshire, the number of radiologists completing training, and the number of radiographers graduating, and data submitted by West Yorkshire Trusts to HEE regarding their plans for growing their radiology and radiographer workforce. Interviews (N=15) conducted with radiology service managers, university academics and key strategic and operational stakeholders delivering radiology services were used to understand the current and future issues around strategic workforce planning, workforce changes and transformation, workforce roles and skills, training and education and service changes. A rapid review of the literature examining the impacts of artificial intelligence (AI) on the workload of radiology services was also undertaken. To put this work in context, we also reviewed relevant policy documents and reports. Alongside this, we consulted with the Yorkshire Imaging Collaborative (YIC) and the West Yorkshire Cancer Alliance (WYCA) and attended a series of workshops run by the Yorkshire Imaging Collaborative. Results Overall, the findings show that demand for radiology services is increasing and that both cancer waiting times and the waiting times for diagnostic tests increased, with a concurrent downward trend in activity that, if all else stays the same, is forecast to continue up to 2025. The cancer waiting times data indicate that patients were waiting longer and that their needs were not being met. Moreover, 3 the proportion of people treated within accepted cancer waiting times decreased both nationally and within the West Yorkshire region from 2013. This was exacerbated by COVID-19 which caused a further decrease nationally and for the West Yorkshire region. National data for waiting times for all diagnostic tests show a significant decline between 2006 and 2008, with a decrease in median waiting times from just under 6.0 weeks to approximately 2.0 weeks. Overall, waiting times remained stable until late 2020 when they started to rise with the longest median waiting times at just over 8.0 weeks in mid-2020. The total number of people waiting for radiology tests nationally is decreasing and is predicted to continue to do so, while in West Yorkshire the number of people waiting for radiology tests decreased until 2020 but has since been on an upward trend which is predicted to continue. Nationally, the total number of radiology tests is on an upward trend that is predicted to continue, while in West Yorkshire activity has been decreasing since well before COVID-19 and is predicted to continue to do so. Data examining the current and future workforce showed that the national figures for the total radiology and radiography workforce are small relative to other health professional groups. In West Yorkshire, 265 radiologists and 926 radiographers were employed, and staff turnover was generally low. Trusts’ forecasts for the number of radiologists and radiographers they believe they need suggest a 16% increase in the number of radiologists in post between March 2022 and March 2027 and a 25% increase in the number of radiographers in post. The numbers of radiographers and radiologists being trained in West Yorkshire suggest that this is feasible. Interview data identified a number of main themes and associated issues: delivering diagnostic cancer targets, strategic workforce planning, workforce roles and skills, service transformation, recruitment and retention, universities, artificial intelligence, collaboration, and international recruitment. Across all themes, some reoccurring issues were identified: a lack of staff, increased demands, a lack of capacity in terms of space and staff, a lack of strategic workforce planning with a focus on operational or financial plans. Respondents proposed potential solutions to some of the issues raised that included: new ways of working, upskilling, developing current and emerging roles, Community Diagnostic Centres (CDCs), greater collaboration between NHS Trusts, universities, CDCs, imaging academies and networks and the private sector, and the international recruitment of radiologists and radiographers to address workforce gaps. The rapid review findings helped to identify a number of potential benefits of use of AI in radiology, including contributing to improved workflow efficacy and efficiency of radiology services. However, this is dependent on the nature of the work and the AI function. As a result of faster AI reading, radiologists may be able to focus more on high-risk, complex reading tasks. AI can support automation of image segmentation and classification and aid the diagnostic confidence of less experienced radiologists. Respondents’ views on AI were mixed. There was acknowledgement that AI was already used to support radiology service delivery and both the benefits and problems associated were identified. The implications of AI for radiologists’ and radiographers’ roles were discussed in terms of changing work, AI being used to support or in some cases substitute radiologists and radiographers, and the need for the radiology workforce to adapt to the technological change whilst maintaining a caring service
  • The role of children’s hospices in perinatal palliative care and advance care planning: the results of a national British survey

    Tatterton, Michael J.; Fisher, Megan J.; Storton, H.; Walker, C. (Wiley, 2023)
    Introduction: perinatal palliative care services are increasingly available globally, offering a range of clinical and psychological support services to families during pregnancy, in the neonatal period and following the death of a baby with a life-limiting or life-threatening condition. Little is understood about the role of children’s hospice care and how it contributes to effective perinatal palliative care. Design: The study aims to answer the question ‘what is the role of children’s hospices in the provision of perinatal palliative care and advance care planning in the United Kingdom?’ Methods: An electronic survey was sent to all 54 children’s hospices in the United Kingdom between May and June 2022. Results: 30 hospices responded, representing 54% of the sector. All regions of all four counties are represented. Numbers of referrals to hospices for perinatal palliative care have increased significantly over the last five years. Hospices provide a range of services for families and babies, usually from the point of diagnosis or recognition of a life-limiting or life-threatening condition, underpinned with counselling and emotional support. Hospices worked with a range of professionals and services, most commonly fetal medicine and neonatal services. Advance care plans were an important element of effective perinatal palliative care, strengthening parent-professional and interprofessional relationships. Conclusion: Children’s hospice services play an important and growing role in the perinatal care of babies and families following the diagnosis or recognition of a life limiting or life-threatening condition. The family centred approach to care, from a broad, biopsychosocial perspective means that hospices make a unique and meaningful contribution to both the clinical and psychological needs of families.
  • Perception of Health Care Workers (HCWs) towards early antenatal booking in Fiji: A qualitative study

    Maharaj, R.; Mohammadnezhad, Masoud (2022-11)
    Background: Early booking or registration into Antenatal Care (ANC) can be defined as initiation of ANC before 12 weeks of gestation and is important for the best health outcome of the mother and the baby. Delayed initiation of ANC has been linked to increased rate of maternal and fetal mortality. There is international consensus that ANC should begin within first trimester yet pregnant women delay initiation of ANC. Health Care Workers (HCWs) understanding of reasons for this can improve patient provider relationship. Objectives: This study aims to explore the perception of the HCWs in Fiji towards early antenatal booking. Methods: A qualitative study was employed using four Focus-Group Discussions (FGDs)with the HCWs who provide health care service for pregnant women in Ba Mission Hospital (BMH) in 2020. Each group comprised of medical officers, mid-wives and registered nurse who were chosen purposively. A semi-structured open ended questionnaire was used to guide the discussion. Data was transcribed and analyzed manually using thematic content analysis using the following process: familiarization, coding, identifying themes, reviewing and refining, integration and interpretation. Results: There was a total of 18 HCWs for the FGDs. The mean age of the participants was 37.4±11.8years. The three themes identified were: knowledge of HCWs on early booking, their perceived barriers and perceived enabling factors to early antenatal booking. The FGDs identified that the HCWs had adequate knowledge on early initiation of ANC and that there were a range of barriers to early initiation of ANC. The HCWs also suggested factors that could enable women to book early. Conclusion: Based on the study it can be concluded that the HCWs have a positive perception of early antenatal booking, however, there are various factors that contribute to delayed antenatal booking. The barriers to early ANC are both an opportunity and a challenge to strengthen and review the maternal services offered. The enabling factors should be reinforced from an individual level to the health system and the general context. The implications of the barriers and enabling factors identified in this study is to implement evidence-based policies to improve early antenatal booking in Ba, Fiji.
  • Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study.

    Ram, S.; Mohammadnezhad, Masoud; Ram, K.; Prasad, K.; Pal, M.; Dalmia, P. (2022-11)
    Inequities in access to diabetic retinopathy (DR) services particularly in rural and remote Fiji is concerning. This is because DR when left undiagnosed and untreated for long, can lead to vision loss and permanent blindness. Appropriate channels must be explored to strengthen services and ensure equitable access to healthcare for everyone. This study describes the development and implementation of DR awareness training for community health workers (CHWs) and their subsequent engagement to raise awareness and scale-up DR screening for communities throughout Fiji. As part of a programme to reduce the incidence of avoidable blindness due to diabetes amongst people living in the Pacific, DR training for primary level nurses was developed and implemented. As these primary level nurses were already inundated by clinical duties and competing health priorities, a shifting of the task was proposed to engage the CHWs who would instead educate communities on diabetes and DR and make referrals for DR screening. A one-day DR awareness training was developed and implemented by the Pacific Eye Institute with funding from the Fred Hollows Foundation New Zealand. At the end of the DR programme in 2019, the team had achieved their target and trained a total of 823 CHWs giving an 81.32% coverage of the total 1012 registered CHW in the MHMS register. Anecdotal evidence showed a spike in DR referrals and screenings recorded at health facilities. Three key themes emerged related to the involvement of CHWs which include engagement of CHWs, benefits of the engagement, and health system-related challenges. The use of CHWs who are already integrated into the health system was considered a sustainable intervention to strengthen diabetes and DR services at the primary level of care, particularly if it involves community awareness, health education, and health services facilitation The future of the CHWs will depend on their being integrated more systematically into local health services with strengthened management and supervision.
  • Identifying factors which enhance the self-management of type 2 diabetes: A systematic review with thematic analysis

    Bako, K.R.; Reynolds, A.N.; Sika-Paotonu, D.; Signal, L.; Mohammadnezhad, Masoud (2022-11)
    Background: Individuals with type 2 diabetes play a pivotal role in their health. Enhancing the self-management of diabetes can improve blood glucose control, and quality of life, and reduce diabetes-related complications. We have identified factors influencing the self-management of type 2 diabetes to inform strategies that may be applied in the long-term management of blood glucose control. Methods: We conducted a systematic literature review of recent studies published between January 2010 to December 2020 to identify the available evidence on effective self-management strategies for type 2 diabetes. The databases used for the searchers were Scopus, PubMed, Science Direct, CINAHL, and Google Scholar. We assessed English language publications only. The screening of titles was duplicated by two researchers. We then conducted a thematic analysis of the key findings from eligible publications to identify reoccurring messages that may augment or abate self-management strategies. Results: We identified 49 relevant publications involving 90,857 participants. Four key themes were identified from these publications: Individual drive, social capital, Knowledge base, and Insufficient health care. High motivation and self-efficacy enabled greater self-management. The importance of family, friends, and the health care professional was salient, as were the negative effects of stigma and labelling. Enablers to good self-management were the level of support provided and its affordability. Finally, the accessibility and adequacy of the health care services emerged as fundamental to permit diabetes self-management. Conclusions: Self-management of type 2 diabetes is an essential strategy given its global presence and impact, and the current resource constraints in health care. Individuals with type 2 diabetes should be empowered and supported to self-manage. This includes awareness raising on their role in self-health, engaging broader support networks, and the pivotal role of health care professionals to inform and support. Further research is needed into the capacity assessment of healthcare systems in diabetes medicine, targeted low-cost resources for self-management, and the financial requirements that enable self-management advice to be enacted.
  • Factors affecting childhood immunization: Thematic analysis of parents and healthcare workers’ perceptions

    Balgovind, P.; Mohammadnezhad, Masoud (2022-11)
    Immunization against common childhood diseases is an important strategy as it is critical for reducing the global child morbidity and mortality. This review explores the perceptions of parents and HCWs toward childhood immunization. The PRISMA guideline was used to search and include the studies. Relevant electronic databases were systemically searched for the years ranging from 2000 to 2021 to identify studies reported in English. Themes were then identified using thematic analysis. A total of 44 studies met the review criteria and were summarized and categorized into 4 themes: barriers to immunization, parental knowledge, attitude and behavior (KAB), health system factors and HCWs’ KAB. This review found that immunization decision-making is a complex process. Parental KAB leads to immunization decisions. HCWs were also noted to be the trusted sources of immunization information. Further research can be conducted on how to improve parents’ perceptions of immunization and immunization practices.
  • “Go beyond your own comfort zone and challenge yourself”: A comparison on the use of physically active learning in Norway, the Netherlands and the UK

    Chalkley, A.E.; Mandelid, M.B.; Thurston, M.; Daly-Smith, Andrew; Singh, A.; Huiberts, I.; Archbold, V.S.J.; Resaland, G.K.; Tjomsland, H.E. (Science Direct, 2022-10)
    The adoption of physically active learning (PAL) in schools is becoming more widespread. To understand how PAL is being used in different countries and explore if and how methods and strategies differ, this paper draws cross-national comparisons in primary school teachers' use of PAL. Thirteen focus groups were conducted with 54 teachers from Norway, the Netherlands and the UK. Four themes were identified using thematic analysis: 1) teachers' values and beliefs about PAL; 2) influence of school context; 3) influence of the national policy context and; 4) managing teacher dissonance when using PAL. Use of PAL was related to teachers' values and beliefs and the degree to which these aligned with the context of the school and the wider educational system. The findings underline the importance of addressing teachers’ competence, opportunity and agency to use PAL in different contexts.
  • Unpacking physically active learning in education: a movement didaktikk approach in teaching?

    Mandelid, M.B.; Resaland, G.K.; Lerum, O.; Teslo, S.; Chalkley, A.; Singh, A.; Bartholomew, J.; Daly-Smith, Andrew; Thurston, M.; Tjomsland, H.E. (Taylor & Francis, 2022)
    This paper explores teachers’ educational values and how they shape their judgements about physically active learning (PAL). Twenty one teachers from four primary schools in Norway participated in focus groups. By conceptualising PAL as a didaktikk approach, the findings indicated that teachers engaged with PAL in a way that reflected their professional identity and previous experiences with the curriculum. Teachers valued PAL as a way of getting to know pupils in educational situations that were different from those when sedentary. These insights illustrate how PAL, as a didaktikk approach to teaching, can shift teachers’ perceptions of pupils’ knowledge, learning, and identity formation in ways that reflect the wider purposes of education. The paper gives support to a classroom discourse that moves beyond the traditional, sedentary one-way transfer of knowledge towards a more collaborative effort for pupils’ development.
  • “Will we ever return to normality?” Findings from Phase 2 (Oct – Dec 2020) of the Born in Bradford Covid-19 Adult Survey

    Moss, R.; McIvor, C.; Kelly, B.; Endacott, C.; Crossley, K.; Lockyer, B.; Sheard, L.; Islam, Shahid; Razaq, R.; Zarate, M.; et al. (https://www.bradfordresearch.nhs.uk/c.sag/, 2021-09-09)
    Born in Bradford (BiB) have carried out surveys of BiB participants during the first national lockdown (April – June 2020) and at a second Phase (Oct – Dec 2020). A third survey took place between June – July 2021. Participants were from either the BiB’s Growing Up (GU) or Better Start (BiBBS) cohorts and had children in pre-school, primary and secondary school age groups. This report presents a summary of the findings identified in Phase 2 (29th October 2020 – 23rd December 2020) of the Born in Bradford’s Covid-19 adult survey.
  • The Impact of Allied Health Professionals on the Primary and Secondary Prevention of Obesity in Young Children: A Scoping Review

    Griffiths, A.; Brooks, Rob; Haythorne, R.; Kelly, G.; Matu, J.; Brown, T.; Ahmed, K.; Hindle, L.; Ells, L. (2023)
    Background: Allied Health Professionals (AHPs) have the capacity to promote healthy behaviours in young children through routine ‘contact points’, as well as structured weight management programmes. This scoping review aims to evaluate the impact of AHPs in the prevention of obesity in young children. Methods: Databases were searched for relevant evidence between 1st January 2000 and 17th January 2022. Eligibility criteria included primary evidence (including, but not limited to; randomised controlled trials, observational studies, service evaluations) evaluating the impact of AHPs on the primary and secondary prevention of obesity in young children (mean age under five years old). Results: AHP related interventions typically demonstrated improvements in outcomes such as nutritional behaviour (e.g., lower sweetened drink intake), with some reductions in screen time. However, changes in weight outcomes (e.g., Body Mass Index (BMI) z score, BMI) in response to an AHP intervention were inconsistent. There was insufficient data to determine moderating effects, however tentative evidence suggests that those with a lower socioeconomic status or living in an underprivileged area may be more likely to lose weight following an AHP intervention. There was no evidence identified evaluating how AHPs use routine ‘contact points’ in the prevention of obesity in young children. Conclusion: AHP interventions could be effective in optimising weight and nutritional outcomes in young children. However, more research is required to determine how routine AHP contact points, across the range of professional groups may be used in the prevention of obesity in young children.
  • The Impact of the Pandemic on Mental Health in Ethnically Diverse Mothers: Findings from the Born in Bradford, Tower Hamlets and Newham COVID-19 Research Programmes

    McIvor, C.; Vafai, Y.; Kelly, B.; O'Toole, S.E.; Hays, M.; Badrick, E.; Iqbal, Halima; Pickett, K.E.; Cameron, C.; Dickerson, J. (2022-11)
    Restrictions implemented by the UK Government during the COVID-19 pandemic have served to worsen mental health outcomes, particularly amongst younger adults, women, those living with chronic health conditions, and parents of young children. Studies looking at the impact for ethnic minorities have reported inconsistent findings. This paper describes the mental health experiences of mothers from a large and highly ethnically diverse population during the pandemic, using secondary analysis of existing data from three COVID-19 research studies completed in Bradford and London (Tower Hamlets and Newham). A total of 2807 mothers participated in this study with 44% White British, 23% Asian/Asian British Pakistani, 8% Other White and 7% Asian/Asian British Bangladeshi backgrounds. We found that 28% of mothers experienced clinically important depressive symptoms and 21% anxiety symptoms during the pandemic. In unadjusted analyses, mothers from White Other, and Asian/Asian British Bangladeshi backgrounds had higher odds of experiencing symptoms, whilst mothers from Asian/Asian British Indian backgrounds were the least likely to experience symptoms. Once loneliness, social support and financial insecurity were controlled for, there were no statistically significant differences in depression and anxiety by ethnicity. Mental health problems experienced during the pandemic may have longer term consequences for public health. Policy and decision makers must have an understanding of the high risk of financial insecurity, loneliness and a lack of social support on mother’s mental health, and also recognise that some ethnic groups are far more likely to experience these issues and are, therefore, more vulnerable to poor mental health as a consequence.
  • Prevalence and determinants of undernutrition among under-five children in Nigeria: A systematic review

    Nwankwo, B.; Mohammadnezhad, Masoud; Hagan, V.M.; Garatsa, C.; Barasa, E.B. (2022-10)
    Background: Child undernutrition is a key public health issue that both causes and contributes to disease and death. Undernutrition accounts for 45% of under-five deaths globally most of which occur in Low- and Middle-income countries (LMIC). Malnutrition has a substantial and long-lasting effect on individuals, families, communities and the entire nation. This study aimed to assess the prevalence and determinants of undernutrition in under-five children in Nigeria. Methodology: This systematic review was done following the Cochrane library guidelines. A search of literature written in English language and published between 2000 and 2022 was done using PubMed, CINAHL, MEDLINE and ProQuest databases. The initial search resulted in 760 studies. These were exported to End note version 9 to remove duplicates. Titles and abstracts were screened for studies that met the inclusion criteria. Finally, 11 studies that met the inclusion criteria were thoroughly assessed and data that were relevant to this systematic review were captured. The study findings were analyzed using descriptive statistics. Results: The prevalence of undernutrition was between 1.0% and 43.3%. The highest prevalence of underweight, wasting and stunting were 43.3%, 29.3% and 41%, respectively. Factors associated with undernutrition were age, sex, birth order, recent acute diarrhoea and acute respiratory infection, maternal literacy level, maternal income <$20 and socio-economic class among others. Conclusion: Under-five undernutrition is a huge public health issue in Nigeria. Prevalence of undernutrition varies widely across geo-political zone with a myriad of associated risk factors. Multi-level and multidisciplinary interventions are required to sustainably address the determinants of under-five undernutrition.
  • Nursing Intervention on Discharge Planning for Elderly Patients with Hip Fracture: A Systematic Review

    Yusoff, R.M.; Mulud, Z.A.; Mohammadnezhad, Masoud (2022-10)
    Aim: This literature review aims to conduct an extensive systematic literature review of the nursing interventions on discharge planning among geriatric patients with hip fractures. Design: The review applied multiple research designs, and the literature search was based on PRISMA’s publication standard. Data Sources: The articles were selected from three primary online databases: Scopus, Science Direct and Web of Science and one supporting database, Google Scholar. Review Method: After searching the eligible articles, 15 articles were selected for thematic analysis. Results: The systematic review came out with five central themes 1) assessments of the patient’s and family member’s needs: 2) diagnosis of an individual discharge planning: 3) prescription of the appropriate nursing interventions; 4) implementation of the nursing interventions and 5) follow -up after the patients have been discharged from hospital. Conclusion: The review’s findings explained the nursing intervention implemented and its effectiveness on elderly patients with hip fractures. Apart from that, this review also highlighted the methodology approach and health outcomes measured, which will help the scholars better understand the study area. Impact: The review contributes needed information for future nursing research and practice of the elderly with hip fractures.
  • Complete denture prostheses (CDP) treatment and care in Fiji: A qualitative study on dental professionals (DPs) perspectives on the triangle of communication (ToC)

    Nand, M.; Mohammadnezhad, Masoud (2022-10)
    Effective communication can aid in improving oral healthcare measures such as treatment outcomes and satisfaction of edentulous patients (EDPs) toward the treatment process. The triangle of communication (ToC) involves communication between the dentist, dental technician (DTech), and EDPs. This research aimed to explore the ToC between dental professionals (DPs) and patients undergoing complete denture prostheses (CDP) treatment in Fiji. Materials and Methods: A descriptive qualitative study was conducted among DPs under purposive sampling where focus group discussions were conducted at the four dental prosthetic clinics in Fiji. A semi-structured questionnaire with open-ended questions was applied to participants virtually via Zoom. The collected data were collated and analyzed manually using thematic analysis. Results: A total of 28 DPs participated in the study. Three themes were identified while exploring the ToC from DPs’ perspectives on CDP treatment and care in Fiji: staff communication—dentist and DTech, ToC and information sharing (dentist–DTech and EDPs), and stage-by-stage procedural checks for CDP between DPs. Effective collaboration between dentists and DTechs is an essence of a successful CDP treatment outcome. Most DPs agreed to undergo continuous communication throughout the treatment to keep EDPs engaged throughout the treatment process. In addition, stage-by-stage procedural checks in dental clinics as well as in dental laboratories improved the quality of CDPs. Conclusion: DPs highlighted predominantly the ToC between DPs and EDPs when receiving CDP treatment in Fiji as an essential tool for effective DP and patient engagement. Discussions should be complemented with the use of verbal, nonverbal, and written modes together with the utilization of interpreters to improve CDP treatment and care in Fiji.
  • A systematic review study on the factors affecting shortage of nursing workforce in the hospitals

    Tamata, A.T.; Mohammadnezhad, Masoud (2022)
    This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses. This study applied a systematic review design. Using Cochrane library guidelines, five electronic databases were systematically searched (Research 4life-PubMed/Medline, Scopus, Embase, CINAHL) from 2010-2021. The remaining articles with pertinent information were presented in a data extraction sheet for further thematic analysis. A Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram was adopted and used. The studies published from 2010-2021 and in English language were examined and included in the systematic review. Four themes were identified as factors influencing the nursing workforce shortage, including Policy and planning barriers, Barriers to training and enrolment, Factors causing nursing staff turnover and Nurses' stress and burnout. Nursing workforce shortage is a global challenge that roots in multiple causes such as individual, educational, organizational and managerial and policy-making factors.
  • Perceptions of Healthcare Workers (HCWs) towards childhood immunization and immunization services in Fiji: a qualitative study

    Balgovind, P.; Mohammadnezhad, Masoud (2022-10)
    Childhood immunization has been globally recognized as the single most effective strategy in preventing childhood diseases and mortality. The perceptions of healthcare workers are important as their behavior and attitudes influence parental decision-making process. This research aimed to explore the factors that influence healthcare workers' experience and perceptions about delivering childhood immunization in Fiji. A qualitative study was conducted in three randomly selected health centers in Suva, Fiji from March 1st to April 5th, 2021. Five focus group discussions were conducted with healthcare workers who were chosen purposively, had worked in the health center for at least 6 months and included either gender. Those that did not consent or did not meet the inclusion criteria were excluded. The interviews were guided by semi-structured open-ended questionnaire and were recorded into a digital voice recorder. The data were coded, sorted, and then categorized into themes, and transcribed onto Microsoft Word. Thematic analysis was utilized to sort the key phrases from the recorded interviews. There were a total of 22 participants for the focus group discussions, with their ages ranging from 25 to 51 years, included 3 medical officers, 1 nurse practitioner and 18 registered nurses. Three major themes emerged, which included: healthcare worker factors, parental factors and health system factors. Subthemes identified from the healthcare worker factors were worker knowledge and attitudes. The subtheme for parental factors that emerged were defaulters, parental attitudes, perceived behavior and religious beliefs. For health system factors the subthemes were service delivery, registration, infrastructure, staff turnover, staff training and changes to the immunization schedule. Some of the perceived barriers reported by the healthcare workers were parental religious beliefs, parental knowledge and attitude, social or physical factors (finances, transportation, childcare and work conflicts), access to health services, immunization services and policies, hours of operation, waiting time and missed opportunities. Health workers acknowledged that they have an important role to play in immunization as they are the source of information and motivation for parents. Further studies are needed to be conducted nationally to determine the perceptions of healthcare workers towards immunization and how the services can be improved on a national level.

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