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Instruments used to measure knowledge and attitudes of healthcare professionals towards antibiotic use for the treatment of urinary tract infections: A systematic review
No full textBackground Urinary tract infections (UTIs) are the second most common condition (after upper respiratory tract infections) for which adults receive antibiotics, and this prevalence may contribute to antibiotic resistance. Knowledge and attitudes have been identified as potential determinants of antibiotic prescribing behaviour among healthcare professionals in the treatment and management of UTIs. An instrument that captures prescribers’ baseline knowledge of and attitudes towards antibiotic prescribing for UTIs could inform interventions to enhance prescribing. The current systematic review evaluates the psychometric properties of instruments already available and describes the theoretical constructs they measure. Methods Five electronic databases were searched for published studies and instruments. The Consensus-based Standards for the selection of health status Measurement Instruments checklist was used to assess the psychometric quality reporting of the instruments. The items included in each instrument were mapped onto the theoretical constructs underlying knowledge and attitudes using a mixed-theoretical model developed for this study. Results Fourteen studies met the review inclusion criteria. All instruments were available for review. None of the instruments had all the psychometric properties evaluated. Most of the instruments sought to identify knowledge and/or attitude factors influencing antibiotic prescribing for UTIs rather than to measure/assess knowledge and attitudes. Conclusions Few instruments for the assessment of knowledge and attitudes of healthcare professionals towards antibiotic use and UTI treatment are available. None of the instruments underwent the full development process to ensure that all psychometric properties were met. Furthermore, none of the instruments assessed all domains of knowledge and attitudes. Therefore, the ability of the instruments to provide a robust measurement of knowledge and attitudes is doubtful. There is a need for an instrument that fully and accurately measures the constructs of knowledge and attitude of healthcare professionals in the treatment of UTIs
Identifying predictors of opioid use among older United States’ adults with pain
No full textObjective: To identify the strongest predictors of opioid use among older United States’ (US) adults (≥50 years) with pain. Design: Cross-sectional retrospective database design. Setting: 2017 Medical Expenditure Panel Survey data. Participants: Civilian, noninstitutionalized sample of US adults aged ≥50 years alive for the calendar year with pain in the past 4 weeks. Interventions: Hierarchical logistic regression models assessed significant predictors of opioid use, which included: predisposing, enabling, need, personal health practices, and external environmental factors. Main outcome measures: Opioid use status (opioid user vs. nonopioid user). Results: Among 51,372,861 civilian, noninstitutionalized US adults alive aged ≥50 years with pain in 2017, the opioid use prevalence was 27.4 percent (95 percent confidence interval=25.8-29.0). Predictors of opioid use included: white versus other race (adjusted odds ratio, AOR=1.430), Hispanic versus non-Hispanic ethnicity (AOR=0.648), up to high school versus higher than high school education (AOR=1.259), functional limitation versus no limitation (AOR=1.580), little/moderate versus quite a bit/extreme pain (AOR=0.422), good versus fair/ poor perceived mental health status (AOR=1.429), smokers versus nonsmokers (AOR=1.523), and residing in the northeast versus west US (AOR=0.646). Conclusions: This study of 51 million older US adults with pain indicated that several factors including race, ethnicity, education, functional limitations, pain severity, mental health status, smoking status, and region of the country were predictors of opioid use. Future research is needed in additional clinical populations and to investigate where these findings diverge from previous studies
Comparison of the properties of the English and Spanish versions of the Patient Satisfaction with Pharmacist Services Questionnaire 2.0
No full textBackground: Pharmacists provide direct patient care services such as chronic disease management and medication therapy management services. Patient satisfaction measures are valuable tools to assess outcomes. Therefore, measuring patient satisfaction with pharmacist services, using tools such as the Patient Satisfaction with Pharmacist Services Questionnaire 2.0 (PSPSQ 2.0), is important to ensure service quality. Objective: The objective of the study was to evaluate the descriptive properties and reliability of the original English and newly translated Spanish versions of the PSPSQ 2.0 in a larger sample. Methods: This project evaluated the functioning of the Spanish translation of the PSPSQ 2.0 compared to the English version. Demographic characteristics were analyzed to determine whether the instrument functioned differently for English- and Spanish-speaking groups. Psychometric properties were analyzed. Results: Completed data for both PSPSQ 2.0 versions were available for 337 patients (English, n = 187; Spanish, n = 150) enrolled. In the English data set, no items had a ceiling or a floor effect, while in the Spanish data set, all items had a ceiling effect, but no items had a floor effect. In both the English and Spanish versions, nearly all the items had a strong, positive correlation with one another (greater than 0.30), indicating the measure was unidimensional. The pattern of the estimated loading indicated the items were assigned as expected. The items functioned differently in the English and Spanish instruments, and there was a statistically significant difference in Wald values between the 2 versions (P \u3e 0.05). Conclusion: The PSPSQ 2.0 demonstrated reliability for this setting and population. However, regarding demonstration of validity, the response categories in the instrument seem not to capture the views of the Spanish-speaking respondents. Further work may focus on uncovering the preferences for use of Likert scale response categories by Spanish speakers to ensure greater cultural fidelity in the translation
Health-related quality of life and treatment satisfaction of patients with cardiovascular disease in Ethiopia
No full textPurpose: Cardiovascular disease is the most prevalent health problem associated with poorer health-related quality of life (HRQoL). We aimed to assess HRQoL and treatment satisfaction of cardiovascular disease patients in Ethiopia. Methods: A cross-sectional survey was conducted among adults attending the outpatient cardiac clinic at Tikur Anbessa Specialized Hospital from July to September 2021. Patients were recruited consecutively during follow-up visits. Treatment Satisfaction Questionnaire for Medication and European Quality of life questionnaires were used to evaluate treatment satisfaction and HRQoL, respectively. Kruskal-Wallis and Mann-Whitney U-tests were used to compare utility weights between patient subgroups. Utility values were computed using disutility weights of the Ethiopian general population derived using a hybrid regression model. Tobit regression modeling was used to explore factors associated with poor HRQoL. Statistical significance was determined at p \u3c 0.05. Results: A total of 357 patients participated in the study with a mean age of 49.3 ± 17.8 years. The most frequently reported health problems were pain/discomfort (75.4%), followed by mobility (73.4%). The median (interquartile range) European Quality questionnaires five dimensions with five levels utility (EQ-5D-5L) and European Quality of life Visual Analog Scale scores were 0.84 (0.55–0.92) and 70.0 (50.0–85.0), respectively. The highest and lowest mean (standard deviation) treatment satisfaction scores were for the convenience and safety satisfaction dimensions: 87.7 (17.9) and 53.1 (33.5), respectively. Unemployment, older age, previous hospital admission, non-adherence to lifestyle modification, and presence of three or more cardiovascular disease factors were significantly negatively associated with HRQoL. Conclusions: Overall, the study found that cardiovascular disease had a profound negative effect on HRQoL and patient treatment satisfaction. We suggest that interventions to enhance HRQoL and treatment satisfactions should focus on modifiable associated factors including lifestyle changes and controlling disease progression
Doctoral Graduate Programs in the Pharmaceutical Sciences: An International Survey
No full textThis publication represents the first to report global information on characteristics and requirements of doctoral programs in the pharmaceutical sciences in schools/colleges of Pharmacy. Survey responses (140 responses) were received from doctoral programs in 23 countries, with the greatest number of responses obtained from Japan, followed by India and the United States. Program characteristics and requirements, and student and faculty information, including graduate placement, in programs in Asia, North America, Europe, Africa and Australia were compared. Survey responses indicated differences in entrance requirements for doctoral programs with minimum requirements being a bachelor\u27s degree, pharmacy degree or master\u27s degree, including a M.Phil. degree. Programs differed widely in size in all geographical areas, but there was a similar emphasis on core educational learning outcomes (core competencies) and Ph.D. graduation requirements including qualifying examinations, thesis defense with internal and external reviewers and requirements for peer-reviewed publications. Additionally, three-quarters of programs indicated that there was external review of their programs every 2-4 or 5-7 years. Female students and female faculty mentors represented about 50% of students/faculty in programs in most geographical areas. Placement of students after graduation indicated that the highest percentage went into the pharmaceutical industry in Asia (predominantly India) and North America, with a lower percentage in Europe, Africa and Australia
Validation and Assessment of a Tool to Measure Psychosocial Readiness to Use Modern Contraceptives among Women in Tigray, Ethiopia
No full textSocial norms, beliefs, and attitudes around modern contraception (MC) use can influence the decision to take up a method, but susceptibility to these factors varies between individuals. The effect of psychosocial readiness to use MC at the individual level is not established for women in Ethiopia. Data from 349 women were used for validity and reliability testing of a 12-item MC psychosocial readiness scale. A rating-scale Rasch model tested for unidimensionality, rating scale functioning, and construct and content validity. Multiple linear regression assessed the effect of respondent characteristics on MC psychosocial readiness scores. The psychometric properties of the univariate MC psychosocial readiness scale were satisfactory after the stepwise removal of two items. Prior MC use, socioeconomic status, geographic zone, and education were significantly associated with increased endorsement of MC psychosocial readiness. The 10-item scale measures the extent of endorsement of MC psychosocial readiness for childbearing women in Tigray, Ethiopia. Further research should qualitatively explore the identified influence of education on MC psychosocial readiness
Cardiovascular Physiology and Pathophysiology in Down Syndrome
No full textDown Syndrome (Ds) is the most common chromosomal cause of intellectual disability that results from triplication of chromosome 21 genes. Individuals with Ds demonstrate cognitive deficits in addition to comorbidities including cardiac defects, pulmonary arterial hypertension (PAH), low blood pressure (BP), and differences in autonomic regulation. Many individuals with Ds are born with heart malformations and some can be surgically corrected. Lower BP at rest and in response to exercise and other stressors are a prevalent feature in Ds. These reduced cardiovascular responses may be due to underlying autonomic dysfunction and have been implicated in lower exercise/work capacity in Ds, which is an important correlate of morbidity, mortality and quality of life. Exercise therapy can be beneficial to normalize autonomic function and may help prevent the development of co-morbidities in Ds. We will review cardiovascular physiology and pathophysiology in individuals with Ds, along with exercise therapy and special considerations for these individual
Psychological Distress among Patients with Advanced Cancer: A Conceptual Analysis
No full textBackground Psychological distress is a common problem that occurs in advanced cancer patients; however, the concept has not been sufficiently specified or clearly described. Objective To develop succinct understanding of psychological distress among advanced cancer patients. Methods A literature search was conducted using the CINAHL, PubMed, and MEDLINE databases from 1988 to 2018. The analysis used the 8 steps of concept analysis developed by Walker and Avant. The final articles selected focused on definitions, predictors, determinant factors, and measurements of psychological distress in advanced cancer. Results Analysis identified that psychological distress in terms of advanced cancer has 5 defining attributes: (1) anxiety, (2) depression, (3) death anxiety, (4) demoralization, and (5) a perceived inability to cope effectively. The primary antecedent is treatment complexity. The consequences are acceptance and living in the present positively, lower performance status, poor quality of life, suicide, and hastened death. Conclusions This concept analysis clarifies the meaning of the concept and differentiates the concept of psychological distress from other emotional symptoms that advanced cancer patients commonly experience. It provides clarity in meaning by examining various ways the concept is used in the area of nursing. Implications for Practice The identified attributes of psychological distress play vital roles in nursing assessments and should be used as guidance for nurses to provide appropriate nursing care for advanced cancer patients. Interventions should address antecedents and consequences of the concept and consider individuals as persons with unique characteristics
Psychometric properties and cross-cultural adaptation of the Indonesian version of the Brief COPE in a sample of advanced cancer patients
No full textThe Brief COPE Inventory has been proven as acceptable psychometric properties to examine coping strategies among cancer patients. However, most psychometric testing studies have been carried out in Western countries, raising concerns about the properties’ relevance and applicability in other cultural contexts. This study aimed to present psychometric properties of the Brief COPE in a sample of patients with advanced cancer in Indonesia. Specifically, we intended to examine the factorial structure and the measure’s validity and reliability. This study included 440 patients from the original study who completed the Indonesian version of Brief COPE. We used exploratory factor analysis and confirmatory factor analysis to assess factor structure and evaluate the structural model fit, respectively. Reliability was demonstrated by internal consistency represented by Cronbach’s alpha coefficient. The factor analysis identified a 21-items scale with 5-factors (avoidance, religion and acceptance, social support coping, problem solving and distraction). Confirmatory factor analysis demonstrated a good model fit. For the whole scale and its subscales Cronbach’s alpha coefficients were acceptable signifying good reliability. Convergent, divergent validity and contrast group comparison were evidenced by significant correlations among subscales and the other instruments used. This study shows that the Indonesian version of Brief COPE is a reliable and valid instrument to measure coping in advanced cancer patients and is ready for use amongst this population in the Indonesian cultural context
A nationwide survey exploring physicians’ and pharmacists’ knowledge, awareness and perceptions regarding generic medicines in China
No full textBackground: Generic medicines substitution is an important means to control rapid growth of pharmaceutical expenditures for the healthcare system in China. Acceptance and utilization of generic medicines is highly influenced by healthcare providers’ perceptions. This study aimed to compare the knowledge, awareness and perceptions of generic medicines between physicians and pharmacists in China. Methods: We used an online, cross-sectional survey across China. The questionnaire explored four sections: demographic characteristics, assessment of the participants’ knowledge and awareness of generic medicines, perceptions of generic medicines and generic substitution practices. Chi-square or Mann–Whitney-U tests were applied to compare differences between physicians and pharmacists. P-values \u3c 0.05 were considered significant. Results: A total of 1644 physicians and 4187 pharmacists participated. Most physicians (82.8%, n = 1362) and pharmacists (89.8%, n = 3760) correctly identified the definition of generic medicines. A similar percentage of physicians and pharmacists agreed that approved generic medicines are as effective (64.1% vs 68.2%) or safe (63.8% vs 69.1%) as brand-name medicines. Most physicians and pharmacists (67.6% vs 71.0%) supported the policy of generic substitution. In practice, 79.4% (n = 1305) of physicians reported that they had prescribed generic medicines. More than 78% of respondents reported an obvious increase in the number of generic medicines prescribed in their medical institutions. The majority of physicians and pharmacists identified lack of trust regarding efficacy and safety of generic medicines and the difficulty of changing patients’ preference as top challenges in generic substitution. Conclusions: Both physicians and pharmacists surveyed had adequate knowledge of generic medicines, and hold positive attitude towards generics and generic substitution. Efficacy and safety are key factors related to prescribing or dispensing generic medicines. Various policies and regulations should be taken to encourage successful generic substitution