scholarly journals The current clinical use of adjuvant analgesics for refractory cancer pain in Japan: a nationwide cross-sectional survey

2020 ◽  
Vol 50 (12) ◽  
pp. 1434-1441
Author(s):  
Keita Tagami ◽  
Hiromichi Matsuoka ◽  
Keisuke Ariyoshi ◽  
Shunsuke Oyamada ◽  
Yusuke Hiratsuka ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Online Survey ◽  
Cord Compression ◽  
Dose Titration ◽  
Pathophysiological Mechanism ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
First Response ◽  
Starting Dose

Abstract Background Although adjuvant analgesics are used to treat opioid-refractory cancer pain, there is insufficient evidence to support this practice and limited data to guide the choice depending on cancer pain pathophysiology, dose titration and starting dose. This survey aimed to clarify the current use of adjuvant analgesics for treating opioid-refractory cancer pain. Methods In this cross-sectional study, we sent an online survey questionnaire to 208 certified palliative care specialists. Primary outcomes were (i) effective pathophysiological mechanism of cancer pain and (ii) initiating doses and time period to the first response to each adjuvant analgesic therapy. Results In total, 87 (42%) palliative care specialists responded. Of all patients with cancer pain, 40% of patients (median) with refractory cancer pain were prescribed adjuvant analgesics. Additionally, 94.3, 93.1 and 86.2% of palliative care specialists found dexamethasone/betamethasone effective for neuropathic pain caused by tumor-related spinal cord compression, pregabalin effective for malignant painful radiculopathy and dexamethasone/betamethasone effective for brain tumor or leptomeningeal metastases-related headache, respectively. The median starting dose of pregabalin, dexamethasone/betamethasone, lidocaine and ketamine were 75, 4, 200, and 50 mg/day, respectively, and the median time to the first response of those medications were 5, 3, 2 and 3 days, respectively. Conclusions Many palliative care specialists select adjuvant analgesics depending on the pathophysiological mechanism of cancer pain in each case. They used such adjuvant analgesics in low doses for cancer pain with short first-response periods.

Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Bob Lew ◽  
Ksenia Chistopolskaya ◽  
Yanzheng Liu ◽  
Mansor Abu Talib ◽  
Olga Mitina ◽  
...  
Keyword(s):  
Social Support ◽  
Suicidal Behavior ◽  
Online Survey ◽  
Perceived Social Support ◽  
Strain Theory ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychological Strains ◽  
Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conflicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Khanh Ngoc Cong Duong ◽  
Tien Nguyen Le Bao ◽  
Phuong Thi Lan Nguyen ◽  
Thanh Vo Van ◽  
Toi Phung Lam ◽  
...  
Keyword(s):  
Psychological Distress ◽  
General Population ◽  
Psychological Health ◽  
Online Survey ◽  
Survey Study ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Event Scale ◽  
The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

scholarly journals Survey of young people in one region of the UK on accessing COVID-19 information (SOCIAL)

2021 ◽  
Vol 5 (1) ◽  
pp. e000942
Author(s):  
Oliver G P Lawton ◽  
Sarah A Lawton ◽  
Lisa Dikomitis ◽  
Joanne Protheroe ◽  
Joanne Smith ◽  
...  
Keyword(s):  
Social Media ◽  
Young People ◽  
Significant Role ◽  
Online Survey ◽  
Descriptive Statistics ◽  
Sources Of Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Education Gaps ◽  
The Uk

COVID-19 has significantly impacted young people’s lives yet little is known about the COVID-19 related sources of information they access. We performed a cross-sectional survey of pupils (11–16 years) in North Staffordshire, UK. 408 (23%) pupils responded to an online survey emailed to them by their school. Descriptive statistics were used to summarise the data. Social media, accessed by 68%, played a significant role in the provision of information, despite it not being considered trustworthy. 89% felt that COVID-19 had negatively affected their education. Gaps in the provision of information on COVID-19 have been identified.

scholarly journals Burnout Determinants among Nurses Working in Palliative Care during the Coronavirus Disease 2019 Pandemic

2021 ◽  
Vol 18 (7) ◽  
pp. 3358
Author(s):  
José Vítor Gonçalves ◽  
Luísa Castro ◽  
Guilhermina Rêgo ◽  
Rui Nunes
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Online Survey ◽  
Three Dimensions ◽  
Linear Regression Models ◽  
Perceived Health Status ◽  
Cross Sectional ◽  
National Network ◽  
Work Related ◽  
High Level

Nurses working in palliative care are at risk of burnout. The Copenhagen Burnout Inventory was used to determine burnout levels of nurses working in the Portuguese national network of palliative care. We evaluated the contribution of personal, work, and COVID-19 variables in three burnout subclasses: personal, work, and patient-related. A cross-sectional, exploratory, and quantitative design was employed and participants were sampled using convenience and snowball technique. An online survey was conducted and 153 nurses participated in our study. Socio-demographic characterization was conducted, levels of burnout and determinants were explored through multiple linear regression models for its three dimensions. High levels of personal, working, and patient burnout were present in 71 (46%), 68 (44%), and 33 nurses (22%), respectively. Most of them agreed that COVID-19 had an impact on their activities. Significant personal and work related burnout factors found were specialization in palliative care, self-perceived health status, unit type, weekly hours of work, and allocation to COVID-19 units. Gender was found to be a significant factor in patient-related burnout. There is a high level of burnout among nurses working in the Portuguese national network of palliative care. Measures for identification and mitigation of burnout are necessary to protect health care professionals.

scholarly journals Knowledge, attitude, and practices (KAPs) of Community pharmacists regarding COVID-19: A cross-sectional survey in two provinces of Pakistan

2021 ◽  
pp. 1-23
Author(s):  
Khayal Muhammad ◽  
Muhammad Saqlain ◽  
Gul Muhammad ◽  
Ataullah Hamdard ◽  
Muhammad Naveed ◽  
...  
Keyword(s):  
Online Survey ◽  
Good Practice ◽  
Community Pharmacists ◽  
Vital Role ◽  
Good Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Knowledge Age ◽  
Good Attitude

Abstract The coronavirus disease 2019 (COVID-19) is a global pandemic having no therapy and pharmacists being a part of the healthcare system had a vital role in the management of COVID-19. The purpose of this study is to assess the knowledge, attitude, and practices (KAPs) of community pharmacists (CPs) regarding COVID-19. An online survey was conducted among 393 CPs in two provinces of Pakistan during the lockdown period. A validated questionnaire (Cronbach alpha, 0.745) was used for data collection. All statistical analysis was analyzed by using SPSS version 21. Among 393 participants, 71.5% (n=281) had good knowledge, 44% (n=175) positive attitude and 57.3% (n=225) had good practice regarding COVID-19. Social media (45.29%, n=178) was reported as the main source to seek information of COVID-19. Good knowledge, age ≥ 26 years and Ph.D. degree level were the substantial determinants (p= <0.05) of a good attitude. Similarly, community pharmacist who had an experience of >5 years, hold a Ph.D. degree, good knowledge and good attitude had higher odds of good practice as compared to reference categories (p= <0.05). In short, majority of CPs had good knowledge, but had a poor attitude and practice towards the COVID-19. Standard-structured educational and counselling programs for CPs regarding COVID-19 are needed for effective management.

scholarly journals Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey

2021 ◽  
pp. bmjspcare-2020-002619
Author(s):  
Marcus Sellars ◽  
Julien Tran ◽  
Linda Nolte ◽  
Ben White ◽  
Craig Sinclair ◽  
...  
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Public Knowledge ◽  
Cross Sectional Survey ◽  
Medical Decisions ◽  
Cross Sectional ◽  
Minimal Support ◽  
Substitute Decision Maker ◽  
Final Sample ◽  
Advance Care

ObjectiveTo describe the Australian adult public’s knowledge and experiences regarding substitute decision-making for medical decisions and their preferences for obtaining information about the substitute decision-maker (SDM) role.MethodsThis is a national cross-sectional online survey of the Australian adult public. The survey examined participants’ advance care planning (ACP) awareness and experience, SDM experiences and preferences for obtaining more information about SDM, and participant knowledge about SDM.ResultsOf 1586 people who opened the survey, 1120 (70.6%) were included in the final sample. 13% (n=142) of participants indicated they had acted as an SDM. A median score of two correct responses out of five showed low to moderate knowledge about the SDM role among all participants, with only 33% reporting awareness of SDM laws existing in Australia. While most (59%) participants ranked a health professional as their preferred source of obtaining information about supporting SDMs, few participants who had been an SDM (n=64, 45%) reported obtaining any support in making medical decisions. The median SDM knowledge scores for people who had discussed ACP (3.0 vs 2.0, U=1 45 222, z=6.910, p<0.001), documented their ACP preferences (3.0 vs 2.0, U=71 984, z=4.087, p<0.001) or acted in the SDM role (3.0 vs 2.0, U=56 353, z=−3.694, p<0.001) were significantly higher compared with those who had not.ConclusionsThe Australian public may have low to moderate knowledge about the SDM role and access only minimal support when making challenging medical decisions.

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

2021 ◽  
pp. 104990912110186
Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Fast Track ◽  
Hospice Care ◽  
Cannabis Use ◽  
Care Plan ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

scholarly journals Examining Australian’s beliefs, misconceptions and sources of information for COVID-19: a national online survey

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043421
Author(s):  
Rae Thomas ◽  
Hannah Greenwood ◽  
Zoe A Michaleff ◽  
Eman Abukmail ◽  
Tammy C Hoffmann ◽  
...  
Keyword(s):  
Public Health ◽  
Online Survey ◽  
Health Behaviours ◽  
National Sample ◽  
Sources Of Information ◽  
Cross Sectional Survey ◽  
Commercial Television ◽  
Cross Sectional ◽  
And Gender ◽  
Public Health Strategies

ObjectivePublic cooperation to practise preventive health behaviours is essential to manage the transmission of infectious diseases such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission and prevention that have the potential to impact the uptake of recommended public health strategies.DesignAn online cross-sectional survey.ParticipantsA national sample of 1500 Australian adults with representative quotas for age and gender provided by an online panel provider.Main outcome measureProportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions.ResultsOf the 1802 potential participants contacted, 289 did not qualify, 13 declined and 1500 participated in the survey (response rate 83%). Most participants correctly identified ‘washing your hands regularly with soap and water’ (92%) and ‘staying at least 1.5 m away from others’ (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them from contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that ‘regular use of antibiotics’ would not prevent COVID-19.Most participants (90%) identified ‘fever, fatigue and cough’ as indicators of COVID-19. However, 42% of participants thought that being unable to ‘hold your breath for 10 s without coughing’ was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%) and the Australian Government COVID-19 information app (31%).ConclusionsPublic messaging about hand hygiene and physical distancing to prevent transmission appears to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long term. We need to develop public health messages that harness these barriers to improve future cooperation. Ensuring adherence to these interventions is critical.

scholarly journals Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea M. Hutchins ◽  
Donna M. Winham ◽  
Jinette P. Fellows ◽  
Michelle M. Heer
Keyword(s):  
Experiential Learning ◽  
Professional Training ◽  
Online Survey ◽  
Selection Process ◽  
National Level ◽  
Cross Sectional Study ◽  
Registered Dietitian ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Entry Level

Abstract Background As is common across the health professions, training of Registered Dietitian Nutritionists (RDNs) requires experiential learning for interns/students to gain skills and demonstrate entry-level competency. Preceptors are essential to the experiential learning component of health care professional training, providing supervision and mentoring as students and interns gain the skills required for entry-level practice competency. Over the past 27 years, 47–73% of applicants to dietetic internships have received a placement. Practitioners willing to volunteer as preceptors are needed to generate more internship or experiential learning opportunities for the profession to continue to meet workforce demands. Methods The objective of this national-level online cross-sectional survey was to identify perceptions and attitudes associated with the preceptor role and incentives that might encourage precepting by current RDNs. A random sample of RDN and Nutrition and Dietetic Technicians, Registered (NDTR) professionals from the Commission on Dietetic Registration credentialed practitioner database were eligible to participate in the online survey. The main outcome measures included perceptions, attitudes, and preferred incentives to precept compared by preceptor experience categories (current, former, never precepted). Comparisons of perceptions, attitudes, and preferred incentives were made between preceptor experience categories using Chi-square and ANOVA. Results Of 2464 invitations, 308 participants had complete variables for analysis. Top incentives were the opportunity to earn continuing education units (65.9%) and having expenses paid to attend a national conference (49.5%). Significantly more (P < 0.001) “former” and “never” preceptors reported the ability to choose when to take an intern, training on how to teach and communicate with interns, and access to an “on-call” specialist as incentives compared to “current” preceptors. Significantly more (P < 0.01) “never” preceptors reported training on internship expectations and the ability to provide input on intern selection process as incentives compared to “current” or “former” preceptors. Conclusions Incentives to serve as a preceptor differ based on “current”, “former”, or “never” precepted status. Promoting and strategizing solutions to the current imbalance between the greater number of dietetic internship applicants compared to preceptors should be targeted based on preceptor status to retain current preceptors, encourage former preceptors to return and recruit professionals who have never served.

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