OBJECTIVES

The current study aimed to evaluate the impact of an interprofessional simulation-based training program on providers' perception, knowledge, and confidence in proning of pregnant patients with Acute Respiratory Distress Syndrome due to COVID -19 or other causes.

A total of 124 healthcare workers who took part in the management of patients in COVID wards and ICUs participated in the study. The simulation workshop was conducted on May 2022 and the participants were divided into interprofessional teams. Standardized patients and mannequins were used to simulate patients with ARDS. Standardized checklists for proning were used. The participants were debriefed after. The participants completed pre- and post-simulation questionnaires.

After the simulation workshop, the participants’ perception on the benefit of prone position in the ventilation of patients with ARDS, level of confidence in handling proning of pregnant patients, comfort in speaking to patient and next of kin regarding prone ventilation, and knowledge on proning significantly improved. Subgroup analysis
showed statistically significant improvements in knowledge scores among registered nurses, resident physicians, and participants with varying degrees of experience managing COVID-19 patients and proning pregnant patients. Majority of participants deemed it was easy to turn patients in the prone position using the supportive pillow as well as expressed confidence in doing the procedure.

OBJECTIVES

Timely access to appropriate levels of care is essential for improving maternal, newborn,
and child health outcomes. To address persistent service delivery fragmentation and strengthen referral systems, the Philippine Department of Health issued Administrative Order 2020-0019 to guide the design of Health Care Provider Networks (HCPNs) under the Universal Health Care Act of 2019. This study assessed the extent to which sixteen municipalities across four provinces in Eastern Visayas comply with the HCPN service delivery guidelines in the context of maternal and newborn care.

The study employed a descriptive cross-sectional mixed-methods design, utilizing structured facility checklists to assess compliance with HCPN standards. Qualitative data were gathered through key informant interviews and focus group discussions with purposively selected stakeholders—decision makers, health personnel, and mothers—to contextualize findings. A three-lever framework for integrated care (policy, operational, and cross- cutting) guided the analysis

The findings revealed significant gaps between the current capacities of study health facilities and the requirements outlined in the HCPN guidelines. Major gaps included (1) weak cooperative governance mechanisms to support network-wide coordination; (2) limited systematic linkages between facilities, including fragmented referral protocols and non-interoperable health information systems; (3) inadequate investments in infrastructure, health human resources, and medical commodities; and (4) absence of performance monitoring systems across HCPNs.

Objectives: 1) To describe the sociodemographic and clinical characteristics of working and retired employees aged 55 years and older; 2) To determine the proportion with visual and hearing impairments in participants with Type 2 diabetes mellitus (T2DM); and 3) To determine the association between quality of life in participants with T2DM and visual and hearing impairments.

Methods: The study utilized a cross-sectional study design - data derived from the findings of the UP Wellness Initiative for Seniors and Elders (UPWISE) Program. The participants were working and retired university employees age 55 years and above residing in urban and rural-urban (rurban) communities. Stratified random sampling was utilized according to working status and sex. Visual and hearing impairments, and the presence of T2DM were assessed using a multidisciplinary diagnostic process, the comprehensive geriatric assessment (CGA).

Results: A total of 301 participants agreed to participate and completed the CGA. The mean age of the participants was 64.8 (±6.3), and 51.2% belonged to the young-old subgroup. There was an almost equal proportion of males and females while there were more working (53.8%) than the retired (46.2%). There were 17.6% of participants with T2DM and of them, 47.2% with visual impairment (VI) alone, 7.5% hearing impairment (HI) alone, and 37.7% with dual sensory impairments (DSI). Good quality of life was reported by 100% of T2DM participants with HI, 80% with VI, and 72.3% with DSI. There was no significant association between quality of life and vision and hearing impairments. On the other hand, a significant association was identified between T2DM and DSI (p-value, 0.001).

Conclusion: T2DM and vision and hearing impairments are prevalent among the two academic communities. Visual impairment was more common than hearing impairment. Participants diagnosed with T2DM and having a visual, hearing, or dual sensory impairments reported good quality of life.

Key Words: sensory, geriatric assessments, retired, employees, quality of life, diabetes mellitus

groups, but the medical expenses of firefighters were much higher than those of government officials and police officers.]]>
Cardiovascular Diseases ; Drug Costs ; Fees and Charges ; Firefighters ; Health Expenditures ; Hospitalization ; Humans ; International Classification of Diseases ; Korea ; Mental Disorders ; Musculoskeletal Diseases ; Myocardial Ischemia ; National Health Programs ; Occupational Groups ; Outpatients ; Police ; Prevalence ; Stomach Neoplasms

Background: Hypertension is the most common reason for consultation at the Cagayan Valley Medical Center Employees’ Health Services (CVMC EHS) Clinic. No local study has been done to investigate the risk factors of hypertension among the employees, purposely for health promotion and specific prevention activities against hypertension Objective: To determine the hypertension-related risk factors among employees of Cagayan Valley Medical Center, Tuguegarao City Methodology: The study was conducted at the CVMC EHS Clinic of the Department of Family and Community Medicine, utilizing the Annual Physical Examination records, with the Non-Communicable Diseases Risk Assessment Form of all employees satisfying the inclusion criteria, who came in for Annual Physical Examination from August 2017 to July 2018. Descriptive statistics was used to describe the collected data Results: Majority of the employees who had their Annual Physical Examination have hypertension (62.96%). Most of them were adults with ages ranging from 40 to 60 years old (73.91%), male (73.69%), and married (73.26%). As to socio-economic profile, most hypertensives were college graduate (96.87%) and with annual family income of Php 250,000 – 480,000 (74.52%). Clinical profile of hypertensive employees revealed a family history of hypertension (57.79%) and with obesity (47.36%). Risk factors noted to be common among the hypertensive employees are low physical activity (95.65%), family history of hypertension (85%), lack or insufficient intake of fruit and vegetables (60.87%) and frequent alcohol consumption (30.43%). Obesity and elevated lipid profile showed high prevalence among the hypertensive with 47.36% and 54.35%, respectively Conclusion The high prevalence of hypertension and its related risk factors among the regular employees of CVMC is of great concern. These underscore the need for urgent public health interventions to encourage changes in lifestyle pattern to promote health and prevent diseases
Hypertension ; Risk Factors ; Occupational Groups

Background: The COVID-19 outbreak broadly affected not only the physical but also the psychological wellbeing of the people. However, few studies have been conducted concerning its psychological impact specifically on employees from the academe. Objectives: To determine the psychological responses and coping styles of employees of the School of Health Sciences at the University of the Philippines - Manila during the COVID-19 pandemic. Specifically, this study sought to determine the association between participants' socio-demographic characteristics and their psychological responses, and between participants' psychological responses and their coping styles used. Methodology: We employed a cross-sectional design and self-selection or volunteer sampling to recruit 46 academics and support staff employed during the COVID-19 pandemic. The data were collected in April 2020. Psychological responses were determined with the 10-item Kessler's Psychological Distress Scale. Coping styles were assessed with the short-form Cognitive Emotion Regulation Questionnaire. Likelihood ratio chisquare tests and Spearman rho tests were conducted to test the hypotheses. Statistical significance was determined at p < .05. Results: The majority of participants reported low levels of psychological distress in the early stage of the pandemic (n=44; 95.65%). We found a statistically significant relationship between psychological responses and coping styles characterized by rumination (rs = 0.454; P = 0.002) and catastrophizing (rs = 0.408; P = 0.005). Conclusions Our study confirmed the significance of psychological responses during the COVID-19 pandemic and demonstrated a specific association with coping styles characterized by rumination and catastrophizing but are unsuitably less adaptive. Hence, the application of less adaptive techniques when psychologically distressed from the pandemic need to be corrected or modified.
COVID-19 ; Pandemics ; Occupational Groups

OBJECTIVES: This study is to scrutinize the website of Seoul National University Hospital in Korea, Clinique Valmont in Switzerland, Medical Center of the University of Munich in Germany, Cleveland Clinic Abu Dhabi in the United Arab Emirates (UAE) to suggest successful communication factors to the medical service providers who deal with Middle Eastern patients. METHODS: Using content analysis and in-depth interviews, this research examines four hospitals commonly visited by Middle East patients. The four hospitals approaches to implementing interactive e-health tools on their web sites are reviewed. Four hospitals selection criterion was process by focus group interview of government officials in UAE health sectors. RESULTS: The way of providing medical information differed by hospitals that used e-health tools. The analysis of each website shows a different way providing medical information, services and education. There are important differences among hospitals. These include decision-making, planning processes and outcomes of implementing e-health tools online, as well as potential obstacles to such implementation. Thus, hospitals can learn and design effective interactive tools by applying e-health tools on their websites. CONCLUSIONS: Each website showed different interactive tools such as traditional functional tools, core e-business tools, patient support tools, visitor related tools, emerging functional tools. By applying the interactive e-health tools sets an objective view for e-health strategy and vision for the hospitals conveying information through the website. According to the type of hospitals and its location different methods of strategy should be applied. Targeting not only the patients but also the general website users will eventually improve health information accessibility.
Education ; Focus Groups ; Germany ; Health Impact Assessment ; Humans ; Korea ; Middle East ; Occupational Groups ; Patient Participation ; Seoul ; Switzerland ; Telemedicine ; United Arab Emirates*

BACKGROUND/AIMS: The Crohn's and Colitis Knowledge (CCKNOW) score does not reflect updated knowledge relating to inflammatory bowel disease (IBD). The aim of this study was to develop, validate, and apply a novel tool to measure disease-related knowledge in IBD patients. METHODS: A questionnaire composed of 24 items regarding knowledge of IBD was developed: Inflammatory Bowel Disease Knowledge (IBD-KNOW). Discriminate ability of IBD-KNOW was validated in three occupational groups (14 doctors, 20 nurses, and 19 clerks). The CCKNOW and IBD-KNOW were administered to IBD patients. Factors affecting the level of IBD-related knowledge were analyzed. RESULTS: The median Inflammatory Bowel Disease Knowledge (IBD-KNOW) score was significantly different among the three groups for validation (22 doctors, 20 nurses, and five clerks; p < 0.001). The IBD-KNOW showed excellent internal consistency (Cronbach α = 0.952) and high correlation with CCKNOW (Spearman ρ = 0.827, p = 0.01). A total of 200 IBD patients (120 Crohn's disease, 80 ulcerative colitis) completed questionnaires. Multivariate analysis showed that a higher IBD-KNOW score than the median was associated with hospitalization history (odds ratio [OR], 2.625; p = 0.003), high education level (OR, 2.498; p = 0.012), and information acquired from patient organization (OR, 3.305, p = 0.035). CONCLUSIONS: The IBD-KNOW demonstrated excellent test characteristics. Hospitalization history, education level, and information acquired from patient organization play an important role in correct IBD-related knowledge.
Colitis ; Crohn Disease ; Education ; Hospitalization ; Humans ; Inflammatory Bowel Diseases* ; Multivariate Analysis ; Occupational Groups ; Ulcer

BACKGROUND: Hand injuries caused by chain saws, electric saws, and hand grinders range from simple lacerations to tendon injuries, fractures, and even amputations. This study aimed to understand the distribution of various types of hand and upper extremity injuries caused by power tools, in order to help prevent them, by investigating the incidence and cause of power tool injuries treated over a 4-year period at a single institution in Korea. METHODS: We reviewed the medical records of patients who visited a single institution for power tool-induced injuries from 2011 to 2014. The distribution of sex, age, injured body part, type of injury, and mechanism of injury sustained by patients who received hand and upper extremity injuries from using an engine saw, electric saw, or hand grinder was evaluated. RESULTS: Among 594 subjects who were injured by power tools, 261 cases were hand and upper extremity injuries. The average age was 53.2 years. Tendon injury was the most common type of injury. An electric saw was the most common type of power tool used. More injuries occurred in non-occupational settings than in occupational settings. CONCLUSIONS: In this study, power tool-induced hand and upper extremity injuries were mostly caused by direct contact with electric saw blades. More injuries occurred due to non-occupational use of these tools, but the ratios of amputations and structural injuries were similar in the non-occupational and occupational groups.
Amputation ; Arm Injuries ; Epidemiologic Studies ; Hand Injuries ; Hand ; Humans ; Incidence ; Korea ; Lacerations ; Medical Records ; Occupational Groups ; Tendon Injuries ; Upper Extremity

These days, medical practice tends to be highly specialized and divided into qualified medical personnel, including nurses. Recent amendments of medical law show the change of the nurse's role in medical practice. Traditionally, nursing has been an aid work to doctor's practices and is one of the core parts of medical practices. Nurses are a skilled occupational group and individuals are trained and licensed as professionals during their educational courses under government supervision. Because all of the nursing practices cannot be directed or recognized by doctors and nurses are building their own expertise as healthcare providers, they can be held accountable in medical malpractice. In the past, from the perspective of legal responsibility, the nurse was only regarded as an assistant to a doctor; hence, a nurse's malpractice was concluded as a supervising doctor's liability. In the case of medical malpractice caused by nurses, the range of responsibility will be different, depending on the scope of the work carried out by nurse and whether it was supervised by a doctor. Therefore, further discussion is needed regarding the scope of independent nursing practice in order to distribute the legal liability. The authors reviewed ten cases of precedents of medical dispute, examined the events in-depth, and analyzed the court rulings determining the legal responsibility of a doctor or nurse.
Dissent and Disputes ; Health Personnel ; Humans ; Jurisprudence ; Liability, Legal ; Malpractice ; Nurse's Role ; Nursing ; Occupational Groups ; Organization and Administration