1.Assessment of knowledge and attitude towards influenza and pertussis vaccination in pregnancy and factors affecting vaccine uptake rates: a cross-sectional survey.
Eliane Yuting HONG ; Kanaka KULKARNI ; Arundhati GOSAVI ; Hung Chew WONG ; Kuldip SINGH ; Anita Sugam KALE
Singapore medical journal 2023;64(8):513-516
		                        		
		                        		
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Influenza, Human/prevention & control*
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Whooping Cough/prevention & control*
		                        			;
		                        		
		                        			Vaccination
		                        			;
		                        		
		                        			Influenza Vaccines/therapeutic use*
		                        			;
		                        		
		                        			Health Knowledge, Attitudes, Practice
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Pregnancy Complications, Infectious/prevention & control*
		                        			;
		                        		
		                        			Patient Acceptance of Health Care
		                        			
		                        		
		                        	
2.Prevalence of burnout among healthcare professionals in Singapore.
Kok Hian TAN ; Boon Leng LIM ; Zann FOO ; Joo Ying TANG ; Mabel SIM ; Phong Teck LEE ; Kok Yong FONG
Annals of the Academy of Medicine, Singapore 2022;51(7):409-416
		                        		
		                        			INTRODUCTION:
		                        			The aim was to study the prevalence of burnout among various groups of healthcare professionals in Singapore.
		                        		
		                        			METHODS:
		                        			An anonymous online survey questionnaire was conducted using the Maslach Burnout Inventory - Human Services to measure three categories of burnout: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) from July 2019 to January 2020 in a healthcare cluster in Singapore.
		                        		
		                        			RESULTS:
		                        			The survey was completed by 6,048 healthcare professionals out of a target survey population of 15,000 (response rate 40.3%). The study revealed 37.8% of respondents had high EE score ≥27, 29.7% of respondents had high DP score ≥10, and 55.3% of respondents had low PA score ≤33. Respondents with either high EE score or high DP score constituted 43.9% (n=2,654). The Allied Health group had the highest mean EE score, which was significantly higher than those of Medical, Nursing and Non-clinical groups (P<0.05). The Medical group had the highest mean DP score and this was significantly higher than the Nursing, Allied Health and Non-clinical groups (P<0.05). The Non-clinical group had the lowest PA, which was significantly lower than the Medical, Nursing and Allied Health groups (P<0.005).
		                        		
		                        			CONCLUSION
		                        			There was high prevalence of burnout among healthcare professionals in Singapore, especially the allied health professionals. There were significant differences in the 3 categories of burnout (EE, DP and PA) among the different groups of healthcare professionals. There is an urgent need to address the high burnout rate.
		                        		
		                        		
		                        		
		                        			Burnout, Professional/psychology*
		                        			;
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Health Personnel/psychology*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Singapore/epidemiology*
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
3.Evaluation of Accuracy and Influencing Factors for Diagnosis of Two Chronic Diseases by Primary Healthcare Providers in Sichuan Rural Areas Based on Standardized Patients.
Yi-Shan ZHOU ; Yan DU ; Yu-Ju WU ; Rui-Xue YE ; Qing-Zhi WANG ; Chang SUN ; Qing-Mei ZHENG ; Huan ZHOU
Acta Academiae Medicinae Sinicae 2022;44(2):213-220
		                        		
		                        			
		                        			Objective We used standardized patients to evaluate the accuracy and explore the influencing factors of the diagnosis of unstable angina pectoris and type 2 diabetes by primary healthcare providers in Sichuan rural areas,aiming to provide a scientific basis for improving the diagnosis accuracy of primary healthcare providers for the two chronic diseases. Methods A multi-stage stratified random cluster sampling method was adopted to select 100 villages from 50 townships in 5 districts/counties in Zigong city,Sichuan province. General and internal medicine practioners who were on duty on the survey day were enrolled in the survey.Two rounds of data collection were conducted.In the first round,the basic information of providers from township health centers and village clinics was collected.One month after the the first survey,standardized patients were used to collect the information related to the diagnosis of unstable angina pectoris and type 2 diabetes by rural primary providers.Logistic regression was carried out to analyze the factors influencing the diagnosis accuracy. Results A total of 172 rural primary healthcare providers were enrolled in the survey,who completed 186 standardized patient visits and showed the correct diagnosis rate of 48.39%.Specifically,the correct diagnosis rates of unstable angina pectoris and type 2 diabetes were 18.68%(17/91) and 76.84%(73/95),respectively.The providers with medical practitioner qualifications were more likely to make correct diagnosis(OR=4.857,95%CI=1.076-21.933, P=0.040).The providers who involved more necessary consultation and examination items in the diagnosis process had higher probability of correct diagnosis(OR=1.627,95%CI=1.065-2.485, P=0.024).Additionally,the providers were more likely to make a correct diagnosis for type 2 diabetes than for unstable angina pectoris(OR=6.306,95%CI=3.611-11.013, P<0.001). Conclusions The overall diagnosis accuracy of unstable angina pectoris and type 2 diabetes was relatively low among primary healthcare providers in Sichuan rural areas.The training of diagnosis process can be taken as a key for improving providers' practice ability so as to increase the diagnosis accuracy of chronic diseases.
		                        		
		                        		
		                        		
		                        			Angina, Unstable
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Chronic Disease
		                        			;
		                        		
		                        			Diabetes Mellitus, Type 2/diagnosis*
		                        			;
		                        		
		                        			Health Personnel
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Primary Health Care
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
4.Willingness of receiving influenza vaccine and its influencing factors among health care workers in Yangtze River Delta region from 2020 to 2021.
Rui YAN ; Zhi LI ; Xiang SUN ; Bin Bing WANG ; Han Qing HE ; Yao ZHU ; Hua Kun LYU ; Zhi Ping CHEN
Chinese Journal of Preventive Medicine 2022;56(11):1571-1575
		                        		
		                        			
		                        			Objective: To analyze the willingness of receiving influenza vaccine and its influencing factors among health care workers (HCWs) in Yangtze River Delta region from 2020 to 2021. Methods: Convenient sampling method was adopted. From July 2020 to March 2021, 76 hospitals in Jiangsu, Zhejiang, Anhui and Shanghai provinces were selected according to the hospital level and job position, and a questionnaire survey was conducted on the willingness of receiving influenza vaccination. Logistic regression model was used to analyze the influencing factors of vaccination intention. Results: A total of 1 332 HCWs were investigated, with a ratio of male to female about 1∶3.2, and the length of working years was (15.07±9.75) years. A total of 614 HCWs had received influenza vaccine in 2019, with a vaccination rate of 46.09%. About 63.21% (842/1 332) of HCWs were willing to be vaccinated with influenza vaccine. The results of binary logistic regression analysis showed that the willingness of receiving influenza vaccine among HCWs in primary hospitals was higher than that in secondary hospitals (OR=0.573) and tertiary hospitals (OR=0.357). The willingness of HCWs who had received influenza vaccine in 2019 was higher than that of HCWs who had not received influenza vaccine (OR=0.226) and had unknown history of influenza vaccination (OR=0.228). The willingness of HCWs in departments of prevention, health care and infection was higher than that in departments of pre-examination, outpatient, emergency, pediatrics and respiratory (OR=1.670). Conclusion: The willingness of receiving influenza vaccination among HCWs in Yangtze River Delta region is high, but it is still lower than that in developed countries. It is necessary to strengthen publicity and education to improve the influenza immunization level of HCWs.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Influenza Vaccines
		                        			;
		                        		
		                        			Influenza, Human/prevention & control*
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Health Personnel
		                        			;
		                        		
		                        			Vaccination
		                        			;
		                        		
		                        			Attitude of Health Personnel
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Tertiary Care Centers
		                        			
		                        		
		                        	
5.Sociodemographic Factors Associated with Participation in Diabetes Education among Community-Dwelling Adults with Diabetes
Yonsei Medical Journal 2020;61(2):169-178
		                        		
		                        			
		                        			Health Survey were analyzed. The relationship between sociodemographic factors and participation in DSME was examined by logistic regression analysis. The study sample was classified according to the type of institution providing DSME: hospitals/medical clinics (HMCs) and/or public health institutions (PHIs).RESULTS: Of the total sample population with diabetes, 27.2% had attended DSME programs, including 21.9% at HMCs, 4.0% at PHIs, and 1.3% at both types of institutions. As age increased and educational level and monthly household income decreased, the odds ratios (ORs) of participation in DSME decreased in a fully adjusted model. Respondents living in rural areas had lower ORs for attending DSME compared to those living in urban areas [OR, 0.85; 95% confidence interval (CI), 0.80–0.91]. Service/sales workers and mechanical/manual workers had lower ORs for attending DSME (OR, 0.84; 95% CI, 0.71–0.99; and OR, 0.81; 95% CI, 0.69–0.94, respectively) compared to professional/managerial workers. However, in the subgroup of participants receiving education at PHIs, the likelihood of participation in DSME increased as age increased, and respondents living in rural areas had higher ORs compared to those living in urban areas (OR, 1.73; 95% CI, 1.51–1.98).CONCLUSION: Customized DSME programs targeting socioeconomically vulnerable groups, including residential region and reimbursement of DSME by public insurance, are needed to resolve the inequalities in participation in DSME.]]>
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Diabetes Mellitus
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Family Characteristics
		                        			;
		                        		
		                        			Health Surveys
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Insurance
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Odds Ratio
		                        			;
		                        		
		                        			Public Health
		                        			;
		                        		
		                        			Self Care
		                        			;
		                        		
		                        			Social Class
		                        			;
		                        		
		                        			Socioeconomic Factors
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
6.Relationship between Complementary Feeding Introduction and Early Childhood Caries: Results from the Korea National Health and Nutrition Examination Survey 2008–2015
Miyong YON ; Hye Sun SHIN ; Haeng Shin LEE
Korean Journal of Community Nutrition 2019;24(2):97-105
		                        		
		                        			
		                        			OBJECTIVES: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. METHODS: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. RESULTS: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27–2.57). CONCLUSIONS: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.
		                        		
		                        		
		                        		
		                        			Breast Feeding
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Hand
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Infant Nutritional Physiological Phenomena
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Nutrition Surveys
		                        			;
		                        		
		                        			Public Relations
		                        			;
		                        		
		                        			Tooth
		                        			
		                        		
		                        	
7.Relationship between Complementary Feeding Introduction and Early Childhood Caries: Results from the Korea National Health and Nutrition Examination Survey 2008–2015
Miyong YON ; Hye Sun SHIN ; Haeng Shin LEE
Korean Journal of Community Nutrition 2019;24(2):97-105
		                        		
		                        			
		                        			OBJECTIVES: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. METHODS: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. RESULTS: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27–2.57). CONCLUSIONS: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.
		                        		
		                        		
		                        		
		                        			Breast Feeding
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Hand
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Infant Nutritional Physiological Phenomena
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Nutrition Surveys
		                        			;
		                        		
		                        			Public Relations
		                        			;
		                        		
		                        			Tooth
		                        			
		                        		
		                        	
8.Association between Types of Usual Source of Care and User Perception of Overall Health Care Service Quality in Korea
Korean Journal of Family Medicine 2019;40(3):143-150
		                        		
		                        			
		                        			BACKGROUND: Patients' perceptions of care tend to correlate with the quality of care provided. Different health care systems and service environments may show different associations between types of usual source of care (USC) and overall service quality assessment. We attempted to analyze this association as a benefit of having a USC. METHODS: This study used the 2012 Korea Health Panel data version 1.1 as representative national household survey data. The total number of subjects aged 18 years or more was 12,708. The number of subjects in the final analysis was 10,665. Multiple logistic regression analysis was used to assess the association between types of USC and overall health care service quality. The main outcome variable was users' ratings of the quality of health care service. RESULTS: People having a usual doctor (n=1,796) were more likely to positively assess the quality of health care they received than those not having a USC (n=7,920; odds ratio [OR], 1.39; 95% confidence interval [CI], 1.20–1.60) or with those having only a place as a USC without a usual doctor (n=949; OR, 1.29; 95% CI, 1.05–1.58) after adjustment for demographic characteristics and health-related variables. CONCLUSION: People having a usual doctor rated overall health care service quality as high, which might be due to benefits of primary care attributes related to usual doctors. Further studies are needed to elucidate the causal relationship. This finding implies that health policies encouraging people to have a usual doctor are needed in Korea.
		                        		
		                        		
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Family Characteristics
		                        			;
		                        		
		                        			Health Policy
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Odds Ratio
		                        			;
		                        		
		                        			Primary Health Care
		                        			;
		                        		
		                        			Quality Assurance, Health Care
		                        			;
		                        		
		                        			Quality of Health Care
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
9.Factors Associated with Unmet Healthcare Needs of the Older Korean Population: The Seventh Korea National Health and Nutrition Examination Survey 2017
Chan Hee JEON ; Jeon Won KWAK ; Min Ho KWAK ; Jeong Hyeon KIM ; Yong Soon PARK
Korean Journal of Health Promotion 2019;19(2):84-90
		                        		
		                        			
		                        			BACKGROUND: South Korea has the fastest growing aging population in the world, and older people require more healthcare services. Unmet healthcare needs still exist in Korea due to several complex reasons. This study aimed to evaluate the factors associated with unmet healthcare needs of the older Korean population. METHODS: This cross-sectional study included 1,194 older adults, aged 65 years and older, who participated in the Seventh Korea National Health and Nutrition Examination Survey conducted in 2017. Sociodemographic factors, lifestyle and health status, comorbidity, and unmet healthcare needs were included in this study's analysis. Multiple logistic regression analysis was used to evaluate the association between unmet healthcare needs and other factors. RESULTS: The prevalence of unmet healthcare needs in this study population was 7.8%. After adjusting for age, sex, education level, household income, living alone, private health insurance, regular walking, body mass index, unintended weight loss, and osteoarthritis, women (adjusted odds ratio [aOR], 1.921; 95% confidence interval [CI], 1.061–3.479) and unintended weight loss (aOR, 2.218; 95% CI, 1.105–4.453) were more likely to have unmet healthcare needs than their counterparts. The group with general obesity (aOR, 1.691; 95% CI, 1.015–2.816) was more likely to have unmet healthcare needs than the group with normal body mass index. CONCLUSIONS: Among the older Korean population, being a woman, general obesity, and unintended weight loss may be risk factors for unmet healthcare needs.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aging
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			Comorbidity
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Family Characteristics
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Insurance, Health
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Life Style
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Needs Assessment
		                        			;
		                        		
		                        			Nutrition Surveys
		                        			;
		                        		
		                        			Obesity
		                        			;
		                        		
		                        			Odds Ratio
		                        			;
		                        		
		                        			Osteoarthritis
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Walking
		                        			;
		                        		
		                        			Weight Loss
		                        			
		                        		
		                        	
10.Applying a mixed methods design for needs assessment of an international fellowship training program for Mongolian health professions
Nomin AMGALAN ; Jwa Seop SHIN ; Seung Hee LEE ; Oyungoo BADAMDORJ ; Hyun Bae YOON
Korean Journal of Medical Education 2019;31(3):227-237
		                        		
		                        			
		                        			PURPOSE: Continuing professional development is essential for improving health care services, especially in developing countries. Most of the training programs in Mongolia were not based on a targeted needs assessment. Therefore, we aimed to apply a mixed methods design to assess the training needs of Mongolian health professions. METHODS: We conducted a needs assessment using a convergent parallel mixed methods design in two steps. The survey and interview questions were developed to identify priority areas, targeted trainees, and effective training methods. A survey on 60 respondents, 15 individual interviews, and a focus group interview with 14 participants were conducted in the first step. In the second step, 12 representatives of key stakeholders were invited to a second focus group interview. RESULTS: Current health policy areas, areas related to future national plans, and areas not currently receiving governmental or international support were suggested as the main priorities. The stakeholder suggested that trainees should be selected based on their professional experience and language level, as well as each hospital’s needs. Building teams including various professions, such as nurses, technicians, and biomedical engineers, was recommended as a way to exchange ideas with each other and to build teamwork for future collaboration. CONCLUSION: Medical training needs are dynamic and complex; therefore, a deep understanding of the context and setting is necessary. In this study, we assessed the targeted training needs of Mongolian health professions through a mixed methods design, which could be an effective way to conduct needs assessments for training programs.
		                        		
		                        		
		                        		
		                        			Cooperative Behavior
		                        			;
		                        		
		                        			Delivery of Health Care
		                        			;
		                        		
		                        			Developing Countries
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Fellowships and Scholarships
		                        			;
		                        		
		                        			Focus Groups
		                        			;
		                        		
		                        			Health Occupations
		                        			;
		                        		
		                        			Health Policy
		                        			;
		                        		
		                        			Methods
		                        			;
		                        		
		                        			Mongolia
		                        			;
		                        		
		                        			Needs Assessment
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
            
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