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Vegan diet consumption is gaining popularity globally and in New Zealand. However, plant foods provide absent or limited quantities of important micronutrients such as vitamin B12, iron, zinc, and omega-three fatty acids(1). A restrictive and unplanned vegan diet may thus increase risks of nutrient deficiencies especially during pregnancy and early life if the nutrient demands are not fulfilled. Health professionals who provide primary support for pregnant women and their children are important figures in monitoring the nutritional statuses during the antenatal and postnatal periods(2). (Being knowledgeable about the nutritional risks of poorly-planned vegan diets, and having access to appropriate educational resources would support vegan mothers and children to achieve a well-balanced diet. Currently, there are insufficient studies investigating the perspectives of New Zealand’s health professionals within the realm of vegan diets during pregnancy and early life. The aim of the research is to utilise a mixed-methods approach to explore these concerns, attitudes, and experiences. Healthcare professionals, including dietitians, nurses, general practitioners and midwives were invited to participate in the study. Knowledge and attitude scores were collected with an online questionnaire and scores were recorded as a proportion of the participants. Subsequently, descriptions of experiences, concerns, and perspectives about the adoption of vegan diets during pregnancy and early life were collected with semi-structured interviews. A total of 14 health professionals completed the study. All health professionals showed positive attitudes towards the adoption of vegan diets during pregnancy but some exhibited greater concern about their restrictive nature especially in early childhood. Achieving intake adequacy and subjecting young children to intensive assessments for nutrient adequacy were among the concerns raised. More than 90% of health professionals were concerned about iron and vitamin B12 deficiencies while less than 50% were concerned about deficiencies in protein, omega-three fatty acids, iodine, zinc and vitamin D. Less than 50% of participants were aware that plant foods do not provide sufficient vitamin B12. More than 50% disagreed that sufficient information about vegan diets during pregnancy and early life is available. Insufficient evidence-based consensus and government guidelines, and limited access and referrals to dietitians for guidance on vegan diets were highlighted as challenges that reduce the overall knowledge and confidence. Hence, continual professional education and updated evidence-based resources would be important steps to support health professionals in providing guidance to individuals on vegan diets.
The current study assessed the views and attitudes of health professionals (HPs) regarding factors associated with energy balance-related health behaviours and weight management in breast cancer survivors (BCS) with overweight and obesity. Semi-structured online interviews were conducted with 21 HPs (oncologists, dietitians- nutritionists, physical education instructors, mental health professionals, and nurses) from Attica and Thessaly. Thematic analysis was used to analyse and present the data. Four main themes arose from the data: “The patients’ mental health wellbeing”, “Survivors’ interest in diet and exercise”, “Interdisciplinary collaboration in patient’s care”, and “Maintaining normality”. HPs agreed that weight loss in BCS with overweight and obesity is important, but negative mental health wellbeing is a main barrier to behaviour change. For many BCS their cancer diagnosis is a “teachable” moment for weight management, especially for women of younger age, who are more keen to discuss weight management issues. Essential characteristics that determine/facilitate behavioural change include education, commitment for regular communication, personalised intervention, and interdisciplinary collaboration. According to HPs, future weight loss interventions should take into account BCS’s mental health wellbeing and level of motivation and should provide regular support and education.
Tending to patients with a diagnosis of borderline personality disorder (BPD) is a challenging task for clinicians due to stigma and differences in opinion within the psychiatric community. Various symptoms of BPD including affective instability, mood reactivity, and extremes of idealization are associated with challenging emotions toward patients with BPD. This observational research study utilized an adaptation of the 37-question Attitude to Personality Disorder Questionnaire (APDQ) to assess the attitudes of clinicians toward patients with BPD.
Methods
This questionnaire was distributed to 139 clinicians including psychiatry attendings, psychiatry residents, registered nurses, nurse practitioners, social workers, recreation and art therapists, and psychologists who worked with patients diagnosed with BPD on an inpatient unit. Responses of participants were compared based on occupation, gender, and duration of years worked on an inpatient psychiatric unit.
Results
Results show that individuals employed in occupations under the “other health professionals” category had more positive transference (which included feelings of respect toward BPD patients along with feelings of closeness and warmth) toward patients with BPD, and nurses had an increased total score for lack of valid difficulties compared with other health professionals. When grouping by gender and duration of year spent working on an inpatient unit, there were no significant differences in the response toward patients with BPD in affective situations.
Conclusion
Clinical implications are discussed, as well as the need for training to help improve staff attitudes toward this patient population.
The aims of this study were to examine the spillover effects of violent attacks, coronavirus disease-2019 (COVID-19) exposure, and their interactions on health professionals’ mental health, and the role of organizational support in their relationships in China. A two-phase survey data (n = 10,901) before and after the first outbreak of COVID-19 was integrated with regional macro data on the number of lawsuit cases of violent attacks and COVID-19 cases. Three studies were designed to isolate the general spillover impact of violent attacks on the mental health of health professionals, how COVID-19 affects the mental health of health professionals, and whether organizational support moderates the relationship between violent attacks and mental health through econometric regressions. Violent attacks and COVID-19 are negatively associated with the mental health of health professionals, and the outbreak of COVID-19 adversely deteriorates the spillover effects of violent attacks. Physicians, not nurses, are the most affected group. Better perceived support from hospitals can significantly mitigate the adverse effects of COVID-19, violent attacks, and their interactions on the mental health of health professionals. COVID-19 deteriorates the adverse effects of violent attacks on the mental health of health professionals, while better organizational support is helpful to mitigate these effects.
The bidirectional relationship between poverty and poor physical and mental health is well-known. All physicians should have sufficient knowledge on poverty as a social determinant and its impact on (mental) health. The knowledge of poverty in physicians is seldom investigated. An online and paper survey was circulated in March/April 2022 in Belgium, to assess physician’s opinions about and attitudes toward patients in poverty. Not only was interest in the subject rather low, but there were also substantial contradictions in the responses. The lack of knowledge about poverty among physicians leads to reduced quality of medical care for this target group. This is an individual medical–ethical and societal problem. We suggest 10 point-action plan for policymakers, educational institutions, and physicians.
To assess the attitudes and perceived knowledge of health professionals regarding the food product judgemental-labelling reform that began in January 2020 in Israel.
Design:
Cross-sectional survey.
Settings:
An online survey among health professionals working in the Israeli health system.
Most respondents (89·9 %) were women, 36 % had over 20 years of professional experience. All nutritionists, 96·6 % of physicians and 94·7 % of nurses reported hearing about the reform, and most (88·9 % of nurses, 76·3 % of physicians and 75·6 % of nutritionists) claimed supporting the reform to a great or very great extent. Most respondents believe they should discuss issues related to healthy eating with their patients (91·8 % of nurses, 94·9 % of physicians and all nutritionists), but only about half (47·5 % of physicians and 57·0 % of nurses) reported that they have sufficient knowledge in this field, particularly about food labelling. Almost two-thirds of nutritionists (60·3 %) reported instructing patients to change their food intake according to labelling v. 40·1 % and 34·7 % of nurses and physicians, respectively. Only some respondents felt that they could influence their patients’ nutrition habits. Most participants believe that additional regulatory measures should also be used to promote healthy nutrition.
Conclusions:
There is a gap between the desire of physicians and nurses to provide nutritional guidance to the public and their actual knowledge about the labels’ meaning as well as their competencies in providing nutrition counselling. When formulating a reform, policymakers should provide clear guidelines about the expectations of implementing it in therapeutic practice.
Mindfulness as a therapeutic modality has its principal roots in Buddhism. First introduced by Jon Kabat-Zinn as a treatment for stress and chronic pain, mindfulness-based approaches have since been trialled in a wide range of mental health disorders. Mindfulness may help patients both by teaching them to bring greater awareness to aspects of their experience that they may have avoided, and by helping them to learn to find ways of being with difficult experience that can mitigate suffering. Reviews of studies suggest that mindfulness is most effective in depression and anxiety. As well as helping patients, mindfulness has been recommended to help health professionals to avoid burnout and promote well-being and empathy. Whether therapeutic mindfulness is religious, secular or spiritual has been debated. This ambiguity may allow patients to contextualise mindfulness practices according to their own worldviews.
The regulation of health claims for foods by the Nutrition and Health Claims Regulation is intended, primarily, to protect consumers from unscrupulous claims by ensuring claims are accurate and substantiated with high quality scientific evidence. In this position paper, the Academy of Nutrition Sciences uniquely recognises the strengths of the transparent, rigorous scientific assessment by independent scientists of the evidence underpinning claims in Europe, an approach now independently adopted in UK. Further strengths are the separation of risk assessment from risk management, and the extensive guidance for those submitting claims. Nevertheless, four main challenges in assessing the scientific evidence and context remain: (i) defining a healthy population, (ii) undertaking efficacy trials for foods, (iii) developing clearly defined biomarkers for some trial outcomes and (iv) ensuring the composition of a food bearing a health claim is consistent with generally accepted nutrition principles. Although the Regulation aims to protect the consumer from harm, we identify some challenges from consumer research: (i) making the wording of some health claims more easily understood and (ii) understanding the implications of the misperceptions around products bearing nutrition or health claims. Recommendations are made to overcome these challenges. Further, the Academy recommends that a dialogue is developed with the relevant national bodies about Article 12(c) in the Regulation. This should further clarify the GB Guidance to avoid the current non-level playing field between health professionals and untrained ‘influencers’ who are not covered by this Article about the communication of authorised claims within commercial communications.
Humanistic studies that explore symbolic aspects of the experience of working on the COVID-19 frontline are necessary. Do these professionals have psychic time to symbolize such acute experiences? We expect these preliminary findings of this research provide subsidies for discussing psychological management in groups with these professionals.
Objectives
To interpret emotional meanings reported by physicians and nurses on their experiences of working at COVID-19 intensive care units.
Methods
Clinical-qualitative design. Data collection with semi-directed interviews with open-ended questions in-depth applied to a sample of six professionals, closed by theoretical information saturation, in a Brazilian university general hospital. Trigger question: “Talk about psychological meanings of your experience in face of management of patients with COVID-19 at ICU”. Data treatment by the Seven Steps of the Clinical-Qualitative Content Analysis. Theoretical framework of Medical Psychology using Balintian concepts.
Results
We raised 3 categories. (1) Psychic time and absence of symbolization in face of the pandemic; (2) Denial as a defense or psychosocial adaptation mechanisms; (3) Tensions and family support: triggers of ambivalent emotional experiences.
Conclusions
Raw experience of COVID-19 pandemic did not allow for realization of symbolization. Psychological defenses are manifested, either to maintain balance or to deny the existence of dangers related to mental health. Presence of families and health team confirm that the feeling of loneliness is avoided. Anxieties related to the fear of contamination are recurrent. There is dual relationship regarding the emotional experiences of health professionals, but the data point to importance of looking at how these individuals perceive and experience the pandemic.
The Covid-19 pandemic brought enormous challenges for health professionals. As in past epidemics, the uncertainty, danger and fear of contamination and an excessive load of work under dramatic conditions may contribute to aggravate the mental health of health professionals.
Objectives
Explore how the Covid-19 crisis impacted the mental health of healthcare workers and how their mental status relates with perspectives on the recent past and near future.
Methods
A longitudinal study will be applied in two phases, Q1 and Q2, one year apart, to evaluate depression, anxiety and post-traumatic stress among health professionals from a healthcare center in Portugal. Phase Q1 is concluded and comprised the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale – Revised (IES-R) and a questionnaire about the past and the future.
Results
The IES-R scale revealed that nurses are at a higher risk of developing post-traumatic stress disorder (PTSD) than other professionals. The levels of depression and anxiety in the DASS-21 show no significant differences. Interestingly, professionals who worked almost exclusively at inpatient wards show higher levels of depression, anxiety and stress than those who worked at several hospital units (emergency, inpatient and outpatient units). A positive correlation was found between depression and anxiety and negative perspectives about the past and the future.
Conclusions
Covid-19 posed a terrible challenge for health professionals. Its impact on the mental health of healthcare workers may be significant even after the pandemic is under control.
The phenomenon of love in the clinical field, in other words, the practical love through specific features, is the “ultimate investment” of the well-being, both to the patient and to the health professional.
Objectives
The aim of this research study is to investigate the role of love and its connection with burnout in the context of clinical professional care.
Methods
The study was cross-sectional and was conducted from September 2020 to February 2021 at the Nursing Department of University of Ioannina, Greece. The sample of the present study was determined to be health professionals, both sex from all over Greece. The research tools which were used in the quantitative study were: 1) Socio-demographic questionnaire, 2) Measurement of social representations of love and 3) Maslach Burnout Inventory - MBI.
Results
The results of the present quantitative research showed that gender, religion, family environment, place of residence, years of work and job position of health professionals affect the love and compassion they can show and offer to their patients, and the love is related to the level of burnout they experience (p <0.05), in the context of clinical occupational care.
Conclusions
In conclusion, love, its traits and expression of the feelings of health professionals, determine the level of clinical care and the burnout of health professionals.
Health Psychology is a scientific branch that studies interpersonal relationships in the field of emotions and behavior in clinical settings. Violence against women is a gender-based action that alarmingly affects the population, with sexual violence (SV) being one of its main phenomena. The complexity of the care offered to SV patients by clinical professionals impacts themselves, affecting their personal lives and the quality of their work.
Objectives
To explore symbolic emotional meanings attributed by health professionals to care and follow-up of women victims of SV in state service of reference of the Unified Health System.
Methods
Clinical-Qualitative design was used to guide semi-directed interviews with open-ended questions in-depth. Clinical-Qualitative Content Analysis was employed to treat data. Five participants make up the multi-professional team at the Hospital of the Woman of the State University of Campinas. Theoretical framework chosen to interpret categories was Balintian Medical Psychology.
Results
Three categories were selected for this presentation: The human anguishes as the main challenge and handling of working with sexual violence; “To see things progressing”: to the patient and together with the team, a facilitator of the work; and “I try to leave it on the three’s leaves”: the difficult attempt to separate work from personal life.
Conclusions
Taking care of SV is a very emotionally demanding task. Working with the team and see expected outcomes help clinical professionals deal with negative feelings, avoiding, for example, compensatory traumas. New research about social-cultural impacts of working with SV is important to develop institutional approaches of coping for health teams.
In March 2020, the World Health Organization characterized the COVID-19 outbreak as a pandemic. This new health situation has created an anxiety-provoking climate, in particular among health professionals
Objectives
To study the prevalence and predictors of anxiety and depression among health workers
Methods
Our study was descriptive and analytical cross-sectional, carried out with healthcare on the period between May until June 2020. An anonymous online survey was sent to caregivers. The HADS questionnaire was used to screen for anxiety and depression
Results
125 responses was collected The average age of the sample was 32 years. The participants were predominantly female (72.8%), married (48%), and had at least one child (39.2%). 21.6% of the participants worked in the resuscitation anesthesia service and urgent medical aid, 14.4% in the medical services at high risk of contamination, 1.6% in the COVID-19 unit Many changes in habits were reported by the participants: 28.7% had increased their consumption of coffee/tea, especially with anxious people (p = 0.001). This increase was also noted for tobacco (30.8%) and alcohol consumption (12.5%). According to the HADS scale, anxiety was retained in 44% and depression in 47.2%. Anxiety was significantly related to sex with (p = 0.039) and affects more women than men The consumers of coffee/tea developed more anxiety (p = 0.034) and depression (p = 0.026).
Conclusions
This tragic health crisis had a major impact on the mental health of our heroes This is why we should better understand their vulnerability to psychological suffering to provide them with the necessary support
Health professionals face an increased risk of developing mental health difficulties due to work-related stress. It has been demonstrated that work engagement has a protective role on mental health from work-related stress. The majority of the research on the psychological impact of job stress among health professionals focused on the work-related stressors or the type of stressors as challenges or hindrances. However, the impact might depend on an individual’s appraisal of challenges and hindrances.
Objectives
- Examine the effects of job appraisals on mental health. - Establish the role of work engagement as a mediator between them.
Methods
An online survey was completed by 196 health professionals and included questionnaires about job appraisals, stressors (variety of tasks, responsibility and cooperation with colleagues), work engagement, anxiety and depression.
Results
Appraising stressors as challenges did not have any direct impact on mental health, whereas hindrance appraisals had a negative influence. Participants who appraised cooperation with colleagues as challenging reported lower levels of depression through higher work engagement (B = − 0.17, 95% CI [− 0.354, − 0.027]). Appraising variety of tasks as a hindrance predicted higher levels of depression through lower work engagement (B = 0.150, 95% CI [0.041, 0.289]). Participants appraising the other two stressors as hindrances were more anxious and depressed through lower work engagement.
Conclusions
The negative psychological impact of hindrance appraisals was persistent, whereas the positive impact of challenge appraisals through work engagement depended on the stressor. Stress interventions may need to consider both the type of appraisal and the type of stressor.
In March 2020,World Health Organization characterized the COVID-19 outbreak as pandemic. This new health situation has created an anxiety-provoking climate among health professionals
Objectives
To provide risks associated with the exposure of caregivers to COVID-19 for their mental health by studying the prevalence and predictors of post-traumatic stress disorder, anxiety and depression.
Methods
Our study was descriptive and analytical cross-sectional, carried out with healthcare in different hospitals in Tunisia, between 13 May until 20 June 2020. An online survey was sent to caregivers. mental health was assessed using 3 scales: PCL-5:measure the symptoms of post-traumatic stress disorder HADS :screen for anxiety and depression. PSQI:see the existence of a disturbance in sleep quality
Results
125 caregivers participated in the survey. The average age was 32 years. The participants were predominantly female (72.8%), married (48%), and had at least one child (39.2%). 28.7% of participants had increased their consumption of coffee, especially anxious people (p = 0.001). Anxiety was retained in 44% and depression in 47.2%. Anxiety was significantly related to sex with (p = 0.039) and affects more women. The consumers of coffee developed more anxiety (p = 0.034) and depression (p = 0.026). 42.4% of participants had presented post-traumatic stress disorder. Three parameters were correlated with post-traumatic stress disorder: young age, having children and fewer years of professional experience. 62.4% of caregivers had a bad quality of sleep
Conclusions
This health crisis had a major impact on the mental health of our heroes. So, we should provide for them with the necessary support.
The new coronavirus has spread rapidly across the planet confining entire populations, filling hospitals overwhelmed by massive arrivals of patients This new health situation was traumatic especially for health-professionals
Objectives
To study the prevalence and predictors of post-traumatic stress disorder, among health-workers.
Methods
Our study was descriptive and analytical cross-sectional, between May until June 2020. An anonymous online-survey was sent to collect those parameters Sociodemographic-information Physical symptoms The existence of contact with a suspected case The need for quarantine The stressful event The state of mental health, using: PCL-5: 20 items which measures the 20 symptoms of post-traumatic stress-disorder according to DSM-5. PSQI: 9 questions to see the existence or not of a disturbance in sleep
Results
125 participants: 28 university-hospital doctors, 55 residents, 5 interns, 4 specialist-doctors, 2 general-practitioners, 14 nurses, 14 senior-technicians, 2 midwives and a pharmacist. The average seniority at the job was 6 years. Two factors were the most stressful: The characteristics of this pandemic 37.6% The fear of caching the virus and transmit it to their families: 37.6%. 42.4% of participants presented a post-traumatic stress disorder. 3 parameters were correlated with post-traumatic stress disorder: young age, having children (p = 0.007) and fewer years of professional-experience. This pandemic altered the quality of sleep of caregivers, 62.4% of them had a bad quality of sleep. The bad sleepers developed more post-traumatic stress disorder
Conclusions
This health crisis had a major impact on the mental health of our heroes that is why we should provide them with the necessary psychological support.
To explore Uruguayan paediatricians’ personal recommendations about complementary feeding and to assess if they are aligned with current guidelines and scientific evidence.
Design:
A questionnaire composed of open-ended questions was used to explore foods recommended to start complementary feeding, foods regarded as the most important during the first meals, recommendations for delayed introduction of foods and foods that should be avoided. Reasons underlying the recommendations were also explored.
Setting:
Montevideo, the capital city of Uruguay (Latin America).
Participants:
A total of 212 paediatricians were recruited during a National Pediatrics Conference, organised by the Uruguayan Society of Pediatrics.
Results:
The recommendations about complementary feeding provided by paediatricians to parents and caregivers in Uruguay seemed not to be fully aligned with the guidelines provided by the Ministry of Health. Paediatricians recommend a rigid food introduction sequence, characterised by the early introduction of soft pureed vegetables and fruits, followed by meat and the delayed introduction of allergenic foods. Food diversity and the concept of ultra-processed were not frequently identified in the responses.
Conclusions:
Results stress the importance of developing educational and communication approaches targeted at paediatricians to contribute to the uptake of updated recommendations regarding complementary feeding.
Frailty is increasingly used in clinical settings to describe a physiological state resulting from a combination of age-related co-morbidities. Frailty also has a strong ‘lay’ meaning that conjures a particular way of being. Recent studies have reported how frail older people perceive the term frailty, showing that frailty is often an unwanted and resisted label. While there are many scores and measures that clinicians can use to determine frailty, little has been published regarding how health-care professionals use and make sense of the term. This paper reports the findings of a qualitative study that explored how health professionals perceive frailty. Forty situated interviews were conducted with health-care professionals working in an emergency department in the English Midlands. The interview talk was analysed using discourse analysis. The findings show that the health professionals negotiate an ‘ideological dilemma’ – a tension between contradictory sets of meanings and consequences for action – based on their ‘lay’ and clinical experience of the term frailty. It is concluded that this dilemma could have a negative impact on the assessment of frailty depending on the system of assessment used.
The literature shows that fighting against stigma with actions on a less grandiose scale seems to be more effective. (Sartorius, 2002)An example is interventions directed at medical personnel including psychiatrists, who are often important sources of stigmatization. The general public and even health professionals tend to hold a stereotyped image of those with schizophrenia. Before starting an educational program anti-stigma we consider important to know which are the most frequent misconceptions of medical personnel.
Aims:
This study want to assess the most frequent misconceptions associated with patients with schizophrenia between medical personnel.
Material and methods:
we applied a questionnaire to three groups: medical students before studying psychiatry, medical personnel working in psychiatric setting and health professionals in general hospital.
Results:
health professionals contribute to stigmatisation of mental illness, using inadequate terms in defining psychiatric affection and a inadequate attitude; the majority of third group don't understand mental illness and avoids contact with psychiatric patients.
Conclusions:
The study underlines the presence of misconceptions associated with patients with schizophrenia between health professionals and the results could be used for a concrete plan for fighting against stigma of this psychiatric disease.