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Human Vaccines & Immunotherapeutics Dec 2024COVID-19 vaccine acceptance is crucial for patients with chronic diseases, but previous studies in Ethiopia have yielded inconsistent and inconclusive findings. To fill... (Meta-Analysis)
Meta-Analysis Review
COVID-19 vaccine acceptance is crucial for patients with chronic diseases, but previous studies in Ethiopia have yielded inconsistent and inconclusive findings. To fill this gap, we conducted a systematic review and meta-analysis following established guidelines. Our search included relevant articles published between 2019 and 2023 from various sources. We assessed study heterogeneity and publication bias, and performed subgroup and sensitivity analyses. Our findings indicate that the COVID-19 vaccine acceptance rate among patients with chronic diseases in Ethiopia was 55.4%. We also found that good knowledge and a favorable attitude toward the vaccine were positively associated with the acceptance rate. Based on these results, we recommend that healthcare professionals, policymakers, and healthcare guide developers should work more to address the relatively low acceptance rate. Improving the knowledge and attitude further about the COVID-19 vaccines is crucial. Future research should include community-based and qualitative studies to enhance our understanding of vaccines acceptance.
Topics: Humans; Ethiopia; COVID-19 Vaccines; Health Knowledge, Attitudes, Practice; COVID-19; Chronic Disease; Patient Acceptance of Health Care; Vaccination Hesitancy; SARS-CoV-2; Vaccination
PubMed: 38757639
DOI: 10.1080/21645515.2024.2350815 -
Nursing & Health Sciences Sep 2023Manual restraint is a hands-on type of physical restraint used to prevent harm to service users and staff, and to administer necessary treatments. This article reports... (Meta-Analysis)
Meta-Analysis Review
Manual restraint is a hands-on type of physical restraint used to prevent harm to service users and staff, and to administer necessary treatments. This article reports on a review and meta-synthesis of the qualitative literature on healthcare staff's experiences of using manual restraint. Three electronic databases (CINAHL Complete, MEDLINE, and PsycINFO) were systematically searched, and 19 studies were included. Thematic synthesis was used to synthesize the findings. The Critical Appraisal Skills Programme (CASP) checklist was used to appraise study quality. The synthesis generated one overarching interpretive theme, "unpleasant but necessary," and five subthemes: "maintaining safety triumphs all," "emotional distress," "significance of coping," "feeling conflicted," and "depletion." Seven studies indicated that, from staff perspectives, manual restraint was not always used as a last resort. Healthcare staff experience manual restraint as a psychologically and physically unpleasant practice, yet paradoxically deem its use to be sometimes necessary to keep themselves and service users safe from harm. The findings indicate a need for healthcare staff support, post-restraint debriefing meetings with service users, and the implementation of manual restraint minimization programs in healthcare settings.
Topics: Humans; Attitude of Health Personnel; Emotions; Qualitative Research; Restraint, Physical
PubMed: 37563098
DOI: 10.1111/nhs.13045 -
Journal of Robotic Surgery Dec 2023Robotic-assisted breast surgery (RABS) is controversial. We systematically reviewed the evidence about RABS, comparing it to open conventional breast surgery (CBS).... (Review)
Review
Robotic-assisted breast surgery (RABS) is controversial. We systematically reviewed the evidence about RABS, comparing it to open conventional breast surgery (CBS). Following prospective registration (osf.io/97ewt), a search was performed in January 2023, without time or language restrictions, through bibliographic databases (PubMed, Web of Science, EMBASE, Scopus, Trip database and CDSR) and grey literature. Quality was assessed in duplicate using Qualsyst criteria (score range 0.0-1.0); reviewer agreement was 98%. The 16 selected studies (total patients: 334,804) had overall high quality (mean score 0.82; range 0.68-0.91). Nine of 16 (56.3%) were cohort studies, 2/16 (12.5%) RCTs, and 5/16 (31.3%) case-control studies. Taking p < 0.05 as the significance threshold, RABS versus CBS was better in aesthetic results and patient satisfaction (10/11 studies; 90%), was surgically costly (4/4 studies; 100%), time-consuming (9/13 studies; 69%), and less painful in the first 6-24 h (2/2 studies; 100%) and without statistically significant differences in complication rates (10/12 studies; 83%) or short-term oncological outcomes (10/10 studies; 100%). Surgical time could be dramatically reduced by training surgical teams, reaching no significant differences between approaches (p = 0.120). RABS was shown to be feasible and safe. The advantages of RABS and long-term outcomes need further research.
Topics: Humans; Female; Robotic Surgical Procedures; Prospective Studies; Robotics; Patient Satisfaction; Breast Neoplasms
PubMed: 37624486
DOI: 10.1007/s11701-023-01698-5 -
Global Health Research and Policy Sep 2023Community-based health insurance (CBHI) schemes are crucial for households to avoid financial hardship, improve healthcare quality, and engage in health policies.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Community-based health insurance (CBHI) schemes are crucial for households to avoid financial hardship, improve healthcare quality, and engage in health policies. Household satisfaction is a key indicator for assessing healthcare quality and identifying service gaps. However, research on household satisfaction with CBHI in Ethiopia is limited. Therefore, this study aimed to evaluate household satisfaction and associated factors with CBHI schemes in Ethiopia.
METHODS
A comprehensive search of relevant literature was conducted using multiple databases, including PubMed, Google Scholar, Africa Journal Online, and Ethiopian Universities' institutional open-access online repositories. The search was carried out between January 25, 2023, and February 28, 2023. Twelve primary studies, including eight published and four unpublished, were identified and included in the analysis with a total sample size of 5311 participants. A protocol with the registration number CRD20531345698 is recorded on the Prospero database. Two authors, DT and MK, independently extracted the required data using a standardized form. The extracted data were then analyzed using STATA version 17 software. Heterogeneity was assessed using the Cochrane Q-test and I tests. Finally, a random-effect model was employed to calculate the overall household satisfaction with CBHI and to determine the associated factors.
RESULTS
The meta-analysis showed that the overall household satisfaction with CBHI in Ethiopia was 62.26% (95% CI 53.25-71.21%). The study found regional variations in household satisfaction, with 63.40% in Oromia, 64.01% in Amhara, 49.58% in Addis Ababa, and 66.76% in SNNPs. The study identified several factors associated with household satisfaction and the CBHI scheme, including the availability of drugs (OR 2.13, 95% CI 1.47-2.78), friendly services (OR 3.85, 95% CI 1.60-6.10), affordability of premium (OR 2.80, 95% CI 1.97-3.63), and knowledge/awareness of CBHI (OR 2.52, 95% CI 1.73-3.33).
CONCLUSIONS
The study provides valuable insights into household satisfaction with CBHI in Ethiopia, with a considerable proportion of enrolees being satisfied. The finding highlights regional variations in household satisfaction and underscores the need for tailored interventions and monitoring to enhance CBHI sustainability and effectiveness. The results suggest that healthcare providers and policymakers should prioritize the availability of drugs, friendly services, affordable premiums, and education to improve household satisfaction with CBHI schemes.
Topics: Humans; Community-Based Health Insurance; Ethiopia; Patient Satisfaction
PubMed: 37710337
DOI: 10.1186/s41256-023-00325-y -
The International Journal of Social... Dec 2023Psychosis is a mental disorder that, despite its low prevalence, causes high disease and economic burden. Inadequate knowledge, lack of confidence and stigmatising... (Review)
Review
BACKGROUND
Psychosis is a mental disorder that, despite its low prevalence, causes high disease and economic burden. Inadequate knowledge, lack of confidence and stigmatising attitudes of healthcare professionals (HCPs) may lead to suboptimal care.
AIM
To review the literature exploring HCPs' knowledge, confidence and attitudes in relation to psychosis care.
METHOD
A systematic search was undertaken across three databases (MEDLINE, Embase, PsycINFO) using a search strategy encompassing the concepts: 'healthcare professionals', 'knowledge, attitude, and confidence in care' and 'psychotic illnesses and symptoms' to identify relevant records published from 1st January 2002 to 18th March 2022. Results were screened against predetermined inclusion and exclusion criteria by title and abstract, followed by full text. Data were extracted into tables and synthesised narratively.
RESULTS
Initially, 7,397 studies were identified. Following two-stage screening, 24 studies were eligible for inclusion. Of these studies, 16 explored attitudes, four explored knowledge and attitudes, one explored knowledge, one explored confidence, one explored attitudes and confidence in care and one explored all three constructs. Most HCPs in the included studies demonstrated stigmatising attitudes towards people with psychosis. Furthermore, certain HCPs, including nurses and general practitioners, demonstrated low levels of knowledge, while psychiatrists, occupational therapists, psychologists and nurses had low levels of confidence in caring for people with psychosis. Conversely, positive attitudes were also observed in some HCPs resulting from having acquaintances with lived experience of psychosis. The need for additional education and training to improve HCPs' knowledge and confidence in relation to caring for people living with psychosis was identified.
CONCLUSIONS
Most attitudes identified were negative and stemmed from stigma, while some were positive due to HCPs' compassion and familiarity with psychosis. The level of knowledge and confidence identified were mostly suboptimal, and so further research is required to develop and evaluate tailored interventions to address this gap.
Topics: Humans; Health Personnel; Attitude of Health Personnel; Health Knowledge, Attitudes, Practice; Psychotic Disorders; Social Stigma; General Practitioners
PubMed: 37691420
DOI: 10.1177/00207640231194490 -
Human Vaccines & Immunotherapeutics Dec 2023While vaccines have played a pivotal role in the fight against infectious diseases, individuals engage in online resources to find vaccine-related support and... (Review)
Review
While vaccines have played a pivotal role in the fight against infectious diseases, individuals engage in online resources to find vaccine-related support and information. The benefits and consequences of these online peers are unclear and mainly cause a behavioral shift in user sentiment toward vaccination. This scoping review aims to identify the community and individual factors that longitudinally influence public behavior toward vaccination. The secondary aim is to gain insight into techniques and methodologies used to extract these factors from Twitter data. We followed PRISMA-ScR guidelines to search various online repositories. From this search process, a total of 28 most relevant articles out of 705 relevant studies. Three main themes emerged including individual and community factors influencing public attitude toward vaccination, and techniques employed to identify these factors. Anti-vax, Pro-vax, and neutral are the major communities, while misinformation, vaccine campaign, and user demographics are the common individual factors assessed during this reviewing process. Twitter user sentiment (positive, negative, and neutral) and emotions (fear, trust, sadness) were also discussed to identify the intentions to accept or refuse vaccines. SVM, LDA, BERT are the techniques used for topic modeling, while Louvain, NodeXL, and Infomap algorithms are used for community detection. This research is notable for being the first systematic review that emphasizes the dearth of longitudinal studies and the methodological and underlying practical constraints underpinning the lucrative implementation of an explainable and longitudinal behavior analysis system. Moreover, new possible research directions are suggested for the researchers to perform accurate human behavior analysis.
Topics: Humans; Vaccination Hesitancy; Social Media; Trust; Vaccination; Vaccines
PubMed: 37981842
DOI: 10.1080/21645515.2023.2278377 -
Journal of Medical Internet Research Aug 2023New approaches to the treatment of depression are necessary for patients who do not respond to current treatments or lack access to them because of barriers such as... (Review)
Review
BACKGROUND
New approaches to the treatment of depression are necessary for patients who do not respond to current treatments or lack access to them because of barriers such as cost, stigma, and provider shortage. Digital interventions for depression are promising; however, low patient engagement could limit their effectiveness.
OBJECTIVE
This systematic literature review (SLR) assessed how participant adherence to and engagement with digital interventions for depression have been measured in the published literature, what levels of adherence and engagement have been reported, and whether higher adherence and increased engagement are linked to increased efficacy.
METHODS
We focused on a participant population of adults (aged ≥18 years) with depression or major depressive disorder as the primary diagnosis and included clinical trials, feasibility studies, and pilot studies of digital interventions for treating depression, such as digital therapeutics. We screened 756 unique records from Ovid MEDLINE, Embase, and Cochrane published between January 1, 2000, and April 15, 2022; extracted data from and appraised the 94 studies meeting the inclusion criteria; and performed a primarily descriptive analysis. Otsuka Pharmaceutical Development & Commercialization, Inc (Princeton, New Jersey, United States) funded this study.
RESULTS
This SLR encompassed results from 20,111 participants in studies using 47 unique web-based interventions (an additional 10 web-based interventions were not described by name), 15 mobile app interventions, 5 app-based interventions that are also accessible via the web, and 1 CD-ROM. Adherence was most often measured as the percentage of participants who completed all available modules. Less than half (44.2%) of the participants completed all the modules; however, the average dose received was 60.7% of the available modules. Although engagement with digital interventions was measured differently in different studies, it was most commonly measured as the number of modules completed, the mean of which was 6.4 (means ranged from 1.0 to 19.7) modules. The mean amount of time participants engaged with the interventions was 3.9 (means ranged from 0.7 to 8.4) hours. Most studies of web-based (34/45, 76%) and app-based (8/9, 89%) interventions found that the intervention group had substantially greater improvement for at least 1 outcome than the control group (eg, care as usual, waitlist, or active control). Of the 14 studies that investigated the relationship between engagement and efficacy, 9 (64%) found that increased engagement with digital interventions was significantly associated with improved participant outcomes. The limitations of this SLR include publication bias, which may overstate engagement and efficacy, and low participant diversity, which reduces the generalizability.
CONCLUSIONS
Patient adherence to and engagement with digital interventions for depression have been reported in the literature using various metrics. Arriving at more standardized ways of reporting adherence and engagement would enable more effective comparisons across different digital interventions, studies, and populations.
Topics: Adult; Humans; Adolescent; Depression; Depressive Disorder, Major; Patient Compliance; Mobile Applications
PubMed: 37566447
DOI: 10.2196/43727 -
The International Journal of Pharmacy... Sep 2023Mental health patients struggle with medication adherence, providing opportunities for pharmacists to have a critical role in implementing key interventions for this... (Review)
Review
OBJECTIVE
Mental health patients struggle with medication adherence, providing opportunities for pharmacists to have a critical role in implementing key interventions for this patient cohort. This scoping review aimed to identify and evaluate evidence of pharmacists' involvement in medication adherence interventions in mental health patients.
METHODS
Three databases were searched from January 2013 to August 2022: PubMed, Embase and CINAHL. The first author independently performed screening and data extraction. Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was utilized to report this review. Themes related to the pharmacist's role in improving medication adherence for mental health patients were identified and the strengths and weaknesses of these studies were evaluated.
KEY FINDINGS
A total of 3476 studies were identified and 11 studies met the selection criteria. Study types included retrospective cohort studies, quality improvement projects, observational studies, impact studies, service evaluations and longitudinal studies. Pharmacists worked primarily in community pharmacies, hospitals, or interdisciplinary mental health clinics, and improved medication adherence within these settings, at transitions of care, and by utilizing digital health. The patient perspective was valuable in identifying barriers and enablers to medication adherence. Pharmacists had varying levels of education and training, with studies highlighting the importance of completing extended training programs and partaking in expanded roles such as pharmacist prescribing.
CONCLUSIONS
This review highlighted the need for expanded pharmacist roles within multidisciplinary mental health clinics and further training in psychiatric pharmacotherapy, to aid pharmacists in confidently improving medication adherence for mental health patients.
Topics: Humans; Pharmacists; Mental Health; Retrospective Studies; Mental Disorders; Medication Adherence
PubMed: 37319335
DOI: 10.1093/ijpp/riad037 -
The International Journal of... Dec 2023To identify and map the scientific evidence regarding factors associated with the nonadaptation of completely edentulous patients to mandibular complete dentures. (Review)
Review
PURPOSE
To identify and map the scientific evidence regarding factors associated with the nonadaptation of completely edentulous patients to mandibular complete dentures.
MATERIALS AND METHODS
This scoping review followed the PRISMA-ScR statement for Scoping Reviews and was based on guidelines proposed by Arksey and O'Malley and the Joanna Briggs Institute Manual for Evidence Synthesis. The methodology was registered on the Open Science Framework. An electronic search strategy was conducted in PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, Virtual Health Library, ClinicalTrials.gov, Google Scholar, and ProQuest databases was conducted. Studies that evaluated factors associated with adaptation to and acceptance of mandibular complete dentures were included, such as sociodemographic, psychologic, patient-related, and denture-related items.
RESULTS
The search conducted in March 2022 yielded 9,978 studies. In total, 24 studies were included for data extraction. Sociodemographic factors did not interfere with adaptation to a mandibular complete denture. Psychologic factors and patient-related aspects showed greater association with nonadaptation to mandibular complete dentures than denture-reported factors.
CONCLUSION
Although it is suggestive that psychologic and patient-related factors have higher association with the acceptance of new dentures, data must be interpreted with caution due to the variability of methodologies of the studies included in this review.
Topics: Humans; Denture, Complete; Mouth, Edentulous; Mandible; Patient Satisfaction
PubMed: 38109397
DOI: 10.11607/ijp.7774 -
The International Journal of Pharmacy... Mar 2024The improper disposal of household pharmaceutical waste (HPW) is an emerging cause of environmental pollution. Behavioural practices are intricately linked to...
OBJECTIVE
The improper disposal of household pharmaceutical waste (HPW) is an emerging cause of environmental pollution. Behavioural practices are intricately linked to individuals' knowledge levels and attitudes. Thus, this systematic review aims to assess the knowledge, attitude, and practice (KAP) of HPW disposal among the public and to examine the interconnectedness of these KAP components.
METHODS
A literature review for articles published from 2013 to 2023 was carried out in scientific databases PubMed, Scopus, and Web of Science, identifying quantitative studies involving the assessment of KAP of the public concerning HPW disposal.
RESULTS
This review incorporated 12 studies conducted in Africa, South Asia, and Southeast Asia. Nine studies highlighted a consistent trend of limited to inadequate knowledge regarding safe medication disposal. Notwithstanding, respondents largely exhibited a positive attitude towards proper medication disposal. This encouraging disposition, unfortunately, stands in stark contrast to the reported practices, which appeared to be inadequate. This dissonance might be due to a deficit in accessible disposal facilities and information, compounded with insufficient guidance from healthcare professionals. Interestingly, the majority expressed support for take-back programs aimed at managing unused and expired medications.
CONCLUSION
This review identified a need for a comprehensive understanding of the interconnected dynamics among KAP components regarding safe medication disposal. The exploration of theoretical behavioural frameworks could help predict public intentions to adopt safe medication disposal practices. Ultimately, a multi-faceted approach that addresses knowledge gaps, reinforces positive attitudes, and promotes accessible safe medication disposal services can collectively safeguard the environment and public health.
Topics: Humans; Health Knowledge, Attitudes, Practice; Refuse Disposal; Intention; Health Personnel; Pharmaceutical Preparations; Surveys and Questionnaires
PubMed: 38300734
DOI: 10.1093/ijpp/riae001