Providing healthcare under the threat of gang-violence: a survey of Haitian healthcare providers
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ABSTRACT:
SUBMITTER: Belt R
PROVIDER: S-EPMC11342466 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundWorkplace violence (WPV) in Emergency Departments (EDs) is an increasingly recognized challenge healthcare providers face in low-resource settings. While studies have highlighted the increased prevalence of WPV in healthcare, most of the existing research has been conducted in developed countries with established laws and repercussions for violence against healthcare providers. More data on WPV against ED providers practicing in low-resource settings is necessary to understand these providers' unique challenges.ObjectiveThis study aims to gain insight into the incidence and characteristics of WPV among ED healthcare providers in India.MethodsThis study was conducted at two EDs in geographically distinct regions of India. A survey was designed to assess violence in EDs among healthcare providers. Surveys were distributed to ED workplace providers, completed by hand, and returned anonymously. Data was entered and stored in the RedCAP database to facilitate analysis.ResultsTwo hundred surveys were completed by physicians, nurses, and paramedics in Indian EDs. Most reported events involved verbal abuse (68%), followed by physical abuse (26%), outside confrontation (17%), and stalking (5%). By far, the most common perpetrators of violence against healthcare workers were bystanders including patient family members or other accompanying individuals. Notably, reporting was limited, with most cases conveyed to ED or hospital administration.ConclusionThese results underscore the prevalence of WPV among Indian ED healthcare providers. High rates of verbal abuse followed by physical abuse are of concern. Most perpetrators of WPV against healthcare providers in this study were patient family members or bystanders rather than the patients themselves. It is imperative to prioritize implementing prevention strategies to create safer work environments for healthcare workers.
| S-EPMC11223359 | biostudies-literature
Project description: Not available
| S-EPMC8166264 | biostudies-literature
Project description:BackgroundGang members engage in many high-risk sexual activities that may be associated with psychiatric morbidity. Victim-focused research finds high prevalence of sexual violence towards women affiliated with gangs.AimsTo investigate associations between childhood maltreatment and psychiatric morbidity on coercive and high-risk sexual behaviour among gang members.MethodCross-sectional survey of 4665 men 18-34 years in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang membership. Participants completed questionnaires covering violent and sexual behaviours, experiences of childhood disadvantage and trauma, and psychiatric diagnoses using standardised instruments.ResultsAntisocial men and gang members had high levels of sexual violence and multiple risk behaviours for sexually transmitted infections, childhood maltreatment and mental disorders, including addictions. Physical, sexual and emotional trauma were strongly associated with adult sexual behaviour and more prevalent among gang members. Other violent behaviour, psychiatric morbidity and addictions accounted for high-risk and compulsive sexual behaviours among gang members but not antisocial men. Gang members showed precursors before age 15 years of adult preference for coercive rather than consenting sexual behaviour.ConclusionsGang members show inordinately high levels of childhood trauma and disadvantage, sexual and non-sexual violence, and psychiatric disorders, which are interrelated. The public health problem of sexual victimisation of affiliated women is explained by these findings. Healthcare professionals may have difficulties promoting desistance from adverse health-related behaviours among gang members whose multiple high-risk and violent sexual behaviours are associated with psychiatric morbidity, particularly addictions.
| S-EPMC7525108 | biostudies-literature
Project description:ObjectivesTo develop a risk prediction algorithm for identifying work units with increased risk of violence in the workplace.DesignProspective cohort study.SettingPublic sector employees in Finland.Participants18 540 nurses, social and youth workers, and teachers from 4276 work units who completed a survey on work characteristics, including prevalence and frequency of workplace violence/threat of violence at baseline in 2018-2019 and at follow-up in 2020-2021. Those who reported daily or weekly exposure to violence or threat of violence daily at baseline were excluded.ExposuresMean scores of responses to 87 survey items at baseline were calculated for each work unit, and those scores were then assigned to each employee within that work unit. The scores measured sociodemographic characteristics and work characteristics of the work unit.Primary outcome measureIncrease in workplace violence between baseline and follow-up (0=no increase, 1=increase).ResultsA total of 7% (323/4487) of the registered nurses, 15% (457/3109) of the practical nurses, 5% of the social and youth workers (162/3442) and 5% of the teachers (360/7502) reported more frequent violence/threat of violence at follow-up than at baseline. The area under the curve values estimating the prediction accuracy of the prediction models were 0.72 for social and youth workers, 0.67 for nurses, and 0.63 for teachers. The risk prediction model for registered nurses included five work unit characteristics associated with more frequent violence at follow-up. The model for practical nurses included six characteristics, the model for social and youth workers seven characteristics and the model for teachers included four characteristics statistically significantly associated with higher likelihood of increased violence.ConclusionsThe generated risk prediction models identified employees working in work units with high likelihood of future workplace violence with reasonable accuracy. These survey-based algorithms can be used to target interventions to prevent workplace violence.
| S-EPMC10465908 | biostudies-literature
Project description:BackgroundShigellosis is an acute diarrheal disease transmitted through contaminated food, water, objects, poor hand hygiene, or sexual activity. Healthcare providers (HCP) may not be aware of the multiple routes of Shigella transmission, populations at increased risk, or importance of antibiotic susceptibility testing (AST). This study assessed HCP knowledge and clinical practices regarding shigellosis and antibiotic resistance.MethodsPorter Novelli Public Services administered a web-based survey (Fall DocStyles 2020) to HCP in the United States. Pediatricians, primary care physicians, nurse practitioners, and physician assistants completed questions about knowledge and clinical practice of acute diarrhea and shigellosis.ResultsOf 2196 HCP contacted, 1503 responded (68% response rate). Most identified contaminated food (85%) and water (79%) as routes of Shigella transmission; fewer recognized person-to-person contact (40%) and sexual activity (18%). Men who have sex with men (MSM) were identified as being at risk for shigellosis by 35% of respondents. Most reported counseling patients to wash hands (86%) and avoid food preparation (77%) when ill with shigellosis; 29% reported recommending avoiding sex. Many HCP reported treating shigellosis empirically with ciprofloxacin (62%) and azithromycin (32%), and 29% reported using AST to guide treatment.ConclusionsWe identified several gaps in shigellosis knowledge among HCP including MSM as a risk group, person-to-person transmission, and appropriate antibiotic use. Improving HCP education could prevent the spread of shigellosis, including drug-resistant infections, among vulnerable populations.
| S-EPMC10717126 | biostudies-literature
Project description:BackgroundAlthough the vast majority of cancer patients use natural health products (NHPs), 59% of oncology healthcare providers (HCP) report not receiving any education on NHPs. KNOWintegrativeoncology.org (KNOW) is a web-based educational platform that provides up-to-date evidence on NHPs used in cancer care with a user-friendly interface. KNOW is a database of human studies systematically gathered from MEDLINE and EMBASE. We surveyed HCPs before and after accessing KNOW to identify their information needs regarding NHPs in cancer care, their preferred way to receive information, barriers they face accessing NHP information, and to obtain feedback on the website.MethodsRecruitment was done through Beaumont Health Systems, the Society for Integrative Oncology, and the Andrew Weil Centre for Integrative Medicine, University of Arizona. HCPs who consented completed an initial survey and then a follow-up survey after being given access to KNOW for 4-6 weeks. Participants were required to access KNOW at least three times before completion of the follow-up survey.ResultsA total of 65 participants completed the initial survey, with 60% (n = 39) from the conventional medical community, 33% (n = 21) from the integrative medicine community, and 7% (n = 5) from the research community. The majority of participants (82%; n = 53) preferred educational websites to email updates, podcasts/webinars, in-house experts, PubMed searches and smartphone apps. The most common barriers identified to accessing information on NHPs were time, accessibility at point-of-care, and credibility of sources. A high number of participants were lost to follow up, with 18 participants demographically representative of the initial sample of 65 completing the follow-up survey. Half (n = 9) of participants stated accessing the KNOW website changed their clinical practice. Close to 90% (n = 16) reported they would recommend KNOW to a colleague.ConclusionOncology HCPs reported preferring to use, and already relying on, numerous web-based educational platforms to gather information on NHPs, with time, accessibility, and credibility being common barriers to obtaining information. Our study findings highlight the promise of the KNOW web-based educational platform in reducing barriers to accessing up-to-date information on NHPs in busy cancer care settings.
| S-EPMC9047465 | biostudies-literature
Project description:Using Pittsburgh Youth Study data, we examined the extent to which over 600 gang members and non-gang involved young men specialized in drug selling, serious theft, or serious violence or engaged simultaneously in these serious delinquent behaviors, throughout the 1990s. We found that the increase in delinquency associated with gang membership was concentrated in two combinations: serious violence and drug selling; serious violence, drug selling, and serious theft. Several covariates were similarly associated with multi-type serious delinquency and gang membership (age, historical time, Black race, and residential mobility), suggesting that these behaviors may share common developmental, familial, and contextual risks. We encourage future research to further examine the association of gang membership with engagement in particular configurations of serious delinquency.
| S-EPMC4060635 | biostudies-literature
Project description:This systematic review and meta-analysis sought to explore the prevalence of sexual violence including both sexual harassment and abuse, perpetrated by clients against home healthcare workers (HCWs), including professional and paraprofessional HCWs. To this end, we systematically searched five relevant databases. Two reviewers extracted data from the included studies independently and performed a quality appraisal. Overall and subgroup random-effects pooled prevalence meta-analyses were performed. Due to high heterogeneity, a more robust model using a quality effect estimator was used. Fourteen studies were included, and the prevalence of sexual violence was 0.06 (95% confidence interval (CI): 0.01-0.13). Paraprofessionals had a higher prevalence of sexual violence (0.07, 95% CI: 0.00-0.18 vs. 0.05, 95% CI: 0.00-0.12), and the prevalence of sexual abuse was lower than that of sexual harassment (0.04, 95% CI: 0.00-0.10 vs. 0.10, 95% CI: 0.03-0.18). This systematic review estimated the prevalence of sexual violence across home HCWs from different high-income countries, highlighting the presence of this phenomenon to a lesser but nevertheless considerable extent compared to other healthcare settings. Health management should consider interventions to prevent and reduce the risk of home HCWs from being subjected to sexual violence, as the home-care sector presents particular risks for HCWs because clients' homes expose them to a relatively uncontrolled work environment.
| S-EPMC7731391 | biostudies-literature
Project description:The concept of "patient-centered care" (PCC) emphasizes patients' autonomy and is commonly promoted as a good healthcare practice that all of medicine should strive for. Here, we assessed how six medical specialties-pediatrics, OBGYN, orthopedics, radiology, dermatology, and neurosurgery-have engaged with PCC and its derivative concepts of "person-centered care" (PeCC) and "family-centered care" (FCC) as a function of the number of female physicians in each field. To achieve this, we conducted a scoping review of three databases-PubMed, CINAHL, and PsycInfo-to assess the extent that PCC, PeCC, FCC, and RCC were referenced by different specialties in the medical literature. Reference to PCC and PeCC in the literature correlates significantly with the number of female physicians in each field (all p < 0.00001) except for neurosurgery (p > 0.5). Pediatrics shows the most extensive reference to PCC, followed by OBGYN, with a significant difference between all disciplines (p < 0.001). FCC remains exclusively embraced by pediatrics. Our results align with documented cognitive differences between men and women that recognize gender differences in empathizing (E) versus systemizing (S) with females demonstrating E > S, which supports PCC/PeCC/FCC approaches to healthcare.
| S-EPMC9957388 | biostudies-literature
Project description:ObjectiveWorkplace violence (WPV) in intensive care units (ICUs) is a prevalent issue that affects staff well-being and patient care. Although individual studies have explored various facets of WPV, there is a need for a comprehensive synthesis to provide a cohesive understanding of the phenomenon and inform effective interventions. This study aimed to understand its impact on the mental health and work status of ICU staff, identify the coping strategies used by ICU staff to manage WPV and explore the support required by healthcare professionals when facing WPV.MethodsA systematic literature search was conducted in PubMed, Scopus, Medline, PsycINFO, and Web of Science from the date of inception until June 5, 2024. Only qualitative studies or the qualitative part of mixed methods studies were included in the analysis, with no restrictions on the type of ICU or type or source of violence. This study assessed the risk of bias in the included studies and synthesized the results according to the guidelines of the Joanna Briggs Institute (2024).ResultsSix studies were included. These studies, which were published between 2018 and 2023, were conducted in four countries and involved 91 participants. Six analytical themes and 17 subthemes emerged from the qualitative data. The themes were as follows: Prevalence of ICUs Violence, ICU healthcare perceptions of WPV, The Ripple Effect of WPV in ICU, Practical Strategies for ICU Staff Dealing with WPV, What they need when facing WPV, and Reasons for Not Reporting WPV.ConclusionsThe synthesized findings highlight the pervasive nature of WPV in ICUs and its profound impact on staff members. This review underscores the need for systematic interventions, including comprehensive training, accessible psychological support, and robust reporting mechanisms, to mitigate the effects of WPV.OtherThis study was funded by the Wu Jieping Medical Foundation(320.6750.18526),China. The review protocol was prospectively registered in the Prospective Register of PROSPERO (CRD42024559076).Relevance to clinical practiceThe research findings can provide important evidence for hospital managers and policymakers, helping them develop more effective workplace management policies to enhance the safety and well-being of ICU staff.
| S-EPMC11917093 | biostudies-literature