Smartphone use habits of anesthesia providers during anesthetized patient care: a survey from Turkey.
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ABSTRACT:
SUBMITTER: Pınar HU
PROVIDER: S-EPMC5054594 | biostudies-other | 2016 Oct
REPOSITORIES: biostudies-other
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Project description:BackgroundHealth care provider usage of mobile devices is increasing globally; however, there is little understanding of patient perceptions on this behavior in a health care setting.ObjectiveThe aim of this study was to assess patients' attitudes toward mobile device usage by health care providers in the emergency department and to identify predictors of these attitudes.MethodsThe study was carried out at the emergency department of a large academic tertiary care medical center in Lebanon. A cross-sectional survey design was adopted by administering a questionnaire to medically stable adult patients who presented to the emergency department with an emergency severity index of 3, 4, or 5 between January 2017 and March 2018. The questionnaire collected relevant patient demographic information and included questions related to their mobile device usage along with those evaluating attitudes for the use of mobile devices by health care providers with respect to six major domains: role in health care, distraction potential, impact on communication, empathy, privacy, and professionalism. The attitude toward mobile device usage by health care providers in the emergency department was the main outcome variable. A stepwise logistic regression model was used to assess the association between the outcome variable and the demographic and attitude-related independent variables.ResultsAmong the 438 eligible patients, 338 patients responded to the questionnaire for a response rate of 70.0%. Overall, 313/338 (92.6%) respondents agreed that mobile devices improve health care delivery, whereas 132/338 (39.1%) respondents were opposed to their usage by health care providers in the emergency department (95% CI: 34.0-44.4). The majority (240/338, 71.0%) of patients agreed that mobile devices are a source of distraction to health care providers in the workplace. Females (odds ratio [OR]=1.67, 95% CI: 1.00-2.78) as well as all patients (OR=2.54, 95% CI 1.36-4.76) who believed that mobile devices were a source of distraction, reflecting a lack of professionalism (OR=2.77, 95% CI 1.59-4.82) and impacting the provider's ability to relate to the patient (OR=2.93, 95% CI 1.72-4.99), were more likely to agree that mobile devices should not be used in the emergency department.ConclusionsPatients' negative attitude toward mobile device use in the emergency department is largely driven by patient gender (females), patient perception of the distraction potential of the devices, and their negative impact on the health care provider's empathy and professionalism. The findings of this study shed light on the importance of encouraging stakeholders to impose a digital professionalism code of conduct for providers working in acute health care settings.
| S-EPMC7157496 | biostudies-literature
Project description:ContextGiven the high prevalence of burdensome symptoms in palliative care (PC) and increasing use of complementary and integrative medicine (CIM) therapies, research is needed to determine how often and what types of CIM therapies providers recommend to manage symptoms in PC.ObjectivesTo document recommendation rates of CIM for target symptoms and assess if, CIM use varies by provider characteristics.MethodsNationwide survey's of physicians (MD and DO), physician assistants, and nurse practitioners in PC.ResultsParticipants (N = 404) were mostly female (71.3%), physicians (74.9%), and cared for adults (90.4%). Providers recommended CIM an average of 6.82 times per-month (95% CI: 6.04-7.60) and used an average of 5.13 (95% CI: 4.90-5.36) out of 10 CIM modalities. Respondents recommended mind-body medicines (e.g., meditation, biofeedback) most, followed by massage, and acupuncture and/or acupressure. The most targeted symptoms included pain; followed by anxiety, mood disturbance, and distress. Recommendation frequencies for specific modality-for-symptom combinations ranged from little use (e.g., aromatherapy for constipation) to occasional use (e.g., mind-body interventions for psychiatric symptoms). Finally, recommendation rates increased as a function of pediatric practice, noninpatient practice setting, provider age, and proportion of effort spent delivering palliative care.ConclusionTo the best of our knowledge, this is the first national survey to characterize PC providers' CIM recommendation behaviors and assess specific therapies and common target symptoms. Providers recommended a broad range of CIM but do so less frequently than patients report using CIM. These findings should be of interest to any provider caring for patients with serious illness.
| S-EPMC9121789 | biostudies-literature
Project description:BackgroundPeople with opioid use disorder (OUD) face barriers to entering and remaining in life-saving treatment (e.g., stigma, detrimental interactions with health care, and privacy concerns). Telehealth and related technology can reduce barriers to entering and staying in care. Patient feedback is critical to the development of these newer treatment approaches to ensure they are usable and do not inadvertently recreate treatment barriers.PurposeEvaluate the perceived usability of existing and planned features of a mobile application (app) that facilitates delivery of OUD treatment via telehealth.MethodsPeople with current or prior experience with OUD treatment were eligible for the study. Participants (n = 31; 55% women) provided feedback on an interactive prototype demonstration via individual qualitative interviews and completed a quantitative survey on the app's perceived usability. Descriptive statistics summarized the usability survey. We analyzed qualitative interview transcripts to elicit common themes.ResultsParticipants were primarily white (77%) with a mean age of 42.2 years (range 22-69). Participants rated the six major features of the current app as helpful (median response 5 out of 5) and appreciated the flexibility of conducting a visit from a place of their choosing. Participants regarded the five proposed components of the app, such as daily affirmations and medication treatment-related reminders (e.g., pick up medication at pharmacy, medication schedule), as useful features with medians 5 out of 5, and reported they would recommend the app to others for OUD care. Participant qualitative interviews provided additional information on perceived usability of existing and proposed app features.ConclusionOur study suggests that an appealing, easy-to-use app-with tools and features that effectively support care-could circumvent existing barriers and foster sustained recovery.
| S-EPMC9462609 | biostudies-literature
Project description:BackgroundA comprehensive picture of how the US population engages in specialty care use is lacking, even though redesign models focused on specialty care are becoming more popular.ObjectiveTo describe the type of provider, primary care or specialist, most often seen by individuals, to test associations between type of provider most often seen and insurance coverage, and to test associations between the number of generalist and specialist visits and insurance coverage.DesignCross-sectional analysis of 2013-2016 Medicaid Expenditure Panel Survey. Logistic and negative binomial models were used in multivariate regression modeling.ParticipantsDepending on the analysis, the study samples include between 71,402 and 79,518 US residents.Main measuresIndividuals' provider type most often seen, primary care visits, and specialist visits were reported.Key resultsMore than half of the sample (55%) predominantly visited primary care providers (or generalists), and 36% predominantly visited specialists. Among individuals primarily visiting generalists, 80% visited only one type of primary care provider, and 24% also visited one or more specialists. Among individuals primarily visiting specialists, 48% visited only one type of specialist, and 47% did not visit any generalists in the year. Among Medicare enrollees, 50% predominantly visited specialists, and 40% predominantly visited generalists. Medicare enrollment was associated with greater odds of predominantly visiting specialists (p < 0.05), and Medicare-Medicaid enrollment and having no insurance were associated with lower odds of predominantly visiting specialists (p < 0.05). Medicare enrollment was associated with 13% more generalist visits and 35% more specialist visits, and Medicare-Medicaid enrollment was associated with 38% more generalist visits and 15% more specialist visits (all p < 0.05).ConclusionsGiven the overall frequency of specialty care use and the reliance on multiple specialists in any given year, particularly among Medicare enrollees, public payers are uniquely positioned to promote specialty care redesign and champion improved coordination between specialists.
| S-EPMC7351893 | biostudies-literature
Project description:BACKGROUND:Patients undergoing oncologic surgery are at risk for persistent postoperative opioid use. As a quality improvement initiative, this study sought to characterize provider perceptions regarding opioid-prescribing after oncologic procedures. METHODS:Surgical oncology attending physicians, clinical fellows, and advanced practice providers (APPs) at a high-volume cancer center were surveyed before and after educational sessions focusing on the opioid epidemic with review of departmental data. RESULTS:The pre-education response rates were 72 (70%) of 103: 22 (65%) of 34 attending physicians, 19 (90%) of 21 fellows, and 31 (65%) of 48 APPs. For five index operations (open abdominal resection, laparoscopic colectomy, wide local excision, thyroidectomy, port), the fellows answered that patients should stop receiving opioids sooner than recommended by the attending surgeons or APPs. For four of five procedures, the APPs recommended higher discharge opioid prescriptions than the attending surgeons or fellows. Almost half of the providers (n = 46, 45%) responded to both the pre- and post-education surveys. After the intervention, the providers recommended lower numbers of opioid pills and indicated that patients should be weaned from opioids sooner for all the procedures. Compared with pre-education, more providers agreed post-education that discharge opioid prescriptions should be based on a patient's last 24 h of inpatient opioid use (83 vs 91%; p = 0.006). The providers who did not attend a session showed no difference in perceptions or recommendations at the repeat assessment. CONCLUSIONS:Variation exists in perioperative opioid-prescribing among provider types, with those most involved in daily care and discharge processes generally recommending more opioids. After education, providers lowered discharge opioid recommendations and thought patients should stop receiving opioids sooner. The next steps include assessing for quantitative changes in opioid-prescribing and implementing standardized opioid prescription algorithms.
| S-EPMC6907739 | biostudies-literature
Project description:Background: Mechanical thrombectomy (MT) for ischemic stroke can be performed under local anesthesia (LA), conscious sedation (CS), or general anesthesia (GA). The need for monitoring by anesthesia providers may be resource intensive. We sought to determine differences in outcomes of MT when sedation is performed by an anesthesia team compared to sedation-trained providers. Methods: We performed a retrospective analysis on patients who were screened by a pre-hospital stroke severity screening tool and underwent MT at two stroke centers. Baseline characteristics, time metrics, sedatives, peri-procedural intubation, complications, and outcomes were recorded. Good outcome was defined as modified Rankin score of ≤2. Results: We analyzed 104 patients (sedation-trained provider = 63, anesthesia team = 41) between July 2015 and December 2017. In the sedation-trained provider group, four patients required intervention by an anesthesia team. There were no differences in patients receiving LA (sedation-trained provider 24% vs. anesthesia team 27% p = 0.82), CS (70 vs. 63%, p = 0.53), or GA (6 vs. 10%, p = 0.71) between groups. Sedation-trained providers were more likely to use only one drug during the procedure (62 vs. 34%, p = 0.009). The rate of procedural complications (9.5 vs. 4.5%, p = 0.48), good outcome (56 vs. 39%, p = 0.11), and mortality (22 vs. 24%, p = 0.82) was similar between groups. Sedation by provider type did not predict functional outcome or mortality at 3 months. Conclusions: Sedation-trained providers are capable of delivering appropriate sedation without compromising patient safety. The use of "as needed" anesthesia teams for MT may have considerable effect on resource allocation and cost.
| S-EPMC6447680 | biostudies-literature
Project description:It is increasingly common to upload photographs on the Internet of sports practices carried out. However, this behavior can be related to smartphone addiction, which has become a global problem. In turn, the intensive use of the Instagram social network has begun to be linked to addictive behaviors on mobile devices. The purposes of this paper were to analyze the Instagram usage habits of future primary school teachers, to determine the influence of sociodemographic factors on intensive Instagram use and smartphone addiction, and to determine the influence of intensive Instagram use on smartphone addiction. For this purpose, a transversal design was adopted where two standardized scales were applied to a sample of university students of the Primary Education Degree of the University of Granada, Spain (n = 385). The results showed that the type of image most uploaded to this social network was the selfie, well above sport. Furthermore, the structural equation model highlighted the significant influence of the intensive use of Instagram and smartphone addiction. Finally, the implications and findings of this study are discussed, highlighting the importance of generating healthy habits regarding the use of technology.
| S-EPMC7312577 | biostudies-literature
Project description:BackgroundThe acceptance of digital health technologies to support patient care for various clinical conditions among primary care providers and staff has not been explored.ObjectiveThe purpose of this study was to explore the extent of potential differences between major groups of providers and staff in primary care, including behavioral health consultants (BHCs; eg, psychologists, social workers, and counselors), primary care providers (PCPs; eg, physicians and nurse practitioners), and nurses (registered nurses and licensed practical nurses) in the acceptance of various health technologies (ie, mobile apps, wearables, live video, phone, email, instant chats, text messages, social media, and patient portals) to support patient care across a variety of clinical situations.MethodsWe surveyed 151 providers (51 BHCs, 52 PCPs, and 48 nurses) embedded in primary care clinics across the United States who volunteered to respond to a web-based survey distributed in December 2020 by a large health care market research company. Respondents indicated the technologies they consider appropriate to support patients' health care needs across the following clinical contexts: acute and chronic disease, medication management, health-promoting behaviors, sleep, substance use, and common and serious mental health conditions. We used descriptive statistics to summarize the distribution of demographic characteristics by provider type. We used contingency tables to compile summaries of the proportion of provider types endorsing each technology within and across clinical contexts. This study was exploratory in nature, with the intent to inform future research.ResultsMost of the respondents were from urban and suburban settings (125/151, 82.8%), with 12.6% (n=19) practicing in rural or frontier settings and 4.6% (n=7) practicing in rural-serving clinics. Respondents were dispersed across the United States, including the Northeast (31/151, 20.5%), Midwest (n=32, 21.2%), South (n=49, 32.5%), and West (n=39, 25.8%). The highest acceptance for technologies across clinical contexts was among BHCs (32/51, 63%) and PCPs (30/52, 58%) for live video and among nurses for mobile apps (30/48, 63%). A higher percentage of nurses accepted all other technologies relative to BHCs and PCPs. Similarly, relative to other groups, PCPs indicated lower levels of acceptance. Within clinical contexts, the highest acceptance rates were reported among 80% (41/51) of BHCs and 69% (36/52) of PCPs endorsing live video for common mental health conditions and 75% (36/48) of nurses endorsing mobile apps for health-promoting behaviors. The lowest acceptance across providers was for social media in the context of medication management (9.3% [14/151] endorsement across provider type).ConclusionsThe survey suggests potential differences in the way primary care clinicians and staff envision using technologies to support patient care. Future work must attend to reasons for differences in the acceptance of various technologies across providers and clinical contexts. Such an understanding will help inform appropriate implementation strategies to increase acceptability and gain greater adoption of appropriate technologies across conditions and patient populations.
| S-EPMC8917439 | biostudies-literature
Project description:Ownership of primary care providers varies in different cities in China. Shanghai represented the full public ownership model of primary providers; Shenzhen had public-owned but private-operated providers; and Hong Kong represented the full private ownership. The study aims to assess the association of primary care ownership and patient perceived quality of care in 3 Chinese megacities.We conducted multistage stratified random surveys in 2013 in the 3 cities. Quality scores of primary care were measured using the validated primary care assessment tools. Multivariate linear regression models were used to compare quality scores after controlling potential confounders of patient demographic, socioeconomic, and healthcare utilization factors.Overall, 797 primary care users in Shanghai, 802 in Shenzhen, and 1325 in Hong Kong participated in the study. The mean total quality scores were reported the highest in Shanghai (28.39), followed by Shenzhen (25.82) and then Hong Kong (25.21) (P < 0.001). Shanghai participants reported the highest scores for 1st contact accessibility, coordination of information, comprehensiveness of service availability, and culture competence, while Hong Kong participants reported the lowest for these domains (P < 0.001). Hong Kong participants from rich households reported higher total scores than those from poor households (P < 0.05); however, this was not found in Shanghai and Shenzhen.The study suggests that private primary care ownership may be associated with lower quality and less equitable care distribution. In China, it suggests that it may be beneficial to promote public-owned and nonprofit providers. Promoting privatization in primary care may be at the cost of quality and equity of primary care.
| S-EPMC5228678 | biostudies-literature
Project description:BackgroundTo gain insight into the opinions and working methods of diabetes care providers after using a diabetes web portal for 4 years in order to understand the role of the provider in patients' web portal use.MethodsSurvey among physicians and nurses from general practices and an outpatient clinic, correlated with data from the common web portal.ResultsOne hundred twenty-eight questionnaires were analysed (response rate 56.6%). Responders' mean age was 46.2 ± 9.8 years and 43.8% were physicians. The majority was of opinion that the portal improves patients' diabetes knowledge (90.6%) and quality of care (72.7%). Although uploading glucose diary (93.6%) and patient access to laboratory and clinical notes (91.2 and 71.0%) were considered important, these features were recommended to patients in only 71.8 and 19.5% respectively. 64.8% declared they informed their patients about the portal and 45.3% handed-out the information leaflet and website address. The portal was especially recommended to type 1 diabetes patients (78.3%); those on insulin (84.3%) and patients aged< 65 years (72.4%). Few found it timesaving (21.9%). Diabetes care providers' opinions were not associated with patients' portal use.ConclusionsProviders are positive about patients web portals but still not recommend or encourage the use to all patients. There seems room for improvement in their working methods.
| S-EPMC6013979 | biostudies-literature