The working poor survey study
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INTRODUCTION: Cardiopulmonary resuscitation (CPR) is often started irrespective of comorbidity or cause of arrest. We aimed to determine the prevalence of perception of inappropriate CPR of the last cardiac arrest encountered by clinicians working in emergency departments and out-of-hospital, factors associated with perception, and its relation to patient outcome. METHODS: A cross-sectional survey was conducted in 288 centres in 24 countries. Factors associated with perception of CPR and outcome were analyzed by Cochran-Mantel-Haenszel tests and conditional logistic models. RESULTS: Of the 4018 participating clinicians, 3150 (78.4%) perceived their last CPR attempt as appropriate, 548 (13.6%) were uncertain about its appropriateness and 320 (8.0%) perceived inappropriateness; survival to hospital discharge was 370/2412 (15.3%), 8/481 (1.7%) and 8/294 (2.7%) respectively. After adjusting for country, team and clinician's characteristics, the prevalence of perception of inappropriate CPR was higher for a non-shockable initial rhythm (OR 3.76 [2.13-6.64]; P < .0001), a non-witnessed arrest (2.68 [1.89-3.79]; P < .0001), in older patients (2.94 [2.18-3.96]; P < .0001, for patients >79 years) and in case of a "poor" first physical impression of the patient (3.45 [2.36-5.05]; P < .0001). In accordance, non-shockable and non-witnessed arrests were both associated with lower survival to hospital discharge (0.33 [0.26-0.41]; P < 0.0001 and 0.25 [0.15-0.41]; P < 0.0001, respectively), as were older patient age (0.25 [0.14-0.44]; P < 0.0001 for patients >79 years) and a "poor" first physical impression (0.26 [0.19-0.35]; P < 0.0001). CONCLUSIONS: The perception of inappropriate CPR increased when objective indicators of poor prognosis were present and was associated with a low survival to hospital discharge. Factoring clinical judgment into the decision to (not) attempt CPR may reduce harm inflicted by excessive resuscitation attempts.
- Klíčová slova
- Cardiac arrest, Cardiopulmonary resuscitation, Inappropriate care, Out-of-hospital, Perception,
- MeSH
- celosvětové zdraví MeSH
- dospělí MeSH
- kardiopulmonální resuscitace škodlivé účinky statistika a číselné údaje MeSH
- klinické rozhodování MeSH
- lidé středního věku MeSH
- lidé MeSH
- percepce MeSH
- postoj zdravotnického personálu MeSH
- procedury zbytečné psychologie statistika a číselné údaje MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- urgentní zdravotnické služby metody statistika a číselné údaje MeSH
- zástava srdce mimo nemocnici mortalita terapie MeSH
- zbytečná diagnóza a terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
AIMS: To assess perceptions, motivations and barriers to treatment adherence depending on emotional, lifestyle, medical and non-adherence risk profiles in hypertensive patients. METHODS AND RESULTS: Cross-sectional data were obtained using an online anonymous survey. Four distinct global risk scores (medical, lifestyle, emotional and quality of life (QoL) and non-adherence risk scores) were calculated based on the responses to specific groups of questions. A total of 2615 treated hypertensive patients (≥18 years of age) from 5 European countries completed the questionnaire. Mean (SD) age was 69.6 years (5.8); 54% males. Overall, antihypertensive therapy represented a low burden in patients' daily life (2.9/10 in the Likert scale). Perfect self-reported adherence was claimed by 59.8% of participants. Reporting of non-adherence episodes to physicians was low (13% always/often). Participants with a high non-adherence risk score had a greater number of associated diseases (obesity, sleep disturbances, depression and cardiac complications), a higher treatment-associated burden on daily life, a greater stress level and more antihypertensive pills per day (p < 0.001 for all). No correlation was found between the clinical and lifestyle risk scores and the risk of non-adherence. The emotional score correlated significantly with the non-adherence risk score (p < 0.001). Comparing patients with a low/middle risk to those with a high risk of non-adherence, female gender and age >65 years were associated with a lower odd ratio of non-adherence whereas depression, stress, family hardships, negative information on drugs and poor information were associated with higher odds of non-adherence. CONCLUSIONS: This large survey reveals several underestimated issues regarding patients' perspective in hypertension. It highlights the impact of emotions, exposure to family hardships, and stress on the risk of non-adherence. Non-adherence is underreported by patients; hence it remains mostly unrecognised.
A good knowledge of patients’ perception, beliefs, motivations and barriers to antihypertensive treatment adherence is essential to improve blood pressure (BP) control in the population.In this large survey conducted in five European countries, we assessed patients according to their medical, emotional, lifestyle and non-adherence risk profiles.Results show that emotional aspects and exposure to family hardships have a significant impact on the risk of non-adherence.Moreover, a poor adherence to medications remains often unknown because patients do not report their difficulties to their physicians.
- Klíčová slova
- Adherence, emotion, medication, patient perspective, quality of life, stress,
- MeSH
- adherence k farmakoterapii * psychologie MeSH
- antihypertenziva * terapeutické užití MeSH
- hypertenze * farmakoterapie psychologie epidemiologie MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- motivace * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- životní styl MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- antihypertenziva * MeSH
Selective reporting of antibiotic susceptibility test (AST) results is one possible laboratory-based antibiotic stewardship intervention. The primary aim of this study was to identify where and how selective reporting of AST results is implemented in Europe both in inpatient and in outpatient settings. An ESCMID cross-sectional, self-administered, internet-based survey was conducted among all EUCIC (European Committee on Infection Control) or EUCAST (European Committee on Antimicrobial Susceptibility Testing) national representatives in Europe and Israel. Of 38 countries, 36 chose to participate in the survey. Selective reporting of AST results was implemented in 11/36 countries (31%), was partially implemented in 4/36 (11%) and was limited to local initiatives or was not adopted in 21/36 (58%). It was endorsed as standard of care by health authorities in only three countries. The organisation of selective reporting was everywhere discretionally managed by each laboratory, with a pronounced intra- and inter-country variability. The most frequent application was in uncomplicated community-acquired infections, particularly urinary tract and skin and soft-tissue infections. The list of reported antibiotics ranged from a few first-line options, to longer reports where only last-resort antibiotics were hidden. Several barriers to implementation were reported, mainly lack of guidelines, poor system support, insufficient resources, and lack of professionals' capability. In conclusion, selective reporting of AST results is poorly implemented in Europe and is applied with a huge heterogeneity of practices. Development of an international framework, based on existing initiatives and identified barriers, could favour its dissemination as one important element of antibiotic stewardship programmes.
- Klíčová slova
- Antibiotic prescription, Antibiotic resistance, Antibiotic stewardship, Antibiotic susceptibility testing, Questionnaire, Selective reporting,
- MeSH
- antibakteriální látky farmakologie terapeutické užití MeSH
- dodržování směrnic MeSH
- lidé MeSH
- mikrobiální testy citlivosti metody MeSH
- průřezové studie MeSH
- spotřeba léčiv normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Izrael MeSH
- Názvy látek
- antibakteriální látky MeSH
AIM: The work of midwives is often mentally and physically exhausting. We sought to determine whether an association exists between personality traits, burnout syndrome, bullying in the workplace, and sleep quality. Additionally, we aimed to assess whether personality traits, dimensions of burnout, and sleep quality differ between a group of bullied and non-bullied midwives. DESIGN: A cross-sectional, correlation study was conducted. METHODS: The research sample consisted of 71 midwives, average age 36 years, average length of practice 14.23 years. Data were collected using a demographic questionnaire, Maslach Burnout Inventory (MBI), Negative Acts Questionnaire-revised (NAQ-R), International Personality Item Pool: Big Five Markers-50 (IPIP-BFM-50) and Pittsburgh Sleep Quality Index (PSQI). RESULTS: There was a significant relationship between personality traits, workplace bullying, the dimensions of burnout, and poor sleep quality. There were significant differences in extroversion, emotional stability, emotional exhaustion, and sleep quality between those midwives that experienced workplace bullying and those that did not. Victims of workplace bullying tended to be more neurotic and less extroverted than non-victims. CONCLUSION: The study findings indicate that personality traits may function as both predictors and outcomes of workplace bullying. There was no patient or public contribution.
- Klíčová slova
- burnout, midwifery, personality, psychosocial risks, sleep quality, workplace bullying,
- MeSH
- babictví * MeSH
- dospělí MeSH
- kvalita spánku * MeSH
- lidé středního věku MeSH
- lidé MeSH
- osobnost * MeSH
- pilotní projekty MeSH
- porodní asistentky * psychologie MeSH
- pracoviště * psychologie MeSH
- profesionální vyhoření * psychologie MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- šikana * psychologie statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Alarms are crucial in informing Healthcare Workers (HCWs) about critical patient needs, but unmanaged frequency and noise of alarms can de-sensitize medical staff and compromise patient safety. Alarm fatigue is identified as the major cause of the clinical alarm management problem. It occurs when the medical staff is overwhelmed by the number of clinical alarms. METHODS: The survey was conducted online using Google's form-making tools from June to July 2023. There were three parts to the survey used in the study: a socio-demographic metric, the Alarm Fatigue Assessment Questionnaire (AFAQ), and The Pittsburgh Sleep Quality Index (PSQI). A significance level of 0.05 was used in the analysis. RESULTS: The survey included 756 medical professionals from three European countries (Slovakia, the Czech Republic and Poland). The participants in the study were 42 years old on average, and they had 12 years of work experience. 603 out of 756 survey participants had poor sleep quality, 147 had good sleep quality, and 6 did not provide an answer. This study analyzed the alarm fatigue levels of respondents in every country. In the Czech Republic, Poland and Slovakia, a statistically significant association (p = 0.039, p = 0.001, p < 0.001) was found between alarm fatigue and sleep quality in medical staff. CONCLUSION: Based on our study, alarm fatigue and sleep quality of HCWs are correlated. Therefore, alarm fatigue and sleep hygiene should be monitored.
- Klíčová slova
- alarm fatigue, ergonomics, healthcare worker, safety, sleep, well-being,
- MeSH
- dospělí MeSH
- ergonomie * MeSH
- klinické alarmy statistika a číselné údaje MeSH
- kvalita spánku * MeSH
- lékařský personál statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- pracoviště MeSH
- průzkumy a dotazníky MeSH
- únava * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Polsko MeSH
STUDY OBJECTIVES: To examine whether psychosocial factors at work are related to self rated health in post-communist countries. DESIGN AND SETTINGS: Random samples of men and women in five communities in four countries were sent a postal questionnaire (Poland, Czech Republic and Lithuania) or were invited to an interview (Hungary). Working subjects (n=3941) reported their self rated health in the past 12 months (5 point scale), their socioeconomic circumstances, perceived control over life, and the following aspects of the psychosocial work environment: job control, job demand, job variety, social support, and effort and reward at work (to calculate a ratio of effort/reward imbalance). As the results did not differ by country, pooled analyses were performed. Odds ratios of poor or very poor health ("poor health") were estimated for a 1 SD increase in the scores of work related factors. MAIN RESULTS: The overall prevalence of poor health was 6% in men and 7% in women. After controlling for age, sex and community, all work related factors were associated with poor health (p<0.05). After further adjustment for perceived control, only two work related factors remained associated with poor health; the odds ratios (95% confidence intervals) for 1 SD increase in the effort/reward ratio (log transformed) and job variety were 1.51 (1.29, 1.78) and 0.82 (0.73, 1.00), respectively. Further adjustment for all work related factors did not change these estimates. There were no interactions between individual work related factors, but the effects of job control and social support at work differed by marital status, and the odds ratio of job demand increased with increasing education. CONCLUSIONS: The continuous measure of effort/reward imbalance at work was a powerful determinant of self rated health in these post-communist populations. Although the cross sectional design does not allow firm conclusions as to causality, this study suggests that the effect of the psychosocial work environment is not confined to Western populations.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- odds ratio MeSH
- postoj ke zdraví MeSH
- pracoviště psychologie MeSH
- prevalence MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- zdravotní stav * MeSH
- zdravotnické přehledy * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Litva epidemiologie MeSH
- Maďarsko epidemiologie MeSH
- Polsko epidemiologie MeSH
BACKGROUND: Previous studies have highlighted risks for depression and suicide in medical cohorts, but evidence regarding psychiatric residents is missing. This study aimed to determine rates of depression, suicide ideation and suicide attempt among psychiatric residents and to identify associated individual, educational and work-related risk factors. METHODS: A total of 1980 residents from 22 countries completed the online survey which collected data on depression (PHQ-9), suicidality (SIBQ), socio-demographic profiles, training, and education. Generalized linear modeling and logistic regression analysis were used to predict depression and suicide ideation, respectively. RESULTS: The vast majority of residents did not report depression, suicide ideation or attempting suicide during psychiatric training. Approximately 15% (n = 280) of residents met criteria for depression, 12.3% (n = 225) reported active suicide ideation, and 0.7% (n = 12) attempted suicide during the training. Long working hours and no clinical supervision were associated with depression, while more completed years of training and lack of other postgraduate education (e.g. PhD or psychotherapy training) were associated with increased risk for suicide ideation during psychiatric training. Being single and female was associated with worse mental health during training. LIMITATIONS: Due to the cross-sectional nature of the study, results should be confirmed by longitudinal studies. Response rate was variable but the outcome variables did not statistically significantly differ between countries with response rates of more or less than 50%. CONCLUSION: Depression rates among psychiatric residents in this study were lower than previously reported data, while suicide ideation rates were similar to previous reports. Poor working and training conditions were associated with worse outcomes. Training programmes should include effective help for residents experiencing mental health problems so that they could progress through their career to the benefit of their patients and wider society.
- Klíčová slova
- Depression *, Psychiatry *, Residents *, Suicide attempt *, Suicide ideation *, Trainees *,
- MeSH
- deprese epidemiologie psychologie MeSH
- dospělí MeSH
- duševní poruchy epidemiologie psychologie MeSH
- duševní zdraví statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- pokus o sebevraždu psychologie MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- sebevražda psychologie MeSH
- sebevražedné myšlenky MeSH
- služby péče o duševní zdraví organizace a řízení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
This study analyses the relationship between immigrants' self-reported/rated health (SRH) and their perceived working conditions in Czechia materialized via discrimination, based on the example of Ukrainian immigrants analyzed by gender dimension. The role of age, education, and marital status is also analyzed. A sample of native-born Czechs serves as a reference frame. A cross-sectional design was applied. Using data from two surveys of Ukrainian immigrants in Czechia and a countrywide health interview survey for Czechs, we analyse inequalities in SRH and workplace discrimination loads. Four binary logistic regression models were computed separately for women and men from Ukraine and Czechia to identify the determinants of fair/poor SRH. We found that only Ukrainian immigrant females were heavily exposed to all four measured types of workplace discrimination, thereby modifying and worsening the quality of their SRH. Determinants which are behind respondents' SRH differ between Ukrainian immigrants vis-à-vis Czechs with one exception. The "oldest age group" (41-62) contributes to poorer assessment of SRH among Ukrainian females, Czech females, and Czech males too. The lowest educational level (primary education) correlates with poor SRH within the sample of Czech males.
- MeSH
- dospělí MeSH
- emigranti a imigranti * MeSH
- lidé středního věku MeSH
- lidé MeSH
- pracoviště * MeSH
- průřezové studie MeSH
- sexismus * MeSH
- socioekonomické faktory MeSH
- věkové faktory MeSH
- xenofobie * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Social hazards as one of the dimensions of workplace discrimination are a potential social determinant of health inequalities. The aim of this study was to investigate relations between self-reported health and social hazard characteristics (defined as-discrimination as such, violence or threat of violence, time pressure or work overload and risk of accident) among Vietnamese and Ukrainian migrants (males and females) in Czechia by age, education level and marital status. This study is based on data from a survey of 669 immigrants in Czechia in 2013. Logistic regression analysis indicates that the given independent variables (given social hazards and socio-demographic characteristics), as predictors of a quality of self-reported health are more important for immigrant females than for males, irrespective of citizenship, albeit only for some of them and to differing extents. We found out that being exposed to the selected social hazards in the workplace leads to worsening self-rated health, especially for females. On the other hand, there was no statistically significant relationship found between poor self-rated health and discrimination as such. Reality calls for more research and, consequently, better policies and practices in the field of health inequalities.
- Klíčová slova
- Czechia, Vietnamese and Ukrainian immigrants, discrimination, logistic regression, questionnaire survey, self-reported health, social hazards, workplace,
- MeSH
- dospělí MeSH
- emigranti a imigranti * MeSH
- lidé středního věku MeSH
- lidé MeSH
- manželský stav MeSH
- mladý dospělý MeSH
- násilí MeSH
- osoby s přechodným pobytem a migranti * MeSH
- pracoviště * MeSH
- předsudek MeSH
- průzkumy a dotazníky MeSH
- socioekonomické faktory * MeSH
- zdravotní stav MeSH
- zpráva o sobě MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Ukrajina MeSH
- Vietnam MeSH
Studies from single countries suggest that local labour market conditions, including rates of employment, tend to be associated with the health of the populations residing in those areas, even after adjustment for individual characteristics including employment status. The aim of this study is to strengthen the cross-national evidence base on the influence of regional employment levels and individual worklessness on health during the period of the Great Recession. We investigate whether higher regional employment levels are associated with better health over and above individual level employment. Individual level data (N = 23,078 aged 15-64 years) were taken from 16 countries (Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Spain, Sweden and United Kingdom) participating in the 2014 European Social Survey. Regional employment rates were extracted from Eurostat, corresponding with the start (2008) and end (2013) of the Great Recession. Health outcomes included self-reported heart or circulation problems, high blood pressure, diabetes, self-rated health, depression, obesity and allergies (as a falsification test). We calculated multilevel Poisson regression models, which included individuals nested within regions, controlling for potential confounding variables and country fixed effects. After adjustment for individual level socio-demographic factors, higher average regional employment rates (from 2008 to 2013) were associated with better health outcomes. Individual level worklessness was associated with worsened health outcomes, most strongly with poor self-rated health. In models including both individual worklessness and the average regional employment rate, regional employment remained associated with heart and circulation problems, depression and obesity. There was evidence of an interaction between individual worklessness and regional employment for poor self-rated health and depression. The findings suggest that across 16 European countries, for some key outcomes, higher levels of employment in the regional labour market may be beneficial for the health of the local population.
- Klíčová slova
- Cross-national, Employment, Geography, Health inequality, Recession, Worklessness,
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- zaměstnanost * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Belgie MeSH
- Česká republika MeSH
- Evropa epidemiologie MeSH
- Finsko MeSH
- Francie MeSH
- Irsko MeSH
- Maďarsko MeSH
- Německo MeSH
- Nizozemsko MeSH
- Norsko MeSH
- Polsko MeSH
- Portugalsko epidemiologie MeSH
- Rakousko MeSH
- Španělsko MeSH
- Spojené království MeSH
- Švédsko MeSH