Yoxas/statistical_literacy huggingface dataset:
The aim of this study was to identify and evaluate patient-relevant experiences that fulfill the expectations and demands of society in Greece and those that could be improved by offering a better quality of care. The satisfaction of health service recipients is one of the key elements of the success of a health system. A cross-sectional survey was conducted to obtain data on satisfaction with hospitalization from patients admitted to 10 public hospitals in Athens between June 2019 and December 2021. Statistical analysis was applied to 57 items and 7 dimensions of patient satisfaction, namely waiting-arrival-admission, nursing staff, medical staff, other staff, service and quality of food, interior environment, and procedures. A total of 3724 patients, aged ≥ 18 years, who had experienced hospitalization and agreed to participate in the study were included, the response rate of which was 93%. Patient satisfaction and experience with healthcare services provided by hospitals is moderate, with almost two-thirds of patients (67.38%) satisfied with the care they received. The encounter with the medical-nursing personnel (3.75/5) and other staff (4/5) were factors that positively affected patients' overall satisfaction with hospitalization. However, there were some causes of dissatisfaction, mainly associated with waiting hours, easy access to medical services or services received in emergencies, delays of planned procedures (3.50/5), or problems with old facilities and equipment (3.56/5). Based on the patients' judgment, the performance of hospitals was rated at a 'tolerable' level. Professionalism and the education of personnel led to a positive treatment outcome and improved the experience of patients to a good level. However, public hospitals continued to be underfunded and lacked strong support, which affected staff communication and responsiveness to patients' requirements, while smart technologies and the simplification of procedures were not adopted to help staff provide a better quality of healthcare. The results suggest that there is plenty of room for improvement.
The aim of this study was to identify factors influencing midwives' conversations about smoking, and referral to specialist smoking cessation services, using an evidence-based theoretical framework. Semi-structured, qualitative interviews were undertaken with community midwives employed within one health board region of Wales. Deductive framework analysis was employed by coding data to the domains of the Theoretical Domains Framework (TDF) and then identifying themes within domains and across participants. Seven midwives took part in the study. 13, out of a possible 14 domains, were mapped from the TDF. Key enablers to conversations and referrals include knowledge of the risks of smoking in pregnancy, congruence with the professional identity of a midwife, and the use of carbon monoxide monitors in initiating conversations and referrals. Limited knowledge of the specialist service, confusion about the opt-out pathway, varied skills in communicating and engaging with women, low confidence in ability to influence women's decisions, limited appointment times, and competing priorities were identified as barriers. Midwives recognise the importance of their role within the provision of smoking cessation advice and referral to specialist services. While there are continued time pressures and competing priorities for midwives, enhancing skills and confidence in collaborative, empowering approaches to addressing smoking would further support in optimising the uptake of maternity smoking cessation support. This could also enhance conversations about other public health issues such diet, physical activity, and alcohol use.
The aim of this study was to identify the impact of social determinants of health on physical and mental health outcomes in a UK population. Structural equation modelling was used to hypothesise a model of relationships between health determinants and outcomes within a region in the North of England using large-scale population survey data (6208 responses). We analysed responses from a population survey to assess the influence of a deprivation-based index at the environmental level, education and income on a behaviour index (smoking, alcohol consumption, physical activity, and dietary habits) and the influence of all these factors on self-reported physical health and the influence of the behaviour index and income on mental wellbeing. The proposed model was well supported by the data. Goodness-of-fit statistics, most notably a low value of the root mean square error of approximation (RMSEA), supported the validity of the proposed relationships (RMSEA = 0.054). The model revealed all examined paths to be statistically significant. Income and education were influential in determining an individual's behaviour index score, which, with income was the most important predictor of both the correlated outcomes of physical health and mental wellbeing (P < 0.001 in all cases). Findings challenge the traditional view of singular causal pathways, emphasising that interventions should consider the underlying influencing socio-economic conditions, which would influence behaviour and therefore physical and mental wellbeing. The extent to which the model is supported by the data, and the statistical significance of individual relationships accentuates the imperative for comprehensive public health strategies that integrate multiple socio-economic factors.
The aim of this study was to investigate associations between oral health literacy (OHL), self-rated oral health (SROH), and oral health-related quality of life (OHRQoL) in Brazilian adults. A sample of 523 Brazilian adults completed the short-form Health Literacy in Dentistry (HeLD-14) and the Oral Health Impact Profile-14 (OHIP-14) instruments that measure OHL and OHRQoL, respectively. The prevalence ratios (PRs) for outcome variables and their 95% CIs were quantified. Multivariable log-binomial regression models were applied, as the statistical models, to estimate bivariate and multivariable relationships of oral health outcomes with OHL, after adjusting for covariates. No significant association was found between poor SROH (as measured by single items) and OHL (PR = 1.28; 95% CI: 0.87-1.88); by contrast, significant associations were found between poor SROH and income (PR = 1.52; 95% CI: 1.04-2.21), toothbrushing frequency (PR = 1.69; 95% CI: 1.11-2.58), reason for dental visiting (PR = 1.48; 95% CI: 1.03-2.13), and self-rated general health (PR = 3.44; 95% CI: 2.38-4.97). The OHL level (PR = 1.76; 95% CI: 1.21-2.56), educational level (PR = 0.62; 95% CI: 0.41-0.93), reason for dental visiting (PR = 1.84; 95% CI: 1.30-2.61), and self-rated general health (PR = 1.51; 95% CI: 1.03-2.23) were associated with poor OHRQoL.
The aim of this study was to investigate nursing students' clinical decision-making by using high-fidelity simulation of a deteriorated patient scenario. A convergent parallel mixed methods research design was used consisting of quantitative and qualitative data collection. Twenty-three students completed the Health Science Reasoning Test before and after the simulation between October 2015 and June 2016. They were presented with a simulated scenario and asked to 'think aloud' during and after the simulation. The students were audio-video recorded and observations were collected by the researcher. There was a significant moderate increase in the 'deduction' and 'analysis' sub-scale scores and overall test score, suggestive of improved analytical decision-making processes through the simulation experience. Think-aloud and observation data identified that students predominantly applied 'forward' reasoning during the simulated 'patient's' deterioration, focusing mainly on cue acquisition. 'Backward' reasoning with a focus on cue interpretation was most prominent in the debriefing data, in line with the survey outcomes. Accurate cue interpretation of critical, key cues appeared more useful than the total number of cues in solving the main clinical case problem. Students learn different clinical decision-making skills during the simulation compared to what they learn from debriefing. Using observation and think-aloud methods have significant benefits for researchers seeking to optimize the evaluation of the clinical decision-making process.
The aim of this study was to investigate student experiences of publishing undergraduate research in biomechanics. A total of 29 former students with experience of publishing peer-reviewed undergraduate biomechanics research completed an online survey regarding their perceived benefits, level of involvement, and experiences in aspects of the research process. On average, students perceived their experiences to be "largely helpful" or greater in all aspects. Areas were identified corresponding to: the greatest perceived benefits (eg, understanding of the research process); the least perceived benefits (eg, statistical analysis skills); the greatest student involvement (eg, reading relevant literature); and the least student involvement (eg, developing hypotheses and/or methods). A thematic analysis of open question responses identified themes relating to: future career, skills, scientific process, intra- and interpersonal factors, and pedagogy. Common intended learning outcomes may be achieved through involvement in the research process independently of the level of staff involvement. Staff should be encouraged to involve students in publishable biomechanics research projects where this is possible without compromising research standards and should explore ways of recreating the publishing process internally for all students.
The aim of this study was to investigate the caregiver burden (CB) of informal caregivers for stroke survivors with and without dysphagia and to assess the relationship between the CB levels of informal caregivers for stroke survivors with dysphagia, patients' swallowing-related quality of life (QoL), and patients' stroke-specific QoL. This multi-center, prospective, cross-sectional study included a total of 120 stroke patients (76 males, 44 females; mean age: 61.1±12.3 years; range, 19 to 86 years) between October 2019 and 2020. Of the patients, 57 had dysphagia and 63 had no dysphagia. The Functional Oral Intake Scale (FOIS) was used to classify the degree of functional dietary limitation caused by each patient's swallowing impairment. Patients and caregivers completed the Eating Assessment Tool (EAT-10), Swallowing Quality of Life (SWQoL) questionnaire, Stroke Impact Scale (SIS), and the Zarit Caregiver Burden Interview (ZBI). The CB levels were higher in those caring for stroke patients with dysphagia than in those caring for stroke patients without dysphagia. Caregiver burden was found to be associated with patients' swallowing-related QoL and stroke-related QoL. Significant predictors of high CB scores (F=2.55, R2=0.59; p=0.007) were being an employed caregiver (B=17.48, p=0.003), being a caregiver with high school (B=-19.6, p=0.03), and secondary school (B=-16.28, p=0.02) educational status, being son, daughter (B=30.63, p=0.007) or other relative of the patient (B=20.06, p=0.01), lower FOIS stage (B=-3.14, p=0.011), lower SWQoL (B=0.52, p=0.009) and lower SIS (B=-0.37, p=0.04) scores. Caregivers of stroke patients with dysphagia suffer from a higher CB than those without dysphagia. In stroke patients with dysphagia, swallowing-related QoL is associated with the QoL levels of stroke patients and the CB levels of their caregivers. Employment status, educational status of caregiver, caregiver's relativity to the patient, FOIS stage, swallowing and stroke related QoL of the patients are factors related to burden levels of caregivers of stroke patients with dysphagia. These results may help health professionals to understand dysphagia as an essential source of CB and consider it, while planning treatments.
The aim of this study was to investigate the impact of early life adversity on cognitive function in patients with schizophrenia, with a focus on social cognition (SC). Two groups of patients with schizophrenia were recruited and matched on sociodemographic and clinical characteristics. One group consisted of 32 patients with a history of childhood trauma (SCZ-ct), and the other group consisted of 30 patients without a history of childhood trauma (SCZ-nct). In addition, 39 healthy controls without a history of childhood trauma (HC-nct) were also recruited. The intelligence of the three groups was assessed using the Wechsler Abbreviated Scale of Intelligence (WAIS-RC) short version. The cognitive function evaluation was conducted using the MATRICS Consensus Cognitive Battery (MCCB), and early life adversity was measured using the Childhood Trauma Questionnaire-Short Form (CTQ) and Bullying Scale for Adults (BSA). Patients with schizophrenia endosed significantly higher scores on the CTQ (F=67.61, p<0.001) and BSA (F=9.84, p<0.001) compared to the HC-nct. Analysis of covariance (ANCOVA) and post-hoc analyses revealed that SCZ-ct (F=11.20, p<0.001) exhibited the most pronounced cognitive impairment among the three groups, as indicated in MCCB total scores and in the domain score of SC. CTQ exhibited a negative correlation with MCCB (r=-0.405, p< 0.001); SC was negatively correlated with physical abuse (PA) of CTQ (r=-0.271, p=0.030) and emotional abuse (EA) of BSA (r=-0.265, p=0.034) in the whole patient sample. Higher SC performance was significantly predicted by CT_total (Beta =-0.582, p<0.001, 95% CI -0.96-0.46), and years of education (Beta=0.260, p =0.014, 95% CI 0.20-1.75) in schizophrenia. Besides familial trauma, schizophrenia patients appear to have a higher likelihood of experiencing bullying in their early life. These experiences seem to contribute significantly to their severe impairments in SC.
The aim of this study was to investigate the influence of primary congenital hypothyroidism (CH) on quality of life, level of education and socioeconomic status (SES). Two independent study cohorts, a national and a regional, were collected from Finnish national registers and patient records. Data on social security benefits, SES, marital status, and education were collected from Statistics Finland. Health-related quality of life (HRQoL) was studied in the regional patient cohort with the standardized 15D and 16D instruments. There were no statistically significant differences in education level, marital status, or SES between CH patients (n = 40) and their matched controls at the age of 25 years. The mean 15D score was both statistically significantly and clinically importantly lower in CH patients (n = 29) than controls (0.904 vs. 0.953, p = 0.008). CH patients reported significantly lower scores across various dimensions of physical and mental HRQoL, including breathing, sleeping, speech, excretion, mental function, distress, and vitality. The mean 16D score was lower in CH patients compared to controls (0.917, vs. 0.947), but without statistical significance. SES of CH patients did not differ from matched controls. Thus, most CH patients integrate well into society, but their HRQoL is impaired. Most patients with primary congenital hypothyroidism integrate well into society. In the current study, their socioeconomic and marital status did not differ from matched controls at the age of 25 years. However, health-related quality of life measured using 15D instrument was impaired. Every fourth patient reported that congenital hypothyroidism influenced everyday life.
The aim of this study was to investigate whether an objective measure of freezing of gait (FOG) using a validated alternating stepping in place (SIP) task, is related to executive and/or visuospatial cognitive impairment in Parkinson's disease (PD). We studied prospectively 30 PD subjects with the Unified Parkinson's Disease Rating Scale (UPDRS) III, the FOGq, Trail Making Test Part B (TMTB), Wisconsin Card Sorting, Initiation/Perseveration, Matrix Reasoning (MR) and Block Design (BD). PD subjects performed three, 100s trials of alternative SIP while standing on two force platforms to assess the number and duration of freezing episodes (FE), SIP rhythmicity and symmetry. Freezers had larger cycle asymmetry and arrhythmicity than non-freezers (P<0.05). Performance on BD and MR tests differentiated freezers from non-freezers (P<0.04; P=0.001, respectively). BD performance negatively correlated with the FOGq total (P<0.05), the number and duration of FE (P<0.01), SIP arrhythmicity and asymmetry (P=0.01, P<0.05). MR performance negatively correlated with all FOGq #3 and total as well as SIP FE metrics (P≤0.01), except for SIP asymmetry. Deficits in visuospatial perception and reasoning not in executive function differentiated freezers from non-freezers. Deficits in visuospatial processing negatively correlated with all SIP freeze metrics, whereas deficits in executive function were only correlated with SIP arrhythmicity, the FOGq total and the duration of freezing episodes. These results suggest that deficits in visuospatial processing to perform a motor task contribute to FOG and that different cognitive deficits may contribute to different aspects of freezing in PD. This is the first study to our knowledge that has compared metrics of freezing to cognitive tasks in the visuospatial and visual reasoning domains.
The aim of this study was to investigate whether the presence of a teacher affects learning related outcomes in teaching basic surgical tasks with a Virtual Reality (VR) headset. 26 fourth-year medical studentsparticipated in a voluntary exercise. Students practiced basic surgical procedure exercises using the VR4HEALTHCARE application in VR with OCULUS Rift S glasses. 12 students performed the exercises under the guidance of a teacher and 14 without the teacher present. After the exercise, the groups filled out a feedback form. Statistical analysis was performed using IBM SPSS Statistics 25.0 software using the Mann-Whitney U test and multivariate analysis of variance. The most important data collected related to whether the student learned something new and whether VR adds value to medical education. Ratings were based on a scale of 0-10 (0 = worst, 10 = best). When the teacher was present, on average, the students felt that they were learning something new and gave an average rating of 7.8 ± 1.8, and when the teacher was not present 5.3 ± 2.6 (p = 0.003). VR added value to teaching with a rating of 7.8 ± 1.7 when the teacher was present and 5.5 ± 3.0 when not present (p = 0.045). This study also analyzed specific use of VR for abscess incision, suturing and insertion of a suprapubic catheter. When a teacher was present VR added value to teaching and the usefulness and usability of VR was experienced more positively. The student should also have adequate knowledge of the subject to be taught before VR training. VR adds value to teaching, but VR exercises may not completely replace high-quality traditional teaching methods. Consequently, it is important to determine the differences between VR and traditional teaching methods and how to combine these methods in the future.
The aim of this study was to translate the Nursing Clinical Reasoning Scale (NCRS) into Persian and evaluate its psychometric properties. This study was a methodological and cross-sectional study. This methodological study was conducted in 2020 in a teaching hospital. After obtaining necessary permission from its developers, NCRS was translated into Persian through the method proposed by the World Health Organization. Then, its face, content, and construct validity and reliability were assessed. For construct validity assessment through exploratory and confirmatory factor analyses, 300 nurses (two 150-nurse samples), who had randomly been selected, completed the instrument. Reliability also assessed through the internal consistency and the stability methods. Data were analysed using the SPSS (v. 20.0) and the AMOS (v. 5.0) software. The content validity indices of NCRS and its items were 0.97 and more than 0.79, respectively. Exploratory factor analysis revealed an assessment and confirmation factor and an implementation and reflection factor for the scale which together explained 57.30% of the total variance. Confirmatory factor analysis also confirmed this two-factor structure (χ2 /df = 2.11, NNFI = 0.952, RMSEA = 0.053, CFI = 0.91, GFI = 0.94, IFI = 0.95, and NFI = 0.96). The Cronbach's alpha and the intraclass correlation coefficient values of the scale were 0.96 and 0.94, respectively. The Persian NCRS can help nursing policy makers and mentors identify the need for developing nurses' and nursing students' CR skills and implement need-based educational courses to improve these skills. Moreover, it helps determine whether the educational programmes are effective in improving nurses' CR skills and clinical competence.
The aim of this study was to understand the provision and need, quality of and trust in COVID-19 vaccines information from the perspectives of people who have had COVID-19 infection. People who have had a COVID-19 infection were approached via their general practice and invited to participate in the Nivel Corona Cohort. They completed questionnaires at baseline (Q1), and at three months (Q2). Outcome measures were based on health information-seeking behaviour, as used in the Comprehensive Model of Information Seeking. Antecedents (i.e., gender, age, education level, health literacy) were used from Q1, and one's beliefs and experiences (i.e., trust in the information and healthcare system, how applicable the information is), information carrier factors (i.e., information quality perceptions and via which sources), health-information seeking actions (i.e., decision to vaccinate and information sufficiency) and vaccination status from Q2. Data were analysed using descriptive analyses, analysis of variance tests (F-tests) and χ2 tests with the statistical software STATA. Of the respondents (N = 314), 96% were vaccinated at least once, mostly after having had the virus. Most retrieved information about COVID-19 vaccines on the website of the National Institute for Public Health and the Environment (79%), broader via the internet (56%), or from family and friends (35%). Almost all had trust in the information (89%) and healthcare system (94%). Most found the information applicable to their situation (67%). Moreover, most perceived the information as correct (71%) and did not perceive the information to be misleading (85%), while fewer people found the information reliable (59%) and clear (58%). Overall, the majority indicated that the information met their expectations to make a well-informed decision to vaccinate (89%). Different characteristics of people who had COVID-19 and sought information were identified, which is important to offer tailored information. People who had COVID-19 in this study, mainly middle-aged, vaccinated and highly educated, were generally positive about the vaccines information, but overall the reliability and clarity could be improved. This is important for a high vaccination uptake, booster programs and coming pandemics. The questionnaire was reviewed by patients who had COVID-19, one of whom is a health services researcher.