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  1. AU="Sultana, Sufia"
  2. AU="Yuan, Shengwang"
  3. AU="Sedehizadeh, Saam"
  4. AU=Jeon Young-Woo
  5. AU=Narayanan Navaneeth
  6. AU=Beckwith Kyle A.
  7. AU=Anderson Robert H
  8. AU=Trindade P A
  9. AU=Gohil R
  10. AU="Zhengyi, Wu"
  11. AU=Wessels J A M
  12. AU="Porter, Lavinia"
  13. AU=Al-Mayman Sulaiman

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  1. Artikel ; Online: Understanding variations in diarrhea management across healthcare facilities in Bangladesh: a formative qualitative study.

    Elshabassi, Nour / Garbern, Stephanie C / Rosen, Rochelle K / Gainey, Monique / Nasrin, Sabiha / Alam, Nur H / Sultana, Sufia / Hasnin, Tahmida / Levine, Adam C

    Journal of infection in developing countries

    2023  Band 17, Heft 5, Seite(n) 665–676

    Abstract: Introduction: Acute diarrhea remains a leading cause of morbidity and mortality with over 6.3 billion cases and 1.3 million deaths annually. Despite the existence of standardized guidelines for diarrhea management, wide variability in clinical practice ... ...

    Abstract Introduction: Acute diarrhea remains a leading cause of morbidity and mortality with over 6.3 billion cases and 1.3 million deaths annually. Despite the existence of standardized guidelines for diarrhea management, wide variability in clinical practice exists, particularly in resource-limited settings. The goal of this study was to qualitatively explore how diarrhea management in Bangladesh varies according to resource availability, clinical setting, and provider roles.
    Methodology: This was a secondary analysis of a cross-sectional qualitative study conducted in three diverse hospital settings (district hospital, subdistrict hospital, and specialty diarrhea research hospital) in Bangladesh. A total of eight focus group discussions with nurses and physicians were conducted. Applied thematic analysis was used to identify themes regarding variations in diarrhea management.
    Results: Of the 27 focus group participants, 14 were nurses and 13 doctors; 15 worked in a private diarrhea specialty hospital and 12 worked in government district or subdistrict hospitals. Several key themes emerged from the qualitative data analysis: 1) priorities in the clinical assessment of diarrhea 2) use of guidelines versus clinical judgment; 3) variability in clinician roles and between clinical settings influences care delivery; 4) impact of resource availability on diarrhea management; and 5) perceptions of community health workers' role in diarrhea management.
    Conclusions: Findings from this study may aid in informing interventions to improve and standardize diarrhea management in resource-constrained settings. Resource availability, practices regarding diarrhea assessment and treatment, provider experience, and variability in provider roles are essential considerations when developing clinical tools in low- and middle- income countries.
    Mesh-Begriff(e) Humans ; Bangladesh/epidemiology ; Cross-Sectional Studies ; Delivery of Health Care ; Qualitative Research ; Diarrhea/epidemiology ; Diarrhea/therapy
    Sprache Englisch
    Erscheinungsdatum 2023-05-31
    Erscheinungsland Italy
    Dokumenttyp Journal Article
    ZDB-ID 2394024-4
    ISSN 1972-2680 ; 2036-6590
    ISSN (online) 1972-2680
    ISSN 2036-6590
    DOI 10.3855/jidc.17260
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Designing a Novel Clinician Decision Support Tool for the Management of Acute Diarrhea in Bangladesh: Formative Qualitative Study.

    Rosen, Rochelle K / Garbern, Stephanie C / Gainey, Monique / Lantini, Ryan / Nasrin, Sabiha / Nelson, Eric J / Elshabassi, Nour / Alam, Nur H / Sultana, Sufia / Hasnin, Tahmida / Qu, Kexin / Schmid, Christopher H / Levine, Adam C

    JMIR human factors

    2022  Band 9, Heft 1, Seite(n) e33325

    Abstract: Background: The availability of mobile clinical decision support (CDS) tools has grown substantially with the increased prevalence of smartphone devices and apps. Although health care providers express interest in integrating mobile health (mHealth) ... ...

    Abstract Background: The availability of mobile clinical decision support (CDS) tools has grown substantially with the increased prevalence of smartphone devices and apps. Although health care providers express interest in integrating mobile health (mHealth) technologies into their clinical settings, concerns have been raised, including perceived disagreements between information provided by mobile CDS tools and standard guidelines. Despite their potential to transform health care delivery, there remains limited literature on the provider's perspective on the clinical utility of mobile CDS tools for improving patient outcomes, especially in low- and middle-income countries.
    Objective: This study aims to describe providers' perceptions about the utility of a mobile CDS tool accessed via a smartphone app for diarrhea management in Bangladesh. In addition, feedback was collected on the preliminary components of the mobile CDS tool to address clinicians' concerns and incorporate their preferences.
    Methods: From November to December 2020, qualitative data were gathered through 8 web-based focus group discussions with physicians and nurses from 3 Bangladeshi hospitals. Each discussion was conducted in the local language-Bangla-and audio recorded for transcription and translation by the local research team. Transcripts and codes were entered into NVivo (version 12; QSR International), and applied thematic analysis was used to identify themes that explore the clinical utility of an mHealth app for assessing dehydration severity in patients with acute diarrhea. Summaries of concepts and themes were generated from reviews of the aggregated coded data; thematic memos were written and used for the final analysis.
    Results: Of the 27 focus group participants, 14 (52%) were nurses and 13 (48%) were physicians; 15 (56%) worked at a diarrhea specialty hospital and 12 (44%) worked in government district or subdistrict hospitals. Participants' experience in their current position ranged from 2 to 14 years, with an average of 10.3 (SD 9.0) years. Key themes from the qualitative data analysis included current experience with CDS, overall perception of the app's utility and its potential role in clinical care, barriers to and facilitators of app use, considerations of overtreatment and undertreatment, and guidelines for the app's clinical recommendations. Participants felt that the tool would initially take time to use, but once learned, it could be useful during epidemic cholera. Some felt that clinical experience remains an important part of treatment that can be supplemented, but not replaced, by a CDS tool. In addition, diagnostic information, including mid-upper arm circumference and blood pressure, might not be available to directly inform programming decisions.
    Conclusions: Participants were positive about the mHealth app and its potential to inform diarrhea management. They provided detailed feedback, which developers used to revise the mobile CDS tool. These formative qualitative data provided timely and relevant feedback to improve the utility of a CDS tool for diarrhea treatment in Bangladesh.
    Sprache Englisch
    Erscheinungsdatum 2022-03-25
    Erscheinungsland Canada
    Dokumenttyp Journal Article
    ISSN 2292-9495
    ISSN (online) 2292-9495
    DOI 10.2196/33325
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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