https://www.um.edu.mt/library/oar/handle/123456789/11486 2026-04-07T18:06:40Z 2026-04-07T18:06:40Z https://www.um.edu.mt/library/oar/handle/123456789/145310 2026-04-02T10:28:36Z 2025-01-01T00:00:00Z

Title: The second victim phenomenon : a case study for Malta Abstract: The Second Victim Phenomenon (SVP) refers to the emotional and occupational challenges healthcare professionals face directly or indirectly after adverse events, with global prevalence ranging from 9% to over 90%. This study investigated SVP in Malta through a nationwide survey of 900 medical practitioners, nurses, and pharmacists. The Second Victims in Deutschland (SeViD) tool, the Big Five Inventory–10 (BFI-10), and open-ended questions were used to examine how demographic, workplace, cultural, and personality traits influenced risk, symptom load, and recovery. Prevalence reached 77.7% in medical practitioners, 69.8% in nurses, and 42.3% in pharmacists. Fewer than 40% recognised the term “second victim.” Event types varied by profession: medical practitioners reported patient deaths, harm, or aggression; nurses cited aggression and deaths; pharmacists noted aggression and dispensing errors. Emotional and cognitive symptoms predominated, particularly reliving the incident, self-doubt, and concentration difficulties, with prolonged symptoms reported by 18.9% of medical practitioners, 14.7% of nurses, and 11.0% of pharmacists. Risk factors differed: in medical practitioners, fewer years of experience predicted higher symptom load; in nurses, older age increased risk, while experience was protective; in pharmacists, female gender and non-Maltese nationality predicted higher symptom load, while area of practice influenced prevalence. Personality traits did not predict SVP status but shaped symptom severity, with neuroticism heightening symptoms in nurses and pharmacists and openness in medical practitioners. Support was largely informal: nurses relied on peers, medical practitioners reported minimal structured help, and pharmacists expressed stronger expectations for institutional backing. Findings aligned with European research but revealed distinctive patterns, including high prevalence and unresolved trauma in medical practitioners, age-related risk and stronger behavioural symptoms in nurses, and nationality-linked severity in pharmacists. This highlights the need for targeted interventions to build resilience, reduce stigma, and implement a phased strategy to prevent SVP and lessen its impact in Maltese healthcare. Description: M.Sc.(Melit.)

2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145309 2026-04-02T10:26:38Z 2025-01-01T00:00:00Z

Title: Malta : an ever-shifting cultural kaleidoscope : exploring cultural competence in doctors working in primary health care Abstract: The increasing cultural diversity within populations presents healthcare systems with the challenge of delivering culturally sensitive care. Although cultural competence is widely recognised as essential, its consistent integration into practice remains limited. This study assessed the cultural competence of family medicine specialists in Malta’s Primary Health Care system, across both public and private sectors, by examining individual competencies and organisational strategies promoted by healthcare leaders. Guided by a pragmatic philosophy and an abductive research strategy, the study employed a concurrent mixed-methods design. Quantitative data were collected using the validated Healthcare Provider Cultural Competence Instrument (HPCCI) via an online survey sent to all eligible family medicine specialists. A total of 41 responses were received from 240 invited MMCFD members, yielding a response rate of 17.1%. Qualitative insights were drawn from seven semi-structured interviews with healthcare leaders and policy-makers from various roles within Primary Health Care. Findings revealed a gap between cultural awareness and its application. While most respondents acknowledged its importance, only 12.2% had received formal training. Younger and less experienced doctors scored higher in awareness and self-assessment, and willingness to engage in training was linked to more culturally responsive behaviours. Although the response rate was low, the findings align with existing literature, supporting their validity. Thematic analysis identified four core themes − Beyond the Textbook, Beyond Barriers, Beyond the White Coat, and Beyond the Present − highlighting conceptual inconsistencies, systemic barriers, emotional strain, and strong support for formal training. The study emphasises the need for longitudinal training, integration of culturally responsive practices into clinical routines, and policy reform to strengthen cultural competence in Malta’s evolving healthcare landscape. Description: M.Sc.(Melit.)

2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145308 2026-04-02T10:24:50Z 2025-01-01T00:00:00Z

Title: The introduction of home haemodialysis in the Maltese islands : a needs analysis Abstract: Chronic kidney disease is a major public health issue, with end-stage kidney disease patients requiring renal replacement therapy. In Malta, haemodialysis is exclusively hospital-based, creating pressures on bed capacity, accessibility and staffing. Home haemodialysis (HHD) may offer improved health outcomes and quality of life while relieving strain on the healthcare system, however, its feasibility and desirability in small island states remain largely unexplored. This study seeks to answer the question: To what extent is home haemodialysis feasible and desirable in a small island state within the European Union? The research, guided by an interpretivist approach, employed a qualitative case-study design. Semi-structured interviews and focus groups with stakeholders were conducted, and the findings were analysed using established frameworks, to provide a multidimensional, person-centred understanding of feasibility and desirability. The analysis revealed five key themes: quality of life and independence, safety and support, training and education, infrastructure and logistics, and sustainability and strategy. Data triangulation across stakeholder groups revealed perceived benefits and concerns, identifying barriers and facilitators. The results indicate that stakeholders perceive home haemodialysis as both feasible and desirable, particularly for its potential to improve quality of life, autonomy, and system efficiency. However, concerns were raised regarding training requirements, psychosocial support, and infrastructural capacity. The study concludes that successful implementation in Malta will depend on careful planning, sustained investment, and supportive policy frameworks. This dissertation contributes to the knowledge base on the introduction of person-centred dialysis care in small island states within the European Union, and its findings may serve as a basis for similar settings. Description: M.Sc.(Melit.)

2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145307 2026-04-02T10:22:27Z 2025-01-01T00:00:00Z

Title: Perceptions of change readiness of allied health professionals within a long-term care facility in Malta Abstract: Healthcare organisations face dynamic and complex environments that require continuous adaptation to sustain high-quality care. Organisational readiness for change (ORC) is a multidimensional construct shaped by leadership, structural systems, organisational culture, and individual psychology. Literature highlights that strong leadership, transparent communication, robust HR systems, and alignment between organisational values and staff engagement are critical to successful transformation. Readiness can differ significantly across professional and demographic groups and overlooking relational and emotional dimensions risks undermining change initiatives. This mixed-methods study examined ORC among Allied Health Professionals (AHPs) at a government-run long-term care facility in Malta, using the Organisational Change Readiness Assessment (OCRA) survey and a management focus group. The survey achieved a 54% response rate (n = 47), revealing notable departmental disparities: Physiotherapy and Podiatry reported higher readiness, whereas Occupational Therapy (OT) and Speech and Language Pathology (SLP) identified more barriers, especially in HR Systems and Information Processes. Statistical analysis showed significant differences between departments in five levers of change, with OT and SLP consistently perceiving them as greater obstacles. Differences also emerged by seniority and educational level, with more senior and postgraduate-qualified staff reporting more perceived barriers. Focus group findings reinforced these patterns, identifying visible leadership, early involvement, pilot testing, and targeted task delegation as key enablers, while poor communication, resource limitations, and change fatigue were common inhibitors. Reliability testing showed good internal consistency (α > 0.7) for most levers, borderline reliability for Lever G Human Resources (α = 0.689), and unacceptable reliability for Lever A External Environment (α = 0.460), suggesting refinement is needed. The report ends with a number of practical recommendations based on the literature and on the findings of this study for improving readiness in multidisciplinary settings and for further research. Description: M.Sc.(Melit.)

2025-01-01T00:00:00Z