https://www.um.edu.mt/library/oar/handle/123456789/688 Previously known as Department of Health Services Management 2026-08-17T21:59:51Z https://www.um.edu.mt/library/oar/handle/123456789/148439 Title: Strengthening safety for informal caregivers in home care Authors: Abed, Nida; Pérez-Esteve, Clara; Knežević-Krajina, Hana; Buttigieg, Sandra C.; Tella, Susanna; Srulovici, Einav; Sousa, Paulo Jorge Dos Santos; Knezevic, Bojana; Mira, Jose J. Abstract: This scientific letter aims to raise awareness of the critical role informal caregivers play in home care settings and the need to find new approaches to ensure patient safety in this specific environment. With Europe’s aging population, the shift of hospital care to the home, and deinstitutionalization policies, the demand for informal caregiving in developing countries is rapidly rising. Informal care, provided by family members, neighbours, friends, and hired personnel by the families, in maintaining patient safety and well-being, Informal care has been estimated to have an economic value equivalent to 50-90% of the overall cost of long-term care across the European countries. In spite of the alteration towards home-based care, the existing patient safety literature remains focused on formal institutions, creating a major gap in patient safety within the unregulated home care environments. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148438 Title: Beyond the hospital walls : integrating clinical wisdom and global equity into the circular economy healthcare paradigm - a response to recent commentaries Authors: Buttigieg, Sandra C.; Soares, Ana Luísa; Bak, Bartosz; McFadden, Sonya; Hughes, Ciara; McClure, Patricia; Couto, Jose Guilherme; Bravo, Isabel Abstract: The publication of our foundational analysis, “A Review of the Applicability of Current Green Practices in Healthcare Facilities,” has catalyzed a sophisticated dialogue that transcends operational efficiency. This commentary is a collective insight that fundamentally shifts our strategic focus from mere green practices, often paying lip service to the term, to a systemic regenerative ethos, thereby aligning with the Lancet Commission’s assertion that the climate crisis represents the greatest global health opportunity of the 21st century. It is a response to the six commentaries that are offered by Gan & Kim, Wu & Liang, Weimann, Zanobini et al, von Eiff & von Eiff, and Esmaeili, which constitute a rigorous international scholarly peer review. Our purpose here is to synthesize these diverse perspectives into a cohesive roadmap for future health policy, bridging the gap between theoretical frameworks and actionable realities of healthcare leadership, so as to achieve a revolutionary shift to an environmentally friendly health sector. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/147949 Title: The second victim phenomenon in medical practitioners, nurses, and pharmacists : the SeViMa study for Malta Authors: Quintano, Lucienne; Vella Bonanno, Patricia; Strametz, Reinhard; Klemm, Victoria; Buttigieg, Sandra C. Abstract: Aim: To determine the prevalence, distribution, symptom burden, and recovery patterns of the second victim phenomenon (SVP) among healthcare professionals in Malta and to assess demographic, workplace, cultural, and personality-related correlates of SVP risk and symptom severity. Subject and methods: This was a cross-sectional study. Data were collected using a questionnaire that incorporated the English translation of the Second Victims in German-speaking countries (SeViD) instrument, the Big Five Inventory-10, and open-ended questions. The questionnaire was sent to all registered medical practitioners, nurses, and pharmacists in Malta. Analyses examined associations between SVP status/symptom load and professional group, demographic variables, workplace characteristics, and personality traits. Results: The prevalence of SVP was 77.7% among medical practitioners, 69.8% among nurses, and 42.3% among pharmacists. Triggers included patient death, patient harm, and aggression. Emotional and cognitive symptoms predominated, particularly intrusive recollections, self-doubt, and concentration difficulties. Prolonged symptoms were reported by 18.9% of medical practitioners, 14.7% of nurses, and 11.0% of pharmacists. Risk factors differed by profession: fewer years of experience predicted a higher symptom load in medical practitioners; older age increased risk in nurses while experience was protective; and female gender, non-Maltese nationality, and community pharmacy setting were associated with higher symptom severity among pharmacists. Personality traits did not predict SVP status but were associated with symptom severity. Conclusion: SVP is significant in Malta, with profession-specific risk profiles and a substantial symptom burden. Informal support predominates, highlighting the need for structured, targeted measures to reduce SVP impacts across professional groups. 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145310 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