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Vadali N, Ní Chróinín D, Short A. 'It helps you forget your worries': A pilot study exploring music therapy in the acute hospital aged care setting. Australas J Ageing 2024. [PMID: 38741416 DOI: 10.1111/ajag.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES Few studies have explored music therapy (MT) in an acute aged care inpatient setting. We aimed to assess feasibility and patient/staff perceptions of an 8-week MT program on an acute geriatric ward. METHODS An 8-week in-person MT program, comprising brief receptive musical interventions up to twice-weekly. All patients admitted to the aged care ward were eligible for inclusion. A hard copy survey was used to assess patient and staff perceptions of MT. Themes raised in free-text responses were manually coded within a thematic analysis approach. A mixed methods approach was used to obtain and analyse data relating to feasibility and patient and staff perceptions of the MT intervention. RESULTS The 8-week program ran to completion and was delivered to a median of 11 patients (IQR 9-12) each session (median 8 new/day). In total, 10 patients completed surveys, mean age 81.1 (SD 7.7); 60% were women and all had cognitive impairment. Following an MT session, eight of eight responding patients reported feeling happy and eight of eight reported they would recommend MT. Staff respondents (n = 19) reported patients appeared happy (19/19), relaxed (13/19) and all would recommend MT to other patients. Common themes were that MT was followed by improved patient behaviour and mood, and stimulated patients. CONCLUSIONS An acute aged care inpatient MT program proves feasible and well-received by staff and patients. Future research may focus on more robust data collection in larger sample sizes, specific types of MT and more in-depth exploration of the patient and carer experiences.
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Affiliation(s)
- Neeraja Vadali
- Department of Geriatric Medicine, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Danielle Ní Chróinín
- Department of Geriatric Medicine, Liverpool Hospital, Sydney, New South Wales, Australia
- South Western Sydney Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - Alison Short
- School of Humanities and Communication Arts, Western Sydney University, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Kennedy DP, Friedman EM, Kirkegaard A, Edgington S, Shih R. Perceived loss of support to community caregivers during the COVID-19 pandemic in the United States. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:475-497. [PMID: 38329412 PMCID: PMC10977083 DOI: 10.1002/jcop.23107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 02/09/2024]
Abstract
Coronavirus disease (COVID-19) had a negative impact on the health and well-being of community caregivers. Few studies examine the pandemic's negative impact on the availability of social networks of caregivers. This article uses data collected during COVID-19 before vaccination to examine caregivers' reports of perceived lost and reduced network support. We assessed the personal networks of a nationally representative sample of 2214 community caregivers in the United States. We analyzed associations between caregiving factors and caregivers' perceptions of lost and reduced network support. Changes in care recipient living circumstances during COVID-19, longer-term caregiving, care recipient hearing/vision/mobility problems, caregiver travel/socializing restrictions, caregiver race/ethnicity, caregiver income, caregiver age, network connectivity, family relationships, and network members' age were associated with perceived lost/reduced support during the pandemic. Findings provide insights for the development of social network interventions to support caregivers and help them cultivate support networks resilient to public health crises.
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Affiliation(s)
- David P. Kennedy
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
| | - Esther M. Friedman
- Institute for Social Research, University of Michigan at Ann Arbor, 426 Thompson St, Ann Arbor, MI 48104
| | | | - Sarah Edgington
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
| | - Regina Shih
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
- Emory University, 1518 Clifton Rd., Atlanta, GA
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Pérez-Rugosa V, de Lorena-Quintal P, Domínguez-Valdés E, Rodríguez-Rodríguez A, Núñez-Castro I, Suárez-Fernández Y, Sarabia-Cobo C. Exploring older people's experiences of the interpersonal care relationship between nurses and patients during hospitalization in the pandemic period: A qualitative study. J Adv Nurs 2024. [PMID: 38225866 DOI: 10.1111/jan.16050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024]
Abstract
AIM This article presents the findings of a qualitative study focusing on the experiences of people aged over 70 years in the interpersonal nurse-patient care relationship in hospital settings during and after the COVID-19 pandemic. The aim was to analyse different aspects of this relationship, including nurses' behaviour and caring attitudes, the person-centred model of care, patients' involvement in their own care and communication in the hospital context. DESIGN An exploratory qualitative study was conducted on the basis of an interpretative framework. METHODS Six focus groups were conducted. A total of 34 participants were purposively recruited from three nursing homes in Spain, Italy and Portugal. Specific inclusion criteria were used to select participants. RESULTS Five main categories were identified. Analysis revealed the importance of empathy and sensitivity in caring relationships, as well as the need for personalized and patient-centred care. The importance of effective communication and recognition of ageist behaviour by professionals was highlighted. In addition, independent of the pandemic, situational factors in the hospital environment were identified that influence the interpersonal care relationship. CONCLUSIONS The study highlights the need to promote a person-centred model of care that takes into account the specific preferences and needs of older people. This is achieved by identifying elements of the interpersonal nurse-patient relationship. In addition to highlighting the disparity of opinion regarding an active or passive role in self-care and decision making, the importance of addressing ageism and improving communication is emphasized. WHAT PROBLEM DID THE STUDY ADDRESS?: The importance of the patient-nurse relationship in hospital care has been highlighted in previous studies. Critical elements of the patient care experience have been identified as empathy and effective communication. Ageism in healthcare has been recognized as a potential barrier to patient-centred care. WHAT WERE THE KEY FINDINGS?: The main findings highlight the importance of empathy and personalized care, emphasize the importance of effective communication and address ageist behaviours in the nurse-patient relationship. WHERE AND WHO WILL THE RESEARCH IMPACT?: By highlighting the need for person-centred care and improved communication strategies, particularly in the context of caring for older patients during and after the COVID-19 pandemic, this research will have an impact on healthcare professionals, policy makers and carers. REPORTING METHOD The COREQ guideline was used. PATIENT OR PUBLIC CONTRIBUTION This study adopted a collaborative approach to ensure that patient perspectives were integrated into the research process. We organized regular focus groups. Patients were actively involved in shaping the research questions, refining the study design and interpreting the emerging findings. Their valuable input helped us to understand the nuances of their experience and to prioritize the aspects that were critical to their well-being. In addition, their insights guided the development of practical recommendations aimed at improving the interpersonal care relationship between nurses and patients in hospital settings, ensuring that their voices were heard and reflected in the proposed interventions. This patient-centred approach fostered a sense of empowerment among the participants. It reinforced the notion that their experiences and opinions are integral to shaping healthcare practice.
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Affiliation(s)
| | | | | | | | | | | | - Carmen Sarabia-Cobo
- Faculty of Nursing, University of Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL. CIBERFRAIL, Santander, Spain
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Faghihi F, Zarshenas L, Tehranineshat B. Compassionate care of nurses for the elderly admitted to the COVID-19 wards in teaching hospitals of southern Iran. BMC Nurs 2024; 23:14. [PMID: 38167005 PMCID: PMC10759730 DOI: 10.1186/s12912-023-01670-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Compassionate care is the main indicator of the quality regarding nursing care. The importance of this care in the recovery process for the elderly hospitalized for COVID-19 has been under-researched in studies. Therefore, this study aimed to determine the compassionate care level of nurses to the elderly hospitalized in the COVID-19 wards of teaching hospitals in the south of Iran. METHODS This descriptive-analytical study was conducted on 212 nurses working in the COVID-19 wards of teaching hospitals in the south of Iran, who were selected through census in a cross-sectional study. The data were collected using the Tehranineshat et al. nurses' compassionate care questionnaire and then the data were analyzed using descriptive and analytical statistics along with SPSS software version 22. RESULTS The mean score of nurses' compassionate care was 130.18 ± 9.42, which was at a high level. The highest and lowest scores were related to professional performance (43.17 ± 2.799) and empathic communication dimension (27.76 ± 2.970). No significant relationship was found between variables such as gender, marital status, education, work experience, and job position with the compassionate care score (P > 0.05). CONCLUSION Nurses providing care for hospitalized elderly are recommended to consider all aspects of compassionate care, especially empathic communication, in their educational planning.
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Affiliation(s)
- Fereshte Faghihi
- Department of Nursing, School of Nursing and Midwifery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ladan Zarshenas
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Banafsheh Tehranineshat
- Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Iqbal MS, Naqvi RA, Alizadehsani R, Hussain S, Moqurrab SA, Lee SW. An adaptive ensemble deep learning framework for reliable detection of pandemic patients. Comput Biol Med 2024; 168:107836. [PMID: 38086139 DOI: 10.1016/j.compbiomed.2023.107836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/14/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024]
Abstract
Nurses, often considered the backbone of global health services, are disproportionately vulnerable to COVID-19 due to their front-line roles. They conduct essential patient tests, including blood pressure, temperature, and complete blood counts. The pandemic-induced loss of nursing staff has resulted in critical shortages. To address this, robotic solutions offer promising avenues. To solve this problem, we developed an ensemble deep learning (DL) model that uses seven different models to detect patients. Detected images are then used as input for the soft robot, which performs basic assessment tests. In this study, we introduce a deep learning-based approach for nursing soft robots, and propose a novel deep learning model named Deep Ensemble of Adaptive Architectures. Our method is twofold: firstly, an ensemble deep learning technique detects COVID-19 patients; secondly, a soft robot performs basic assessment tests on the identified patients. We evaluate the performance of various deep learning-based object detectors for patient detection, examining implementations of You Only Look Once (YOLO), Single Shot MultiBox Detector (SSD), Region-Based Convolutional Neural Network (RCNN), and Region-Based Fully Convolutional Network (R-FCN) on a proprietary dataset comprising 32,668 hospital surveillance images. Our results indicate that while YOLO and VGG facilitate rapid detection, Faster-RCNN (Inception ResNet-v2) and our proposed Ensemble-DL achieve the highest accuracy. Ensemble-DL offers accurate results in a reasonable timeframe, making it apt for patient detection on embedded platforms. Through real-world experiments, our method outperforms baseline approaches (including Faster-RCNN, R-FCN variants, CNN+LSTM, etc.) in terms of both precision and recall. Achieving an impressive accuracy of 98.32%, our deep learning-based model for nursing soft robots presents a significant advancement in the identification and assessment of COVID-19 patients, ultimately enhancing healthcare efficiency and patient care.
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Affiliation(s)
- Muhammad Shahid Iqbal
- School of Computer Science and Technology, Anhui University, Hefei, China; Department of Computer Science and Information Technology, Women University of Azad Jammu & Kashmir, Bagh, Pakistan.
| | - Rizwan Ali Naqvi
- Department of Artificial Intelligence and Robotics, Sejong University, Seoul 05006, Republic of Korea.
| | - Roohallah Alizadehsani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Waurn Ponds, Geelong, VIC 3216, Australia
| | - Sadiq Hussain
- Examination Branch, Dibrugarh University, Dibrugarh 786004, India
| | - Syed Atif Moqurrab
- School of Computing, Gachon University, 1342, Seongnam-daero, Sujeong-gu, Seongnam-si, 13120, Republic of Korea.
| | - Seung-Won Lee
- School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea.
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Östlund AS, Högnelid J, Olsson A. Being an older hospitalized patient during the COVID-19 pandemic - A qualitative interview study. BMC Geriatr 2023; 23:810. [PMID: 38053062 PMCID: PMC10698926 DOI: 10.1186/s12877-023-04562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/04/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Older people hospitalized for COVID-19 are a vulnerable group due to the disease itself, aging and often loss of hearing and vision. Person-centered care, where patients have opportunities to communicate and participate in their own care, is important. However, because healthcare staff needed to wear personal protective equipment during the pandemic, to protect the patients and themselves, providing person-centered care was often difficult. This study aims to describe older hospitalized patients' experiences both of being cared for, while having COVID-19, and of the care provided by healthcare staff wearing PPE. METHODS Fourteen older patients, over 65 years of age, were interviewed, and the data were analyzed using qualitative content analysis. The study adhered to Consolidated criteria for reporting qualitative research guidelines. RESULTS Three subthemes and one overall theme, "The desire for survival overshadows difficulties", emerged in the analysis. The main findings revealed that the older hospitalized patients experienced the care they received from the healthcare staff as satisfactory. The older patients reported understanding and accepting that the pandemic situation meant that their ability to participate in their own care and communicate with healthcare staff were given lower priority. CONCLUSIONS Older hospitalized patients need to be provided person-centered care, and situations such as a pandemic are no exception. Care tasks that are not acute in nature, e.g., planning for patients' return home, could be conducted by healthcare staff not required to wear PPE.
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Affiliation(s)
- Ann-Sofi Östlund
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden
| | - Julia Högnelid
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden
| | - Annakarin Olsson
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden.
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Sousa SS, Andrade MJ, Fernandes CS, Barbeiro SR, Teixeira VT, Pereira RS, Martins MM. Healthcare Experience of People with Acute Spinal Cord Injury: A Phenomenological Study. NURSING REPORTS 2023; 13:1671-1683. [PMID: 38133114 PMCID: PMC10746080 DOI: 10.3390/nursrep13040138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
Living with spinal cord injury (SCI) is a challenge that begins in the acute phase, when the disease, the limitations, and the treatments fill the days at the hospital. This study aims to understand the healthcare experience of the person with SCI in the acute phase, based on the Activities of Living Nursing Model (ALNM). It is a qualitative and phenomenological study based on the Standards for Reporting Qualitative Research. Data were collected via semi-structured interviews. Content analysis was performed using the ATLAS.ti software and Bardin's methodology. The article was written following the COREQ guidelines. The categories were defined using the Roper-Logan-Tierney Model for Nursing. The sample included 16 people with incomplete SCI, different etiology, and neurological levels. Eleven of the twelve ALNM emerged from the interviews. The activities of mobilizing, eliminating, maintaining a safe environment, and communicating were emphasized the most. Controlling body temperature was not relevant. Mobility deficits and pain increased dependence. Feelings of motivation, encouragement, and frustration were highlighted. Professional expertise, rehabilitation resources, and support equipment promoted independence. The results in this sample revealed that people with SCI in the acute phase have complex challenges related to dependence awareness and treatments, but they always keep recovery expectations in mind.
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Affiliation(s)
- Salomé Sobral Sousa
- Abel Salazar Institute of Biomedical Sciences, 4050-313 Porto, Portugal; (S.S.S.); (M.J.A.); (R.S.P.); (M.M.M.)
- Department of Neurosciences, University Hospital Center of Santo António, 4099-001 Porto, Portugal; (S.R.B.); (V.T.T.)
| | - Maria João Andrade
- Abel Salazar Institute of Biomedical Sciences, 4050-313 Porto, Portugal; (S.S.S.); (M.J.A.); (R.S.P.); (M.M.M.)
- Department of Neurosciences, University Hospital Center of Santo António, 4099-001 Porto, Portugal; (S.R.B.); (V.T.T.)
| | | | - Sara Rodrigues Barbeiro
- Department of Neurosciences, University Hospital Center of Santo António, 4099-001 Porto, Portugal; (S.R.B.); (V.T.T.)
| | - Vanessa Taveira Teixeira
- Department of Neurosciences, University Hospital Center of Santo António, 4099-001 Porto, Portugal; (S.R.B.); (V.T.T.)
| | - Rute Silva Pereira
- Abel Salazar Institute of Biomedical Sciences, 4050-313 Porto, Portugal; (S.S.S.); (M.J.A.); (R.S.P.); (M.M.M.)
| | - Maria Manuela Martins
- Abel Salazar Institute of Biomedical Sciences, 4050-313 Porto, Portugal; (S.S.S.); (M.J.A.); (R.S.P.); (M.M.M.)
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Wong ELY, Wang K, Cheung AWL, Graham C, Yeoh EK. Thinking beyond the virus: perspective of patients on the quality of hospital care before and during the COVID-19 pandemic. Front Public Health 2023; 11:1152054. [PMID: 37744522 PMCID: PMC10515219 DOI: 10.3389/fpubh.2023.1152054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives The COVID-19 pandemic has a huge impact on the healthcare system and affects the normal delivery of routine healthcare services to hospitalized patients. This study aimed to examine the differences in patient experience of hospital service before and during COVID-19 among the discharged adult population. Methods A territory-wide patient experience survey was conducted before and during COVID-19 (between October 2019 and April 2020) among patients discharged from the main acute and rehabilitation public hospitals in Hong Kong. A hierarchical ordinal logistic model was employed to examine the difference in multiple dimensions of patient experience, with adjustments of covariates. Results In total, 9,800 participants were recruited. During the pandemic, there was a marginally significant increase in overall care rating (AOR: 1.12, 95% CI: 0.99-1.27), and an improvement in the timeliness of admission. However, significant reductions in patients' confidence in nurses were observed. Communication of information regarding medication side effects reduced significantly (AOR: 0.72, 95% CI: 0.64-0.82). Conclusion The patients hospitalized during the pandemic reported worse responsiveness in communication in their patient journey than those admitted before the pandemic. These findings will help develop appropriate strategies to address patients' concerns in the new normal.
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Affiliation(s)
- Eliza Lai-yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
| | - Kailu Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
| | - Annie Wai-ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
| | | | - Eng-kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong SAR, China
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Strayer AL, King BJ. COVID-19 and Elective Spine Surgery: The Older Persons' Experience of Going It Alone. J Neurosci Nurs 2023; 55:113-118. [PMID: 37318188 PMCID: PMC10332507 DOI: 10.1097/jnn.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
ABSTRACT BACKGROUND: Older people with debilitating degenerative spine disease may benefit from surgery. However, recovery is described as a circuitous process. In general, they describe feeling powerless and receiving depersonalized care during hospitalization. Institution of hospital no-visitor policies to reduce COVID-19 spread may have caused additional negative consequences. The purpose of this secondary analysis was to understand experiences of older people who underwent spine surgery during early COVID-19. METHODS: Grounded theory guided this study of people 65 years or older undergoing elective spine surgery. Fourteen individuals were recruited for 2 in-depth interviews at 2 time points: T1 during hospitalization and T2, 1 to 3 months post discharge. All participants were affected by pandemic-imposed restrictions with 4 interviews at T1 with no visitors, 10 with a 1-visitor policy, and 6 interviews at T2 rehabilitation setting with no visitors. Discriminate sampling of data in which participants described their experiences with COVID-19 visitor restrictions was used. Open and axial coding (consistent with grounded theory) was used for data analysis. RESULTS: Three categories, worry and waiting , being alone , and being isolated , emerged from the data. Participants had delays ( waiting ) in getting their surgery scheduled, which produced worry that they would lose more function, become permanently disabled, have increased pain, and experience more complications such as falls. Participants described being alone during their hospital and rehabilitation recovery, without physical or emotional support from family and limited nursing staff contact. Being isolated often occurred from institution policy, restricting participants to their rooms leading to boredom and, for some, panic. CONCLUSIONS: Restricted access to family after spine surgery and during recovery resulted in emotional and physical burden for participants. Our findings support neuroscience nurses advocating for family/care partner integration into patient care delivery and investigation into the effect of system-level policies on patient care and outcomes.
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Corcoran G, Bernard P, Kenna L, Malone A, Horgan F, O'Brien C, Ward P, Howard W, Hogan L, Mooney R, Masterson S. "Older People Want to Be in Their Own Homes": A Service Evaluation of Patient and Carer Feedback after Pathfinder Responded to Their Emergency Calls. PREHOSP EMERG CARE 2023; 27:866-874. [PMID: 36633524 DOI: 10.1080/10903127.2023.2168094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Older people experience high rates of adverse outcomes following emergency department (ED) presentation. There is growing evidence to support alternative care pathways for certain types of emergency medical services (EMS) calls. Pathfinder is one such service and targets patients aged 65 years and over, whose presenting issues can be safely managed at home by immediate paramedic, occupational therapy, and/or physiotherapy interventions. The aim of this service evaluation was to understand how older people feel about being treated at home as a result of EMS calls and to understand their experiences of the Pathfinder service. METHODS This was a thematic analysis of open-ended responses recorded from telephone interviews during routine service evaluation with service users (patients or their next-of-kin). RESULTS Of 573 service users, telephone interviews were conducted with 429 (75%). Five primary themes were identified: (1) professionalism of the multidisciplinary clinical team; (2) "the right service, in the right place, at the right time"; (3) role of Pathfinder in "getting the ball rolling"; (4) lasting effects of the experience on the patient and his or her next-of-kin; (5) value of skilled communication with the older person. CONCLUSION Older people and their next-of-kin voiced a clear preference for hospital avoidance, and strongly valued the opportunity to be treated in their homes at the time of an EMS call rather than default conveyance to the ED. They appreciated the importance of a skilled multidisciplinary team with a follow-up service that effectively positions itself between the acute hospital and community services.
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Affiliation(s)
- Grace Corcoran
- Physiotherapy Department, Beaumont Hospital, Dublin, Ireland
| | - Paul Bernard
- Occupational Therapy Department, Beaumont Hospital, Dublin, Ireland
| | - Lawrence Kenna
- National Ambulance Service, Health Service Executive, Dublin, Ireland
| | - Ailish Malone
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Claire O'Brien
- Occupational Therapy Department, Beaumont Hospital, Dublin, Ireland
| | - Peter Ward
- Physiotherapy Department, Beaumont Hospital, Dublin, Ireland
| | - Willie Howard
- National Ambulance Service, Health Service Executive, Dublin, Ireland
| | - Laura Hogan
- National Ambulance Service, Health Service Executive, Dublin, Ireland
| | - Rebecca Mooney
- National Ambulance Service, Health Service Executive, Dublin, Ireland
| | - Siobhan Masterson
- National Ambulance Service, Health Service Executive, Dublin, Ireland
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Ren M, Zhang H, Meltzer D, Arora VM, Prochaska M. Changes in Patient Perceptions of the Provider Most Involved in Care During COVID-19 and Corresponding Effects on Patient Trust. J Patient Exp 2023; 10:23743735231166501. [PMID: 37035096 PMCID: PMC10074613 DOI: 10.1177/23743735231166501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
During COVID-19 routine clinical operations were disrupted, including limits on the types of providers allowed to perform in-person care and frequency of times they could enter a patient's room. Whether these changes affected patients’ trust in the care they received during hospitalization is unknown. Hospitalized patients on the general medicine service were called after discharge and asked to identify who (attending, resident, etc.) was most involved in their inpatient care, and how much trust they had in the physician caring for them. During the pandemic patients were more likely to report attending physicians (29% to 34%) and nurses (30% to 35%), and less likely to report residents/interns (8.1% to 6.5%) or medical students (1.7% to 1.4%) as most involved in their care (chi-squared test, p = 0.04). Patients reporting their attending physician as most involved in their care were more likely to report trusting their doctor (chi-squared test, p < 0.01). As such, trends in medical education that limit trainees’ time in direct patient care may affect the development of clinical and interpersonal skills necessary to establish patient trust.
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Affiliation(s)
- Megan Ren
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Hui Zhang
- Department of Medicine, Section of Hospital Medicine, University of Chicago, Chicago, IL, USA
| | - David Meltzer
- Department of Medicine, Section of Hospital Medicine, University of Chicago, Chicago, IL, USA
| | - Vineet M. Arora
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Micah Prochaska
- Department of Medicine, Section of Hospital Medicine, University of Chicago, Chicago, IL, USA
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Zhang H, Wu Y, Wang N, Sun X, Wang Y, Zhang Y. Caregivers' experiences and perspectives on caring for the elderly during the COVID-19 pandemic: A qualitative systematic review. J Nurs Manag 2022; 30:3972-3995. [PMID: 36208194 PMCID: PMC9874760 DOI: 10.1111/jonm.13859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/19/2022] [Accepted: 10/02/2022] [Indexed: 01/27/2023]
Abstract
AIMS The goal of this study was to explore caregivers' experiences, perspectives, emotions, knowledge and needs in caring for older people during the COVID-19 pandemic. These included, but were not limited to, experiences in hospital care, home care and nursing home care. BACKGROUND Because of the high mortality rate associated with the COVID-19 pandemic, senior care is critical. During the COVID-19 pandemic, caregivers caring for older people have had unique experiences potentially affecting the quality of care provided. This topic has received substantial attention since the start of the pandemic and has been studied by numerous researchers. However, experiences may differ among countries and time periods. In addition, no qualitative systematic reviews on this topic appear to have been published. EVALUATION In this systematic review of qualitative studies, data were collected from the following electronic databases: PubMed, Web of Science, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Science Direct and PsycINFO. Titles and abstracts were screened according to the inclusion and exclusion criteria, full texts were screened and the methodological quality of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research by two independent reviewers. KEY ISSUE(S) A total of 141 findings were extracted and aggregated into 20 categories; 6 synthesized findings were identified. CONCLUSION This review indicates caregivers' experiences and perceptions regarding caring for older people during the COVID-19 pandemic. The results of a qualitative systematic review show that caregivers' emotions, cognitions and knowledge have affected the quality of caregivers' senior care services during the pandemic. Caregivers caring for older adults should practise self-awareness, understanding their knowledge and attitudes to improve the quality of senior care. Moreover, health care administrators and policymakers should make concerted efforts to cultivate a better working environment. IMPLICATIONS FOR NURSING MANAGEMENT Managers should formulate timely and effective management strategies. During the COVID-19 pandemic, the workload of caregivers has increased, thus requiring better scheduling by managers. Furthermore, managers should consider the negative emotions of caregivers and prevent negative emotions from affecting their work. Besides, virtual technology should be applied to senior care and psychological support be provided for caregivers in this special care setting.
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Affiliation(s)
- Huichao Zhang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuan Wu
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Nannan Wang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Xuhan Sun
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuqing Wang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuxi Zhang
- Geriatric Hematology/Radiotherapy Wardthe First Affiliated Hospital of Nanjing Medical University300 Guangzhou RoadNanjingJiangsuChina
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Tao X, Yu CC, Low JA. Exploring loss and grief during the COVID-19 pandemic: A scoping review of qualitative studies. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022. [DOI: 10.47102/annals-acadmedsg.2021460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Introduction: The COVID-19 pandemic has brought about multiple losses to various groups, namely patients, families and healthcare professionals. Grief, which is the reaction to these losses, could cause strain on these individuals’ physical and mental health if not identified and managed early. This scoping review analysed loss, grief and how they were managed among these groups during the pandemic.
Method: This scoping review utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute framework for scoping reviews. Only qualitative studies relating to loss and grief and their management were included. Of 166 studies screened, 69 were included in the study. Qualitative analysis and data coding of each record were conducted through qualitative data analysis software.
Results: Losses included the death of family members, patients, colleagues and others. They also included the loss of usual routines, lifestyles and physical health. The grief experienced was multidimensional, affecting mainly the emotional, physical, social and existential realms. Anger, guilt and fear resulted from unsatisfactory farewells, issues with funerals, social isolation, financial strain and stigmatisation. Management strategies could be categorised into 5 themes: communication, finance, counselling, education and spiritual care.
Conclusion: Loss and grief identification and management among patients, family members and healthcare professionals are critically important during this COVID-19 pandemic. Current operating guidelines have proven insufficient in managing loss and grief. Innovative strategies are essential to tackle the many dimensions of loss and grief. Nevertheless, further research is necessary to better understand the effectiveness of implemented policies.
Keywords: Bereavement, death, mourning, outbreak, palliative care
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Affiliation(s)
- Xinyu Tao
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Chou Chuen Yu
- Geriatric Education and Research Institute, Yishun Community Hospital, Singapore
| | - James Alvin Low
- Geriatric Education and Research Institute, Yishun Community Hospital, Singapore
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14
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Jøranson N. Older patients' perspectives on illness and healthcare during the early phase of the COVID-19 pandemic. Nurs Ethics 2022; 29:872-884. [PMID: 35239421 PMCID: PMC8894901 DOI: 10.1177/09697330211072362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Equal access to healthcare is a core principle in Norway's public healthcare system. The COVID-19 pandemic challenged healthcare systems in the early phase - in particular, related to testing and hospital capacity. There is little knowledge on how older people experienced being infected with an unfamiliar and severe disease, and how they experienced the need for healthcare early in the pandemic. AIM To explore the experiences of older people infected by COVID-19 and their need for testing and hospitalisation. RESEARCH DESIGN An explorative and descriptive approach, with qualitative interviews conducted in October 2020. PARTICIPANTS AND RESEARCH CONTEXT Seventeen participants above 60 years of age hospitalised due to COVID-19 during spring 2020 were recruited 6 months after discharge. ETHICAL CONSIDERATIONS Ethical approval was granted by the Regional Committee for Medical and Health Research Ethics in South-Eastern Norway (155425). FINDINGS The main finding was that the informants experienced vulnerability and arbitrariness. This finding was supported by three sub-themes: experiences with a severe and unfamiliar disease, the strict criteria and the importance of someone advocating needs. DISCUSSION Participants described varying access to healthcare. Those who did not meet the national criteria to be tested or hospitalised struggled against the system. Findings reveal arbitrary access to healthcare, in contrast to Norway's ethical principle of fair and just access to health services. Moreover, to access and receive necessary healthcare, informants were dependent on their next-of-kin's advocacy. CONCLUSION Even when dealing with an unfamiliar disease, health professionals' assessments of symptoms must be performed with an ethical obligation to applicate competent appraisal and the exercise of discernment; this is in line with care ethics and ethical standards for nurses. These perspectives are a significant part of caring and the intension of doing good.
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Affiliation(s)
- Nina Jøranson
- Faculty of Health Studies VID Specialized University Oslo, Norway
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Moeyersons M, De Vliegher K, Huyghe B, De Groof S, Milisen K, de Casterlé BD. 'Living in a shrinking world'-The experience of loneliness among community-dwelling older people with reduced mobility: a qualitative grounded theory approach. BMC Geriatr 2022; 22:285. [PMID: 35387595 PMCID: PMC8984073 DOI: 10.1186/s12877-022-02998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loneliness is associated with severe consequences for both the physical and mental health of older people. Research has shown that mobility limitations are an important risk factor for the emergence and maintenance of feelings of loneliness. The aim of this study was to explore the experiences of loneliness among community-dwelling older people with reduced mobility and its underlying dynamics. METHODS This study employed a qualitative, descriptive design, inspired by a grounded theory approach. Participants were purposively recruited in collaboration with home health care providers. The main inclusion criteria were as follows: aged 75 years or older, being mobile impaired, experiencing feelings of loneliness, and living at home and being cognitively able to be interviewed. Data analysis of 15 semi-structured, in-depth interviews was conducted based on the Qualitative Analysis Guide of Leuven (QUAGOL). RESULTS Loneliness was expressed through all the stories, but it appeared as an elusive, intangible phenomenon. Both indicating the presence of loneliness and describing what this phenomenon means were difficult to express for most participants. Loneliness was experienced as an inherent part of the ageing process characterised by losses, limitations and meaninglessness. Participants described how they have experienced losing grip on the world in which they live and feel isolated in a literally and figuratively shrinking world. Loneliness is described as the feeling that one is unable to address the situation that results in deep sadness and the feeling of no longer being of value to their environment. CONCLUSIONS This study shows that loneliness among community-dwelling older persons with reduced mobility is embedded in experiences of loss related to ageing, among which reduced mobility plays a significant role. The results suggest the existence of a more profound experience of loneliness than might appear at first glance. How to recognise experiences of loneliness and how to support a meaningful existence for community-dwelling older persons should be given priority in health care. The findings of this study can increase professional caregivers' sensitivity to implicit signals of loneliness. Further research is necessary to refine the outcomes and to further explore the role of reduced mobility in the experience of loneliness.
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Affiliation(s)
- Marika Moeyersons
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium
| | - Kristel De Vliegher
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium.,Nursing Departement, Wit-Gele Kruis van Vlaanderen, Frontispiesstraat 8 bus 1.2 1000, Brussels, Belgium
| | - Brooke Huyghe
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium
| | - Sacha De Groof
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium.,Department of Geriatric Medicine, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Bernadette Dierckx de Casterlé
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium.
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Hoffmann E, Specht K, Elkjær M, Kjær M, Primdahl J. Relatives’ experiences of the hospitalisation of older people with COVID‐19: A qualitative interview study. Int J Older People Nurs 2022; 17:e12451. [PMID: 35156293 PMCID: PMC9115343 DOI: 10.1111/opn.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/03/2021] [Accepted: 01/29/2022] [Indexed: 12/01/2022]
Abstract
Background During the COVID‐19 pandemic, visitors were restricted from hospitals, separating them from hospitalised friends and family to reduce the infection risk. Objectives The objective was to explore how relatives of older people acutely admitted to hospital with COVID‐19 experienced being a relative, and how they felt about their contact with health care professionals (HCPs) when visitor restrictions prevented their physical presence in the ward. Method This study employed a qualitative design. We used individual qualitative semi‐structured interviews and the participants were relatives of acutely admitted older people from three COVID‐19 wards in Denmark. A total of 18 relatives participated, 14 female and 4 male, aged between 45 and 83 years. The analysis was guided by Graneheim and Lundman’s qualitative content analysis. Results The analysis derived the following three themes: (1) the importance of trust in a period of uncertainty; (2) the meaning of contact with HCPs, and (3) active but at a distance—a balancing act. The participants' feelings of uncertainty were prominent. The unknown nature of the disease and the unusual situation challenged relatives' trust in HCPs and the health care system. Conclusions and relevance to practice The findings highlight relatives' stress when the possibilities for visiting are restricted and the importance of trust in, and the relationship with HCPs. This study can strengthen HCPs' understanding of relatives' situation when older people are hospitalised during and after the COVID‐19 pandemic.
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Affiliation(s)
- Eva Hoffmann
- University College South Denmark Aabenraa Denmark
- Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
- OPEN Odense Denmark
| | - Kirsten Specht
- Department of Regional Health Research University of Southern Denmark Odense Denmark
- Department of Orthopaedic Surgery Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
| | - Mette Elkjær
- Department of Emergency Medicine Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
| | - Maria Kjær
- University College South Denmark Aabenraa Denmark
| | - Jette Primdahl
- Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
- Department of Regional Health Research University of Southern Denmark Odense Denmark
- Danish Hospital for Rheumatic Diseases University Hospital of Southern Denmark Sønderborg Denmark
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