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Butun A. Healthcare staff experiences on the impact of COVID-19 on emergency departments: a qualitative study. BMC Health Serv Res 2024; 24:921. [PMID: 39135193 PMCID: PMC11320844 DOI: 10.1186/s12913-024-11362-9] [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: 06/27/2024] [Accepted: 07/25/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a major impact on the access and delivery of healthcare services, posing unprecedented challenges to healthcare staff worldwide. Frontline healthcare staff faced unique stressors and challenges that impact their well-being and patient care. This qualitative study aimed to explore the experiences and perspectives of frontline ED healthcare staff on emergency care services during the COVID-19 pandemic, providing valuable insights into the challenges, adaptations, and lessons learned in delivering emergency care. METHODS This study utilized a qualitative approach. In-depth semi-structured interviews were conducted with 30 ED healthcare staff from three different hospitals located in Turkey between 15/03/2022 and 30/04/2022. Convenience sampling was used to recruit participants. The duration of the interviews ranged from 28 to 37 min. Data saturation was reached as no new information was gathered. The data were analyzed using the thematic analysis method. NVivo software was used to manage the data analysis process. Member check was carried out to ensure that the generated themes conformed to the participants' views. RESULTS 15 sub-themes under three themes emerged: (1) the impact of COVID-19 on emergency care services, including sub-themes of "introducing a COVID-19 unit in the ED", "changes in the routine functioning of EDs", "changes in the number of ED visits", "quality of care", "resources", and "increased workload"; (2) the psychological effects of COVID-19 on ED healthcare staff, including sub-themes of "staying away from family", "fear", "society's perspective on healthcare professionals", "morale-staff burnout", "psychological and emotional effects", and "unable to receive sufficient support"; and (3) the difficulties faced by ED healthcare staff, including sub-themes of "difficult working conditions", "community-based effects difficulties", and "COVID-19 is an unknown situation". CONCLUSION Staff burnout threatens the quality of patient care and staff retention, and therefore this should be addressed by ED directors and leaders. This study could inform appropriate stakeholders regarding lessons learned from COVID-19 to better manage future pandemics. Learning from such lived experiences and developing appropriate interventions to minimize the difficulties faced during COVID-19 would allow better management of future pandemics. This study calls for a reform to address the challenges faced by healthcare staff, improve the overall response to public health crises, and enhance the resilience of healthcare systems for future crises.
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Affiliation(s)
- Ahmet Butun
- Faculty of Health Sciences, Mardin Artuklu University, Kampus yerleskesi, Artuklu/Mardin, Mardin, 47000, Turkey.
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Dowling-Cullen C, Sakellariou D. Decision-making regarding accessing paediatric unscheduled healthcare during the COVID-19 pandemic: a mixed methods rapid review and thematic synthesis. BMJ Open 2024; 14:e085796. [PMID: 39053956 DOI: 10.1136/bmjopen-2024-085796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE Reductions in paediatric unscheduled healthcare utilisation were seen during the COVID-19 pandemic, with concerns around their impact on children's health. The reasons for these changes are not well described. This review aims to explore the factors reported by parents that influenced their decision-making around accessing paediatric unscheduled healthcare during the COVID-19 pandemic. DESIGN Mixed methods rapid review and thematic synthesis based on the Enhancing Transparency of Reporting the Synthesis of Qualitative research framework. DATA SOURCES MEDLINE, Embase, Web of Science, PsycEXTRA, PsycINFO, Global Health, Global Index Medicus, Dissertations and Theses Global, Google Scholar and OAISter. Studies published from January 2020 to July 2023 were included. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Qualitative, quantitative and mixed methods studies that assessed the perspectives of parents on decisions to access or delay or avoid accessing paediatric unscheduled healthcare during the COVID-19 pandemic. DATA EXTRACTION AND SYNTHESIS Nvivo 14.23.0 was used to code results the of the primary studies and develop themes, following a thematic synthesis approach. RESULTS Twelve studies were included, all from high-income settings, mainly in Europe. The studies were conducted across varying times and levels of COVID-19-related restrictions. The principal descriptive themes identified were (i) concerns about COVID-19 infection, (ii) balancing and navigating risks, (iii) perception of healthcare service status and conditions and (iv) perception of information and advice. These were developed into analytic themes to further describe the decision-making process. CONCLUSIONS Parents balanced a range of risks, concerns, advice and responsibilities when considering accessing paediatric unscheduled healthcare during the COVID-19 pandemic. External sources of advice and information were important; misconceptions around public health advice may reflect the multitude of information sources and the rapidly changing circumstances of the pandemic. Public health policy and planning should consider parent perspectives when developing measures to ensure equitable access to appropriate paediatric healthcare services.
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Hayrumyan V, Abrahamyan A, Harutyunyan A, Libaridian L, Sahakyan S. Impact of COVID-19 on essential healthcare services at the primary healthcare level in Armenia: a qualitative study. BMC PRIMARY CARE 2024; 25:131. [PMID: 38658818 PMCID: PMC11044568 DOI: 10.1186/s12875-024-02377-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The COVID-19 pandemic has presented significant global healthcare challenges, particularly impacting the continuity of essential health services in low- and middle-income countries. This study investigates the impact of the COVID-19 pandemic on the utilization and provision of essential health services in Armenia. METHODS We employed a conventional qualitative study design, conducting semi-structured in-depth interviews (n = 17) within public and private primary healthcare (PHC) facilities in Armenia in 2021. Our study participants encompassed physicians providing specialty services in PHC facilities (e.g. endocrinologists, gynecologists/obstetricians, and pediatricians), regular visitors to PHC facilities (e.g. adults with chronic diseases, parents of children), and policymakers. Thematic analysis was conducted, yielding five emergent categories: mobilization and organization of PHC services during COVID-19; PHC visits during COVID-19; worsening of chronic conditions due to the decline in PHC visits; problems with routine childhood vaccinations; and patient-provider communication challenges. RESULTS The number of in-person visits to PHC facilities declined due to adaptations in service delivery, imposed lockdown measures, and the public's fear of visiting healthcare facilities. Maternal and child health services continued with no major disruptions. PHC providers deliberately limited the number of maternal and child visits to essential antenatal care, newborn screenings, and routine childhood immunizations. Still, children experienced some delays in vaccination administration. The pandemic resulted in a notable reduction in follow-up visits and monitoring of patients with chronic conditions, thereby exacerbating their chronic conditions. Phone calls were the primary method of patient-provider communication during the pandemic. CONCLUSIONS The COVID-19 pandemic has had a profound impact on the delivery and utilization of essential healthcare services at PHC facilities, especially for those with chronic conditions who needed continuous care. Unified national-level guidance and technical capacity are needed to direct the provision of essential services at the PHC level, promote effective health communication, and implement digital platforms for the uninterrupted provision of essential care during public health emergencies.
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Affiliation(s)
- Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia.
| | - Arpine Abrahamyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
| | - Arusyak Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
| | - Lorky Libaridian
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
| | - Serine Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
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Ogello V, Thuo N, Okello P, Wairimu N, Mwangi P, Maina G, Mwenda H, Mutua P, Kinuthia J, Ongeri L, Mugo N, Ngure K. The Effects of the COVID-19 Pandemic on Healthcare Providers' Mental Health: Experiences at Kenyatta National Hospital, Kenya. Behav Sci (Basel) 2024; 14:351. [PMID: 38785842 PMCID: PMC11118936 DOI: 10.3390/bs14050351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND In 2020, healthcare providers were expected to provide care to individuals with coronavirus disease 2019 (COVID-19), putting them at risk of acquiring COVID-19. The possibility of acquiring poorly understood infectious diseases while providing care may have an impact on the mental health of providers. We conducted a study to explore the effects of COVID-19 on the mental health of healthcare providers. METHODS Between April and August 2021, we conducted in-depth interviews with 60 healthcare providers in the infectious disease unit (IDU) and other units of the hospital (non-IDU). The healthcare providers completed an online self-administered survey form with demographic data (age, sex, average income, and known contact with a COVID-19 patient). We used semi-structured interview guides to understand the healthcare providers' lived experiences of stress, anxiety, depression, and their associated factors. We transcribed the interviews verbatim and coded and analyzed the transcripts to derive thematic concepts related to mental health experiences. RESULTS The healthcare providers had a median age of 37 years [IQR 20.0-58.0], and 56.7% were female, 30.0% nurses, 18.3% medical doctors, and 11.7% laboratory technologists. The healthcare providers reported increased stress during the pandemic, attributed to the high demand for patient care, changes in social life, and fear of COVID-19 infection. They also reported experiences of anxiety and depression as a result of limited knowledge at the beginning of the pandemic and the perception that "COVID-19 resulted in death". Testing positive for COVID-19, high exposure to COVID-19 risks, and the death of patients and colleagues reportedly affected the healthcare providers' mental health. Additionally, the healthcare providers reported mental health support through debriefing meetings, peer-to-peer support, and psychological counseling, with privacy and confidentiality concerns. CONCLUSIONS Healthcare providers faced mental health issues such as stress and anxiety while taking care of COVID-19 patients. An effective mental health response requires institutional practices that address context-specific challenges such as privacy and confidentiality.
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Affiliation(s)
- Vallery Ogello
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Nicholas Thuo
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Phelix Okello
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Njeri Wairimu
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Paul Mwangi
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | - Gakuo Maina
- Partners in Health Research and Development, Centre for Clinical Research, Kenya Medical Research Institute, Nairobi 19865-00202, Kenya
| | | | - Paul Mutua
- Kenyatta National Hospital, Nairobi 20723-00202, Kenya
| | - John Kinuthia
- Kenyatta National Hospital, Nairobi 20723-00202, Kenya
| | - Linnet Ongeri
- Kenya Medical Research Institute, Nairobi 54840-00200, Kenya
| | - Nelly Mugo
- Kenya Medical Research Institute, Nairobi 54840-00200, Kenya
- Department of Global Health, University of Washington, Seattle, WA 98105, USA
| | - Kenneth Ngure
- Department of Global Health, University of Washington, Seattle, WA 98105, USA
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi 62000-00200, Kenya
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Mineva G, Culleton E, Falusi T, Ryan D. Outcomes of abdominal pain among children presenting to the Emergency Department of a tertiary hospital in the Republic of Ireland before and during the COVID-19 pandemic. Ir J Med Sci 2024; 193:1033-1041. [PMID: 37851331 DOI: 10.1007/s11845-023-03547-8] [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: 10/29/2022] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Acute abdominal pain in paediatric patients is a common presentation to the Emergency Department (ED). The COVID-19 pandemic had a significant impact on the health care sector leading to a decline in hospital attendance. AIMS We compare the burden of paediatric abdominal pain 1 year before and after the start of the COVID-19 pandemic in an Irish ED. METHODS A retrospective cohort study was conducted in a tertiary hospital. Ethical approval was obtained. Data was collected from January 1 to June 30, 2019, and 2021. Patients' charts were accessed using Therefore® software. Key variables were extracted and summarised in Microsoft Excel tables. Univariate and multivariate data analysis were conducted in SPSS® software. RESULTS Six hundred sixty-one (2019) and 479 (2021) patient records were evaluated. There was a 28% reduction in case presentations during pandemic months. Age group, sex and attending discipline were similar for both years. Rates of imaging were significantly higher in 2021 (22.5% vs. 10.6%). Overall admission rate was higher in 2021 (37% vs. 25%, p < 0.001). Viral gastroenteritis decreased (13%) and non-specific diagnosis increased (46%) in 2021. Fewer children re-presented in 2021 (13%). CONCLUSIONS The COVID-19 pandemic had an impact on the presentation, investigations and admission rates of abdominal pain in the ED. Our study highlights the need for increased awareness of severe abdominal pain signs and symptoms in paediatric patients and importance for diagnostic accuracy. Improving patient flow through the ED and having clear guidelines for staff and parents can optimise clinical practice and improve patient outcomes.
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Affiliation(s)
- Gabriela Mineva
- University Hospital Limerick, St Nessan's Road, Dooradoyle, Co. Limerick, V94 F858, Ireland.
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland.
| | - Emma Culleton
- University Hospital Limerick, St Nessan's Road, Dooradoyle, Co. Limerick, V94 F858, Ireland
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Tolulope Falusi
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Damien Ryan
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
- ALERT, Emergency Department, University Hospital Limerick, St. Nessan's Road, Limerick, Ireland
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Mantegazza C, Ferraro S, Biganzoli D, Destro F, Quitadamo P, Isoldi S, Torroni F, Malamisura M, Renzo S, Fioretti L, Gandullia P, Tantari G, Maino M, Fava G, Bramuzzo M, Zingarella S, Illiceto MT, Norsa L, Pellegrino M, Antoniello LM, Orizio P, Nanni A, Cisarò F, Felici E, Romano C, Oliva S. Foreign body ingestion in children: Definition of a nomogram to predict surgical or endoscopic intervention. Dig Liver Dis 2024; 56:312-321. [PMID: 37586909 DOI: 10.1016/j.dld.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/28/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND AIMS Foreign body ingestion (FBI) in children requires early identification to prevent adverse outcomes and may necessitate endoscopic or surgical intervention. This study aims to develop a nomogram that identifies children who require urgent surgical or endoscopic intervention by using the patient's medical history and clinical parameters collected at admission. METHODS This study is a retrospective review (01/2015-12/2020) of a multicenter case series of children admitted for FBI. Data from 5864 records from 24 hospitals in Italy were analyzed. Logistic regression models were used to establish the probability of requiring surgical or endoscopic intervention based on patient history and clinical characteristics. The nomogram representing the results from the multivariable model was reported to examine the propensity for surgery/endoscopy. RESULTS The study identified a significant association between intervention and various factors, including type of foreign body (blunt: reference category, disk battery (odds ratio OR:4.89), food bolus (OR:1.88), magnets (OR:2.61), sharp-pointed (OR:1.65), unknown (OR:1.02)), pre-existing diseases or conditions (OR 3.42), drooling (OR 10.91), dysphagia (OR 5.58), vomiting (OR 3.30), retrosternal pain (OR 5.59), abdominal pain (OR 1.58), hematemesis (OR 2.82), food refusal/poor feeding (OR 2.99), and unexplained crying (OR 2.01). The multivariable regression model showed good calibration and discrimination ability, with an area under the ROC curve of 0.77. CONCLUSIONS This study developed the first nomogram to predict the probability of the need for surgical or endoscopic intervention in children with FBI, based on the information collected at admission. The nomogram will aid clinicians in identifying children who require early intervention to prevent adverse outcomes.
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Affiliation(s)
| | - Simona Ferraro
- Center of Functional Genomics and Rare diseases Department of Pediatrics Buzzi Children's Hospital, Milan, Italy
| | - Davide Biganzoli
- Center of Functional Genomics and Rare Diseases, Buzzi Children's Hospital, Via Castelvetro 24, Milan, Italy
| | - Francesca Destro
- Department of Paediatric Surgery, Buzzi Children's Hospital, Milan, Italy
| | - Paolo Quitadamo
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Sara Isoldi
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy; Maternal and Child Health Department, Sapienza - University of Rome, Santa Maria Goretti Hospital, Polo Pontino, Latina, Italy
| | - Filippo Torroni
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monica Malamisura
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Sara Renzo
- Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy
| | - Lorenzo Fioretti
- Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy
| | - Paolo Gandullia
- Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giacomo Tantari
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Maino
- Digestive Endoscopy, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Giorgio Fava
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Bramuzzo
- Pediatric Gastroenterology, Digestive Endoscopy and Clinical Nutrition Unit, Department of Pediatric, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Silvia Zingarella
- Department of Pediatrics, Woman's and Child's University Hospital of Verona, Italy
| | - Maria Teresa Illiceto
- Pediatric Gastroenterology and Digestive Endoscopic Unit, Department of Pediatrics, "Santo Spirito" Hospital of Pescara, Italy
| | - Lorenzo Norsa
- Pediatric Hepatology Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maristella Pellegrino
- Pediatric Surgery Unit, Maternal and Child Department, ASST GOM of Niguarda, Milan, Italy
| | - Luca Maria Antoniello
- Pediatric Surgery Unit, Division of Women's and Children's Health, Padova University Hospital
| | - Paolo Orizio
- Department of Pediatric Surgery, Spedali Civili Children's Hospital, Brescia, Italy
| | - Alessio Nanni
- Department of Paediatrics, Marche Polytechnic University, G.Salesi Hospital, Ancona, Via Corridoni 11, 60123 Ancona, Italy
| | - Fabio Cisarò
- Digestive Endoscopy Unit, San Giovanni Battista Molinette Hospital, Azienda Ospedaliera-Universitaria, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology and Pediatrics, University of Messina, Italy
| | - Salvatore Oliva
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy.
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Rapoport A, Nicholas DB, Zulla RT. Balancing pandemic public health restrictions and family support at the end of life: palliative care and bereavement experiences of parents whose child died during the COVID-19 pandemic. BMC Palliat Care 2023; 22:162. [PMID: 37891620 PMCID: PMC10604781 DOI: 10.1186/s12904-023-01280-8] [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: 02/14/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Little is known about the impact of the COVID-19 pandemic on families of children with chronic life-limiting conditions who died during the COVID-19 pandemic. METHODS In this qualitative study, parents of a child (< 18 years) who died during the COVID-19 pandemic from an underlying chronic medical condition were interviewed to explore how the pandemic impacted end-of-life care and bereavement experiences. Parents of children followed by the pediatric palliative care service were recruited from a large children's hospital in eastern Canada. RESULTS Twenty bereaved parents, consisting of 12 mothers and 8 fathers, participated in individual interviews between January and December 2021. Findings identified impacts of the COVID-19 pandemic on children's end-of-life care, experiences in hospital and at home, and family bereavement processes and experiences. Most parents experienced substantial worry about their child's physical status and the additional risk of COVID-19 given her/his vulnerability. Parents also struggled to navigate public health protocols as they attended to their child's needs and their family's desire for engagement and support. Key facilitators that helped families cope included a strong network of formal and informal supports. CONCLUSION Implications highlight the need to critically reflect on pandemic care in the context of co-occurring end-of-life processes. Findings amplify the need to balance necessary infection control practices with access to essential supports for families.
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Affiliation(s)
- Adam Rapoport
- Departments of Paediatrics and Family & Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Emily's House Children's Hospice, Toronto, ON, Canada.
| | - David B Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Rosslynn T Zulla
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
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Quek SE, Seow C, Ganapathy S. Caregiver experiences in an Asian paediatric emergency department during the COVID-19 pandemic. Singapore Med J 2023:384041. [PMID: 37675668 DOI: 10.4103/singaporemedj.smj-2021-394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Affiliation(s)
- Samuel Enci Quek
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Christopher Seow
- Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Sashikumar Ganapathy
- Department of Emergency Medicine, KK Women's and Children's Hospital; Duke-NUS Medical School, Singapore
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Burrell R, Saravanos G, Britton PN. Unintended impacts of COVID-19 on the epidemiology and burden of paediatric respiratory infections. Paediatr Respir Rev 2023:S1526-0542(23)00044-1. [PMID: 37580220 DOI: 10.1016/j.prrv.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023]
Abstract
Acute respiratory infections (ARI), especially lower respiratory infections (LRI), are a leading cause of childhood morbidity and mortality globally. Non-pharmaceutical interventions (NPI) employed during the COVID-19 pandemic have impacted on the epidemiology and burden of paediatric ARI, although accurately describing the full nature of the impact is challenging. For most ARI pathogens, a reduction was observed in the early phase of the pandemic, correlating with the most stringent NPI. In later phases of the pandemic resurgence of disease was observed as NPI eased. This pattern was most striking for seasonal viruses, such as influenza and respiratory syncytial virus. The impact on ARI-associated bacterial disease varied; marked reductions in invasive Streptococcus pneumoniae and Streptococcus pyogenes were observed, followed by a resurgence that correlated with increases in respiratory viral infections. For Corynebacterium diphtheriae,Bordetella pertussis, andMycoplasma pneumoniae, a sustained reduction of disease was observed well into 2022 in most regions. Proposedmechanisms for the varied epidemiological disruption amongst ARI pathogens includedifferential effects of NPI on specific pathogens, population-level immunological effects, and ecological and genetic pathogen adaptations. Additionally, important indirect effects of pandemic restrictions on paediatric respiratory infections have been identified. These occurred as a result of disruptions to routine health services, reductions in vaccination coverage, and disruptions to respiratory infection research and surveillance activities. Impacts have been disproportionately borne by those in low resource settings. We discuss opportunities to leverage pandemic learnings to support improved understanding of the epidemiology of paediatric respiratory infections to inform future prevention and health system strengthening. Educational Aims. The reader will gain an improved understanding of.
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Affiliation(s)
- Rebecca Burrell
- Sydney Medical School, University of Sydney, Australia; Sydney Infectious Diseases Institute, University of Sydney, New South Wales, Australia
| | - Gemma Saravanos
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Australia; Sydney Infectious Diseases Institute, University of Sydney, New South Wales, Australia
| | - Philip N Britton
- Sydney Medical School, University of Sydney, Australia; Department of Infectious Diseases & Microbiology, The Children's Hospital at Westmead, Westmead, Australia; Sydney Infectious Diseases Institute, University of Sydney, New South Wales, Australia.
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Saifullah, Ma Z, Li M, Maqbool MQ. Impact of COVID-19 pandemic on health care workers (HCWs) in Sindh Province of Pakistan. Health Res Policy Syst 2023; 21:78. [PMID: 37525274 PMCID: PMC10388469 DOI: 10.1186/s12961-023-01022-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/19/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND In Pakistan, the COVID-19 outbreak posed a significant challenge for healthcare workers in the country's public hospitals. The HCWs faced several problems in terms of the COVID-19 pandemic. Therefore this study investigated how the COVID-19 pandemic has affected the medical staff at the public hospital in Sindh Province, Pakistan. METHODS In this study, a qualitative exploratory design was used. Semi-Structure interviews (SSI) were conducted by using an open-indeed questionnaire (OIQ) for data collection. An inductive approach was used for theoretical data analysis. A total of 320 HCWs participated to complete the criteria of the study from 10 different public hospitals. RESULTS The study result showed the Sindh public hospital's insufficient infrastructure, lack of health protective equipment, shortages of isolation rooms and beds, and emergencies during the COVID-19 pandemic caused HCWs to experience physical and psychological weariness, sleep disturbance, mental stress, and fear of infection. CONCLUSION The study concluded that public hospitals' insufficient infrastructure, furniture, emergency wards, and safety equipment during the COVID-19 pandemic significantly damaged HCWs' physical and psychological health, generating fear of infection and sleep disturbance. Additionally, Sindh healthcare workers' fear of illness and isolation may impair family connections.
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Affiliation(s)
- Saifullah
- School of Management, Jiangsu University, Zhenjiang, 212013, China
| | - Zhiqiang Ma
- School of Management, Jiangsu University, Zhenjiang, 212013, China
| | - Mingxing Li
- School of Management, Jiangsu University, Zhenjiang, 212013, China.
| | - Muhammad Qasim Maqbool
- Department of Management Sciences, University of Okara, Renala, Okara, 044, Punjab, Pakistan.
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Agostini L, Onofrio R, Piccolo C, Stefanini A. A management perspective on resilience in healthcare: a framework and avenues for future research. BMC Health Serv Res 2023; 23:774. [PMID: 37468875 DOI: 10.1186/s12913-023-09701-3] [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: 02/01/2023] [Accepted: 06/14/2023] [Indexed: 07/21/2023] Open
Abstract
Recent major health shocks, such as the 2014-16 Ebola, the Zika outbreak, and, last but not least, the COVID-19 pandemic, have strongly contributed to drawing attention to the issue of resilience in the healthcare domain. Nevertheless, the scientific literature appears fragmented, creating difficulties in developing incremental research in this relevant managerial field.To fill this gap, this systematic literature review aims to provide a clear state of the art of the literature dealing with resilience in healthcare. Specifically, from the analysis of the theoretical articles and reviews, the key dimensions of resilience are identified, and a novel classification framework is proposed. The classification framework is then used to systematize extant empirical contributions. Two main dimensions of resilience are identified: the approach to resilience (reactive vs. proactive) and the type of crisis to deal with (acute shocks vs. chronic stressors). Four main streams of research are thus identified: (i) proactive approaches to acute shocks; (ii) proactive approaches to chronic stressors; (iii) reactive approaches to acute shocks; and (iv) reactive approaches to chronic stressors. These are scrutinised considering three additional dimensions: the level of analysis, the resources to nurture resilience, and the country context. The classification framework and the associated mapping contribute to systematising the fragmented literature on resilience in healthcare, providing a clear picture of the state of the art in this field and drawing a research agenda that opens interesting paths for future research.
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Affiliation(s)
- L Agostini
- Department of Management and Engineering, University of Padova, Stradella San Nicola 3, Padua, Italy.
| | - R Onofrio
- Department of Management, Economics and Industrial Engineering, Politecnico Di Milano, Piazza Leonardo da Vinci, 32, Milano, Italy
| | - C Piccolo
- Department of Industrial Engineering, University of Naples Federico II, C.So Umberto I, 40, Naples, Italy
| | - A Stefanini
- Department of Energy, Systems, Territory and Construction Engineering, University of Pisa, Lungarno Antonio Pacinotti, 43, Pisa, Italy
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12
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Katz C, Glucklich T, Attrash-Najjar A, Jacobson M, Cohen N, Varela N, Priolo-Filho SR, Bérubé A, Chang OD, Collin-Vézina D, Fouché A, Haffejee S, Katz I, Maguire-Jack K, Massarweh N, O'Reilly M, Tiwari A, Truter E, de Andrade Vieira RV, Walker-Williams H, Zibetti MR, Werkele C. The global impact of COVID-19 on child protection professionals: A scoping review and thematic analysis. CHILD ABUSE & NEGLECT 2023:106347. [PMID: 37479549 DOI: 10.1016/j.chiabu.2023.106347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/04/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND The COVID-19 pandemic triggered new risks for child maltreatment (CM) and exacerbated existing challenges for families and children, elevating the importance of child protection professionals (CPPs) while also adding barriers to their work. During the pandemic, many CPPs experienced increased workloads, a disrupted work environment, and personal pandemic-related hardships. However, the scope of how COVID-19 impacted CPPs globally, as well as their adopted coping strategies, have not been well explored. OBJECTIVE This study addresses these gaps in the research by conducting an international scoping review to explore and analyze these topics. METHOD The scoping review was performed in six languages: English, Hebrew, Arabic, French, Spanish, and Portuguese, across 16 databases. Sixteen manuscripts were included in the final thematic analysis of this review. RESULTS Two main themes were identified: 1) the impact of COVID-19 on CPPs, and 2) the coping and adaptation strategies employed by CPPs during COVID-19. This review revealed and emphasized the importance of CPPs' resilience during COVID-19, underpinned by the theoretical framework of the social ecology of resilience. CONCLUSIONS This study highlights the responsibility of social ecologies and organizational structures to create readiness for a rapid response in times of crisis as well as valuable evidence to inform how CPPs, children, and families may be better supported in the event of a future crisis.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel.
| | - Talia Glucklich
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel
| | - Afnan Attrash-Najjar
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel
| | - Ma'ayan Jacobson
- Haruv Institute, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel.
| | - Noa Cohen
- Bob Shapell School of Social Work, Tel Aviv University, Chaim Levanon 30, Tel Aviv 69978, Israel
| | - Natalia Varela
- Faculty of Social and Human Sciences, Externado University, Calle 12 No. 1-17 Este, Bogotá, Colombia.
| | - Sidnei Rinaldo Priolo-Filho
- Laboratório de Pesquisa, Prevenção e Intervenção em Psicologia Forense - Universidade Tuiuti do Paraná, Brazil
| | - Annie Bérubé
- The Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Canada.
| | - Olivia D Chang
- School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Delphine Collin-Vézina
- The Centre for Research on Children and Families, McGill University, Suite 106, Wilson Hall, 3506 University Street, Montreal, Quebec H3A 2A7, Canada.
| | - Ansie Fouché
- Department of Social Wellbeing, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates; North-West University, Vanderbijlpark Campus, COMPRES Research Entity, Gauteng, South Africa.
| | - Sadiyya Haffejee
- Centre for Social Development in Africa, University of Johannesburg, South Africa.
| | - Ilan Katz
- Social Policy Research Centre (SPRC), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Kathryn Maguire-Jack
- School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI 48109, USA.
| | - Nadia Massarweh
- The Al-Qasemi Academic College of Education, P.O. Box 124, Baqa-El-Gharbia 3010000, Israel
| | - Michelle O'Reilly
- School of Media, Communication, and Sociology, University of Leicester and Leicestershire Partnership NHS Trust, UK.
| | - Ashwini Tiwari
- The Institute of Public and Preventive Health, Augusta University, 1120 15th St, Augusta, GA 30912, USA.
| | - Elmien Truter
- North-West University, Vanderbijlpark Campus, COMPRES Research Entity, Gauteng, South Africa.
| | | | - Hayley Walker-Williams
- North-West University, Vanderbijlpark Campus, COMPRES Research Entity, Gauteng, South Africa.
| | | | - Christine Werkele
- The Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, ON L8S 4K1, Canada.
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13
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Amado V, Moller J, Couto MT, Wallis L, Laflamme L. Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique's central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020. Trauma Surg Acute Care Open 2023; 8:e001062. [PMID: 37484836 PMCID: PMC10350904 DOI: 10.1136/tsaco-2022-001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/25/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives Hospital-based studies indicate that restriction measures imposed during the COVID-19 pandemic have affected the number and characteristics of pediatric injuries. However, few studies have been conducted in resource-poor countries. This study aimed to determine whether injury-related emergency department (ED) attendances in Mozambique were affected during the restriction periods in 2020 and how the pattern of injury changed. Methods Mozambique faced two restriction periods in 2020. An interrupted time series was applied to weekly data of pediatric injuries from the ED records of four central hospitals in Mozambique in 2019 and 2020. Weekly numbers of injuries were modeled using a Poisson regression model to estimate the effect of COVID-19 restrictions on trends over calendar time. Then, for each restriction period, differences in injury mechanisms, severity, need for surgery, and intensive care unit (ICU) attendances were compared between 2019 and 2020. Results During the 76 weeks preceding the restrictions, there was a stable trend in ED attendances. The weekly number dropped by 48.7% after implementation of the first restrictions. By the end of 2020, the weekly numbers were back to the levels observed before the restrictions. Road traffic injuries (RTIs) and falls dropped during the first restriction period and RTIs and burns during the second. There was an increase of 80% in ICU attendances in all periods of 2020 at three hospitals during the first and second restriction periods. Conclusion The COVID-19 restrictions yielded a reduction in the weekly number of pediatric injuries seen at Mozambique's central hospitals, above all RTIs and falls. The drop reflects reductions in visits most importantly for RTIs, falls, and burns, but was accompanied by an increase in the proportion of ICU cases. This effect was not maintained when the restrictions were relaxed. Whether this reflects reduced exposure to injury or hesitancy to seek care remains to be determined. Level of evidence Level III, retrospective study with up to two negative criteria.
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Affiliation(s)
- Vanda Amado
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Department of Surgery, University of Eduardo Mondlane Faculty of Medicine, Maputo, Mozambique
| | - Jette Moller
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Maria Tereza Couto
- Department of Community Health, University of Eduardo Mondlane Faculty of Medicine, Maputo, Mozambique
| | - Lee Wallis
- Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
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14
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ÓhAiseadha C, Quinn GA, Connolly R, Wilson A, Connolly M, Soon W, Hynds P. Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5223. [PMID: 37047846 PMCID: PMC10094123 DOI: 10.3390/ijerph20075223] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.
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Affiliation(s)
- Coilín ÓhAiseadha
- Department of Public Health, Health Service Executive, D08 W2A8 Dublin, Ireland
| | - Gerry A. Quinn
- Centre for Molecular Biosciences, Ulster University, Coleraine BT52 1SA, UK
| | - Ronan Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Awwad Wilson
- National Drug Treatment Centre, Health Service Executive, D02 NY26 Dublin, Ireland
| | - Michael Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Willie Soon
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
- Institute of Earth Physics and Space Science (ELKH EPSS), H-9400 Sopron, Hungary
| | - Paul Hynds
- SpatioTemporal Environmental Epidemiology Research (STEER) Group, Environmental Sustainability & Health Institute, Technological University, D07 H6K8 Dublin, Ireland
- Irish Centre for Research in Applied Geoscience, University College Dublin, D02 FX65 Dublin, Ireland
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15
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Akram F, Pidcock M, Oake D, Sholler GF, Farrar MA, Kasparian NA. "The usual challenges of work are all magnified": Australian paediatric health professionals' experiences during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2023; 11:100434. [PMID: 36571073 PMCID: PMC9769021 DOI: 10.1016/j.ijcchd.2022.100434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/28/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background The COVID-19 pandemic has significantly increased stress and strain on health professionals. With a focus on paediatric cardiac care, this study explored health professionals' concerns about COVID-19, perceptions of the impact of pandemic on healthcare, and experiences of psychological stress. Methods Paediatric health professionals working at a large quaternary hospital in Australia were invited to complete a survey between June 2020 and February 2021. Demographic factors, clinical role characteristics, and anxiety and depressive symptoms were assessed. Qualitative data on experiences and perceived effects of the pandemic on paediatric cardiac care were also collected. Results 228 health professionals (152 nurses, 37 medical doctors, 22 allied and mental health professionals, 17 medical research and administrative staff) participated in the survey (54.4% response rate, 85% women). Half the sample (52.2%) endorsed 'moderate' to 'extreme' worry about COVID-19 and 38% of participants perceived healthcare services as adversely impacted by the pandemic to a 'great' or 'very great' extent. Almost one in five health professionals reported anxiety (18%) and 11% reported depressive symptoms indicative of a need for clinical intervention. Six themes were identified in the qualitative data: (1) Concern about the consequences of visitor restrictions and disrupted patient services, (2) Intensified strain on healthcare workers, (3) Feelings of fear and loss, (4) Social isolation and disconnection, (5) Adapting to change, and (6) Gratitude. Conclusion Timely, tailored policies, supports, and interventions are needed to address health professionals' mental health needs during and beyond the pandemic, to minimize the far-reaching impact of situational stressors.
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Affiliation(s)
- Farah Akram
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Madeleine Pidcock
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Diane Oake
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Gary F Sholler
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
- Paediatrics and Child Health, University of Sydney, Sydney, Australia
| | - Michelle A Farrar
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, The University of New South Wales, Sydney, Australia
- Department of Neurology, Randwick, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Nadine A Kasparian
- Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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16
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Lemkow–Tovías G, Lemkow L, Cash‐Gibson L, Teixidó‐Compañó E, Benach J. Impact of COVID-19 inequalities on children: An intersectional analysis. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:145-162. [PMID: 36181484 PMCID: PMC9538856 DOI: 10.1111/1467-9566.13557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 08/31/2022] [Indexed: 05/07/2023]
Abstract
Societal concerns about the effects of the COVID-19 pandemic have largely focussed on the social groups most directly affected, such as the elderly and health workers. However, less focus has been placed on understanding the effects on other collectives, such as children. While children's physical health appears to be less affected than the adult population, their mental health, learning and wellbeing is likely to have been significantly negatively affected during the pandemic due to the varying policy restrictions, such as withdrawal from face to face schooling, limited peer-to-peer interactions and mobility and increased exposure to the digital world amongst other things. Children from vulnerable social backgrounds, and especially girls, will be most negatively affected by the impact of COVID-19, given their different intersecting realities and the power structures already negatively affecting them. To strengthen the understanding of the social determinants of the COVID-19 crisis that unequally influence children's health and wellbeing, this article presents a conceptual framework that considers the multiple axes of inequalities and power relations. This understanding can then be used to inform analyses and impact assessments, and in turn inform the development of effective and equitable mitigation strategies as well as assist to be better prepared for future pandemics.
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Affiliation(s)
- Gabriel Lemkow–Tovías
- Facultat de Ciències Socials de ManresaUniversitat Vic‐Universitat Central de Catalunya (UVic‐UCC)ManresaSpain
| | - Louis Lemkow
- Institut de Ciència i Tecnologia AmbientalsUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Lucinda Cash‐Gibson
- Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS‐EMCONET), Department of Political and Social SciencesUniversitat Pompeu FabraBarcelonaCataloniaSpain
- Johns Hopkins University ‐ Pompeu Fabra University Public Policy Center (UPF‐BSM)BarcelonaCataloniaSpain
- Pompeu Fabra University‐UPF Barcelona School of Management (UPF‐BSM)BarcelonaSpain
| | - Ester Teixidó‐Compañó
- Facultat de Ciències de la Salut de ManresaUniversitat Vic‐Universitat Central de Catalunya (UVic‐UCC)ManresaSpain
| | - Joan Benach
- Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS‐EMCONET), Department of Political and Social SciencesUniversitat Pompeu FabraBarcelonaCataloniaSpain
- Johns Hopkins University ‐ Pompeu Fabra University Public Policy Center (UPF‐BSM)BarcelonaCataloniaSpain
- Pompeu Fabra University‐UPF Barcelona School of Management (UPF‐BSM)BarcelonaSpain
- Ecological Humanities Research Group (GHECO)Universidad AutónomaMadridSpain
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Göldel JM, Kamrath C, Minden K, Wiegand S, Lanzinger S, Sengler C, Weihrauch-Blüher S, Holl RW, Tittel SR, Warschburger P. Access to Healthcare for Children and Adolescents with a Chronic Health Condition during the COVID-19 Pandemic: First Results from the KICK-COVID Study in Germany. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010010. [PMID: 36670561 PMCID: PMC9856628 DOI: 10.3390/children10010010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0−10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany.
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Affiliation(s)
- Julia M. Göldel
- Department of Psychology, Counseling Psychology, University of Potsdam, 14476 Potsdam, Germany
| | - Clemens Kamrath
- Center of Child and Adolescent Medicine, Division of Pediatric Endocrinology and Diabetology, Justus-Liebig-University, 35392 Giessen, Germany
| | - Kirsten Minden
- Program Area Epidemiology, Deutsches Rheuma-Forschungszentrum (DRFZ), 10117 Berlin, Germany
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Susanna Wiegand
- SPZ-Pädiatrische Endokrinologie und Diabetologie, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Stefanie Lanzinger
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, 89081 Ulm, Germany
- Germany and German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Claudia Sengler
- Program Area Epidemiology, Deutsches Rheuma-Forschungszentrum (DRFZ), 10117 Berlin, Germany
| | - Susann Weihrauch-Blüher
- Department of Pediatrics I, Pediatric Endocrinology, University Hospital Halle (Saale), 06120 Halle (Saale), Germany
| | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, 89081 Ulm, Germany
- Germany and German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Sascha R. Tittel
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, 89081 Ulm, Germany
- Germany and German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Petra Warschburger
- Department of Psychology, Counseling Psychology, University of Potsdam, 14476 Potsdam, Germany
- Correspondence: ; Tel.: +49-331-977-2988
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18
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Zulla RT, Nicholas DB, West LJ, Chan S, McCoy M, Urschel S. The experiences of children with a cardiac transplant, their families and health care providers in the COVID-19 pandemic. Pediatr Transplant 2022; 26:e14388. [PMID: 36101008 DOI: 10.1111/petr.14388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/26/2022] [Accepted: 08/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had deleterious impacts on pediatric patients and families, as well as the healthcare providers who have attended to their care needs. METHODS In this qualitative study, children with a cardiac transplant, as well as their families and healthcare providers were interviewed to explore the impact of the COVID-19 pandemic on pediatric care, as well as on patients' and their families' daily lives. Participants were recruited from a children's hospital in western Canada. Fifteen caregiving parents of transplanted children, 2 young patients, and 8 healthcare providers participated in interviews. RESULTS Findings highlighted how families and their healthcare providers experienced pandemic-related shifts. Themes highlighted experiences, which entailed (1) initially hearing about the COVID-19 pandemic; (2) learning about their new reality; (3) adjusting to the pandemic; (4) adjusting to shifts in pediatric services; (5) evolving a view on the future, and (6) offering recommendations for cardiac care in a pandemic. CONCLUSIONS Study implications emphasize the need to critically reflect on, and advance, methods of helping young patients and their families in pandemic circumstances, and supporting healthcare providers.
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Affiliation(s)
- Rosslynn T Zulla
- University of Calgary, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - David B Nicholas
- University of Calgary, Central and Northern Alberta Region, Edmonton, Alberta, Canada
| | - Lori J West
- University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Sarah Chan
- Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Marie McCoy
- Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Simon Urschel
- University of Alberta, Edmonton, Alberta, Canada.,Stollery Children's Hospital, Edmonton, Alberta, Canada
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19
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Harrison M, Rhodes T, Lancaster K. How do care environments shape healthcare? A synthesis of qualitative studies among healthcare workers during the COVID-19 pandemic. BMJ Open 2022; 12:e063867. [PMID: 36171049 PMCID: PMC9527744 DOI: 10.1136/bmjopen-2022-063867] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic. DESIGN Critical interpretive synthesis (CIS) of qualitative research. PARTICIPANTS Studies included qualitative research investigating the experiences of healthcare workers involved in the care of individuals during the COVID-19 pandemic. RESULTS 134 articles were identified in the initial sampling frame with 38 studies involving 2507 participants included in the final synthesis. Three themes were identified in the analysis: (1) the hospital transformed, (2) virtual care spaces and (3) objects of care. Through the generation of these themes, a synthesising argument was developed to demonstrate how material spaces and practices of healthcare shape care delivery and to provide insights to support healthcare providers in creating enabling and resilient care environments. CONCLUSIONS The findings of this study demonstrate how healthcare environments enable and constrain modes of care. Practices of care are shaped through the materiality of spaces and objects, including how these change in the face of pandemic disruption. The implication is that the healthcare environment needs to be viewed as a critical adaptive element in the optimisation of care. The study also develops a versatile and coherent approach to CIS methods that can be taken up in future research.
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Affiliation(s)
- Mia Harrison
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tim Rhodes
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Kari Lancaster
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
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20
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Sahoo KC, Doley C, Negi S, Das S, Verma P, Kanungo S, Pati S. Experiences of Urban Slum-Dwelling Women With Maternal and Child Health Services During COVID-19 Pandemic: A Multi-City Qualitative Study From India. Int J Public Health 2022; 67:1604348. [PMID: 36204007 PMCID: PMC9530035 DOI: 10.3389/ijph.2022.1604348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: The COVID-19 pandemic containment necessitated the diversion of substantial health care resources thus affecting the routine essential care, and posing barriers to achieving the Sustainable Development Goals (SDGs). We explored the experiences of vulnerable communities—urban-slum-dwelling women regarding maternal and child health services during COVID-19.Methods: We conducted 48 in-depth interviews in four Indian states—12 in each state among urban-slum antenatal, intra-natal, and postnatal women. We used framework analysis.Results: Amidst the implementation of the mandatory stay-at-home, many women acknowledged that routine immunization services and antenatal check-ups remained uninterrupted, and were mostly provided at the community level. To prevent transmission, the family members and relatives had restricted visits to the health facility during labor or post-delivery. Women preferred to have a shorter hospital stay post-delivery and reduced routine postnatal check-ups for fear of infection.Conclusion: India has a variety of national and state-level programs focused on improving MCH indicators to achieve the SDGs. COVID-19 inadvertently interrupted some components of health services, insinuating the need for a disaster or pandemic-resilient MCH services delivery system.
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21
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Loh TP, Greaves RF, Mak CM, Salomons GS, Bonham JR, Lang T. Impact of COVID-19 on Pediatric Laboratory Medicine: An IFCC C-ETPLM, SSIEM, ISNS Global Survey. EJIFCC 2022; 33:194-208. [PMID: 36313903 PMCID: PMC9562476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE Pediatric laboratory medicine is a unique practice serving a vulnerable group of patients including highly specialized testing aiming to detect and treat inherited conditions early to avoid adverse outcomes. Data on the actual impact of COVID-19 pandemic on this speciality is lacking. METHODS A survey was conducted by the IFCC Committee on Emerging Technologies in Pediatric Laboratory Medicine in partnership with the Society for the Study of Inborn Errors of Metabolism and International Society for Neonatal Screening, to assess the impact on the clinical service provision during the initial wave (January to July 2020) of the COVID-19 pandemic and to gather experiences learned in order to improve laboratory preparedness for future outbreaks. RESULTS 217 survey responses were received from 69 regions. Sixty-three laboratories (29%) reported a restriction or suspension of service for a median period of four months. The common tests/ services suspended were new-born screening program, body fluids and sweat testing. The reasons for the suspension were related to bio-safety risks of COVID-19 transmission, manpower constraints and supplies disruption. A minority (9-10%) of laboratories did observe delayed/missed diagnoses or a more severe presentation of a clinical disorder. The critical operational decisions that helped manage the initial wave of COVID-19 included modifying work shift patterns, split-teams arrangement, use of personal protection equipment and social distancing. CONCLUSION The provision and delivery of pediatric laboratories services were affected during the initial wave of the COVID-19 pandemic. Manpower preparedness for future potential disruptions to pediatric laboratory services is a key finding and recommendation from this survey.
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Affiliation(s)
- Tze Ping Loh
- Department of Laboratory Medicine, National University Hospital, Singapore,Corresponding authors: Dr. Tze Ping Loh 5 Lower Kent Ridge Road Singapore 119074 Phone: (+65) 67724345 Fax: (+65) 67771613 E-mail:
| | - Ronda F. Greaves
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Victoria, Australia
| | - Chloe M. Mak
- Division of Chemical Pathology, Hong Kong Children’s Hospital, Hong Kong SAR, China
| | - Gajja S. Salomons
- Department of Clinical Chemistry, Metabolic Unit, VU University Medical Center & Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - James R. Bonham
- Pharmacy, Diagnostics and Genetics, Sheffield Children’s Hospital NHS Foundation Trust, Sheffield, United Kingdom
| | - Tim Lang
- Department of Clinical Biochemistry, University Hospital of North Durham, United Kingdom
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22
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Cox M, Phillips G, Mitchell R, Herron LM, Körver S, Sharma D, Brolan CE, Kendino M, Masilaca OK, O'Reilly G, Poloniati P, Kafoa B. Lessons from the frontline: Documenting the experiences of Pacific emergency care clinicians responding to the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100517. [PMID: 35818574 PMCID: PMC9259209 DOI: 10.1016/j.lanwpc.2022.100517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Low- and middle-income countries (LMICs) across the Pacific region have been severely impacted by the COVID-19 pandemic, and emergency care (EC) clinicians have been on the frontline of response efforts. Their responsibilities have extended from triage and clinical management of patients with COVID-19 to health system leadership and coordination. This has exposed EC clinicians to a range of ethical and operational challenges.This paper describes the context and methodology of a rapid, collaborative, qualitative research project that explored the experiences of EC clinicians in Pacific LMICs during the COVID-19 pandemic. The study was conducted in three phases, with data obtained from online regional EC support forums, key informant interviews and focus group discussions. A phenomenological approach was adopted, incorporating a hybrid inductive and deductive thematic analysis. Research findings, reported in other manuscripts in this collection, will inform multi-sectoral efforts to improve health system preparedness for future public health emergencies. Funding Epidemic Ethics/World Health Organization (WHO) initiative, supported by Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z (Phases 1 and 2A) and an Australasian College for Emergency Medicine Foundation International Development Fund Grant.
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Affiliation(s)
- Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
| | - Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Rob Mitchell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Körver
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Deepak Sharma
- Emergency Department, Colonial War Memorial Hospital, Suva, Fiji
| | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Policy Futures, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | | | | | - Gerard O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency & Trauma Centre, Alfred Health, Australia
| | | | - Berlin Kafoa
- Public Health Division, Secretariat of the Pacific Community, Suva, Fiji
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23
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Chemali S, Mari-Sáez A, El Bcheraoui C, Weishaar H. Health care workers' experiences during the COVID-19 pandemic: a scoping review. HUMAN RESOURCES FOR HEALTH 2022; 20:27. [PMID: 35331261 PMCID: PMC8943506 DOI: 10.1186/s12960-022-00724-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/09/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers' (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs' experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included. RESULTS 161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs' well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs' personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs' experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs' experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries. DISCUSSION This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs' experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs' circumstances. CONCLUSIONS Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.
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Affiliation(s)
- Souaad Chemali
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Almudena Mari-Sáez
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Charbel El Bcheraoui
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Heide Weishaar
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
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24
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Efendi D, Hasan F, Natalia R, Utami AR, Sonko I, Asmarini TA, Yuningsih R, Wanda D, Sari D. Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review. PLoS One 2022; 17:e0263267. [PMID: 35113925 PMCID: PMC8812980 DOI: 10.1371/journal.pone.0263267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/14/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting. METHODS AND FINDINGS The selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning). CONCLUSION Apart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.
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Affiliation(s)
- Defi Efendi
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, Indonesia
| | - Faizul Hasan
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Regina Natalia
- School of Nursing, Mitra Bunda Health Institute, Batam, Indonesia
| | - Ayuni Rizka Utami
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Ismaila Sonko
- School of Nursing, Taipei Medical University, Taipei, Taiwan
- Ministry of Health and Social Welfare, The Quadrangle, Banjul, The Gambia, West Africa
| | - Titik Ambar Asmarini
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal and Pediatric Intensive Care Unit, Gatot Soebroto Indonesian Central of Army Hospital, Jakarta, Indonesia
| | - Risna Yuningsih
- Neonatal Intensive Care Unit, Dr. Dradjat Prawiranegara General Hospital, Banten, Indonesia
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Dian Sari
- School of Nursing, Prima Nusantara Health Institute, Bukittinggi, Indonesia
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25
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Afshari A, Disma N, von Ungern-Sternberg BS, Matava C. COVID-19 implications for pediatric anesthesia: Lessons learnt and how to prepare for the next pandemic. Paediatr Anaesth 2022; 32:385-390. [PMID: 34850493 DOI: 10.1111/pan.14347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
COVID-19 is mainly considered an "adult pandemic," but it also has strong implications for children and consequently for pediatric anesthesia. Despite the lethality of SARS-CoV-2 infection being directly correlated with age, children have equally experienced the negative impacts of this pandemic. In fact, the spectrum of COVID-19 symptoms among children ranges from very mild to those resembling adults, but may also present as a multisystemic inflammatory syndrome. Moreover, the vast majority of children might be affected by asymptomatic or pauci-symptomatic infection making them the "perfect" carriers for spreading the disease in the community. Beyond the clinical manifestations of SARS-CoV-2 infection, the COVID-19 pandemic may ultimately have catastrophic health and socioeconomic consequences for children and adolescents, which are yet to be defined. The aim of this narrative review is to highlight how COVID-19 pandemic has affected and changed the pediatric anesthesia practice and which lessons are to be learned in case of a future "pandemic." In particular, the rapid evolution and dissemination of research and clinical findings have forced the scientific community to adapt and alter clinical practice on an unseen and pragmatic manner. Equally, implementation of new platforms, techniques, and devices together with artificial intelligence and large-scale collaborative efforts may present a giant step for mankind. The valuable lessons of this pandemic will ultimately translate into new treatments modalities for various diseases but will also have the potential for safety improvement and better quality of care. However, this pandemic has revealed the vulnerability and deficiencies of our health-care system. If not addressed properly, we may end up with a tsunami of burnout and compassionate fatigue among health-care professionals. Pediatric anesthesia and critical care staff are no exceptions.
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Affiliation(s)
- Arash Afshari
- Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Nicola Disma
- Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genoa, Italy
| | - Britta S von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, WA, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, WA, Australia
| | - Clyde Matava
- Department of Anaesthesia and Pain Medicine, Perioperative Medicine Team, Telethon Kids Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Anaesthesiology and Pain Medicine, Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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26
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Bhattacharyya H, Agarwalla R, Khandelwal A. Impact of COVID-19 on child health and healthcare services. Med J Armed Forces India 2022; 78:3-6. [PMID: 35002050 PMCID: PMC8721860 DOI: 10.1016/j.mjafi.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/03/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Himashree Bhattacharyya
- Associate Professor (Community & Family Medicine), All India Institute of Medical Sciences (AIIMS), Guwahati, Assam, India
| | - Rashmi Agarwalla
- Assistant Professor (Community & Family Medicine), All India Institute of Medical Sciences (AIIMS), Guwahati, Assam, India
| | - Ankur Khandelwal
- Assistant Professor (Anaesthesiology & Critical Care), Sharda University School of Medical Sciences & Research, Greater Noida, Uttar Pradesh, India
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27
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Kotiso M, Qirbi N, Al-Shabi K, Vuolo E, Al-Waleedi A, Naiene J, Senga M, Khalil M, Basaleem H, Alhidary A. Impact of the COVID-19 pandemic on the utilisation of health services at public hospitals in Yemen: a retrospective comparative study. BMJ Open 2022; 12:e047868. [PMID: 34980605 PMCID: PMC8724586 DOI: 10.1136/bmjopen-2020-047868] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to a global crisis, creating an unprecedented situation, which has taken the world by storm, overshadowing on all life' aspects and having a significant impact on the health systems of most countries. In this study, the delivery of health services is investigated both before and during the outbreak of the COVID-19 pandemic at public hospitals in Yemen to assess the impact of COVID-19 on the utilisation of health services. METHOD Data collected from 127 hospitals in Yemen were reviewed using the DHIS2 system. The data represented 3 months before the outbreak of COVID-19 between January and March 2020 and during the outbreak of COVID-19 outbreak between April and June 2020. The results were then compared with the same period in 2019. The utilisation pattern of healthcare services during the period of investigation was compiled and analysed by applying a generalised estimating equation (GEE) to examine the effects of the COVID-19 outbreak in Yemen. The data collected from the targeted hospitals included information related to consultations, surgeries, deliveries, C-sections and penta-3rd dose immunisation. RESULTS The trendline of health services used during the pandemic showed a gradual decline beginning from April 2020 for consultations, surgeries and penta-3rd dose utilisation. The GEE model revealed a significant effect (p<0.05) during the outbreak compared with preoutbreak in the consultation services (B=-1,343.9; 95% CI -1,767.2 to -920.6; χ2=38.718), surgeries (B=-54.98; 95% CI -79.13 to -30.83, χ2=19.911) and penta-3rd dose (B=-24.47; 95% CI -30.56 to -18.38 and χ2=62.010). As for deliveries and C-sections, the results were shown to be statistically non-significant. CONCLUSION The impact of COVID-19 on continuity of health services delivery in Yemen has been distinct and profound, where the study revealed that the number of the consultations, surgeries and number of vaccinated children have been declined during the COVID-19 pandemic, likely due to the partially lockdown measures taken and fear of being infected. However, the deliveries and C-section services remained nearly in the same level and did not affect by the COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | - Ali Al-Waleedi
- Yemen Ministry of Public Health and Population, Aden, Yemen
| | | | | | - Mohammed Khalil
- Yemen Ministry of Public Health and Population, Sana'a, Yemen
| | - Huda Basaleem
- Department of Community Medicine, University of Aden Faculty of Medicine and Health Science, Aden, Yemen
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28
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Herle M, Brunner-Krainz M, Karall D, Goeschl B, Möslinger D, Zobel J, Plecko B, Scholl-Bürgi S, Spenger J, Wortmann SB, Huemer M. A retrospective study on disease management in children and adolescents with phenylketonuria during the Covid-19 pandemic lockdown in Austria. Orphanet J Rare Dis 2021; 16:367. [PMID: 34412683 PMCID: PMC8374407 DOI: 10.1186/s13023-021-01996-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/12/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND In classical phenylketonuria (PKU) phenylalanine (Phe) accumulates due to functional impairment of the enzyme phenylalanine hydroxylase caused by pathogenic variants in the PAH gene. PKU treatment prevents severe cognitive impairment. Blood Phe concentration is the main biochemical monitoring parameter. Between appointments and venous blood sampling, Austrian PKU patients send dried blood spots (DBS) for Phe measurements to their centre. Coronavirus disease-19 (COVID-19), caused by the SARS CoV-2 virus, was classified as a pandemic by the World Health Organization in March 2020. In Austria, two nationwide lockdowns were installed during the first and second pandemic wave with variable regional and national restrictions in between. This retrospective questionnaire study compared the frequency of Phe measurements and Phe concentrations during lockdown with the respective period of the previous year in children and adolescents with PKU and explored potential influencing factors. RESULTS 77 patients (30 female, 47 male; mean age 12.4 [8-19] years in 2020) from five centres were included. The decline of venous samples taken on appointments in 2020 did not reach significance but the number of patients with none or only one DBS tripled from 4 (5.2%) in 2019 to 12 (15.6%) in 2020. Significantly more patients had a decline than a rise in the number of DBS sent in between 2019 and 2020 (p < 0.001; Chi2 = 14.79). Especially patients ≥ 16 years sent significantly less DBS in 2020 (T = 156, p = 0.02, r = 0.49). In patients who adhered to DBS measurements, Phe concentrations remained stable. Male or female sex and dietary only versus dietary plus sapropterin treatment did not influence frequency of measurements and median Phe. CONCLUSION During the COVID pandemic, the number of PKU patients who stopped sending DBS to their metabolic centre increased significantly, especially among those older than 16 years. Those who kept up sending DBS maintained stable Phe concentrations. Our follow-up system, which is based on DBS sent in by patients to trigger communication with the metabolic team served adherent patients well. It failed, however, to actively retrieve patients who stopped or reduced Phe measurements.
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Affiliation(s)
- Marion Herle
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna, Vienna, Austria
| | - Michaela Brunner-Krainz
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
| | - Daniela Karall
- Department of Pediatrics I, Inherited Metabolic Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernadette Goeschl
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna, Vienna, Austria
| | - Dorothea Möslinger
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna, Vienna, Austria
| | - Joachim Zobel
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
| | - Barbara Plecko
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
| | - Sabine Scholl-Bürgi
- Department of Pediatrics I, Inherited Metabolic Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes Spenger
- University Children's Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Saskia B Wortmann
- University Children's Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.,Amalia Children's Hospital, Radboudumc, Nijmegen, The Netherlands
| | - Martina Huemer
- Division of Metabolism and Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland. .,Department of Paediatrics, Landeskrankenhaus Bregenz, Carl-Pedenz-Str. 2, 6900, Bregenz, Austria.
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