1
|
Cooney E, Toomey E, Ryan K, Meade O, McSharry J. What's different about digital? A qualitative interview study exploring experiences of adapting in-person behaviour change interventions for digital delivery. Br J Health Psychol 2024; 29:972-999. [PMID: 39075024 DOI: 10.1111/bjhp.12741] [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: 12/08/2023] [Accepted: 07/08/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVES Digital health behaviour change interventions may be adapted from in-person interventions, without appropriate consideration of how the digital context might differ. Drawing on the wider literature on behaviour change intervention development, this research aims to explore the digital adaptation process of health behaviour change interventions and the specific considerations for digital modes of delivery. DESIGN A qualitative interview study. METHODS Interviews with 15 intervention developers/facilitators were analysed using inductive thematic analysis. RESULTS Findings highlight a continuum of digitalization, where variation in technology available and human support influences considerations for digital adaptation. 'What vs how: "trying to do the impossible"' describes the balance between retaining the intervention's active ingredients while modifying for digital delivery. Through 'Trial and error', participants described an iterative process based on experience of delivery. 'Creating connection and engagement' emphasizes the importance of social support and the challenges of replicating this. CONCLUSIONS Several considerations for digital adaptations are proposed including the involvement of end-users (facilitators and recipients) during adaptation, the need to understand the original intervention and new context for use, and the different motivational needs of digital intervention recipients.
Collapse
Affiliation(s)
- Eva Cooney
- School of Psychology, University of Galway, Galway, Ireland
- S3 Connected Health, Dublin, Ireland
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Elaine Toomey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Centre for Health Research Methods, University of Galway, Galway, Ireland
| | - Kathleen Ryan
- School of Psychology, Dublin City University, Galway, Ireland
| | - Oonagh Meade
- School of Psychology, University of Galway, Galway, Ireland
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Jenny McSharry
- School of Psychology, University of Galway, Galway, Ireland
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| |
Collapse
|
2
|
Kang B, Oh EG, Kim S, Jang Y, Choi J, Konlan KD, Lee H. Roles and experiences of nurses in primary health care during the COVID-19 pandemic: a scoping review. BMC Nurs 2024; 23:740. [PMID: 39394107 PMCID: PMC11468121 DOI: 10.1186/s12912-024-02406-w] [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: 08/02/2024] [Accepted: 10/04/2024] [Indexed: 10/13/2024] Open
Abstract
BACKGROUND Nurses form the frontline of the healthcare system's response to both epidemics and pandemics, and this was especially the case during the novel coronavirus disease (COVID-19) pandemic. Although the influence of COVID-19 on nursing roles has attracted interest, there is no integrated knowledge of nurses' roles and experiences in primary health care settings during the COVID-19 pandemic. Thus, this study identifies the roles and experiences of nurses in primary health care during the COVID-19 pandemic. METHODS A scoping review study design and the Joanna Briggs Institute methodology were used. The study searched five electronic databases (PubMed, CINAHL, EMBASE, Scopus, and PsychINFO) and included studies published in English from March 2020 to June 2023 that focused on the roles and experiences of nurses (participants) during COVID-19 (concept) in primary health care settings (context). RESULTS Fourteen articles were selected for review, involving a total of 1,487 nurses as study participants. The various roles undertaken by nurses in primary health care settings were categorized as comprehensive care providers, supporters and empowerers, coordinators and collaborators, information navigators, and change agents. Challenges and strategies are multilevel intrapersonal, interpersonal, organizational, community, and societal issues, but are not mutually exclusive. CONCLUSIONS The pandemic-induced challenges revealed primary health care nurses' vital and indispensable roles and resilience. They also fostered a heightened awareness of technological influence on the progression of primary health care in the current milieu. Policymakers and healthcare organizations need to integrate primary health care nurses' expanding and emerging roles within the scope of practice, ensuring their effective implementation without excessive regulatory constraints. This study emphasizes the importance of developing multilevel interventions to address the support needs of primary health care nurses through a system-based approach. Building a strong infrastructure to support nurses' self-care, offering continuing professional development opportunities, and securing official government recognition will be essential for enhancing the resilience of primary healthcare nurses in preparation for future, potentially devastating pandemics.
Collapse
Affiliation(s)
- Bada Kang
- WHO Collaborating Centre for Research and Training for Nursing Development in Primary Health Care, College of Nursing, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea
| | - Eui Geum Oh
- WHO Collaborating Centre for Research and Training for Nursing Development in Primary Health Care, College of Nursing, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea
| | - Sue Kim
- WHO Collaborating Centre for Research and Training for Nursing Development in Primary Health Care, College of Nursing, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea
| | - Yeonsoo Jang
- WHO Collaborating Centre for Research and Training for Nursing Development in Primary Health Care, College of Nursing, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea
| | - JiYeon Choi
- WHO Collaborating Centre for Research and Training for Nursing Development in Primary Health Care, College of Nursing, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
- Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea
| | - Kennedy Diema Konlan
- Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Hyeonkyeong Lee
- WHO Collaborating Centre for Research and Training for Nursing Development in Primary Health Care, College of Nursing, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.
- Yonsei Evidence Based Nursing Centre of Korea: A JBI Affiliated Group, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Sager B. Functional Medicine in Nursing. Am J Nurs 2024; 124:32-40. [PMID: 39259866 DOI: 10.1097/01.naj.0001063812.69063.b1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
ABSTRACT Functional medicine is a patient-centered approach that seeks to address the underlying causes of disease rather than focusing on managing the symptoms. This article explains the core principles of functional medicine and explores the potential for nurses to learn and incorporate functional medicine into their practice. By adopting a functional medicine approach, nurses can promote a more personalized and collaborative health care environment that can improve patient outcomes and empower patients to take an active role in their own health journey.
Collapse
Affiliation(s)
- Brigitte Sager
- Brigitte Sager is a functional medicine NP and nurse educator at Manifest Wellbeing, Silverdale, WA. She is also on the faculty of the Integrative Nurse Coach Academy, where she teaches courses on functional medicine and nutrition for nurses, and is the host of The Functional Nurse Podcast . Contact the author through her website: www.brigittesager.com . The author and planners have disclosed no potential conflicts of interest, financial or otherwise. Listen to a podcast with the author by clicking on the Podcast tab at www.ajnonline.com
| |
Collapse
|
4
|
Malani K, Elfanagely Y, Promrat K. Understanding Patient Perspectives to Improve Colorectal Cancer Screening Following the COVID-19 Pandemic: Assessment of a Mailed Fecal Immunochemical Testing Program. J Gastrointest Cancer 2024; 55:1460-1462. [PMID: 38764007 DOI: 10.1007/s12029-024-01041-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 05/21/2024]
Affiliation(s)
- Kanika Malani
- The Warren Alpert Medical School, Brown University, 195 Waterman Street, Providence, RI, 02906, USA.
| | | | - Kittichai Promrat
- Division of Gastroenterology, Brown University, Providence, RI, USA
- Section of Gastroenterology, Providence Veterans Affairs Medical Center, Providence, RI, USA
| |
Collapse
|
5
|
Ellis LA, Dammery G, Gillespie J, Ansell J, Wells L, Smith CL, Wijekulasuriya S, Braithwaite J, Zurynski Y. Public Perceptions of the Australian Health System During COVID-19: Findings From a 2021 Survey Compared to Four Previous Surveys. Health Expect 2024; 27:e14140. [PMID: 38992904 PMCID: PMC11239533 DOI: 10.1111/hex.14140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/03/2024] [Accepted: 06/19/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND This study examines the perceptions of the Australian public canvassed in 2021 during the COVID-19 pandemic about their health system compared to four previous surveys (2008, 2010, 2012 and 2018). METHODS In 2021, a nationwide online survey was conducted with a representative sample of Australians (N = 5100) recruited via market research panels. The results were compared to previous nationwide Australian survey samples from 2018 (N = 1024), 2012 (N = 1200), 2010 (N = 1201) and 2008 (N = 1146). The survey included questions consistent with previous polls regarding self-reported health status and overall opinions of, and confidence in, the Australian health system. RESULTS There was an increase in the proportion of respondents reporting positive perceptions at each survey between 2008 and 2021, with a significantly higher proportion of respondents expressing a more positive view of the Australian healthcare system in 2021 compared to previous years (χ2(8, N = 9645) = 487.63, p < 0.001). In 2021, over two-thirds of respondents (n = 3949/5100, 77.4%) reported that following the COVID-19 pandemic, their confidence in the Australian healthcare system had either remained the same (n = 2433/5100, 47.7%) or increased (n = 1516/5100, 29.7%). Overall, respondents living in regional or remote regions, younger Australians (< 45 years) and women held less positive views in relation to the system. In 2021, the most frequently identified area for urgent improvement was the need for more healthcare workers (n = 1350/3576, 37.8%), an area of concern particularly for Australians residing in regional or remote areas (n = 590/1385, 42.6%). CONCLUSIONS Irrespective of disruptions to the Australian healthcare system caused by the COVID-19 pandemic, Australians' perceptions of their healthcare system were positive in 2021. However, concerns were raised about inadequate workforce capacity and the cost of healthcare, with differences identified by age groups and geographical location. PATIENT OR PUBLIC CONTRIBUTION Health consumer representatives from the Consumers Health Forum of Australia contributed to the co-design, deployment, analysis and interpretation of the results of this survey. J.A. and L.W. from the Consumers Health Forum of Australia contributed to the development of the paper.
Collapse
Affiliation(s)
- Louise A. Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
- NHMRC Partnership Centre for Health System SustainabilitySydneyNew South WalesAustralia
| | - Genevieve Dammery
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
- NHMRC Partnership Centre for Health System SustainabilitySydneyNew South WalesAustralia
| | - James Gillespie
- Sydney School of Public Health, Menzies Centre for Health PolicyThe University of SydneySydneyNew South WalesAustralia
| | - James Ansell
- Consumers Health Forum of AustraliaCanberraAustralian Capital TerritoryAustralia
| | - Leanne Wells
- Consumers Health Forum of AustraliaCanberraAustralian Capital TerritoryAustralia
| | - Carolynn L. Smith
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
- NHMRC Partnership Centre for Health System SustainabilitySydneyNew South WalesAustralia
| | - Shalini Wijekulasuriya
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
- NHMRC Partnership Centre for Health System SustainabilitySydneyNew South WalesAustralia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
- NHMRC Partnership Centre for Health System SustainabilitySydneyNew South WalesAustralia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
- NHMRC Partnership Centre for Health System SustainabilitySydneyNew South WalesAustralia
| |
Collapse
|
6
|
Rodríguez-Prat A, Pergolizzi D, Crespo I, Monforte-Royo C. Experiences of Isolation among Patients Hospitalized during an Infectious Disease Outbreak: A Systematic Review and Meta-Ethnography. Behav Med 2024; 50:195-210. [PMID: 37343055 DOI: 10.1080/08964289.2023.2214717] [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: 09/27/2022] [Revised: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023]
Abstract
Hospital isolation is common for people during infectious disease outbreaks. Anxiety, stress, depression and other psychosocial outcomes have been reported due to these measures. However, there is scarce evidence about the experience of being isolated and about best practices for empathic clinical care in these circumstances. The aim of this study was to explore the experience of isolation on patients hospitalized during an infectious disease outbreak. A systematic review and meta-ethnography was carried out. A search strategy was applied to the PubMed, CINAHL, Web of Science, and PsycINFO databases on April 14, 2021 and again May 2, 2022. Data synthesis was conducted using Noblit and Hare's method of qualitative thematic synthesis. Twenty reports were included in this review: 16 qualitative, two mixed-methods (only the qualitative part was analyzed), plus 2 personal view pieces. They described the experiences of a total of 337 people hospitalized and isolated with an infectious disease. Following analysis and coding of data, four themes emerged: 1) Feelings triggered by isolation; 2) Coping strategies; 3) Connection/disconnection; 4) Factors that influence the experience of isolation. Despite a sensitive search strategy, limited studies represent patient experiences using qualitative methods. The experience of isolation among patients hospitalized during an outbreak is characterized by fear, perceived stigma, and a sense of disconnection from others and the outside world due to a lack of information. Fostering a person-centered care model could help hospitalized patients develop adaptive mechanisms that minimize the impact of isolation.
Collapse
Affiliation(s)
| | - Denise Pergolizzi
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Iris Crespo
- Department of Psychology; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- Department of Nursing; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona
| |
Collapse
|
7
|
Yun IJ, Park HJ, Chae J, Heo SJ, Kim YC, Kim B, Choi JY. Nationwide Analysis of Antimicrobial Prescription in Korean Hospitals between 2018 and 2021: The 2023 KONAS Report. Infect Chemother 2024; 56:256-265. [PMID: 38960739 PMCID: PMC11224044 DOI: 10.3947/ic.2024.0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/15/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Data on antimicrobial use at the national level are crucial for establishing domestic antimicrobial stewardship policies and enabling medical institutions to benchmark each other. This study aimed to analyze antimicrobial use in Korean hospitals. MATERIALS AND METHODS We investigated antimicrobials prescribed in Korean hospitals between 2018 and 2021 using data from the Health Insurance Review and Assessment. Primary care hospitals (PCHs), secondary care hospitals (SCHs), and tertiary care hospitals (TCHs) were included in this analysis. Antimicrobials were categorized according to the Korea National Antimicrobial Use Analysis System (KONAS) classification, which is suitable for measuring antimicrobial use in Korean hospitals. RESULTS Among over 1,900 hospitals, PCHs constituted the highest proportion, whereas TCHs had the lowest representation. The most frequently prescribed antimicrobials in 2021 were piperacillin/β-lactamase inhibitor (9.3%) in TCHs, ceftriaxone (11.0%) in SCHs, and cefazedone (18.9%) in PCHs. Between 2018 and 2021, the most used antimicrobial classes according to the KONAS classification were 'broad-spectrum antibacterial agents predominantly used for community-acquired infections' in SCHs and TCHs and 'narrow spectrum beta-lactam agents' in PCHs. Total consumption of antimicrobials decreased from 951.7 to 929.9 days of therapy (DOT)/1,000 patient-days in TCHs and 817.8 to 752.2 DOT/1,000 patient-days in SCHs during study period; however, no reduction was noted in PCHs (from 504.3 to 527.2 DOT/1,000 patient-days). Moreover, in 2021, the use of reserve antimicrobials decreased from 13.6 to 10.7 DOT/1,000 patient-days in TCHs and from 4.6 to 3.3 DOT/1,000 patient-days in SCHs. However, in PCHs, the use increased from 0.7 to 0.8 DOT/1,000 patient-days. CONCLUSION This study confirmed that antimicrobial use differed according to hospital type in Korea. Recent increases in the use of total and reserve antimicrobials in PCHs reflect the challenges that must be addressed.
Collapse
Affiliation(s)
- I Ji Yun
- Department of Pharmacy, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Hyo Jung Park
- Department of Pharmaceutical Services, Samsung Medical Center, Seoul, Korea
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Jungmi Chae
- Health Insurance Review and Assessment (HIRA) Assessment Policy Institute, Wonju, Korea
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Chan Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | - Bongyoung Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
| | - Jun Yong Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
8
|
Howarth U, Zimmerman PA, van de Mortel TF, Barr N. Paramedics' experiences of barriers to, and enablers of, responding to suspected or confirmed COVID-19 cases: a qualitative study. BMC Health Serv Res 2024; 24:678. [PMID: 38811956 PMCID: PMC11134757 DOI: 10.1186/s12913-024-11120-x] [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: 11/07/2023] [Accepted: 05/19/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Paramedics' work, even pre-pandemic, can be confronting and dangerous. As pandemics add extra stressors, the study explored paramedics' lived experience of the barriers to, and enablers of, responding to suspected or confirmed Coronavirus Disease 2019 (COVID-19) cases. METHODS This exploratory-descriptive qualitative study used semi-structured interviews to investigate Queensland metropolitan paramedics' experiences of responding to cases during the COVID-19 pandemic. Interview transcripts were analysed using thematic analysis. Registered Paramedics were recruited by criterion sampling of staff who experienced the COVID-19 pandemic as active officers. RESULTS Nine registered paramedics participated. Five themes emerged: communication, fear and risk, work-related protective factors, leadership, and change. Unique barriers included impacts on effective communication due to the mobile nature of paramedicine, inconsistent policies/procedures between different healthcare facilities, dispatch of incorrect information to paramedics, assisting people to navigate the changing healthcare system, and wearing personal protective equipment in hot, humid environments. A lower perceived risk from COVID-19, and increased empathy after recovering from COVID-19 were unique enablers. CONCLUSIONS This study uncovered barriers and enablers to attending suspected or confirmed COVID-19 cases unique to paramedicine, often stemming from the mobile nature of prehospital care, and identifies the need for further research in paramedicine post-pandemic to better understand how paramedics can be supported during public health emergencies to ensure uninterrupted ambulance service delivery.
Collapse
Affiliation(s)
- Ursula Howarth
- Queensland Ambulance Service, GPO Box 1425, Brisbane, QLD, 4001, Australia
| | - Peta-Anne Zimmerman
- School of Nursing & Midwifery, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia
- Collaborative for the Advancement for Infection Prevention and Control, Gold Coast, QLD, Australia
- Gold Coast Hospital and Health Service, Southport, QLD, Australia
- Menzies Health Institute, Southport, QLD, Australia
| | - Thea F van de Mortel
- School of Nursing & Midwifery, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
| | - Nigel Barr
- University of Sunshine Coast School of Health, Locked Bag 4, Maroochydore, DC, QLD, 4558, Australia
| |
Collapse
|
9
|
van der Ven J, van den Bemt BJF, Wielsma S, Flendrie M, Verhoef LM. The Use of Remote Consultations and Associated Factors in Rheumatology: A Large Retrospective Cohort Study of Follow-Up Consultations Before, During, and After COVID-19. Arthritis Care Res (Hoboken) 2024; 76:72-80. [PMID: 37652748 DOI: 10.1002/acr.25224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To investigate the use of remote consultations (RCs) and the influence of consultation, health care provider (HCP), and patient characteristics on the choice for remote or face-to-face consultation. METHODS A monocenter retrospective cohort study was conducted on follow-up consultations of patients with rheumatic diseases from January 1, 2019 to January 16, 2023, using data from electronic health records. Trends in the proportion of RCs before, during, and after COVID-19 were studied. Cross-classified multilevel logistic regression models were built to account for clustering of consultations (level 1) within both patients and HCPs (level 2). The influence of consultation, patient, and HCP characteristics on the type of consultation was assessed. RESULTS 157,028 consultations of 30,215 unique patients seen by 64 HCPs were included in the data set. After an initial sharp increase in RC use at the beginning of the COVID-19 pandemic, the proportion of RCs decreased toward a seemingly steady state at around 30%. 90% of the variance in the use of RCs can be attributed to the consultation level, whereas 4% and 6% can be attributed to the patient and HCP level. Longer consultation durations and time since last consultation decreased the odds for a RC, as did higher patient age, shared care, and longer disease duration. Higher travel distance, consultation density, and patient digital access increased the odds for a RC. CONCLUSION The COVID pandemic resulted in a structural increase in the use of RCs. Although several patient characteristics are associated with the type of consultation, most variance resulted from consultation characteristics compared with patients and HCPs.
Collapse
Affiliation(s)
- Jeffrey van der Ven
- Sint Maartenskliniek, Department of Research and Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bart J F van den Bemt
- Sint Maartenskliniek, Department of Research and Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Sabien Wielsma
- Sint Maartenskliniek, Department of Rheumatology, Nijmegen, The Netherlands
| | - Marcel Flendrie
- Sint Maartenskliniek, Department of Research and Radboud University Medical Centre, Nijmegen, The Netherlands
- Sint Maartenskliniek, Department of Rheumatology, Nijmegen, The Netherlands
| | - Lise M Verhoef
- Sint Maartenskliniek, Department of Research, Nijmegen, The Netherlands
| |
Collapse
|
10
|
Njuguna C, Tola HH, Maina BN, Magambo KN, Phoebe N, Tibananuka E, Turyashemererwa FM, Rubangakene M, Richard K, Opong G, Richard S, Opesen C, Mateeba T, Muyingo E, George U, Namukose S, Woldemariam YT. Essential health services delivery and quality improvement actions under drought and food insecurity emergency in north-east Uganda. BMC Health Serv Res 2023; 23:1387. [PMID: 38082433 PMCID: PMC10714455 DOI: 10.1186/s12913-023-10377-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Essential health services can be disrupted due to several naturally occurring public health emergencies such as drought, flood, earthquake and outbreak of infectious diseases. However, little evidence exists on the status of essential health services delivery under the effect of drought and food insecurity. North-east Uganda is severely affected by prolonged drought that significantly affected the livelihood of the residents. Therefore, we aimed to determine the current status of essential health services and quality improvement (QI) actions in health facilities in north-east Uganda. METHODS We used a descriptive cross-sectional study design to assess the availability of essential health service and quality improvement activities in drought and food insecurity affected districts of north-east Uganda. We included a total of 150 health facilities from 15 districts with proportionated multistage sampling method. We interviewed health facilities' managers and services focal persons using structured questionnaire and observation checklist. We used a descriptive statistic to analyze the data with SPSS version 22. RESULTS A few health facilities (8.7%) had mental health specialist. There was also lack of capacity building training on essential health services. Considerable proportion of health facilities had no non-communicable diseases (38.3%), mental health (47.0%), and basic emergency obstetric care (40.3%) services. Stock out of essential medicines were observed in 20% of health facilities. There was lack of supportive supervision, and poor documentation of QI activities. CONCLUSION Essential health service and QI were suboptimal in drought and food insecure emergency affected districts. Human resource deployment (especially mental health specialist), provision of capacity building training, improving non-communicable diseases, mental health and basic emergency obstetric care services are required to improve availability of essential health services. Supporting supply chain management to minimize stock out of medicines, and promoting QI activities are also vital to assure quality of health service in drought and food insecurity affected districts in north-Eastern Uganda.
Collapse
Affiliation(s)
- Charles Njuguna
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda.
| | - Habteyes Hailu Tola
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Benson Ngugi Maina
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Kwikiriza Nicholas Magambo
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Nabunya Phoebe
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Evelyne Tibananuka
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Florence M Turyashemererwa
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Moses Rubangakene
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Kisubika Richard
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - George Opong
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Ssekitoleko Richard
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Chris Opesen
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| | - Tim Mateeba
- Ministry of Health of Uganda, Kampala, Uganda
| | | | | | | | - Yonas Tegegn Woldemariam
- World Health Organization Uganda Country Office, Plot 60 Prince Charles Drive, Kololo, P.O. Box 24578, Kampala, Uganda
| |
Collapse
|
11
|
Metta E, Shayo EH, Ngalesoni F, Kalolo A, Nyamuryekung'e K, Mboya IB, Ndumwa HP, Njiro BJ, Amour MA. The role of trust in the implementation and uptake of COVID-19 response measures: a qualitative study of health professionals' experiences in Tanzania. BMC Health Serv Res 2023; 23:1077. [PMID: 37817175 PMCID: PMC10566036 DOI: 10.1186/s12913-023-10043-3] [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: 03/02/2023] [Accepted: 09/17/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Even though trust is placed at the central point in ensuring proper functioning of the health systems, studies remain scant on how it affects both the implementation and uptake of COVID-19 response measures in low- and middle-income countries such as Tanzania. This study, therefore, explored the role of trust in the implementation and uptake of recommended COVID-19 response measures including vaccines from the perspective of health professionals in Tanzania. METHODS This cross-sectional qualitative study was implemented in four of Tanzania's thirty-one regions. Qualitative data was collected through 26 in-depth interviews held with regional and district disease outbreak response teams, district cold chain co-ordinators and health facility in-charges. In addition, five focus group discussions and seven group interviews were conducted with healthcare workers from the lower-level health facilities. Thematic analysis was conducted and applied the trust constructs. RESULTS Interpersonal trust and health system trust emerged as two major themes in the study. Interpersonal trust was reported to stem from lack of transparency that instigated fear, worries, and confusion regarding the implementation and uptake of the recommended response measures. The distrust was mainly between health professionals in health facilities and those assigned to isolation centres as well as between patients and community members. On the other hand, the health system trust was shaped by mixed feelings regarding COVID-19 vaccine national decisions, and conflicting messages from national officials, politicians and religious leaders on COVID-19 responses, safety, and effectiveness of the vaccines. Questions surrounding the short duration of clinical trials, indeterminate post-vaccination protection duration, impotence-linked beliefs, freemasonry notion and unclear vaccinated cards information are other reported contributory factors to mistrust in the health system. However, after a comprehensive health education and experience in COVID-19 vaccination administration most professionals affirmed the effectiveness of the vaccines in limiting infections and its severe consequences. CONCLUSION Participants indicated limited trust at both interpersonal and health system levels aggravated by lack of transparency, unclear and conflicting messages on COVID-19 infections and response measures. Enforced transparency on pandemics alongside standardised messages from the reliable sources is crucial in enhancing trust in implementation and uptake of the recommended response measures.
Collapse
Affiliation(s)
- Emmy Metta
- Department of Behavioral Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
| | - Elizabeth H Shayo
- National Institute for Medical Research, P.O. Box 9653, Dar es Salaam, Tanzania
| | - Frida Ngalesoni
- AMREF Health Africa in Tanzania, P.O. Box 2773, Dar es Salaam, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health, and Allied Sciences, P.O. Box 175, Morogoro, Tanzania
| | - Kasusu Nyamuryekung'e
- Department of Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Innocent B Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Department of Translational Medicine, Lund University, 202 13 Malmö, P.O. Box 50332, Malmö, Sweden
| | - Harrieth P Ndumwa
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Belinda J Njiro
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Maryam A Amour
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| |
Collapse
|
12
|
Roden RC, Ryan S. Privacy, Parental Consent, and Relational Autonomy. J Adolesc Health 2023; 73:616-617. [PMID: 37716714 DOI: 10.1016/j.jadohealth.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 09/18/2023]
Affiliation(s)
- Rosemary Claire Roden
- Division of Adolescent Medicine, Department of Pediatrics, Penn State Health Children's Hospital, Hershey, Pennsylvania
| | - Sheryl Ryan
- Division of Adolescent Medicine, Department of Pediatrics, Penn State Health Children's Hospital, Hershey, Pennsylvania
| |
Collapse
|
13
|
Shao JH, Yu KH, Chen SH. COVID-19-related disruptions in implementation of a randomized control trial: An autoethnographic report. Appl Nurs Res 2023; 72:151698. [PMID: 37423680 DOI: 10.1016/j.apnr.2023.151698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 05/10/2023] [Accepted: 06/15/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND AND AIMS The SARS-Cov-2 virus (COVID-19) has not only threatened the health of the world's population but also presented challenges for conducting human subject research studies. Although many institutions have now established guidelines for conducting research during the COVID-19 pandemic, reports of the practical experiences of researchers are limited. This report presents the challenges nurse researchers encountered when conducting a randomized controlled trial to develop an arthritis self-management application during the COVID-19 pandemic in Taiwan and how researchers responded to the challenges. METHODS Qualitative data from five nurse researchers were collected from August 2020 to July 2022 at a rheumatology clinic in northern Taiwan. This collaborative autoethnographic report was drawn from data comprised of detailed field notes and weekly discussions regarding research challenges we were confronting. Data were analyzed to determine successful strategies employed to overcome the challenges and allow for completion of the study. RESULTS Minimizing the risk of exposure to the virus for researchers and participants resulted in four major challenges to conducting our research: patient screening and recruitment, delivery of the intervention, obtaining follow-up data, and unanticipated budget increases. CONCLUSIONS Challenges reduced sample size, altered intervention delivery, increased time and money beyond what was originally budgeted, and delayed completion of the study. Adapting to a new healthcare environment required flexibility for recruitment, alternate means of providing intervention instructions, and an awareness of disparities in participants' internet proficiency. Our experiences can serve as an example for other institutions and researchers faced with similar challenges.
Collapse
Affiliation(s)
- Jung-Hua Shao
- School of Nursing, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33303, Taiwan; Department of Joint Reconstruction, Chang Gung Memorial Hospital, No.5, Fu-Hsin St., Guishan Dist., Taoyuan City 333, Taiwan.
| | - Kuang-Hui Yu
- Department of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, No.5, Fu-Hsin St., Guishan Dist., Taoyuan City 333, Taiwan.
| | - Su-Hui Chen
- Department of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, No.5, Fu-Hsin St., Guishan Dist., Taoyuan City 333, Taiwan; School of Nursing, Chang Gung University of Science and Technology, Taiwan.
| |
Collapse
|
14
|
Lizambri D, Giacalone A, Shah PA, Tovani-Palone MR. Reconstruction surgery in head and neck cancer patients amidst the COVID-19 pandemic: Current practice and lessons for the future. World J Clin Cases 2023; 11:1434-1441. [PMID: 36926409 PMCID: PMC10011991 DOI: 10.12998/wjcc.v11.i7.1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/20/2022] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has imposed a radical change in daily life and work routine. In this context, health systems have suffered important and serious repercussions in all fields. Among the changes brought about by the state of global health emergency, adjustments to guidelines, priorities, structures, professional teams, and epidemiological data stand out. In light of this, the oncological field has witnessed several changes in the approach to cancer, whether due to delay in diagnosis, screening deficit, personnel shortage or the psychological impact that the pandemic has had on cancer patients. This article focuses on the management of oral carcinoma and the surgical approaches that oral and maxillofacial specialists have had at their disposal during the health emergency. In this period, the oral and maxillofacial surgeons have faced many obstacles. The proximity of maxillofacial structures to the airways, the need of elective and punctual procedures in cancerous lesions, the aggressiveness of head and neck tumors, and the need for important healthcare costs to support such delicate surgeries are examples of some of the challenges imposed for this field. One of the possible surgical 'solutions' to the difficulties in managing surgical cases of oral carcinoma during the pandemic is locoregional flaps, which in the pre-COVID-19 era were less used than free flaps. However, during the health emergency, its use has been widely reassessed. This setback may represent a precedent for opening up new reflections. In the course of a long-term pandemic, a reassessment of the validity of different medical and surgical therapeutic approaches should be considered. Finally, given that the pandemic has high-lighted vulnerabilities and shortcomings in a number of ways, including the issues of essential resource shortages, underinvestment in public health services, lack of coordination and versatility among politicians, policymakers and health leaders, resulting in overloaded health systems, rapid case development, and high mortality, a more careful analysis of the changes needed in different health systems to satisfactorily face future emergencies is essential to be carried out. This should be directed especially towards improving the management of health systems, their coordination as well as reviewing related practices, even in the surgical field.
Collapse
Affiliation(s)
- Daniele Lizambri
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Caserta 81100, Italy
| | - Andrea Giacalone
- Department of Industrial Engineering, Technologies for Sports Medicine and Rehabilitation, University of Rome Tor Vergata, Rome 00133, Italy
| | - Pritik A Shah
- Bangalore Medical College and Research Institute, Karnataka 560002, India
| | - Marcos Roberto Tovani-Palone
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India
| |
Collapse
|
15
|
Kim Y, Shin JM, Yoo SH, Keam B. Challenges in Care for Non-COVID-19 Patients with Severe Chronic Illnesses during COVID-19 Pandemic: A Qualitative Study of Healthcare Providers Working around Acute Care Hospitals in South Korea. Healthcare (Basel) 2023; 11:611. [PMID: 36833145 PMCID: PMC9957023 DOI: 10.3390/healthcare11040611] [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: 01/03/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The COVID-19 epidemic has afflicted patients with severe chronic illnesses who need continuous care between home and hospitals. This qualitative study examines the experiences and challenges of healthcare providers around acute care hospitals who have cared for patients with severe chronic illness in non-COVID-19 situations during the pandemic. METHODS Eight healthcare providers, who work in various healthcare settings around acute care hospitals and frequently care for non-COVID-19 patients with severe chronic illnesses, were recruited using purposive sampling from September to October 2021 in South Korea. The interviews were subjected to thematic analysis. RESULTS Four overarching themes were identified: (1) deterioration in the quality of care at various settings; (2) new emerging systemic problems; (3) healthcare providers holding on but reaching their limit; and (4) a decline in the quality of life of patients at the end of their lives, and their caregivers. CONCLUSION Healthcare providers of non-COVID-19 patients with severe chronic illnesses reported that the quality of care was declining due to the structural problems of the healthcare system and policies centered solely on the prevention and control of COVID-19. Systematic solutions are needed for appropriate and seamless care for non-infected patients with severe chronic illness in the pandemic.
Collapse
Affiliation(s)
- Yejin Kim
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jeong Mi Shin
- Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Shin Hye Yoo
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| |
Collapse
|
16
|
Seyedfatemi N, Abbasi Z, Bahrami R, Siah Mansour Khorin Z. The Association between Caring Behavior and Death Anxiety among Iranian Nurses Working in Covid-19 Wards. SAGE Open Nurs 2023; 9:23779608231219125. [PMID: 38152446 PMCID: PMC10752057 DOI: 10.1177/23779608231219125] [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: 04/26/2023] [Revised: 10/09/2023] [Accepted: 11/10/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction Nurses who are at the forefront of the fight against Covid-19 have faced problems such as anxiety and stress due to the high contagiousness of this disease and the challenges of providing services to infected patients. Death anxiety and the resulting fear following the Covid-19 pandemic can affect caring behaviors and the quality of nursing care services. Objective The present study was conducted with the aim of determining the association between caring behaviors and death anxiety among Iranian nurses working in COVID-19 wards. Methods This cross-sectional study was conducted in 2021 in Tehran. The participants consisted of 233 nurses who were purposively selected from university hospitals in Iran. Data collection tools included Demographic Information Form, Death Anxiety Scale, and Caring Dimension Inventory (CDI-25). Data analysis was done using SPSS (version 16). Results Most of the participants were female (79.4%), had less than 5 years of work experience (50.6%), and had bachelor's degree (88.8%). Based on the results, the level of death anxiety among nurses was moderate (7.05 ± 3.85) and their caring behavior was at optimal level (103.03 ± 13.15). Among the subscales of caring behavior, physical-technical behaviors with mean of 46.43 ± 6.20 got the highest score, and unnecessary behaviors with mean of 4.39 ± 0.73 got the lowest score compared to other subscales. Based on data analysis findings, caring behavior and its dimensions had no significant correlation with nurses' death anxiety (p = 0.111). Conclusions Our results showed that despite having a moderate level of anxiety, nurses try to provide good care behaviors to patients with covid-19. However, reducing nurses' anxiety can improve caring behaviors.
Collapse
Affiliation(s)
- Naiemeh Seyedfatemi
- Nursing Care Research Center (NCRC), Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Abbasi
- Nursing Care Research Center (NCRC), Iran University of Medical Sciences, Tehran, Iran
| | - Raheleh Bahrami
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | | |
Collapse
|
17
|
Chkadua TZ, Oltarzhevskaya ND, Cholokava TD, Baisova LM, Sogachev GV, Egiazaryan AK. [Post-Covid osteomyelitis of the facial bones]. STOMATOLOGIIA 2023; 102:68-72. [PMID: 38096398 DOI: 10.17116/stomat202310206268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The pandemic of coronavirus infection existed from 2019 to 2023. The World Health Organization (WHO) has announced on May 5, 2023 that the pandemic had ended. However, it does not cease to have an adverse effect on the health of the world population. Necrotic lesions of the bones of the facial skeleton are now a characteristic sign of a severe coronavirus infection. We conducted a review of scientific publications that reflected the relationship between coronavirus and necrotic processes of the skull bones, methods of treatment, prevention and the latest developments in this direction. The purpose of this article is to review existing studies on Post-Covid osteomyelitis of facial bones, its impact, features of the clinical picture of this disease, analysis of methods and means of treatment of this group of patients. Analysis of literature data has shown that the search for an ideal dressing material continues, especially the developments of native developers stand emphasized. The advantages of modern materials over traditional ones have become unquestionable, but further research in this direction is required.
Collapse
Affiliation(s)
- T Z Chkadua
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | | | - T D Cholokava
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - L M Baisova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - G V Sogachev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A K Egiazaryan
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| |
Collapse
|
18
|
Islam MI, Bagnulo S, Wang Y, Ramsden R, Wrightson T, Masset A, Colbran R, Edwards M, Martiniuk A. Job Satisfaction of Health Practitioners Providing Outreach Health Services during COVID-19 in Rural New South Wales (NSW) and the Australian Capital Territory (ACT), Australia. Healthcare (Basel) 2022; 11:3. [PMID: 36611463 PMCID: PMC9819187 DOI: 10.3390/healthcare11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners' job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners' job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.
Collapse
Affiliation(s)
- Md Irteja Islam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Centre for Health Research and Faculty of Health, Engineering and Sciences, The University of Southern Queensland, West Street, Darling Heights, Toowoomba, QLD 4350, Australia
| | - Sharif Bagnulo
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- Australasian College of Health Service Management, 11/41-43 Higginbotham Rd., Gladesville, Sydney, NSW 2111, Australia
| | - Yiwen Wang
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - Robyn Ramsden
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, VIC 3220, Australia
| | - Trent Wrightson
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Amanda Masset
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Richard Colbran
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Mike Edwards
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Alexandra Martiniuk
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Office of the Chief Scientist, The George Institute for Global Health, Level 5/1 King Street, Newtown, Sydney, NSW 2042, Australia
- Dalla Lana School of Public Health, The University of Toronto, 155 College Street Room 500, Toronto, ON M5T 3M7, Canada
| |
Collapse
|
19
|
Puce L, Trabelsi K, Ammar A, Jabbour G, Marinelli L, Mori L, Kong JD, Tsigalou C, Cotellessa F, Schenone C, Samanipour MH, Biz C, Ruggieri P, Trompetto C, Bragazzi NL. A tale of two stories: COVID-19 and disability. A critical scoping review of the literature on the effects of the pandemic among athletes with disabilities and para-athletes. Front Physiol 2022; 13:967661. [PMID: 36439247 PMCID: PMC9682264 DOI: 10.3389/fphys.2022.967661] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/25/2022] [Indexed: 10/28/2023] Open
Abstract
The still ongoing COVID-19 pandemic has dramatically impacted athletes, and, in particular, para-athletes and athletes with disabilities. However, there is no scholarly appraisal on this topic. Therefore, a critical scoping review of the literature was conducted. We were able to retrieve sixteen relevant studies. The sample size ranged from 4 to 183. Most studies were observational, cross-sectional, and questionnaire-based surveys, two studies were interventional, and two were longitudinal. One study was a technical feasibility study. Almost all studies were conducted as single-country studies, with the exception of one multi-country investigation. Five major topics/themes could be identified: namely, 1) impact of COVID-19-induced confinement on training and lifestyles in athletes with disabilities/para-athletes; 2) impact of COVID-19-induced confinement on mental health in athletes with disabilities/para-athletes; 3) impact of COVID-19-induced confinement on performance outcomes in athletes with disabilities/para-athletes; 4) risk of contracting COVID-19 among athletes with disabilities/para-athletes; and, finally, 5) impact of COVID-19 infection on athletes with disabilities/para-athletes. The scholarly literature assessed was highly heterogeneous, with contrasting findings, and various methodological limitations. Based on our considerations, we recommend that standardized, reliable tools should be utilized and new, specific questionnaires should be created, tested for reliability, and validated. High-quality, multi-center, cross-countries, longitudinal surveys should be conducted to overcome current shortcomings. Involving all relevant actors and stakeholders, including various national and international Paralympic Committees, as a few studies have done, is fundamental: community-led, participatory research can help identify gaps in the current knowledge about sports-related practices among the population of athletes with disabilities during an unprecedented period of measures undertaken that have significantly affected everyday life. Moreover, this could advance the field, by capturing the needs of para-athletes and athletes with disabilities and enabling the design of a truly "disability-inclusive response" to COVID-19 and similar future conditions/situations. Furthermore, follow-up studies on COVID-19-infected para-athletes and athletes with disabilities should be conducted. Evidence of long-term effects of COVID-19 is available only for able-bodied athletes, for whom cardiorespiratory residual alterations and mental health issues a long time after COVID-19 have been described.
Collapse
Affiliation(s)
- Luca Puce
- DINOGMI, University of Genoa, Genoa, Italy
| | - Khaled Trabelsi
- Institut Supérieur Du Sport et de L’Éducation Physique de Sfax, Université de Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, Sfax University, Sfax, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Laboratoire Interdisciplinaire en Neurosciences, Physiologie et Psychologie: Activité Physique, Santé et Apprentissages (LINP2-APSA), UFR STAPS, UPL, Université Paris Nanterre, Nanterre, France
| | - Georges Jabbour
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Lucio Marinelli
- DINOGMI, University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Laura Mori
- DINOGMI, University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Jude Dzevela Kong
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Christina Tsigalou
- Laboratory of Microbiology, Department of Medicine, Democritus University of Thrace, Dragana, Greece
| | - Filippo Cotellessa
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Cristina Schenone
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Carlo Biz
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padova, Italy
| | - Pietro Ruggieri
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, Padova, Italy
| | - Carlo Trompetto
- DINOGMI, University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| |
Collapse
|
20
|
Kamble S, Joshi A, Kamble R, Kumari S. Influence of COVID-19 Pandemic on Psychological Status: An Elaborate Review. Cureus 2022; 14:e29820. [PMCID: PMC9622468 DOI: 10.7759/cureus.29820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/01/2022] [Indexed: 11/05/2022] Open
|
21
|
Mahmoodpour-Azari M, Hajizadeh M, Kazemi-Karyani A, Haidari A, Rezaei S. COVID-19 Pandemic and Hospital Efficiency in Iran: Insight from an Interrupted Time Series Analysis and Pabon Lasso Model. J Lifestyle Med 2022; 12:178-187. [PMID: 36628180 PMCID: PMC9798875 DOI: 10.15280/jlm.2022.12.3.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/17/2022] [Indexed: 12/24/2022] Open
Abstract
Background Limited evidence exists on the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on hospital efficiency worldwide. This study aimed to investigate the impact of the COVID-19 pandemic on public hospitals in Iran. Methods In this quasi-experimental study, monthly data on the average length of stay (ALoS), bed occupancy rate (BOR), bed turnover rate (BTR) and bed turnover interval (BTI) were collected for 58 months (36 months before and 22 months after the COVID-19 outbreak in Iran) from the health information systems of all 18 public hospitals affiliated with Kermanshah University of Medical Sciences in Kermanshah province, Iran. We used interrupted time series analysis and the Pabon Lasso model to investigate the impact of the COVID-19 pandemic on hospital efficiency. Results The monthly average ALoS, BOR, BTR and BTI before (after) the COVID-19 pandemic was 3.30 (3.48) days, 70.14% (49.37), 6.78 (4.81) patients per bed and 1.15 (2.88) days, respectively. The study indicated that a statistically significant decrease in ALoS of 0.29 and BOR of 25.09 in the first month following the COVID-19 pandemic. Compared with the before pandemic period, we observed a significant increase in the monthly trend of ALoS (coefficient = 0.021; p = 0.015), BOR (coefficient = 1.30; p = 0.002), and BTR (coefficient = 0.08, p = 0.012). We found a significant decrease in the monthly trend in BTI (coefficient = -0.11, p = 0.009) after the COVID-19 pandemic when compared with before the pandemic. Based on the Pabon Lasso model, before (after) the pandemic, 29.4% (29.4%) of the hospitals were located in zone 1 as an inefficient area, and 17.6% (35.3%) of hospitals were located in zone 3 as an efficient area. Conclusion The study demonstrated that the BOR and BTR decreased substantially after the outbreak of COVID-19. In contrast, the ALoS and BTI have significantly increased following the COVID-19 pandemic. We also found that hospitals' performance in both periods was poor, and only 30% of hospitals were located in the efficient zone (zone three) based on the Pabon Lasso model. Further studies aimed at identifying the main factors affecting lower efficiency among hospitals in Iran are recommended.
Collapse
Affiliation(s)
- Monireh Mahmoodpour-Azari
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Ali Kazemi-Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Afshar Haidari
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
22
|
Delgado F, Lepre D, Aliberti L, Marra AM, Cittadini A. The COVID-19 pandemic as an opportunity to move healthcare system from hospital-centered care to patient-centered care: do black swans really exist? Intern Emerg Med 2022; 17:1263-1265. [PMID: 35689781 PMCID: PMC9188305 DOI: 10.1007/s11739-022-03009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/14/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Francesca Delgado
- Department of Translational Medical Sciences, "Federico II" University of Naples-Attending Physician, "Federico II" University Hospital and School of Medicine, Via Pansini n.5, 80127, Naples, Italy
| | - Davide Lepre
- Department of Translational Medical Sciences, "Federico II" University of Naples-Attending Physician, "Federico II" University Hospital and School of Medicine, Via Pansini n.5, 80127, Naples, Italy
| | - Ludovica Aliberti
- Department of Translational Medical Sciences, "Federico II" University of Naples-Attending Physician, "Federico II" University Hospital and School of Medicine, Via Pansini n.5, 80127, Naples, Italy
| | - Alberto M Marra
- Department of Translational Medical Sciences, "Federico II" University of Naples-Attending Physician, "Federico II" University Hospital and School of Medicine, Via Pansini n.5, 80127, Naples, Italy.
- Center for Pulmonary Hypertension, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany.
- Interdepartmental Center for Biomaterials (CRIB), "Federico II" University of Naples, Naples, Italy.
| | - Antonio Cittadini
- Department of Translational Medical Sciences, "Federico II" University of Naples-Attending Physician, "Federico II" University Hospital and School of Medicine, Via Pansini n.5, 80127, Naples, Italy
- Interdepartmental Center for Biomaterials (CRIB), "Federico II" University of Naples, Naples, Italy
| |
Collapse
|
23
|
Komici K, Bencivenga L, Rengo G. Editorial: Post COVID-19 physical performance and functional capacity. Front Med (Lausanne) 2022; 9:920645. [PMID: 35966844 PMCID: PMC9373793 DOI: 10.3389/fmed.2022.920645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Klara Komici
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Leonardo Bencivenga
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, Toulouse, France
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
- Istituti Clinici Scientifici Maugeri SpA Societa Benefit (ICS Maugeri SpA SB), Telese Terme, Italy
| |
Collapse
|
24
|
Sarkar S, Sen R. Insights into Cardiovascular Defects and Cardiac Epigenome in the Context of COVID-19. EPIGENOMES 2022; 6:epigenomes6020013. [PMID: 35645252 PMCID: PMC9150012 DOI: 10.3390/epigenomes6020013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023] Open
Abstract
Although few in number, studies on epigenome of the heart of COVID-19 patients show that epigenetic signatures such as DNA methylation are significantly altered, leading to changes in expression of several genes. It contributes to pathogenic cardiac phenotypes of COVID-19, e.g., low heart rate, myocardial edema, and myofibrillar disarray. DNA methylation studies reveal changes which likely contribute to cardiac disease through unknown mechanisms. The incidence of severe COVID-19 disease, including hospitalization, requiring respiratory support, morbidity, and mortality, is disproportionately higher in individuals with co-morbidities. This poses unprecedented strains on the global healthcare system. While their underlying conditions make patients more susceptible to severe COVID-19 disease, strained healthcare systems, lack of adequate support, or sedentary lifestyles from ongoing lockdowns have proved detrimental to their underlying health conditions, thus pushing them to severe risk of congenital heart disease (CHD) itself. Prophylactic vaccines against COVID-19 have ushered new hope for CHD. A common connection between COVID-19 and CHD is SARS-CoV-2’s host receptor ACE2, because ACE2 regulates and protects organs, including the heart, in various ways. ACE2 is a common therapeutic target against cardiovascular disease and COVID-19 which damages organs. Hence, this review explores the above regarding CHDs, cardiovascular damage, and cardiac epigenetics, in COVID-19 patients.
Collapse
Affiliation(s)
- Shreya Sarkar
- New Brunswick Heart Centre, Saint John Regional Hospital, Saint John, NB E2L 4L2, Canada;
| | - Rwik Sen
- Active Motif, Inc., 1914 Palomar Oaks Way, Suite 150, Carlsbad, CA 92008, USA
- Correspondence:
| |
Collapse
|