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Kollmann J, Sana S, Magnée T, Boer S, Merkelbach I, Kocken PL, Denktaș S. Patients' and professionals' experiences with remote care during COVID-19: a qualitative study in general practices in low-income neighborhoods. Prim Health Care Res Dev 2024; 25:e32. [PMID: 38826073 DOI: 10.1017/s1463423624000240] [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] [Indexed: 06/04/2024] Open
Abstract
AIM To explore how patients and general practice professionals in low-income neighborhoods experienced the increase of remote care during COVID-19. BACKGROUND As the GP (general practitioner) is the first point of contact in Dutch health care, there are concerns about access to remote care for patients from low-income neighborhoods. Now that general practice professionals have returned to the pre-pandemic ways of healthcare delivery, this paper looks back at experiences with remote care during COVID-19. It investigates experiences of both patients and general practice professionals with the approachability and appropriateness of remote care and their satisfaction. METHODS In this qualitative study, 78 patients and 18 GPs, 7 nurse practitioners and 6 mental health professionals were interviewed. Interviews were held on the phone and face-to-face in the native language of the participants. FINDINGS Remote care, especially telephone consultation, was generally well-approachable for patients from low-income neighborhoods. Contrarily, video calling was rarely used. This was partly because patients did not know how to use it. The majority of patients thought remote care was possible for minor ailments but would also still like to see the doctor face-to-face regularly. Patients were generally satisfied with remote care at the time, but this did not necessarily reflect their willingness to continue using it in the future. Moreover, there was lack in consensus among general practice professionals on the appropriateness of remote care for certain physical and mental complaints. Nurse practitioners and mental health professionals had a negative attitude toward remote care. In conclusion, it is important to take the opinions and barriers of patients and care providers into account and to increase patient-centered care elements and care provider satisfaction in remote care. Integrating remote care is not only important in times of crisis but also for future care that is becoming increasingly digitalized.
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Affiliation(s)
- Jelena Kollmann
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Shakib Sana
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Tessa Magnée
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Sarah Boer
- Municipality of Rotterdam, Rotterdam, the Netherlands
| | - Inge Merkelbach
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Paul L Kocken
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Semiha Denktaș
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Mafra D, Kemp JA, Cardozo LFMF, Borges NA, Nerbass FB, Alvarenga L, Kalantar-Zadeh K. COVID-19 and Nutrition: Focus on Chronic Kidney Disease. J Ren Nutr 2023; 33:S118-S127. [PMID: 37632513 DOI: 10.1053/j.jrn.2023.01.004] [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: 10/03/2022] [Revised: 12/14/2022] [Accepted: 01/09/2023] [Indexed: 08/28/2023] Open
Abstract
Some chronic diseases, including chronic kidney disease (CKD), may be associated with poor outcomes, including a high rate of hospitalization and death after COVID-19 infection. In addition to the vaccination program, diet intervention is essential for boosting immunity and preventing complications. A healthy diet containing bioactive compounds may help mitigate inflammatory responses and oxidative stress caused by COVID-19. In this review, we discuss dietary interventions for mitigating COVID-19 complications, including in persons with CKD, which can worsen COVID-19 symptoms and its clinical outcomes, while diet may help patients with CKD to resist the ravages of COVID-19 by improving the immune system, modulating gut dysbiosis, mitigating COVID-19 complications, and reducing hospitalization and mortality. The concept of food as medicine, also known as culinary medicine, for patients with CKD can be extrapolated to COVID-19 infection because healthy foods and nutraceuticals have the potential to exert an important antiviral, anti-inflammatory, and antioxidant role.
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Affiliation(s)
- Denise Mafra
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil; Graduate Program in Biological Sciences - Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro Rio de Janeiro, Brazil; Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil.
| | - Julie A Kemp
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Ludmila F M F Cardozo
- Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Natália A Borges
- Institute of Nutrition, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Fabiana B Nerbass
- Research Department, Fundação Pró-Rim, Joinville, Santa Catarina, Brazil
| | - Lívia Alvarenga
- Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Kamyar Kalantar-Zadeh
- Divsion of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California
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3
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Mfinanga SG, Mbuli TW, Moshiro C. Leveraging remote consultations in resource-limited settings. Lancet Glob Health 2023; 11:e1674-e1675. [PMID: 37858574 DOI: 10.1016/s2214-109x(23)00455-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/21/2023]
Affiliation(s)
- Sayoki G Mfinanga
- National Institute for Medical Research, Muhimbili Centre, Dar es Salaam, Tanzania; Institute for Global Health, University College London, London, London WC1N 1EH, UK; Alliance for Africa Health and Research, Dar es Salaam, Tanzania; School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Theresia W Mbuli
- National Institute for Medical Research, Muhimbili Centre, Dar es Salaam, Tanzania
| | - Candida Moshiro
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Mathew S, Fitts MS, Liddle Z, Bourke L, Campbell N, Murakami-Gold L, Russell DJ, Humphreys JS, Mullholand E, Zhao Y, Jones MP, Boffa J, Ramjan M, Tangey A, Schultz R, Wakerman J. Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? BMC Health Serv Res 2023; 23:341. [PMID: 37020234 PMCID: PMC10074370 DOI: 10.1186/s12913-023-09265-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/08/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. This paper explores the perspectives of health care staff on the key elements relating to the effective use of telehealth for patients living in remote Australia. METHODS Between February 2020 and October 2021, interviews and discussion groups were conducted with 248 clinic staff from 20 different remote communities across northern Australia. Interview coding followed an inductive approach. Thematic analysis was used to group codes into common themes. RESULTS Reduced need to travel for telehealth consultations was perceived to benefit both health providers and patients. Telehealth functioned best when there was a pre-established relationship between the patient and the health care provider and with patients who had good knowledge of their personal health, spoke English and had access to and familiarity with digital technology. On the other hand, telehealth was thought to be resource intensive, increasing remote clinic staff workload as most patients needed clinic staff to facilitate the telehealth session and complete background administrative work to support the consultation and an interpreter for translation services. Clinic staff universally emphasised that telehealth is a useful supplementary tool, and not a stand-alone service model replacing face-to-face interactions. CONCLUSION Telehealth has the potential to improve access to healthcare in remote areas if complemented with adequate face-to-face services. Careful workforce planning is required while introducing telehealth into clinics that already face high staff shortages. Digital infrastructure with reliable internet connections with sufficient speed and latency need to be available at affordable prices in remote communities to make full use of telehealth consultations. Training and employment of local Aboriginal staff as digital navigators could ensure a culturally safe clinical environment for telehealth consultations and promote the effective use of telehealth services among community members.
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Affiliation(s)
- Supriya Mathew
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
| | - Michelle S Fitts
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW, Australia
| | - Zania Liddle
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
| | - Lisa Bourke
- Department of Rural Health, The University of Melbourne, Shepparton, VIC, Australia
| | - Narelle Campbell
- Flinders Rural and Remote Health Northern Territory, College of Medicine and Public Health, Flinders University, Darwin, NT, Australia
| | | | - Deborah J Russell
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
| | - John S Humphreys
- School of Rural Health, Monash University, Bendigo, VIC, Australia
| | | | - Yuejen Zhao
- Northern Territory Department of Health, Darwin, NT, Australia
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, North Ryde, NSW, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - Mark Ramjan
- Top End Population and Primary Health Care, Northern Territory Government, Casuarina, NT, Australia
| | - Annie Tangey
- Ngaanyatjarra Health Service, Alice Springs, NT, Australia
| | | | - John Wakerman
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
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Consultation Management during the COVID-19 Pandemic: The Experience of Lithuanian Physicians. Healthcare (Basel) 2022; 10:healthcare10122472. [PMID: 36553996 PMCID: PMC9778364 DOI: 10.3390/healthcare10122472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Crises in the medicine sector such as the COVID-19 pandemic encourage the search for effective solutions for the provision of health care services, when conventional face-to-face consultations may be difficult to deliver effectively due to contact restrictions. The main objective of this study was to investigate consultation management provided by physicians during the COVID-19 pandemic in Lithuania. The dependence of diagnostic testing and vaccination of patients on the socio-demographic characteristics of physicians was also assessed. An anonymous survey was carried out during the COVID-19 pandemic, between 21 June 2021 and 17 September 2021, involving 191 physicians (9% of the total population) working in family physician teams in Lithuania. Thirty-nine Lithuanian Primary Health Care Institutions (PHCIs) were selected for this study, of which 11 were public and 28 were private. Private and public PHCIs employed 31% and 63% of the respondents, respectively, and 6% of respondents worked at both types of institutions. Concerning telemedicine, the physician-respondents frequently provided consultations over the telephone (79.6%) and in-person (63.9%), but less so via the Internet, with the latter option never being used at all by 57.1% of the respondents. Whilst telephone consultations were frequently provided by Lithuanian physicians, only half of the respondents chose to provide services over the Internet. Private, smaller, and rural-based PHCIs should more actively offer viral diagnostics and vaccination services.
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Pool J, Namvar M, Akhlaghpour S, Fatehi F. Exploring public opinion about telehealth during COVID-19 by social media analytics. J Telemed Telecare 2022; 28:718-725. [PMID: 36346934 PMCID: PMC9646901 DOI: 10.1177/1357633x221122112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2023]
Abstract
While COVID-19 catalyzed the acceptance and use of telehealth, our understanding of how it is perceived by multi-stakeholders such as patients, clinicians, and health authorities is limited. Drawing on social media analytics, this research examines social media discourses and users' opinions about telehealth during the COVID-19 pandemic. It applies natural language processing and deep learning to explore word of mouth on telehealth with a contextualized focus on the COVID-19 pandemic. We conducted topic modeling, sentiment analysis, and emotion analysis (fearful, happy, sad, surprised, and angry emotions). The topic modeling analysis led to the identification of 18 topics, representing 6 themes of digital health service delivery, pandemic response, communication and promotion, government action, health service domains (e.g. mental health, cancer, aged care), as well as pharma and drug. The sentiment analysis revealed that while most opinions expressed in tweets were positive, the public expressed mostly negative opinions about certain aspects of COVID-19 such as lockdowns and cyberattacks. Emotion analysis of tweets showed a dominant pattern of fearful and sad emotions in particular topics. The results of this study that inductively emerged from our social media analysis can aid public health authorities and health professionals to address the concerns of telehealth users and improve their experiences.
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Affiliation(s)
- Javad Pool
- Business School, The University of
Queensland, Brisbane, Australia
| | - Morteza Namvar
- Business School, The University of
Queensland, Brisbane, Australia
| | | | - Farhad Fatehi
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Centre for Health Services Research, The University of
Queensland, Brisbane, Australia
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Budrevičiūtė A, Raila G, Paukštaitienė R, Valius L. An analysis of the causes of exhaustion among physicians working in family physician teams during the COVID-19 pandemic in Lithuania. PLoS One 2022; 17:e0274360. [PMID: 36301891 PMCID: PMC9612553 DOI: 10.1371/journal.pone.0274360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/25/2022] [Indexed: 11/06/2022] Open
Abstract
Background The COVID-19 pandemic had a severe impact on public life around the world, influencing medicine and health, the economy, employment, science, and education. Health care specialists are key workers who faced extreme challenges posed by the pandemic, including threats to their own lives due to the rapid spread of the virus, a huge increase in workload, and professional burnout syndrome. Analysis of the factors that physicians found most exhausting during the pandemic could lay the groundwork for the effective management of future crises. Objective To identify the factors that physicians working in family physician (family and internal medicine) teams found most exhausting during the COVID-19 pandemic in Lithuania and assess their causes. Methods An anonymous survey of physicians (n = 191) working in family physician teams was carried out from 21 June 2021 to 17 September 2021. Physicians signed an informed consent form prior to completion of the questionnaire. Mixed data analysis was performed, consisting of statistical analysis using the SPSS 27 software and a qualitative causal analysis. Results During the pandemic, physicians were most exhausted by: chaotic vaccination priorities (44.5%); unsatisfied patients (52.4%); constantly changing legislation (71.7%); the large workload (75.9%); and the malfunctioning of online systems (81.2%). Conclusions Physicians in family physician teams indicated the following aspects that require improvement: service provision; effective work organization for physicians; and the satisfaction of patients with decisions made during the pandemic.
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Affiliation(s)
- Aida Budrevičiūtė
- Independent Scientist, Chief Researcher of the Biomedical Study “Challenges of COVID-19 in Family Medicine”, Vilnius, Lithuania
- * E-mail:
| | - Gediminas Raila
- Department of Family Medicine, Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Renata Paukštaitienė
- Department of Physics, Mathematics, and Biophysics, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Leonas Valius
- Department of Family Medicine, Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
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8
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Excess mortality associated with the COVID-19 pandemic in Latvia: a population-level analysis of all-cause and noncommunicable disease deaths in 2020. BMC Public Health 2022; 22:1109. [PMID: 35659648 PMCID: PMC9163859 DOI: 10.1186/s12889-022-13491-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/19/2022] [Indexed: 02/08/2023] Open
Abstract
Background Age-standardised noncommunicable disease (NCD) mortality and the proportion of the elderly population in Latvia are high, while public health and health care systems are underresourced. The emerging COVID-19 pandemic raised concerns about its detrimental impact on all-cause and noncommunicable disease mortality in Latvia. We estimated the timing and number of excess all-cause and cause-specific deaths in 2020 in Latvia due to COVID-19 and selected noncommunicable diseases. Methods A time series analysis of all-cause and cause-specific weekly mortality from COVID-19, circulatory diseases, malignant neoplasms, diabetes mellitus, and chronic lower respiratory diseases from the National Causes of Death Database from 2015 to 2020 was used by applying generalised additive modelling (GAM) and joinpoint regression analysis. Results Between weeks 14 and 52 (from 1 April to 29 December) of 2020, a total of 3111 excess deaths (95% PI 1339 – 4832) were estimated in Latvia, resulting in 163.77 excess deaths per 100 000. Since September 30, with the outbreak of the second COVID-19 wave, 55% of all excess deaths have occurred. Altogether, COVID-19-related deaths accounted for only 28% of the estimated all-cause excess deaths. A significant increase in excess mortality was estimated for circulatory diseases (68.91 excess deaths per 100 000). Ischemic heart disease and cerebrovascular disease were listed as the underlying cause in almost 60% of COVID-19-contributing deaths. Conclusions All-cause mortality and mortality from circulatory diseases significantly increased in Latvia during the first pandemic year. All-cause excess mortality substantially exceeded reported COVID-19-related deaths, implying COVID-19-related mortality during was significantly underestimated. Increasing mortality from circulatory diseases suggests a negative cumulative effect of COVID-19 exposure and reduced access to healthcare services for NCD patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13491-4.
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Flodin P, Sörberg Wallin A, Tarantino B, Cerchiello P, Mladá K, Kuklová M, Kondrátová L, Parimbelli E, Osika W, Hollander AC, Dalman C. Differential impact of the COVID-19 pandemic on primary care utilization related to common mental disorders in four European countries: A retrospective observational study. Front Psychiatry 2022; 13:1045325. [PMID: 36699500 PMCID: PMC9868724 DOI: 10.3389/fpsyt.2022.1045325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is commonly believed to have increased common mental disorders (CMD, i.e., depression and anxiety), either directly due to COVID-19 contractions (death of near ones or residual conditions), or indirectly by increasing stress, economic uncertainty, and disruptions in daily life resulting from containment measure. Whereas studies reporting on initial changes in self-reported data frequently have reported increases in CMD, pandemic related changes in CMD related to primary care utilization are less well known. Analyzing time series of routinely and continuously sampled primary healthcare data from Sweden, Norway, Netherlands, and Latvia, we aimed to characterize the impact of the pandemic on CMD recorded prevalence in primary care. Furthermore, by relating these changes to country specific time-trajectories of two classes of containment measures, we evaluated the differential impact of containment strategies on CMD rates. Specifically, we wanted to test whether school restrictions would preferentially affect age groups corresponding to those of school children or their parents. METHODS For the four investigated countries, we collected time-series of monthly counts of unique CMD patients in primary healthcare from the year 2015 (or 2017) until 2021. Using pre-pandemic timepoints to train seasonal Auto Regressive Integrated Moving Average (ARIMA) models, we predicted healthcare utilization during the pandemic. Discrepancies between observed and expected time series were quantified to infer pandemic related changes. To evaluate the effects of COVID-19 measures on CMD related primary care utilization, the predicted time series were related to country specific time series of levels of social distancing and school restrictions. RESULTS In all countries except Latvia there was an initial (April 2020) decrease in CMD care prevalence, where largest drops were found in Sweden (Prevalence Ratio, PR = 0.85; 95% CI 0.81-0.90), followed by Netherlands (0.86; 95% CI 0.76-1.02) and Norway (0.90; 95% CI 0.83-0.98). Latvia on the other hand experienced increased rates (1.25; 95% CI 1.08-1.49). Whereas PRs in Norway and Netherlands normalized during the latter half of 2020, PRs stayed low in Sweden and elevated in Latvia. The overall changes in PR during the pandemic year 2020 was significantly changed only for Sweden (0.91; 95% CI 0.90-0.93) and Latvia (1.20; 95% CI 1.14-1.26). Overall, the relationship between containment measures and CMD care prevalence were weak and non-significant. In particular, we could not observe any relationship of school restriction to CMD care prevalence for the age groups best corresponding to school children or their parents. CONCLUSION Common mental disorders prevalence in primary care decreased during the initial phase of the COVID-19 pandemic in all countries except from Latvia, but normalized in Norway and Netherlands by the latter half of 2020. The onset of the pandemic and the containment strategies were highly correlated within each country, limiting strong conclusions on whether restriction policy had any effects on mental health. Specifically, we found no evidence of associations between school restrictions and CMD care prevalence. Overall, current results lend no support to the common belief that the pandemic severely impacted the mental health of the general population as indicated by healthcare utilization, apart from in Latvia. However, since healthcare utilization is affected by multiple factors in addition to actual need, future studies should combine complementary types of data to better understand the mental health impacts of the pandemic.
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Affiliation(s)
- Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Alma Sörberg Wallin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Barbara Tarantino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paola Cerchiello
- Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Karolína Mladá
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia.,Department of Psychiatry, Faculty of Medicine, University Hospital in Pilsen, Charles University, Prague, Czechia
| | - Marie Kuklová
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia.,Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czechia
| | - Lucie Kondrátová
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia
| | - Enea Parimbelli
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.,Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Walter Osika
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Center for Social Sustainability, Karolinska Institutet, Stockholm, Sweden
| | | | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Center for Epidemiology and Community Medicine, Stockholm, Sweden
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Schutz S, Walthall H, Snowball J, Vagner R, Fernandez N, Bartram E, Merriman C. Patient and clinician experiences of remote consultation during the SARS-CoV-2 pandemic: A service evaluation. Digit Health 2022; 8:20552076221115022. [PMID: 35959197 PMCID: PMC9358347 DOI: 10.1177/20552076221115022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives During the SARS-CoV-2 pandemic, clinicians were instructed to move all but
emergency consultations to remote means to reduce the spread of the virus.
The aim of this study was to evaluate patients’ and clinicians’ experiences
of moving to remote means of consultation with their health care
professionals during the SARS-CoV-2 pandemic. Methods The study design was a qualitative service evaluation. Twenty-six clinicians
and forty-eight patients who met the inclusion criteria consented to be
interviewed. Clinician participants were from either medical, nursing, or
allied health professional backgrounds. Patients were recruited from
diabetes, acute care, and haematology and cancer areas. Data analysis was
conducted using a thematic analysis framework. Results Following coding and thematic analysis of the data collected from clinicians,
five themes were identified: personal and professional well-being; providing
a safe and high-quality experience; adapting to a new way of working; making
remote consultations fit for purpose and an awareness of altered dynamics
during consultation. Patient data was coded into 3 themes: remote
consultation adds value; remote consultation brings challenges and concerns
about remote consultation. Conclusions Clinician and patient experiences reported here are reflected in the
literature. The study indicates that remote consultation is not suitable for
all patients and in all contexts. Whilst maintaining the benefits to
patients, remote means of consultation needs organisational support and
preparation. A way forward that maintains the benefits whilst addressing
concerns seems urgent.
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Affiliation(s)
- Sue Schutz
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK
| | - Helen Walthall
- Nursing and Midwifery Research and Innovation, Oxford University Hospitals NHS Foundation Trust and Oxford Biomedical Research Centre, Oxford, UK
| | - Joanna Snowball
- Oxford University Hospitals NHS Foundation Trust and Oxford Biomedical Research Centre, Oxford, UK
| | - Raluca Vagner
- Oxford University Hospitals NHS Foundation Trust and Oxford Biomedical Research Centre, Oxford, UK
| | - Nicola Fernandez
- Oxford University Hospitals NHS Foundation Trust and Oxford Biomedical Research Centre, Oxford, UK
| | - Emilia Bartram
- Oxford University Hospitals NHS Foundation Trust and Oxford Biomedical Research Centre, Oxford, UK
| | - Clair Merriman
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK
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Fadare JO, Adeoti AO, Dada SA, Dele-Ojo BF, Raimi TH, Isikekpei B, Ajayi AO, Ajayi EA. COVID-19 Pandemic- Ethical Challenges for Healthcare Workers Practicing in Resource-Limited Settings. Niger Med J 2022; 63:1-9. [PMID: 38798972 PMCID: PMC11117041 DOI: 10.60787/nmj-63-1-116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
In this review, the ethical issues peculiar to the COVID-19 pandemics and the role of healthcare workers, especially those in resource-limited settings are x-rayed. We contend that there is a pressing ethical issue that needs urgent clarification on the rights and responsibilities of healthcare workers, especially in the current context of COVID-19 pandemic preparedness and responsiveness. We searched MEDLINE, Web of Science, EMBASE, Google Scholar, PUBMED related articles, newspaper articles, and online news sources for relevant information. The various professional codes of conduct (World Medical Association, Medical and Dental Council of Nigeria) were also consulted. The ethical principles of equitable distribution of healthcare resources, confidentiality with associated stigmatization, issues relating to duty to care by the healthcare workers and those pertaining to conduct of clinical trials and access to approved therapies or vaccines were highlighted in this study. We agree with the submission that healthcare workers only have a moral duty to treat patients with COVID-19 if the necessary protective equipment and adequate compensation are not provided. We argue that the duty of physicians and other healthcare workers to care for patients during pandemics such as COVID-19 is obligatory in the absence of required protective equipment and other forms of compensation. There is a need for the government and other stakeholders to put in place a National Pandemic /Epidemic Ethical Framework to address these identified ethical challenges.
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Affiliation(s)
| | | | - Samuel Ayokunle Dada
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | | | - Taiwo Hussean Raimi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Brenda Isikekpei
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Lagos, Nigeria
| | | | - Ebenezer Adekunle Ajayi
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
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