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Genowska A, Zarębska-Michaluk D, Dobrowolska K, Kanecki K, Goryński P, Tyszko P, Lewtak K, Rzymski P, Flisiak R. Trends in Hospitalizations of Patients with Hepatitis C Virus in Poland between 2012 and 2022. J Clin Med 2024; 13:5618. [PMID: 39337105 PMCID: PMC11433470 DOI: 10.3390/jcm13185618] [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: 09/03/2024] [Revised: 09/13/2024] [Accepted: 09/20/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Analyzing hospitalizations of patients with hepatitis C virus (HCV) infection is essential for an effective action plan to eliminate hepatitis C as a public health threat. This study aimed to explore trends in hospitalizations of patients with HCV infection and factors related to these hospitalizations. Methods: This 11-year retrospective study (2012-2022) explored trends in hospitalizations of patients with HCV infection in Poland based on data from the Nationwide General Hospital Morbidity Study. Results: The mean age of individuals was 55 years, with hospitalization rates among men and women of 15.5 and 13.7 per 100,000 population, respectively. Hospitalizations were 1.8-fold higher among urban residents. The most frequent comorbidities were digestive (24%) and cardiovascular (18%) diseases. During the studied period, the hospitalization rates significantly decreased from 31.9 per 100,000 in 2012 to 5.0 per 100,000 in 2022, with stays requiring 0-3, 4-7, and ≥8 days becoming 8-fold, 6-fold, and 4-fold less frequent, respectively. The flattening of hospitalizations was apparent across all age groups, including children. Conclusions: While significant progress has been made in managing HCV in Poland, continued efforts are required to eliminate disparities in care and to sustain the momentum toward HCV elimination, particularly through enhanced political commitment and the implementation of comprehensive national screening programs.
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Affiliation(s)
- Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland;
| | - Dorota Zarębska-Michaluk
- Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland;
| | | | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.K.); (P.T.); (K.L.)
| | - Paweł Goryński
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH-National Research Institute, 00-791 Warsaw, Poland;
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.K.); (P.T.); (K.L.)
- Institute of Rural Health, 20-090 Lublin, Poland
| | - Katarzyna Lewtak
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.K.); (P.T.); (K.L.)
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland;
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Mitura KM, Celiński D, Snarska J, Szajda SD. Effect of the COVID-19 pandemic on potential health emergencies in paediatric patients: a retrospective cohort study. Front Public Health 2024; 12:1402525. [PMID: 39314797 PMCID: PMC11416952 DOI: 10.3389/fpubh.2024.1402525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 08/30/2024] [Indexed: 09/25/2024] Open
Abstract
The COVID-19 pandemic compromised the principles underlying the functioning of public health, which is understood as the prevention of diseases and care for the health of entire communities. During the pandemic period, the efforts of the health system focused on patients with suspected infection and those infected with the SARS-CoV-2 virus, which led to changes in the provision of health services and the characteristics of patients receiving medical services at the pre-hospital stage. The objective of this study was to investigate the effects of the COVID-19 pandemic on potential health emergencies in paediatric patients based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The data used in the study were derived from interventions carried out by Emergency Medical Teams (EMT) in central and eastern Poland, involving patients who were under 18 years of age (n = 12,619). The data were collected from 1 January 2017 to 31 December 2022. The study used descriptive statistics, the Mann-Whitney U Test, and the Chi-square test. The study reveals that fewer paediatric patients (5.28%) were provided medical services by EMTs during the COVID-19 pandemic compared to the pre-pandemic period (5.86%). There was a decrease in the number of injuries in paediatric patients (from 42.0 to 32.7%; p < 0.001), and more patients were left at the location from which the call was made (18.9 vs. 23.9%; p < 0.001). Moreover, during the pandemic, as compared to the pre-pandemic period, there was an increase in the number of cases of pre-hospital assistance provided to paediatric patients with fever, irrespective of gender, area (village, city) or patient age. During the pandemic, paediatric patients consumed alcohol more frequently. The age of patients who were provided with assistance by EMTs decreased (median of 10.0 vs. 9.0; p < 0.001). The COVID-19 pandemic brought about changes in the prevalence of potential health emergencies in children. The incidence of injuries decreased, while the number of interventions due to fever and alcohol consumption increased. There was a reduction in the number of patients transported to the hospital. In addition, the age of patients who received medical assistance decreased. The study shows health problems that were faced by paediatric patients during the COVID-19 pandemic and, therefore, can be helpful in preparing the healthcare system for emergency situations.
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Affiliation(s)
- Krzysztof Marek Mitura
- Independent Public Health Care Center RM-MEDITRANS Emergency Station and Sanitary Transport in Siedlce, Siedlce, Poland
| | - Daniel Celiński
- Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland
| | - Jadwiga Snarska
- Department of Surgery, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Sławomir Dariusz Szajda
- Department of Emergency Medical Service, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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Bronshtein O, Konson A, Kuniavsky M, Goldschmidt N, Hanhart S, Mahalla-Garashi H, Peri S, Rosenfelder C, Niv Y, Dollberg S. COVID-19 Inpatient Caseloads in General Hospitals Did Not Affect Quality Indicator Compliance Rates in Israel. Qual Manag Health Care 2024:00019514-990000000-00083. [PMID: 39038060 DOI: 10.1097/qmh.0000000000000458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
BACKGROUND AND OBJECTIVES Early in the global COVID-19 pandemic, a concern was raised that potentially high volumes of COVID-19 inpatients in general hospitals might compromise the hospitals' capabilities to maintain high-quality care for routine patients and, thereby, to comply with indicators specifying quality of care. The objective of this study is to evaluate the impact of the surges of COVID-19 inpatients into general hospitals in Israel on the compliance rates for selected quality indicators reported by these hospitals within the Israeli National Program for Quality Indicators (NPQI). METHODS Compliance rate data were collected from the quality indicators reports made to the NPQI by participating hospitals. COVID-19 inpatient volume data were obtained from the Ministry of Health Digital Technologies and Data Division. Both datasets were analyzed on a week-by-week basis and plotted one alongside the other on a time scale. Association of each quality indicator's compliance rate with the number of COVID-19 inpatients was tested by Pearson's correlation analysis. The study included data from July 1, 2019 through June 30, 2022, spanning the duration of the COVID-19 pandemic in Israel. Five quality indicators included in the study were: Surgical repair of femoral neck fracture within 48 h of admission; Assessment of cerebral ischemic event risk for patients with atrial fibrillation; Duplex carotid ultrasound within 72 h of emergency department admission for patients with suspected transient ischemic attack; Antibiotic prophylaxis for caesarean sections; and Percutaneous coronary intervention within 90 min for patients presenting with ST-elevation myocardial infarction. RESULTS Compliance rates for five quality indicators, representing different aspects of routine health care, remained steady - even at times with high volumes of COVID-19 inpatients in general hospitals. This lack of effect was prominent throughout the analyzed period, i.e., general hospitals maintained similar compliance rates for all quality indicators both during the surges of COVID-19 patients and between these periods. Statistical analysis showed no correlation between the quality indicators' compliance rates and the number of COVID-19 inpatients. CONCLUSIONS Our findings indicate that high volumes of COVID-19 inpatients in general hospitals did not affect the hospitals' capability to comply with routine health care quality indicators. The results of our study imply that general hospitals in Israel were able to withstand the challenges associated with the care of COVID-19 inpatients while preserving high quality of care for routine patients.
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Affiliation(s)
- Olga Bronshtein
- Author Affiliations: The National Program for Quality Indicators (NPQI), Ministry of Health, Jerusalem, Israel (Mrs Bronshtein, Drs Konson and Kuniavsky, Mr Goldschmidt, Mmes Hanhart and Mahalla-Garashi, Ms Peri, Mrs Rosenfelder, and Profs Niv and Dollberg); and Sheldon Adelson Faculty of Medicine, Ariel University, Ariel, Israel (Prof Niv)
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Thanh NH, Manh Hung T, Ngoc TN, San BV, Hung DQ, Hung ND, Binh VD, Trung LH, Tinh LV, Nam NT, Tan PH, Khoa PTA, Thach PN, Khanh NT, Chinh CD, Trung NV, Thi TTM, Hien PB, Long TA, Thuong NV, Thanh NV, Thang TX, Truong LD, Hieu VQ, Otsu S. Demand for mental health support services among health professionals in Vietnam: Lesson from COVID-19 Pandemic. PLoS One 2024; 19:e0305869. [PMID: 38913676 PMCID: PMC11195960 DOI: 10.1371/journal.pone.0305869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/04/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND This study aimed to measure the preferences for mental health support among health professionals, their willingness to support the mental health of colleagues and associated factors. METHOD A descriptive cross-sectional study was performed from August to October 2022 within five hospitals located in Hanoi, Vietnam. A total of 244 health professionals participated in the study. Data on socio-economic status, health and COVID-19-related characteristics, Depression Anxiety Stress Scale (DASS-21); and preferences for mental health support services were collected by using a structured self-reported questionnaire. Multivariate logistic regression models were utilized to identify associated factors with the demand for mental support services. RESULTS 13.9%, 17.1% and 8.6% reported having at least mild depression, anxiety and stress, respectively. There 13.9% did not seek any mental health support during the COVID-19 pandemic. The most common support included talking with friends (52.9%), family (50.8%), colleagues (47.6%) and using social networks/Internet (43.5%). There 31.1% had been aware of mental health services, but only 18.0% used this service at least once. Regarding preferences, 47.3% had a demand for mental support services, and the most preferred service was providing coping skills (25.9%), followed by skills to support others against mental problems (22.2%). Major sources of support included psychiatrists (34.4%), colleagues (29.1%) and family (27.9%). The main preferred channels for support included telephone/mobile phone (35.7%) and Internet (20.9%). Only 12.3% were willing to provide mental support for colleagues during the pandemic. Age, education, perceived mental health status, ever seeking any mental service, and DASS-21 depression score were associated with demand for mental support services. CONCLUSION This study found a lack of awareness of mental health services for health professionals, as well as moderate levels of demand for this service in this population. Raising awareness and developing tailored mental health support services are important to enhancing the mental well-being of health professionals in Vietnam to prepare for the next pandemic.
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Affiliation(s)
- Nguyen Hoang Thanh
- Hanoi Medical University, Hanoi, Vietnam
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Than Manh Hung
- National Hospital of Tropical Diseases, Hanoi, Vietnam
- VNU University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Tran Nguyen Ngoc
- Hanoi Medical University, Hanoi, Vietnam
- Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Bui Van San
- Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Doan Quoc Hung
- Department of Surgery, Hanoi Medical University, Hanoi, Vietnam
- Department of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital, Hanoi, Vietnam
- Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam
| | | | - Vu Duc Binh
- Clinical Hematology Department, National Institute of Hematology and Blood Transfusion, Hanoi, Vietnam
- Education and Healthcare Direction Center, National Institute of Hematology and Blood Transfusion, Hanoi, Vietnam
| | - Le Hong Trung
- Department of Health, Vinh Phuc Province, Vĩnh Yên, Vietnam
| | - Le Van Tinh
- Vinh Phuc Provincial General Hospital, Vinh Phuc Province, Vĩnh Yên, Vietnam
| | - Nguyen Thanh Nam
- Vinh Phuc Provincial General Hospital, Vinh Phuc Province, Vĩnh Yên, Vietnam
| | - Pham Huy Tan
- Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam
| | | | | | | | | | | | | | | | | | | | | | | | - Lai Duc Truong
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Hanoi, Vietnam
| | - Vu Quang Hieu
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Hanoi, Vietnam
| | - Satoko Otsu
- Disease Control and Health Emergency Program, World Health Organization Vietnam Country Office, Hanoi, Vietnam
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Mitura KM, Celiński D, Snarska J, Szajda SD. Impact of COVID-19 Pandemic on Health and Life Emergencies Resulting from Illness Cases and Injuries-A Preliminary Study. J Clin Med 2024; 13:3552. [PMID: 38930081 PMCID: PMC11205222 DOI: 10.3390/jcm13123552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Despite organised efforts, the COVID-19 pandemic had a significant impact on the health status of the population and health services including the emergency medical system. The objective of the study was to investigate, based on the Emergency Medical Teams' (EMT) interventions, the impact of the COVID-19 pandemic on health and life emergencies resulting from illness cases and injuries of Polish females and males. Material and Methods: The data under analysis concern EMT interventions carried out in central and eastern Poland from 1 January 2017 to 31 December 2022 (n = 226,038). The study used descriptive statistics, the Mann-Whitney U Test, and the Chi-square test. Results: A significant increase was observed in the proportion of EMT interventions (p < 0.001) to patients with illness cases (80.30% vs. 83.17%) and a decrease in interventions to patients with injuries (19.70% vs. 16.83%) during the pandemic as compared to the pre-pandemic period. As for illness cases, the patients' ages during both periods were similar (Me = 66.00 vs. 66.00, p = 0.071). On the other hand, during the pandemic, injuries mainly affected elderly patients as compared to the pre-pandemic period (Me = 50.00 vs. 47.00, p < 0.001). The increase in the proportion of EMT interventions to patients with illness cases and the decrease in patients with injuries during the pandemic, as compared to the pre-pandemic period, concerned the area of intervention, patient's sex, and age. During the pandemic period, a significantly lower proportion of patients transported to the hospital (p < 0.001) and an increase in the proportion of patients left at the place of call (p < 0.001) were noted. Conclusions: The restrictions aimed at preventing the spread of the SARS-CoV-2 virus contributed to a reduced number of injuries without, however, reducing the number of illness cases. During the pandemic, the elderly were affected by injuries. The study indicates the need for further in-depth analyses to prepare the pre-hospital care system in Poland for the occurrence of other or similar emergencies.
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Affiliation(s)
- Krzysztof Marek Mitura
- Independent Public Health Care Center RM-MEDITRANS Emergency Station and Sanitary Transport in Siedlce, 08-110 Siedlce, Poland
| | - Daniel Celiński
- Department of Emergency Medical Service, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Jadwiga Snarska
- Department of Surgery, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Sławomir Dariusz Szajda
- Department of Emergency Medical Service, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
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Fullaondo A, Erreguerena I, Keenoy EDM. Transforming health care systems towards high-performance organizations: qualitative study based on learning from COVID-19 pandemic in the Basque Country (Spain). BMC Health Serv Res 2024; 24:364. [PMID: 38515068 PMCID: PMC10958960 DOI: 10.1186/s12913-024-10810-w] [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: 01/28/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic is one of the worst health catastrophes of the last century, which caused severe economic, political, and social consequences worldwide. Despite these devastating consequences, lessons learned provide a great opportunity that can drive the reform of health systems to become high-performing, effective, equitable, accessible, and sustainable organisations. This work identifies areas in which changes must be encouraged that will enable health systems to deal effectively with current and future challenges, beyond COVID-19. METHODS A realist design was chosen, based on qualitative data collection techniques, content analysis and triangulation to identify key domains of organizational interventions behind the changes implemented to react to the COVID-19 pandemic in the Basque Country. Twenty key informants were used as an expert source of information. Thematic analysis was done using the Framework Method. RESULTS The analysis of the interviews resulted in the identification of 116 codes, which were reviewed and agreed upon by the researchers. Following the process of methodological analysis, these codes were grouped into domains: seven themes and 23 sub-themes. Specifically, the themes are: responsiveness, telehealth, integration, knowledge management, professional roles, digitisation, and organisational communication. The detailed description of each theme and subtheme is presented. CONCLUSIONS The findings of this work pretend to guide the transformation of health systems into organisations that can improve the health of their populations and provide high quality care. Such a multidimensional and comprehensive reform encompasses both strategic and operational actions in diverse areas and requires a broad and sustained political, technical, and financial commitment.
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Affiliation(s)
- Ane Fullaondo
- Kronikgune Institute for Health Services Research, Barakaldo, Spain.
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Bayram A, Chiappinotto S, Palese A. Unfinished nursing care in healthcare settings during the COVID-19 pandemic: a systematic review. BMC Health Serv Res 2024; 24:352. [PMID: 38504283 PMCID: PMC10949800 DOI: 10.1186/s12913-024-10708-7] [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: 11/02/2023] [Accepted: 02/12/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Unfinished nursing care is becoming increasingly more of a concern in worldwide healthcare settings. Given their negative outcomes, it is crucial to continuously assess those nursing interventions that are commonly postponed or missed, as well as the underlying reasons and consequences. The worldwide COVID-19 pandemic has made it difficult for health facilities to maintain their sustainability and continuity of care, which has also influenced the unfinished nursing care phenomenon. However, no summary of the studies conducted during the COVID-19 pandemic was produced up to now. The main aim of this study was to systematically review the occurrence of, reasons for, and consequences of unfinished nursing care among patients in healthcare settings during the COVID-19 pandemic. METHODS Systematic review registered in PROSPERO (CRD42023422871). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline and the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies were used. MEDLINE-PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from March 2020 up to May 2023, using keywords established in the field as missed care, unfinished nursing care, or implicit rationing. RESULTS Twenty-five studies conducted mainly in European and Asiatic countries were included and assessed as possessing good methodological quality. The following tools were used: the MISSCARE Survey (= 14); the Basel Extent of Rationing of Nursing Care (= 1), also in its revised form (= 2) and regarding nursing homes (= 2); the Perceived Implicit Rationing of Nursing Care (= 4); the Intensive Care Unit-Omitted Nursing Care (= 1); and the Unfinished Nursing Care Survey (= 1). The order of unfinished nursing care interventions that emerged across studies for some countries is substantially in line with pre-pandemic data (e.g., oral care, ambulation). However, some interesting variations emerged at the country and inter-country levels. Conversely, labour resources and reasons close to the emotional state and well-being of nurses were mentioned homogeneously as most affecting unfinished nursing care during the pandemic. None of the studies investigated the consequences of unfinished nursing care. CONCLUSIONS Two continents led the research in this field during the pandemic: Europe, where this research was already well established, and Asia, where this research is substantially new. While unfinished care occurrence seems to be based on pre-established patterns across Europe (e.g., regarding fundamentals needs), new patterns emerged across Asiatic countries. Among the reasons, homogeneity in the findings emerged all in line with those documented in the pre-pandemic era.
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Affiliation(s)
- Aysun Bayram
- Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | | | - Alvisa Palese
- Department of Medicine, University of Udine, Udine, Italy
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Gutierrez JP, Olaiz G, Juárez-Flores A, Borja-Aburto VH, Ascencio-Montiel IJ, Bertozzi SM. How predictive of SARS-CoV-2 infection are clinical characteristics at presentation among individuals with COVID-like symptoms treated at the Mexican Institute of Social Security. PLoS One 2023; 18:e0296320. [PMID: 38128048 PMCID: PMC10735012 DOI: 10.1371/journal.pone.0296320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has progressed rapidly, with the emergence of new virus variants that pose challenges in treating infected individuals. In Mexico, four epidemic waves have been recorded with varying disease severity. To understand the heterogeneity in clinical presentation over time and the sensitivity and specificity of signs and symptoms in identifying COVID-19 cases, an analysis of the changes in the clinical presentation of the disease was conducted. AIM To analyze the changes in the clinical presentation of COVID-19 among 3.38 million individuals tested for SARS-CoV-2 at the Mexican Social Security Institute (IMSS) from March 2020 to October 2021 and evaluate the predictivity of signs and symptoms in identifying COVID-19 cases. METHODS A retrospective analysis of clinical presentation patterns of COVID-19 among individuals treated at IMSS was performed, contrasting the signs and symptoms among SARS-CoV-2-positive individuals with those who tested negative for the virus but had respiratory infection symptoms. The sensitivity and specificity of each sign and symptom in identifying SARS-CoV-2 infection were estimated. RESULTS The set of signs and symptoms reported for COVID-19-suspected patients treated at IMSS were not highly specific for SARS-CoV-2 positivity. The signs and symptoms exhibited variability based on age and epidemic wave. The area under the receiver operating characteristic (ROC) curve was 0.62 when grouping the five main symptoms (headache, dyspnea, fever, arthralgia, and cough). Most of the individual symptoms had ROC values close to 0.5 (16 out of 22 between 0.48 and 0.52), indicating non-specificity. CONCLUSIONS The results highlight the difficulty in making a clinical diagnosis of COVID-19 due to the lack of specificity of signs and symptoms. The variability of clinical presentation over time and among age groups highlights the need for further research to differentiate whether the changes are due to changes in the virus, who is becoming infected, or the population, particularly with respect to prior infection and vaccination status.
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Affiliation(s)
- Juan Pablo Gutierrez
- Center for Policy, Population and Health Research, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Gustavo Olaiz
- Center for Policy, Population and Health Research, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Arturo Juárez-Flores
- Center for Policy, Population and Health Research, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Víctor H. Borja-Aburto
- Education and Research Unit, Mexican Institute of Social Security, Benito Juarez, Mexico City, Mexico
| | - Iván J. Ascencio-Montiel
- Coordination of Epidemiological Surveillance, Mexican Institute of Social Security, Benito Juarez, Mexico City, Mexico
| | - Stefano M. Bertozzi
- University of California, Berkeley, California, United States of America
- University of Washington, Seattle, Washington, United States of America
- National Institute of Public Health, Mexico (INSP), Cuernavaca, Mexico
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9
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Peters MA, Cloete K, Odwe G, Tadele G, Hirschhorn LR, Magge H, Roder-DeWan S. Embedding implementation research to cross the quality of care chasm during the covid-19 pandemic and beyond. BMJ 2023; 383:e076331. [PMID: 38081643 PMCID: PMC10704412 DOI: 10.1136/bmj-2023-076331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
| | - Keith Cloete
- Western Cape Department of Health and Wellness, Cape Town, South Africa
| | | | | | | | - Hema Magge
- Bill and Melinda Gates Foundation, Seattle, USA
- Harvard University, Brigham and Women's Hospital, Division of Global Equity, Boston, USA
| | - Sanam Roder-DeWan
- World Bank Group, Washington DC, USA
- Dartmouth University, Hanover, USA
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10
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Meulenbroeks I, Raban MZ, Seaman K, Wabe N, Westbrook J. Allied health service delivery in residential aged care and the impact of the coronavirus (COVID-19) pandemic: a survey of the allied health workforce. AUST HEALTH REV 2023; 47:729-734. [PMID: 37758280 DOI: 10.1071/ah23093] [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: 04/21/2023] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
Objectives Industry reports suggest that routine and essential care in Australian residential aged care (RAC), including allied health (AH) services, were disrupted during the coronavirus diseas 2019 (COVID-19) pandemic. This study aimed to explore whether AH services in RAC were paused during the pandemic, factors associated with a pause in care delivery, and qualitative details on how COVID-19 impacted AH service delivery. Methods A 26-question survey was distributed via social media, health service providers, and AH networks between February and April 2022. Participation was restricted to AH professionals and assistants with experience in RAC during the pandemic. A mix of closed and open-ended response questions was used to collect demographic data and experiences of delivering care during the pandemic. Quantitative responses were analysed with descriptive statistics and a probit model. Content analysis was performed on open-ended questions. Results One hundred and four AH professionals and assistants responded to the survey. Fifty-five percent of participants (n = 51) were contractually or casually employed. AH services were negatively impacted by the pandemic with 52% of respondents experiencing a pause in service delivery and 78% reporting poorer AH care quality. In a probit model, contracted/casually employed respondents were more likely to experience a pause in care delivery (1.03, P < 0.05) compared to permanently employed AH professionals. Conclusion Insecure work arrangements may have exacerbated inconsistent care during the pandemic (impacting residents) and may have negative implications on the RAC AH workforce. In the future, an AH inclusive workforce policy including data collection and research is required to monitor and plan the RAC workforce.
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Affiliation(s)
- Isabelle Meulenbroeks
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2122, Australia
| | - Magdalena Z Raban
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2122, Australia
| | - Karla Seaman
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2122, Australia
| | - Nasir Wabe
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2122, Australia
| | - Johanna Westbrook
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2122, Australia
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Ahmead M, Daghlas F. The effect of the COVID-19 pandemic on the provision of outpatient clinic services in East Jerusalem hospitals: patients' perspectives. Front Public Health 2023; 11:1252449. [PMID: 38074699 PMCID: PMC10704241 DOI: 10.3389/fpubh.2023.1252449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background Due to the decreased availability, accessibility, and quality of services, the COVID-19 pandemic has an impact on the healthcare system. In the wake of the COVID-19 pandemic, patients' perceptions of healthcare have changed, and out-patient visits to clinics have decreased. As part of the COVID-19 outbreak in East Jerusalem, this study aims to assess how patients perceive the way that outpatient clinic services were delivered before and during COVID-19 outbreak. Methodology Convenience sampling and self-reported questionnaires were used in a cross-sectional study. Three hundred people from three significant outpatient clinic hospitals in East Jerusalem-Al-Makassed Hospital, Augusta Victoria Hospital, and Sant-Joseph Hospital- made up the sample. Multivariate tests, frequencies, and percentages were used in the statistical analysis. Results The results showed that the most of the participants (98.6%) had negative opinion when the current situation is compared with before the COVID-19 period in terms of accessibility, availability of resources, quality of care, attitudes and patient's preference. Finally, multivariate analysis indicated a significant relationship between participant opinion and education level and participants with educational levels of 12 study years or less had more positive opinions of the delivery of the healthcare system during the COVID-19 outbreak period than the group with more than 12 study years. Also, the multivariate analysis revealed a significant `relationship between participant opinion and the duration of the illness as those with years of illness and less had more negative opinion toward the delivery of the healthcare system than those with more than 3 years of illness. Conclusion This study found that when the current situation during the COVID-19 outbreak is compared to before the COVID-19 period in terms of accessibility, availability of resources, quality of care, attitudes, and patient preferences, the majority of the participants with chronic diseases or cancer had a negative opinion. Policymakers and health managers should enhance patient preferences and attitudes during the COVID-19 pandemic and other pandemics by increasing accessibility, availability of health resources, and the quality of healthcare.
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Mohd Ujang IR, Hamidi N, Ab Hamid J, Awang S, Zulkifli NW, Supadi R, Mohamed NE, Sooryanarayana R. The COVID-19 pandemic and disruptions to maternal and child health services in public primary care Malaysia: a retrospective time-series analysis. BMJ Glob Health 2023; 8:e013397. [PMID: 37949498 PMCID: PMC10649372 DOI: 10.1136/bmjgh-2023-013397] [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: 07/12/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide. Maintaining essential health services, including maternal and child health (MCH), while addressing the pandemic is an enormous task. This study aimed to assess the impact of the COVID-19 pandemic on the utilisation of MCH services in Malaysian public primary care. METHODS A retrospective analysis was conducted using national administrative data from 1124 public primary care clinics. Eight indicators were selected to measure service utilisation covering antenatal, postnatal, women's health, child health, and immunisation services. Interrupted time-series analysis was used to evaluate changes in levels and trends of indicators during four different periods: pre-pandemic (January 2019-February 2020), during pandemic and first lockdown (March-May 2020), after the first lockdown was lifted (June-December 2020) and after the second lockdown was implemented (January-June 2021). RESULTS Most indicators showed no significant trend in monthly utilisation prior to the pandemic. The onset of the pandemic and first lockdown implementation were associated with significant decreasing trends in child health (-19.23%), women's health (-10.12%), antenatal care (-8.10%), contraception (-6.50%), postnatal care (-4.85%) and postnatal care 1-week (-3.52%) indicators. These indicators showed varying degrees of recovery after the first lockdown was lifted. The implementation of the second lockdown caused transient reduction ranging from -11.29% to -25.92% in women's health, contraception, child and two postnatal indicators, but no sustained reducing trend was seen afterwards. Two immunisation indicators appeared unaffected throughout the study period. CONCLUSION The COVID-19 pandemic significantly impacted MCH services utilisation in Malaysia. While most MCH services were negatively affected by the lockdown implementation with varying degrees of recovery, infant immunisation showed resilience throughout. This highlights the need for a targeted preparedness plan to ensure the resilience of MCH services in future crises.
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Affiliation(s)
- Izzatur Rahmi Mohd Ujang
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Normaizira Hamidi
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Jabrullah Ab Hamid
- Centre for Health Equity Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Samsiah Awang
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | | | - Roslina Supadi
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Nur Ezdiani Mohamed
- Centre for Healthcare Quality Research, Institute for Health Systems Research, Ministry of Health, Shah Alam, Malaysia
| | - Rajini Sooryanarayana
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
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Soysal P, Veronese N, Smith L, Chen Y, Akpinar Soylemez B, Coin A, Religa D, Välimäki T, Alves M, Shenkin SD. The Impact of the COVID-19 Pandemic on the Psychological Well-Being of Caregivers of People with Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. Geriatrics (Basel) 2023; 8:97. [PMID: 37887970 PMCID: PMC10606547 DOI: 10.3390/geriatrics8050097] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09-0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05-2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42-4.95; p < 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13-0.56; p = 0.001; I2 = 54.1%) (p < 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers' psychological well-being is assessed and supported, to benefit both themselves and those for whom they care.
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Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, 90133 Palermo, Italy
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Yaohua Chen
- Department of Geriatrics, Lille Neurosciences & Cognition, University of Lille, 59000 Lille, France
| | - Burcu Akpinar Soylemez
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir 35210, Turkey
| | - Alessandra Coin
- Geriatrics Division, Department of Medicine, University of Padua, 35122 Padua, Italy
| | - Dorota Religa
- Division for Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, 14152 Stockholm, Sweden
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, 70211 Kuopio, Finland
| | - Mariana Alves
- Serviço de Medicina III, Hospital Pulido Valente, CHLN, Alameda das Linhas de Torres, 117, 1769-001 Lisbon, Portugal
| | - Susan D. Shenkin
- Ageing and Health Research Group, Usher Institute, University of Edinburgh, Edinburgh EH16 4SB, UK
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Kintrilis N, Blek N, Blek S, Olkiewicz A, Ladny JR, Szarpak L. Effect of the pandemic on prehospital management of patients with mental and behavioral disorders: a retrospective cohort study. Front Public Health 2023; 11:1174693. [PMID: 37780449 PMCID: PMC10535562 DOI: 10.3389/fpubh.2023.1174693] [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: 08/24/2023] [Indexed: 10/03/2023] Open
Abstract
The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection and the accompanying coronavirus disease (Covid-19) have shifted the priority of human and technical resources toward their handling, thus affecting the usual standards of care for populations diagnosed with other clinical entities. The phenomenon becomes even more apparent in patients with presenting symptoms of mental and behavioral disorders, a category already vulnerable and underrepresented in regard to its prehospital approach and management. For the purposes of the current retrospective cohort study, we used records of the Polish National Emergency Medical Service Command Support System for the time period between April 1, 2019 and April 30, 2021, the official register of medical interventions delivered in Poland by Emergency Medical Services (EMS). We aimed to examine the potential impact of the COVID-19 pandemic across the Masovian Voivodeship on individuals seeking medical care for mental and behavioral disorders pertaining in the "F" category of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). We examined the individuals' baseline characteristics, prehospital vital parameters and EMS processing times in a population of 59,651 adult patients (04/2019-03/2020, 28,089 patients, 04/2020-03/2021, 31,562 patients) handled by EMS teams. Compared to pre-COVID-19, EMS personnel handled fewer patients, but more patients required mental and behavioral care. Throughout the duration of the pandemic, all prehospital time periods were significantly delayed due to the increased time needed to prepare crew, vehicles, and technical equipment to ensure COVID-19 prevention and overcrowding in Emergency Departments (EDs).
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Affiliation(s)
- Nikolaos Kintrilis
- Infectious Disease Unit, General Military Hospital of Athens, Athens, Greece
| | - Natasza Blek
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
- Department of Neurology, Wolski Hospital, Warsaw, Poland
| | - Sergiusz Blek
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | | | - Jerzy Robert Ladny
- Department of Emergency Medicine, Bialystok Medical University, Białystok, Poland
| | - Lukasz Szarpak
- Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, United States
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15
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Walkowiak MP, Walkowiak D, Walkowiak J. To vaccinate or to isolate? Establishing which intervention leads to measurable mortality reduction during the COVID-19 Delta wave in Poland. Front Public Health 2023; 11:1221964. [PMID: 37744498 PMCID: PMC10513426 DOI: 10.3389/fpubh.2023.1221964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background During the Delta variant COVID-19 wave in Poland there were serious regional differences in vaccination rates and discrepancies in the enforcement of pandemic preventive measures, which allowed us to assess the relative effectiveness of the policies implemented. Methods Creating a model that would predict mortality based on vaccination rates among the most vulnerable groups and the timing of the wave peak enabled us to calculate to what extent flattening the curve reduced mortality. Subsequently, a model was created to assess which preventive measures delayed the peak of infection waves. Combining those two models allowed us to estimate the relative effectiveness of those measures. Results Flattening the infection curve worked: according to our model, each week of postponing the peak of the wave reduced excess deaths by 1.79%. Saving a single life during the Delta wave required one of the following: either the vaccination of 57 high-risk people, or 1,258 low-risk people to build herd immunity, or the isolation of 334 infected individuals for a cumulative period of 10.1 years, or finally quarantining 782 contacts for a cumulative period of 19.3 years. Conclusions Except for the most disciplined societies, vaccination of high-risk individuals followed by vaccinating low-risk groups should have been the top priority instead of relying on isolation and quarantine measures which can incur disproportionately higher social costs. Our study demonstrates that even in a country with uniform policies, implementation outcomes varied, highlighting the importance of fine-tuning policies to regional specificity.
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Affiliation(s)
- Marcin Piotr Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland
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Al Waziza R, Sheikh R, Ahmed I, Al-Masbhi G, Dureab F. Analyzing Yemen's health system at the governorate level amid the ongoing conflict: a case of Al Hodeida governorate. DISCOVER HEALTH SYSTEMS 2023; 2:15. [PMID: 37520515 PMCID: PMC10169293 DOI: 10.1007/s44250-023-00026-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/27/2023] [Indexed: 08/01/2023]
Abstract
Background Yemen is regarded as one of the Middle East's poorest countries. Decades of political, economic, and social difficulties have culminated in the current protracted conflict. As a result, the globe experienced its worst humanitarian catastrophe. The ongoing war has affected several public services, notably the health sector, which is operating at less than half its capacity. This study aims to examine Yemen's health system at the governorate level (Al Hodeida) amidst the current conflict. It analyzes current challenges and produces suggestions for enhancement. Methods The study used qualitative research methods such as Key Informant Interviews (KIIs) and document analysis. The study used WHO's health systems framework to measure health system performance. Twelve KIIs were conducted via Skype with several health stakeholders. In addition, documents were analyzed to inform the subject guide, generate themes, and aid in the triangulation of results. Results According to the study findings, the governorate health system managed to offer a minimum level of healthcare services while making some advances in outbreak control jointly with other partners. One of the main difficulties confronting the governorate's health system is a severe lack of financial resources forcing it to rely entirely on external aid. Furthermore, other significant deficiencies include inadequate health system organogram, low reporting capacities, insufficient funding, and scarcity of health professionals. Conclusion Yemen's frail health system has been weakened by almost eight years of insecurity and conflict. If the current scenario continues, most of Yemen's health system's operations and indicators will likely deteriorate. On the other hand, progress in some areas, such as primary healthcare (PHC) services and disease management, is remarkable. However, for better performance, Yemen's health system leadership and stakeholders should seek a holistic strategy to improve the entire dimensions of the health system.
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Affiliation(s)
- Raof Al Waziza
- Institute for Research in International Assistance (IRIA), Akkon Hochschule für Humanwissenschaften, Berlin, Germany
| | | | - Iman Ahmed
- World Health Organization, Gaziantep, Turkey
| | | | - Fekri Dureab
- Institute for Research in International Assistance (IRIA), Akkon Hochschule für Humanwissenschaften, Berlin, Germany
- Heidelberg Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany
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Damian AC, Ciobanu AM, Anghele C, Papacocea IR, Manea MC, Iliuță FP, Ciobanu CA, Papacocea Ș. Caregiving for Dementia Patients during the Coronavirus Pandemic. J Clin Med 2023; 12:2616. [PMID: 37048700 PMCID: PMC10095033 DOI: 10.3390/jcm12072616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
The coronavirus pandemic has had a global impact on both mental and physical health. Caregiving has become more difficult during this time due to the quick spread of this respiratory disease, dread of the unknown, congested hospitals, and many restrictions, particularly for people with multiple comorbidities. We aimed to assess the impact of this pandemic on a group of caregivers of patients with dementia and their needs during this time. The study's findings indicate that females assumed the role of the caregiver more often than men (88.5% of the participants) and scored lower on the life quality scale. The most often issue encountered during the pandemic was difficulty in accessing health care facilities (36%). Participants with a higher education level scored better in the physical (24.67, p = 0.01 and 24.48, p = 0.01) and mental health (20.67, p = 0.002; 19,82, p = 0.008) domains of the life quality test. The fear of COVID questionnaire showed a low level of concern in the category of participants with a high education level. Overall, this pandemic emphasizes the importance of social interaction and the possibilities to improve health care services through telemedicine. Caregivers could benefit from socialization and support programs as well as the early detection of affective disorders.
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Affiliation(s)
- Ana Claudia Damian
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Cristina Anghele
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Ioana Raluca Papacocea
- Discipline of Physiology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Floris Petru Iliuță
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | | | - Șerban Papacocea
- Department of Neurosurgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Petry H, Pelzelmayer K, Ernst J, Thuerlimann E, Naef R. Nurse-patient interaction during the Covid-19 pandemic: Creating and maintaining an interactive space for care. J Adv Nurs 2023; 79:281-296. [PMID: 36344480 DOI: 10.1111/jan.15486] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/03/2022] [Accepted: 10/12/2022] [Indexed: 11/09/2022]
Abstract
AIMS To explore nurse-patient interactions during the Covid-19 pandemic from both nurses' and patients' perspectives. DESIGN Qualitative study using constructive grounded theory. METHODS A total of 34 patients and 49 nurses from acute and home care settings participated in individual or focus group interviews between December 2020 and May 2021. Data were analysed by a team of researchers using coding, memo-writing, theoretical sampling and constant comparison and integration. RESULTS We identified the creation and maintenance of an interactive space as the main social process. This interactive space was shaped by the care context and the course of the pandemic. For nurses, four factors were key, namely protecting oneself and others, navigating communication barriers, adapting nursing actions to the evolving situation, and providing emotional care work. Patients experienced attentive caring relationships with nurses and felt that, for the most part, their individual needs had been met despite the pandemic challenges. CONCLUSION Nurses and patients created an interactive space in which they were able to provide and receive the necessary care. Maintaining the interactive space was often challenging, and required an intentional effort by nurses, particularly in acute care settings. The findings illustrate that nurses ensured the provision of necessary care even during a public health crisis, thereby enabling patient access to good quality care. IMPACT Nurse-patient relationships are important for effective, person-centred care delivery. Despite the pandemic challenges, nurses managed to uphold their caring imperative and ensure quality care. Findings provide further insights on the importance of nurse-patient interaction in maintaining quality care. They inform models of nursing care delivery and strategies to support quality care during public health crises.
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Affiliation(s)
- Heidi Petry
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | | | - Jutta Ernst
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Eva Thuerlimann
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Rahel Naef
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.,Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Aparicio Betancourt M, Duarte-Díaz A, Vall-Roqué H, Seils L, Orrego C, Perestelo-Pérez L, Barrio-Cortes J, Beca-Martínez MT, Molina Serrano A, Bermejo-Caja CJ, González-González AI. Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10332. [PMID: 36011970 PMCID: PMC9408445 DOI: 10.3390/ijerph191610332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evidence on COVID-19-related healthcare needs of adult patients, their family members, and the professionals involved in their care during the first year of the pandemic. We searched the databases MEDLINE, Embase, and Web of Science. Two reviewers independently screened titles and abstracts and assessed full texts for eligibility. Disagreements were resolved by consensus. Descriptive data were extracted and inductive qualitative content analysis was used to generate codes and derive overarching themes. Thirty-six studies met inclusion criteria, with the majority reporting needs from the perspective of professionals (35/36). Professionals' needs were grouped into three main clusters (basic, occupational, and psycho-socio-emotional needs); patients' needs into four (basic, healthcare, psycho-socio-emotional, and other support needs); and family members' needs into two (psycho-socio-emotional and communication needs). Transversal needs across subgroups were also identified and grouped into three main clusters (public safety, information and communication, and coordination and support needs). This evidence map provides valuable insight on COVID-19-related healthcare needs. More research is needed to assess first-person perspectives of patients and their families, examine whether needs differ by country or region, and evaluate how needs have evolved over time.
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Affiliation(s)
- Mariana Aparicio Betancourt
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 El Rosario, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Helena Vall-Roqué
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Laura Seils
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), 38109 El Rosario, Spain
| | - Jaime Barrio-Cortes
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Fundación para la Investigación e Innovación Biosanitaria en Atención Primaria, 28003 Madrid, Spain
| | | | | | - Carlos Jesús Bermejo-Caja
- Unidad de Apoyo Técnico Dirección Técnica de Sistemas de información, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, 28035 Madrid, Spain
- Departamento de Enfermería. Universidad Autónoma de Madrid, 28034 Madrid, Spain
| | - Ana Isabel González-González
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Innovación y Proyectos Internacionales, Dirección General de Investigación, Docencia y Documentación, Consejería de Sanidad, 28034 Madrid, Spain
- Institute of General Practice, Goethe University, 60323 Frankfurt, Germany
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