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Moitra S, Anderson A, Eathorne A, Brickstock A, Adan A, Akgün M, Tabrizi AF, Haldar P, Henderson L, Jindal A, Jindal SK, Kerget B, Khadour F, Melenka L, Moitra S, Moitra T, Mukherjee R, Murgia N, Semprini A, Turner AM, Lacy P. COVID-19 infodemic and health-related quality of life in patients with chronic respiratory diseases: A multicentre, observational study. J Glob Health 2023; 13:06045. [PMID: 37947025 PMCID: PMC10636600 DOI: 10.7189/jogh.13.06045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Background The explosion of information, misinformation and disinformation (the "infodemic") related to the coronavirus disease 2019 (COVID-19) pandemic on digital and social media is reported to affect mental health and quality of life. However, reports assessing the COVID-19 infodemic on health-related quality of life (HRQL) in patients with chronic diseases are scarce. In this study, we investigated the associations between the infodemic and HRQL in uninfected individuals with pre-existing chronic respiratory diseases (CRDs) such as asthma, chronic obstructive pulmonary disease (COPD) and other CRDs. Methods We conducted a multi-national, cross-sectional, observational study in Canada, India, New Zealand and the United Kingdom where we distributed a set of digitised questionnaires among 1018 participants with chronic respiratory diseases who were not infected with the SARS-CoV-2 virus at least three months prior to the study. We collected information about the infodemic such as news watching or social media use more than usual during the pandemic. HRQL was assessed using the short form of the chronic respiratory questionnaire (SF-CRQ). Demographic information, comorbidities, compliance, mental health, behavioural function, and social support were also recorded. We analysed the direct and indirect relationships between infodemic and HRQL using structural equation models (SEM). Results Of all participants, 54% were females and had a mean (standard deviation (SD)) age of 53 (17) years. We found that higher infodemic was associated with worse emotional function (regression coefficient β = -0.08; 95% confidence interval (CI) = -0.14 to -0.01), which means a one SD change of the higher infodemic latent variable was associated with a 0.08 SD change of emotional function level. The association between higher infodemic and worse emotional function was mediated by worse mental health and behavioural functions but is marginally ameliorated by improved social support. In stratification analysis, we found significant disease and country-wise variations in the associations between infodemic and SF-CRQ domain scores. Conclusions These results provide new evidence that the COVID-19 infodemic significantly influences the HRQL in patients with CRDs through a complex interplay between mental health, behavioural function, and social support. This new dimension of research also opens avenues for further research on infodemic-related health effects in other chronic diseases.
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Affiliation(s)
- Subhabrata Moitra
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Allie Eathorne
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Amanda Brickstock
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, UK
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Metin Akgün
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey
| | - Ali Farshchi Tabrizi
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Prasun Haldar
- Department of Medical Laboratory Technology, Supreme Institute of Management and Technology, Mankundu, India
- Department of Physiology, West Bengal State University, Barasat, India
| | - Linda Henderson
- Synergy Respiratory and Cardiac Care, Sherwood Park, Alberta, Canada
| | | | | | - Bugra Kerget
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey
| | - Fadi Khadour
- Synergy Respiratory and Cardiac Care, Sherwood Park, Alberta, Canada
| | - Lyle Melenka
- Synergy Respiratory and Cardiac Care, Sherwood Park, Alberta, Canada
| | - Saibal Moitra
- Department of Allergy & Immunology, Apollo Multispeciality Hospital, Kolkata, India
| | - Tanusree Moitra
- Department of Psychology, Barrackpore Rashtraguru Surendrananth College, Barrackpore, India
| | - Rahul Mukherjee
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Alex Semprini
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Alice M Turner
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| | - Paige Lacy
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Padhye R, Sahasrabudhe SD, Orme MW, Pina I, Dhamdhere D, Borade S, Bhakare M, Ahmed Z, Barton A, Modi M, Malcolm D, Salvi S, Singh SJ. Perspectives of Patients With Chronic Respiratory Diseases and Medical Professionals on Pulmonary Rehabilitation in Pune, India: Qualitative Analysis. JMIR Form Res 2023; 7:e45624. [PMID: 37934558 PMCID: PMC10664007 DOI: 10.2196/45624] [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: 01/10/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Chronic respiratory diseases (CRDs) contribute significantly to morbidity and mortality worldwide and in India. Access to nonpharmacological options, such as pulmonary rehabilitation (PR), are, however, limited. Given the difference between need and availability, exploring PR, specifically remotely delivered PR, in a resource-poor setting, will help inform future work. OBJECTIVE This study explored the perceptions, experiences, needs, and challenges of patients with CRDs and the potential of and the need for PR from the perspective of patients as well as medical professionals involved in the referral (doctors) and delivery (physiotherapists) of PR. METHODS In-depth qualitative semistructured interviews were conducted among 20 individuals diagnosed with CRDs and 9 medical professionals. An inductive thematic analysis approach was used as we sought to identify the meanings shared both within and across the 2 participant groups. RESULTS The 20 patients considered lifestyle choices (smoking and drinking), a lack of physical activity, mental stress, and heredity as the triggering factors for their CRDs. All of them equated the disease with breathlessness and a lack of physical strength, consulting multiple doctors about their physical symptoms. The most commonly cited treatment choice was an inhaler. Most of them believed that yoga and exercise are good self-management strategies, and some were performing yoga postures and breathing exercises, as advised by friends or family members or learned from a televised program or YouTube videos. None of them identified with the term "pulmonary rehabilitation," but many were aware of the exercise component and its benefits. Despite being naive to smartphone technology or having difficulty in reading, most of them were enthusiastic about enrolling in an application-based remotely delivered digital PR program. The 9 medical professionals were, however, reluctant to depend on a PR program delivered entirely online. They recommended that patients with CRDs be supported by their family to use technology, with some time spent with a medical professional during the program. CONCLUSIONS Patients with CRDs in India currently manage their disease with nonguided strategies but are eager to improve and would benefit from a guided PR program to feel better. A home-based PR program, with delivery facilitated by digital solutions, would be welcomed by patients and health care professionals involved in their care, as it would reduce the need for travel, specialist equipment, and setup. However, low digital literacy, low resource availability, and a lack of expertise are of concern to health care professionals. For India, including yoga could be a way of making PR "culturally congruent" and more successful. The digital PR intervention should be flexible to individual patient needs and should be complemented with physical sessions and a feedback mechanism for both practitioners as well as patients for better uptake and adherence.
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Affiliation(s)
- Rashmi Padhye
- Clinical Research Department, Symbiosis Medical College for Women, Symbiosis University Hospitals and Research Centre, Symbiosis (Deemed University), Pune, India
| | - Shruti D Sahasrabudhe
- Clinical Research Department, Symbiosis Medical College for Women, Symbiosis University Hospitals and Research Centre, Symbiosis (Deemed University), Pune, India
| | - Mark W Orme
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Ilaria Pina
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Dipali Dhamdhere
- Clinical Research Department, Symbiosis Medical College for Women, Symbiosis University Hospitals and Research Centre, Symbiosis (Deemed University), Pune, India
| | - Suryakant Borade
- Clinical Research Department, Symbiosis Medical College for Women, Symbiosis University Hospitals and Research Centre, Symbiosis (Deemed University), Pune, India
| | - Meenakshi Bhakare
- Department of Respiratory Medicine, Symbiosis Medical College for Women, Symbiosis (Deemed University), Pune, India
| | - Zahira Ahmed
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Andy Barton
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Mahavir Modi
- Pulmonology Department, Ruby Hall Clinic, Pune, India
| | - Dominic Malcolm
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sundeep Salvi
- Clinical Research Department, Symbiosis Medical College for Women, Symbiosis University Hospitals and Research Centre, Symbiosis (Deemed University), Pune, India
- Pulmonary Research and Education Foundation, Pune, India
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Wang Z, Tang Y, Cui Y, Guan H, Cui X, Liu Y, Liu Y, Kang Z, Wu Q, Hao Y, Liu C. Delay in seeking health care from community residents during a time with low prevalence of COVID-19: A cross-sectional national survey in China. Front Public Health 2023; 11:1100715. [PMID: 36895687 PMCID: PMC9989024 DOI: 10.3389/fpubh.2023.1100715] [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: 11/17/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
Background The pandemic of COVID-19 has significant implications on health resources allocation and health care delivery. Patients with non-COVID illness may have to change their care seeking behaviors to mitigate the risk of infections. The research aimed to investigate potential delay of community residents in seeking health care at a time with an overall low prevalence of COVID-19 in China. Methods An online survey was conducted in March 2021 on a random sample drawn from the registered survey participants of the survey platform Wenjuanxing. The respondents who reported a need for health care over the past month (n = 1,317) were asked to report their health care experiences and concerns. Logistic regression models were established to identify predictors of the delay in seeking health care. The selection of independent variables was guided by the Andersen's service utilization model. All data analyses were performed using SPSS 23.0. A two-sided p value of <0.05 was considered as statistically significant. Key results About 31.4% of respondents reported delay in seeking health care, with fear of infection (53.5%) as a top reason. Middle (31-59 years) age (AOR = 1.535; 95% CI, 1.132 to 2.246), lower levels of perceived controllability of COVID-19 (AOR = 1.591; 95% CI 1.187 to 2.131), living with chronic conditions (AOR = 2.008; 95% CI 1.544 to 2.611), pregnancy or co-habiting with a pregnant woman (AOR = 2.115; 95% CI 1.154 to 3.874), access to Internet-based medical care (AOR = 2.529; 95% CI 1.960 to 3.265), and higher risk level of the region (AOR = 1.736; 95% CI 1.307 to 2.334) were significant predictors of the delay in seeking health care after adjustment for variations of other variables. Medical consultations (38.7%), emergency treatment (18.2%), and obtainment of medicines (16.5%) were the top three types of delayed care, while eye, nose, and throat diseases (23.2%) and cardiovascular and cerebrovascular diseases (20.8%) were the top two conditions relating to the delayed care. Self-treatment at home was the most likely coping strategy (34.9%), followed by Internet-based medical care (29.2%) and family/friend help (24.0%). Conclusions Delay in seeking health care remained at a relatively high level when the number of new COVID-19 cases was low, which may present a serious health risk to the patients, in particular those living with chronic conditions who need continuous medical care. Fear of infection is the top reason for the delay. The delay is also associated with access to Internet-based medical care, living in a high risk region, and perceived low controllability of COVID-19.
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Affiliation(s)
- Ziyu Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yurong Tang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yu Cui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hanwen Guan
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xiaoqian Cui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yuan Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yanni Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- School of Health Management, Harbin Medical University, Harbin, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Karaman I, Ildir S, Ozkaya S. A Glance Into Healthcare Delivery During COVID-19 Pandemic: A Survey Among Turkish Medical Doctors. Front Med (Lausanne) 2022; 9:890417. [PMID: 35928291 PMCID: PMC9345501 DOI: 10.3389/fmed.2022.890417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic had an enormous impact on healthcare delivery globally. We conducted a cross-sectional online survey in Turkey to evaluate the impact of COVID-19 on healthcare services in Turkey. A 35-item anonymized online survey was completed by HCPs (medical doctors, MD) who continued their clinical practice during the COVID-19 pandemic in Turkey, regardless of their specialties or degrees. Overall, 209 HCPs participated in the study. Forty-two percent of the participants stated that their current workload intensity has been increased compared with the pre-pandemic era. More than half of the participants (54.6%) were using telemedicine services during their clinical practice, however, the effectiveness of telemedicine for first-time patients and follow-up patients was rated as low. The majority of participants (59.3%) reported that during the peak period of the pandemic, they encountered only a small variety of cases, other than COVID-19. Fifty-two percent of the participants agreed that they occasionally had patients who received misdiagnosis in the first admission due to the suspicion of a possible COVID-19 infection predominating the diagnostic process (eg., not excluding COVID-19 even though the PCR test is negative). For the distribution of possible late-diagnosed diseases, 25.8% of HCPs selected chest diseases, followed by infectious diseases, heart diseases, and cancer. In general, participants agreed that there was an increase in the negligence in the follow-up of various diseases and/or complication rates due to COVID-19 pandemic. Sixty percent of the HCPs agreed that HCPs are being much more rigorous to diagnose/treating COVID-19 than other important diseases. Fifty-seven percent of the participants stated that the diagnosis and follow-up of chronic diseases are affected, while 57.9% of the HCPs stated that some diseases that show similar signs and symptoms as COVID-19 are not diagnosed correctly during COVID-19 pandemic. Findings from this study emphasize that COVID-19 pandemic has significantly caused delayed diagnoses and interruption in the management of chronic diseases, and also increased the risk of missing out the diagnosis of non-COVID-19 diseases. The study genuinely aims to yield the floor to a permanent improvement in post-pandemic clinical management and it also shows the need for a focused approach in distinct areas of medical care. Policymaking is required to drive changes to better support HCPs in Turkey.
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Affiliation(s)
- Irem Karaman
- School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Selin Ildir
- School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Sevket Ozkaya
- Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
- Department of Pulmonary Medicine, Faculty of Medicine, Altinbas University, Istanbul, Turkey
- *Correspondence: Sevket Ozkaya
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A wearable eddy current based pulmonary function sensor for continuous non-contact point-of-care monitoring during the COVID-19 pandemic. Sci Rep 2021; 11:20144. [PMID: 34635738 PMCID: PMC8505507 DOI: 10.1038/s41598-021-99682-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 09/29/2021] [Indexed: 11/10/2022] Open
Abstract
Pulmonary function testing (PFT) allows for quantitative analysis of lung function. However, as a result of the coronavirus disease 2019 (COVID-19) pandemic, a majority of international medical societies have postponed PFTs in an effort to mitigate disease transmission, complicating the continuity of care in high-risk patients diagnosed with COVID-19 or preexisting lung pathologies. Here, we describe the development of a non-contact wearable pulmonary sensor for pulmonary waveform analysis, pulmonary volume quantification, and crude thoracic imaging using the eddy current (EC) phenomenon. Statistical regression analysis is performed to confirm the predictive validity of the sensor, and all data are continuously and digitally stored with a sampling rate of 6,660 samples/second. Wearable pulmonary function sensors may facilitate rapid point-of-care monitoring for high-risk individuals, especially during the COVID-19 pandemic, and easily interface with patient hospital records or telehealth services.
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Jindal SK. Caring for respiratory disease in India in the COVID era. Expert Rev Respir Med 2021; 15:959-961. [PMID: 33929927 DOI: 10.1080/17476348.2021.1924682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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