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Wu MP, Hsiaog SH, Huang TC, Chu DC, Liu CY. Impacts of COVID-19 pandemic prevention measures to the palliative care in Taiwan. Front Public Health 2024; 12:1411185. [PMID: 39118972 PMCID: PMC11309006 DOI: 10.3389/fpubh.2024.1411185] [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: 04/02/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
Background Prevention measures for palliative care and the provision of discharge planning services for inpatients in Taiwan before and during the COVID-19 pandemic had not been investigated. This study was aimed to investigate the factors associated with heightened palliative care needs and increased mortality rates. Methods This research adopts a retrospective case-control study design. The investigation encompasses patients admitted before the pandemic (from January 1, 2019, to May 31, 2019) and during the COVID-19 pandemic (from January 1, 2020, to May 31, 2020). The case group consisted of 231 end-of-life inpatients during the pandemic, control group was composed of the pool of inpatients with pre-pandemic and matched with cases by sex and age in a 1:1 ratio. Results The results showed that the prevalence of respiratory failure symptoms (p = 0.004), residing in long-term care facilities (p = 0.017), palliative care needs assessment scores (p = 0.010), as well as the provision of guidance for nasogastric tube feeding (p = 0.002), steam inhalation (p = 0.003), turning and positioning (p < 0.001), percussion (p < 0.001), passive range of motion (p < 0.001), and blood pressure measurement (p < 0.001). Furthermore, the assessment of the necessity for assistive devices, including hospital beds, also exhibited statistically significant variations (p < 0.001). Further investigation of the factors associated with high palliative care needs and the risk of mortality for both the case and control groups. Risk factors for high palliative care needs encompassed assessments of daily activities of living, the presence of pressure ulcers, and the receipt of guidance for ambulation. Risk factors for mortality encompassed age, a diagnosis of cancer, palliative care needs assessment scores, and the provision of guidance for disease awareness. Conclusion This research highlights the heightened risk of COVID-19 infection among end-of-life inpatients during the COVID-19 pandemic. The findings of this study may advance care planning to alleviate avoidable suffering. To meet the needs of inpatients during pandemic, healthcare professionals should undergo comprehensive palliative care training and receive policy support.
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Affiliation(s)
- Meng-Ping Wu
- Department of Nursing, Taipei City Hospital, Taipei City, Taiwan
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
- Department of Psychology and Counseling, University of Taipei, Taipei City, Taiwan
| | | | - Tsun-Cheng Huang
- Administrative Deputy Superintendent Office, Taipei City Hospital, Taipei City, Taiwan
| | | | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
- Department of Research and Development, Taipei City Hospital, Taipei City, Taiwan
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2
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van de Wiel M, van Ierssel S, Verbrugghe W, Mertens V, Janssens A. Do-Not-ResuscitateDecision-Making during the COVID-19 Pandemic in a Teaching Hospital: Lessons Learned for the Future. J Aging Res 2023; 2023:2771149. [PMID: 38152565 PMCID: PMC10752667 DOI: 10.1155/2023/2771149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/20/2023] [Accepted: 11/06/2023] [Indexed: 12/29/2023] Open
Abstract
Method A cross-sectional survey study was conducted between February 2021 and April 2021 for all doctors and doctors in training, working in the Antwerp University Hospital during the COVID-19 pandemic. Results 127 doctors participated in this study. The familiarity with the different scores used in the triage during the COVID-10 pandemic was 51% for the Clinical Frailty Scale (CFS) and 20% for the Charlson Comorbidity Index (CCI). Participants indicated that their DNR decision is based on various aspects such as clinical assessment, comorbidities, patient's wishes, age, prognosis, and functional state. Conclusion The familiarity with the different scores used during triage assessments is low. The total clinical picture of the patient is needed to make a considered decision, and this total picture of the patient seems to be well encompassed by frailty measurement (CFS). Although many participants indicated that the different scores do not offer much added value compared to their clinical assessment, it can help guide DNR decisions, especially for doctors in training.
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Affiliation(s)
- Mick van de Wiel
- Antwerp University Hospital (UZA), Department of Thoracic Oncology, Drie Eikenstraat 655, Edegem 2650, Belgium
| | - Sabrina van Ierssel
- Antwerp University Hospital (UZA), Department of General Internal Medicine, Infectious Diseases and Tropical Medicine, Edegem 2650, Belgium
| | - Walter Verbrugghe
- Antwerp University Hospital (UZA), Department of Intensive Care, Edegem 2650, Belgium
| | - Veerle Mertens
- Antwerp University Hospital (UZA), Department of Geriatrics, Edegem 2650, Belgium
| | - Annelies Janssens
- Antwerp University Hospital (UZA), Department of Thoracic Oncology, Drie Eikenstraat 655, Edegem 2650, Belgium
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Correa T, Salomão Simão ÁM, Barros Sobreira JV, Baeninger Anbar F, Yarshell F, Brandão AB, Queirós Estuque M, Aparecida Rocha J, Tavares de Carvalho R. Evaluation of a New Triage Protocol for Palliative Care for Patients with COVID-19 in Brazil. J Palliat Med 2023; 26:253-256. [PMID: 36318484 DOI: 10.1089/jpm.2022.0324] [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: 02/03/2023] Open
Abstract
Objectives: To evaluate the implementation of a triage protocol for palliative care (PC) during the COVID-19 pandemic (PALI-COVID) at a referral center in Brazil. Methods: A retrospective observational study was conducted. Based on the triage protocol, patients were classified into a red group, a yellow group, and a green group (GG). Patients should receive PC as recommended for each group. Results: A total of 1517 patients were included in the analysis. About 11% (n = 162) of patients received PC. About 35% (n = 529) of all patients died. There was a significant difference in the mortality rate between the groups; the GG had the highest mortality rate. Most patients who died (77.1%) did not receive PC. Conclusion: PALI-COVID was effective in identifying patients who had a higher risk of death and needed end-of-life support. Despite the protocol, few patients received PC.
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Affiliation(s)
- Tulio Correa
- Faculty of Medicine, Universidade Federal de Pelotas, Pelotas, Brazil
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
| | - Áurea Maria Salomão Simão
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
| | - Joyce Veceli Barros Sobreira
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
- Faculty of Nursing, Universidade Federal do Maranhão, Sao Luis, Brazil
| | - Fernanda Baeninger Anbar
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
| | - Flávia Yarshell
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil
| | - Ana Beatriz Brandão
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
| | - Monica Queirós Estuque
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
| | - Juraci Aparecida Rocha
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
| | - Ricardo Tavares de Carvalho
- Department of Palliative Care, Hospital das Clínicas University of São Paulo Faculty of Medicine (HCFMUSP), Sao Paulo, Brazil
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Abd El-Moneam Ahmed S, Gaballah S. Conflict and communication gap among the critical care nurses during care of patients with COVID-19. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2023; 18:100499. [PMID: 36313002 PMCID: PMC9597530 DOI: 10.1016/j.ijans.2022.100499] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/19/2021] [Accepted: 10/21/2022] [Indexed: 11/05/2022] Open
Abstract
Background COVID-19 overwhelmed many countries' healthcare systems causing high levels of conflict amongst frontlines nurses. Aim Explore the conflict level and communication gap among the critical care nurses during care of patients with COVID-19. Subjects and methods A descriptive exploratory design was utilized on a convenience sample of (80) nurse working at the Critical Care Units affiliated to a specialized isolation hospital in Ismailia City, Egypt, from May to July 2020 using self-administered questionnaire to assess types of conflicts and Rahim Organizational Conflict Inventory-II to assess staff nurses' conflict resolution strategies. Results All the critical care nurses experienced conflict with significance level in female, due to recurrent contact with infected patients and fear of infection for themselves and their loved ones. Conclusion Around half of nurses (42.5%) had moderate conflict level, and collaborating was the most common used conflict resolution strategy. Recommendations Training in conflict resolution strategies during outbreaking terrorism as COVID- 19.
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Affiliation(s)
| | - Samia Gaballah
- Corresponding author at: 4.5 K Ring road, Faculty of Nursing, Suez Canal University, Ismailia, Egypt
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Meurisse M, Van Oyen H, Blot K, Catteau L, Serrien B, Klamer S, Cauët E, Robert A, Van Goethem N. Evaluating methodological approaches to assess the severity of infection with SARS-CoV-2 variants: scoping review and applications on Belgian COVID-19 data. BMC Infect Dis 2022; 22:839. [DOI: 10.1186/s12879-022-07777-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Differences in the genetic material of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may result in altered virulence characteristics. Assessing the disease severity caused by newly emerging variants is essential to estimate their impact on public health. However, causally inferring the intrinsic severity of infection with variants using observational data is a challenging process on which guidance is still limited. We describe potential limitations and biases that researchers are confronted with and evaluate different methodological approaches to study the severity of infection with SARS-CoV-2 variants.
Methods
We reviewed the literature to identify limitations and potential biases in methods used to study the severity of infection with a particular variant. The impact of different methodological choices is illustrated by using real-world data of Belgian hospitalized COVID-19 patients.
Results
We observed different ways of defining coronavirus disease 2019 (COVID-19) disease severity (e.g., admission to the hospital or intensive care unit versus the occurrence of severe complications or death) and exposure to a variant (e.g., linkage of the sequencing or genotyping result with the patient data through a unique identifier versus categorization of patients based on time periods). Different potential selection biases (e.g., overcontrol bias, endogenous selection bias, sample truncation bias) and factors fluctuating over time (e.g., medical expertise and therapeutic strategies, vaccination coverage and natural immunity, pressure on the healthcare system, affected population groups) according to the successive waves of COVID-19, dominated by different variants, were identified. Using data of Belgian hospitalized COVID-19 patients, we were able to document (i) the robustness of the analyses when using different variant exposure ascertainment methods, (ii) indications of the presence of selection bias and (iii) how important confounding variables are fluctuating over time.
Conclusions
When estimating the unbiased marginal effect of SARS-CoV-2 variants on the severity of infection, different strategies can be used and different assumptions can be made, potentially leading to different conclusions. We propose four best practices to identify and reduce potential bias introduced by the study design, the data analysis approach, and the features of the underlying surveillance strategies and data infrastructure.
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Arshadi Bostanabad M, Namdar Areshtanab H, Shabanloei R, Hosseinzadeh M, Hogan U, Brittain AC, Pourmahmood A. Clinical competency and psychological empowerment among ICU nurses caring for COVID-19 patients: A cross-sectional survey study. J Nurs Manag 2022; 30:2488-2494. [PMID: 35666638 PMCID: PMC9347934 DOI: 10.1111/jonm.13700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/15/2022] [Accepted: 06/01/2022] [Indexed: 12/01/2022]
Abstract
Aim This study aimed to determine clinical competency and psychological empowerment among ICU nurses caring for COVID‐19 patients. Background Nurses need clinical competency (skills pertaining to knowledge, reasoning, emotions and communication) and psychological empowerment (regard for one's organisational role and efforts) to deliver quality care. Methods This cross‐sectional study was conducted with 207 nurses working in ICUs in Iran. A clinical competency survey instrument consisting of basic demographic questions and the Spreitzer psychological empowerment questionnaire was completed online. Descriptive and inferential statistics were used to analyse the data in SPSS software version 13 to address the primary research question. Results There was a significant positive relationship between clinical competency and psychological empowerment (r = .55, p < .001). Clinical competency had a significant positive relationship with work experiences (r = .17, p = .01). Conclusion Clinical competency has been tied to nurse health and quality of care. Given the significant positive relationship between clinical competency and psychological empowerment, attention must be given to ways to psychologically empower nurses. Implications for Nursing Management Nursing managers can consider the promotion of psychological empowerment related to its significant positive relationship to clinical competency. Psychological empowerment can be bolstered through the promotion of servant leadership, organisational justice and empowering leadership practices.
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Affiliation(s)
- Mohammad Arshadi Bostanabad
- Department of Pediatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Namdar Areshtanab
- Department of Mental Health and Psychiatric Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Shabanloei
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Unarose Hogan
- Adjunct Faculty, Public Health Programme, School of Medicine, University of Limerick, Ireland
| | | | - Akram Pourmahmood
- Imam Reza General Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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7
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Cocker A, Singy P, Jox RJ. How should health care providers inform about palliative sedation? A qualitative study with palliative care professionals. Eur J Cancer Care (Engl) 2022; 31:e13602. [PMID: 35488398 PMCID: PMC9541839 DOI: 10.1111/ecc.13602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/24/2021] [Accepted: 04/18/2022] [Indexed: 11/30/2022]
Abstract
Objective In Switzerland, palliative sedation consists of using sedatives to relieve terminally ill patients. It is divided into several steps, with one of them consisting of informing patients and relatives about the procedure. In the current recommendations, there is a lack of orientation about how and when this discussion should take place. Hence, we aim to explore perceptions and experiences of palliative care professionals regarding these questions. Methods Qualitative semi‐structured interviews with five physicians and five nurses working in specialised palliative care were conducted. They were then analysed with thematic analysis. Results Results showed a uniformity around definition, goals and indications of palliative sedation. However, there was a lack of consistency regarding the process of delivering this information to patients and relatives. Finally, some participants strongly opposed the idea of systematically informing patients in specialised palliative care, while others were more divided on this question. Conclusion Despite a common understanding of the concept of palliative sedation, there is no standard practice when informing patients on palliative sedation among palliative care professionals. Therefore, this study demonstrates the need for further guidelines on this question and calls for a better understanding and knowledge of palliative sedation among health professionals outside palliative care.
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Affiliation(s)
- Allan Cocker
- Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Pascal Singy
- Liaison Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland
| | - Ralf J Jox
- Geriatric Palliative Care, CHUV, University of Lausanne, Lausanne, Switzerland.,Institute of Humanities in Medicine, CHUV, University of Lausanne, Lausanne, Switzerland
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8
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Updates on Palliative Medicine in the COVID-19 Era. J Clin Med 2022; 11:jcm11020315. [PMID: 35054011 PMCID: PMC8779552 DOI: 10.3390/jcm11020315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 12/25/2022] Open
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9
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Poggiali E, De Iaco F. The pain in the Emergency Department: Choosing and treating wisely before and during the COVID-19 era. EMERGENCY CARE JOURNAL 2021. [DOI: 10.4081/ecj.2021.9903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pain is a frequent reason for referral to the Emergency Department (ED). Adequate management of pain is a moral and ethical imperative. If not correctly treated, acute pain can cause physical and psychological complications, and become chronic with severe consequences such as anxiety, depression, and social isolation. As consequence, emergency clinicians should treat pain as soon as possible, avoiding delays even in case of acute abdominal pain. Pain management is particularly complex in the elderly and emergency clinicians should always consider AGS Beers criteria ® to avoid inappropriate medications, severe side-effects, and drug-drug interactions. Pain is also a common cause of delirium in older patients. The SARS CoV-2 infection not only can cause acute pain, but also exacerbate chronic pain, particularly in the elderly, who are at high risk to be infected. Looking at all this evidence, emergency clinicians should treat pain with different strategies according to their experience and cultural background, making the right choice for each patient. This work is a critical review of the pain management in the ED, with a particular attention on the effects of COVID-19 in the EDs. We conducted a systematic search of the following databases: PubMed, Google Scholar, Science Direct, Medline from 2000 to 2020, using the keywords of “pain”, “emergency”, “COVID19”, “elderly”, “palliative care”, “ketamine”, “dexmedetomidine”, and “post-traumatic stress disorder”. The aim of this review is to help emergency clinicians to correctly manage pain in the ED with a new point of view regarding the pain management in COVID-19 patients.
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Villa M, Balice-Bourgois C, Tolotti A, Falcó-Pegueroles A, Barello S, Luca EC, Clivio L, Biegger A, Valcarenghi D, Bonetti L. Ethical Conflict and Its Psychological Correlates among Hospital Nurses in the Pandemic: A Cross-Sectional Study within Swiss COVID-19 and Non-COVID-19 Wards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212012. [PMID: 34831768 PMCID: PMC8618535 DOI: 10.3390/ijerph182212012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022]
Abstract
Background: During the Covid-19 pandemic, nurses experienced increased pressure. Consequently, ethical concerns and psychological distress emerged. This study aimed to assess nurses’ ethical conflict, resilience and psychological impact, and compare these variables between nurses who worked in Covid-19 wards and nurses who did not. Methods: Design—Multicentre online survey. Setting—Multi-site public hospital; all nursing staff were invited to participate. The survey included validated tools and a novel instrument to assess ethical conflict. Spearman’s rho coefficient was used to assess correlations between ethical conflict and psychological distress, logistic regressions to evaluate relationships between nurses’ characteristics and outcome variables, and the Mann–Whitney/t-test to compare groups. Results: 548 questionnaires out of 2039 were returned (275 = Covid-19; 273 = non-Covid-19). We found a low–moderate level of ethical conflict (median = 111.5 [76–152]), which emerged mostly for seeing patients dying alone. A moderate and significant positive correlation emerged between ethical conflict and psychological distress rs (546) = 0.453, p < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96–13.01; p < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56–9.6; p < 0.001) showed higher ethical conflict. Resilience was a protective factor for ethical conflict. Conclusions: Ethical conflict was significantly linked to psychological distress, while a higher level of resilience was found to be a protective factor. These results can be informative for nursing management in future similar crises.
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Affiliation(s)
- Michele Villa
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900 Lugano, Switzerland;
| | - Colette Balice-Bourgois
- Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
| | - Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
- Correspondence:
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona (Spain), Campus Bellvitge, Pavelló de Govern, 3a planta, Despatx 331, Feixa Llarga, s/n L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Serena Barello
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy;
| | - Elena Corina Luca
- Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland;
| | - Luca Clivio
- ICT Data Science & Research Unit, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland;
| | - Annette Biegger
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzonal, Switzerland;
| | - Dario Valcarenghi
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
- Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
| | - Loris Bonetti
- Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
- Department of Business Economics, University of Applied Sciences and Arts of Southern Switzerland, Health and Social Care, Via Violino, 11, 6928 Manno, Switzerland
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Potenza L, Luppi M, Efficace F, Bruera E, Bandieri E. COVID-19 Pandemic and Cancer: The Importance of Early Palliative Care. Oncologist 2021; 26:e2094-e2096. [PMID: 33150691 PMCID: PMC8571746 DOI: 10.1002/onco.13587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/14/2020] [Indexed: 11/24/2022] Open
Abstract
In terms of clinical and ethical situations, this narrative compares the COVID‐19 pandemic to the cancer endemic and shares information that may be helpful to improve the management of both future pandemics and cancer care.
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Affiliation(s)
- Leonardo Potenza
- Hematology Unit, Azienda Ospedaliera Universitaria di ModenaModenaItaly
- Department of Medical and Surgical Sciences, University of Modena and Reggio EmiliaModenaItaly
| | - Mario Luppi
- Hematology Unit, Azienda Ospedaliera Universitaria di ModenaModenaItaly
- Department of Medical and Surgical Sciences, University of Modena and Reggio EmiliaModenaItaly
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research UnitRomeItaly
| | - Eduardo Bruera
- Palliative Care & Rehabilitation Medicine, University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Elena Bandieri
- Oncology and Palliative Care Units, Civil Hospital Carpi, Unità Sanitaria LocaleCarpiItaly
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Tark A, Kamalumpundi V, Song J, Chae S, Stone PW, Gilbertson-White S, Buck H. A Review of Web-Based COVID-19 Resources for Palliative Care Clinicians, Patients, and Their Caregivers. J Hosp Palliat Nurs 2021; 23:316-322. [PMID: 33605646 PMCID: PMC8265238 DOI: 10.1097/njh.0000000000000755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Palliative and end-of-life care has been pushed to the forefront of medical care during the pandemic caused by the coronavirus-2019 (COVID-19). Palliative care organizations have responded to the growing demand for the rapid dissemination of research, clinical guidance, and instructions for care to clinicians, patients with COVID-19, and their caregivers by creating COVID-19 resource Web pages. Here, end users can access resources that can be updated in real time. These Web pages, however, can be variable in what resources they offer and for whom they are designed for (clinicians, patients, caregivers). Therefore, this project was conducted to consolidate these resources via summary tables of specific contents available through each Web page grouped by palliative care domains (eg, care discussion and planning, communication, symptom management, care access) and to identify the target audience. This environmental scan was conducted by compiling a comprehensive list of COVID-19 resource Web pages of palliative care organizations generated by reviewing previously published research studies and consulting with palliative care research experts. Snowballing techniques were used to identify resource Web pages not captured in the initial scan. Two reviewers independently evaluated eligible Web pages for content via a form developed for the study, and Cohen κ statistic was calculated to ensure interrater reliability. The final κ statistic was 0.76. Of the 24 websites screened, 15 websites met our eligibility criteria. Among the eligible resource Web pages, most (n = 12, 80%) had specific target audiences and care settings, whereas the rest presented information targeted to all audiences. Although 11 Web pages offered resources that addressed all 4 domains, only 1 Web page conveyed all 12 subdomains. We recommend the use of this guide to all frontline clinicians who require guidance in clinically managing patients with COVID-19 receiving palliative care and/or end-of-life care.
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Stavroglou SK, Ayyub BM, Kallinterakis V, Pantelous AA, Stanley HE. A Novel Causal Risk-Based Decision-Making Methodology: The Case of Coronavirus. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:814-830. [PMID: 33448080 PMCID: PMC8013713 DOI: 10.1111/risa.13678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/10/2020] [Accepted: 12/21/2020] [Indexed: 05/08/2023]
Abstract
Either in the form of nature's wrath or a pandemic, catastrophes cause major destructions in societies, thus requiring policy and decisionmakers to take urgent action by evaluating a host of interdependent parameters, and possible scenarios. The primary purpose of this article is to propose a novel risk-based, decision-making methodology capable of unveiling causal relationships between pairs of variables. Motivated by the ongoing global emergency of the coronavirus pandemic, the article elaborates on this powerful quantitative framework drawing on data from the United States at the county level aiming at assisting policy and decision makers in taking timely action amid this emergency. This methodology offers a basis for identifying potential scenarios and consequences of the ongoing 2020 pandemic by drawing on weather variables to examine the causal impact of changing weather on the trend of daily coronavirus cases.
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Affiliation(s)
- Stavros K. Stavroglou
- Department of Econometrics and Business StatisticsMonash UniversityClaytonVIC3800Australia
| | - Bilal M. Ayyub
- Center for Technology and Systems ManagementUniversity of MarylandCollege ParkMD20742USA
| | | | | | - H. Eugene Stanley
- Department of Physics and Center for Polymer StudiesBoston UniversityBostonMA02215USA
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Kasnakova P, Ivanova S. Patient-centered approach to pharmaceutical care in the recovery of patients with post-Covid syndrome. PHARMACIA 2021. [DOI: 10.3897/pharmacia.68.e66727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The possibilities for pharmaceutical care in the recovery of patients with post-COVID syndrome in the context of a patient-centered approach have been explored. The global COVID-19 pandemic has necessitated a reorientation of the concept of providing healthcare to patients with COVID and post-COVID syndrome in patient-centered treatment and rehabilitation. Maximum recovery in holistic practice adopts a broader view of the patient’s health, disease and treatment process. Applying a patient-centered approach to patients who have had a coronavirus infection will lead to many benefits, both in terms of the quality of health and pharmaceutical care, and in increasing their satisfaction with their quality of life.
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15
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Nguyen AL, Davtyan M, Taylor J, Christensen C, Brown B. Perceptions of the Importance of Advance Care Planning During the COVID-19 Pandemic Among Older Adults Living With HIV. Front Public Health 2021; 9:636786. [PMID: 33614590 PMCID: PMC7892764 DOI: 10.3389/fpubh.2021.636786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/15/2021] [Indexed: 01/10/2023] Open
Abstract
Background: The importance of advance care planning (ACP) discussions have been heightened during the COVID-19 pandemic. We assessed advance directive completion, healthcare proxy (HCP), and attitudes toward ACP among older adults ages 50+ living with HIV during the COVID-19 pandemic. Methods: Internet-based surveys were administered to 100 participants residing in the Coachella Valley, California from April to June 2020. We examined self-reported completion of an advance directive, HCP, and attitudes toward ACP before and after COVID-19. Adjusted regressions were performed on attitudes toward ACP. Results: Participants' mean age was 64.2 years, most were non-Hispanic white (88.0%), men (96.0%), and identified as sexual minorities (96.0%). Many reported having an advance directive (59.6%) or HCP (67.3%). Most (57.6%) believed ACP to be more important now compared to the pre-pandemic era. Having an advance directive was associated with increase in age, higher education, living with other people, never having an AIDS diagnosis, and current undetectable viral load (p < 0.05). Having a HCP was associated with higher education, being married/partnered, and living with other people (p < 0.05). In a logistic regression model adjusted for education and living situation, the belief that ACP was more important during COVID was associated with not having an advance directive (OR: 5.07, 95% CI: 1.78-14.40) and fear of COVID-19 infection (OR: 4.17, 95% CI: 1.61-10.76.) Conclusions: The COVID-19 pandemic presents a window of opportunity to engage people aging with HIV in ACP discussions, particularly those who do not already have an advance directive.
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Affiliation(s)
- Annie L Nguyen
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Mariam Davtyan
- Department of Pediatrics, Maternal, Child and Adolescent/Adult Center for Infectious Diseases and Virology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jeff Taylor
- HIV + Aging Research Project-Palm Springs, Palm Springs, CA, United States
| | | | - Brandon Brown
- Department of Social Medicine, Population and Public Health, Riverside School of Medicine, University of California, Riverside, CA, United States
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16
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Dutra CCD, Rocha HS. Religious Support as a Contribution to Face the Effects of Social Isolation in Mental Health During the Pandemic of COVID-19. JOURNAL OF RELIGION AND HEALTH 2021; 60:99-111. [PMID: 33405093 PMCID: PMC7786321 DOI: 10.1007/s10943-020-01140-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 05/12/2023]
Abstract
Coping with the COVID-19 pandemic has required measures to contain the contagion, including social isolation. However, this and other factors have caused mental health problems, both in patients and health professionals and in family members or asymptomatic population. Religious support can be an ally for this type of confrontation. In the case of the COVID-19 pandemic, spiritual/religious care has been restricted and insufficient. When accessible to patients and frontline professionals, they are offered by virtual means, almost always by recorded media and made available in bulk. This essay argues, based on references in the areas of psychology, psychoneuroimmunology, biosafety, and military, that the face-to-face and personalized relationship between religious leaders, patients, health professionals, family members, and faith communities is as essential as possible for the dignified treatment victims, referral to spiritual needs and resilience of society, in addition to contributing to the improvement of the immune response of all. Practical examples are cited in the areas of military chaplaincy and hospital civilian chaplaincy. The essay also proposes the adoption of protocols already published by WHO and other safety measures such as the use of robotics and the recruitment/training of mass chaplains. In addition to contributing to the improvement of COVID-19 pandemic coping processes, the study also contributes to improving the delivery of spiritual/religious care as an ally to physical and mental, individual, and collective health.
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Affiliation(s)
- Cláunei C D Dutra
- Aerospace Sciences Postgraduate Program, Universidade da Força Aérea, Av. Marechal Fontenelle, 1000 - Campo dos Afonsos, Rio de Janeiro, RJ, 21740-002, Brazil
| | - Henrique S Rocha
- Aerospace Sciences Postgraduate Program, Universidade da Força Aérea, Av. Marechal Fontenelle, 1000 - Campo dos Afonsos, Rio de Janeiro, RJ, 21740-002, Brazil.
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17
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Practical nursing recommendations for palliative care for people with dementia living in long-term care facilities during the COVID-19 pandemic: A rapid scoping review. Int J Nurs Stud 2021; 113:103781. [PMID: 33080475 PMCID: PMC7526658 DOI: 10.1016/j.ijnurstu.2020.103781] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The acute nature of COVID-19 and its effects on society in terms of social distancing and quarantine regulations affect the provision of palliative care for people with dementia who live in long-term care facilities. The current COVID-19 pandemic poses a challenge to nursing staff, who are in a key position to provide high-quality palliative care for people with dementia and their families. OBJECTIVE To formulate practice recommendations for nursing staff with regard to providing palliative dementia care in times of COVID-19. DESIGN AND METHOD A rapid scoping review following guidelines from the Joanna Briggs Institute. Eligible papers focused on COVID-19 in combination with palliative care for older people or people with dementia and informed practical nursing recommendations for long-term care facilities. After data extraction, we formulated recommendations covering essential domains in palliative care adapted from the National Consensus Project's Clinical Practice Guidelines for Quality Palliative Care. DATA SOURCES We searched the bibliographic databases of PubMed, CINAHL and PsycINFO for academic publications. We searched for grey literature using the search engine Google. Moreover, we included relevant letters and editorials, guidelines, web articles and policy papers published by knowledge and professional institutes or associations in dementia and palliative care. RESULTS In total, 23 documents (7 (special) articles in peer-reviewed journals, 6 guides, 4 letters to editors, 2 web articles (blogs), 2 reports, a correspondence paper and a position paper) were included. The highest number of papers informed recommendations under the domains 'advance care planning' and 'psychological aspects of care'. The lowest number of papers informed the domains 'ethical care', 'care of the dying', 'spiritual care' and 'bereavement care'. We found no papers that informed the 'cultural aspects of care' domain. CONCLUSION Literature that focuses specifically on palliative care for people with dementia in long-term care facilities during the COVID-19 pandemic is still largely lacking. Particular challenges that need addressing involve care of the dying and the bereaved, and ethical, cultural and spiritual aspects of care. Moreover, we must acknowledge grief and moral distress among nursing staff. Nursing leadership is needed to safeguard the quality of care and nursing staff should work together within an interprofessional care team to initiate advance care planning conversations in a timely manner, to review and document advance care plans, and to adapt goals of care as they may change due to the COVID-19 situation. Tweetable abstract: The current COVID-19 pandemic affects people living with dementia, their families and their professional caregivers. This rapid scoping review searched for academic and grey literature to formulate practical recommendations for nursing staff working in long-term care facilities on how to provide palliative care for people with dementia in times of COVID-19. There is a particular need for grief and bereavement support and we must acknowledge grief and moral distress among nursing staff. This review exposes practice and knowledge gaps in the response to COVID-19 that reflect the longstanding neglect and weaknesses of palliative care in the long-term care sector. Nursing leadership is needed to safeguard the quality of palliative care, interprofessional collaboration and peer support among nursing staff.
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18
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Ferorelli D, Mandarelli G, Solarino B. Ethical Challenges in Health Care Policy during COVID-19 Pandemic in Italy. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E691. [PMID: 33322462 PMCID: PMC7764230 DOI: 10.3390/medicina56120691] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/28/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023]
Abstract
Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Italy has proven to be one of the countries with the highest coronavirus-linked death rate. To reduce the impact of SARS-CoV-2 coronavirus, the Italian Government decision-makers issued a series of law decrees that imposed measures limiting social contacts, stopped non-essential production activities, and restructured public health care in order to privilege assistance to patients infected with SARS-CoV-2. Health care services were substantially limited including planned hospitalization and elective surgeries. These substantial measures were criticized due to their impact on individual rights including freedom and autonomy, but were justified by the awareness that hospitals would have been unable to cope with the surge of infected people who needed treatment for COVID-19. The imbalance between the need to guarantee ordinary care and to deal with the pandemic, in a context of limited health resources, raises ethical concerns as well as clinical management issues. The emergency scenario caused by the COVID-19 pandemic, especially in the lockdown phase, led the Government and health care decision-makers to prioritize community safety above the individuals' rights. This new community-centered approach to clinical care has created tension among the practitioners and exposed health workers to malpractice claims. Reducing the morbidity and mortality rates of the COVID-19 pandemic is the priority of every government, but the legitimate question remains whether the policy that supports this measure could be less harmful for the health care system.
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Affiliation(s)
- Davide Ferorelli
- Interdisciplinary Department of Medicine, Section of Legal Medicine, University of Bari, Piazza Giulio, Cesare 11, 70100 Bari, Italy; (G.M.); (B.S.)
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19
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Mirfazeli FS, Faiz SHR, Shariati B, Rahimzadeh P, Kalantari S. Mental health care for hospitalized COVID-19 patients; an experience from Iran. Med J Islam Repub Iran 2020; 34:162. [PMID: 33816361 PMCID: PMC8004565 DOI: 10.47176/mjiri.34.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Seyed Hamid Reza Faiz
- Rasoul Akram Hospital Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
| | - Behnam Shariati
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Poupak Rahimzadeh
- Rasoul Akram Hospital Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Kalantari
- Antimicrobial Resistance Research Center, Iran University of Medical Sciences, Tehran, Iran
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20
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Dying patients with COVID-19: What should Hospital Palliative Care Teams (HPCTs) be prepared for? Palliat Support Care 2020; 18:382-384. [PMID: 32631469 PMCID: PMC7324302 DOI: 10.1017/s1478951520000450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The COVID-19 pandemic is a care crisis of unknown duration which has seemingly not yet reached its peak in many countries. A significant number of elderly and frail people and those with underlying serious illness will continue to develop severe forms of the COVID-19 infection. Most of them are not eligible for intensive care treatment but can still expect palliative care - in many cases provided by a Hospital Palliative Care Team (HPCT). Several teams have already gained experience in caring for these patients and their families, others are preparing for it. METHOD We report on a COVID-19 patient with pre-existing acute myeloid leukemia who was looked after by a HPCT until death. We discuss the challenges and difficulties while caring for COVID-19-positive palliative patients in a non-ICU setting. RESULTS Hospitalization of the patient in an isolation ward caused an enormous burden for the dying patient and his family. Symptom control was particularly difficult because of rapid deteriorating dyspnea and the scarce presence of medical staff in the patient's room. SIGNIFICANCE OF RESULTS COVID-19 patients who are not eligible for ICU treatment may have a particularly high need for palliative care. Since beds in specialist palliative care units are limited, the HPCT should be prepared to care for these patients. They may offer support in decision-making, optimize symptom control, and provide psychosocial care for patients and their families. Visiting restrictions aimed to protect the general public must be weighted against the patient's and family's suffering.
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21
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Al Thobaity A, Alshammari F. Nurses on the Frontline against the COVID-19 Pandemic: An Integrative Review. DUBAI MEDICAL JOURNAL 2020. [PMCID: PMC7490501 DOI: 10.1159/000509361] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
COVID-19 has affected the life and health of more than 1 million people across the world. This overwhelms many countries' healthcare systems, and, of course, affects healthcare providers such as nurses fighting on the frontlines to safeguard the lives of everyone affected. Exploring the issues that nurses face during their battle will help support them and develop protocols and plans to improve their preparedness. Thus, this integrative review will explore the issues facing nurses during their response to the COVID-19 crisis. The major issues facing nurses in this situation are the critical shortage of nurses, beds, and medical supplies, including personal protective equipment and, as reviews indicate, psychological changes and fears of infection among nursing staff. The implications of these findings might help to provide support and identify the needs of nurses in all affected countries to ensure that they can work and respond to this crisis with more confidence. Moreover, this will help enhance preparedness for pandemics and consider issues when drawing up crisis plans. The recommendation is to support the nurses, since they are a critical line of defense. Indeed, more research must be conducted in the field of pandemics regarding nursing.
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Affiliation(s)
- Abdullelah Al Thobaity
- Nursing Department, Applied Medical Sciences College, Ta'if University, Ta'if, Saudi Arabia
- *Abdullelah Al Thobaity, Nursing Department, Applied Medical Sciences Collage, Ta'if University, P.O. Box 888, Hawiyah, Ta'if (Saudi Arabia),
| | - Farhan Alshammari
- Medical-Surgical Department, College of Nursing, University of Ha'il, Ha'il, Saudi Arabia
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22
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Haydar A, Lo KB, Goyal A, Gul F, Peterson E, Bhargav R, DeJoy R, Salacup G, Pelayo J, Albano J, Azmaiparashvili Z, Ansari H, Aponte GP. Palliative Care Utilization Among Patients With COVID-19 in an Underserved Population: A Single-Center Retrospective Study. J Pain Symptom Manage 2020; 60:e18-e21. [PMID: 32454186 PMCID: PMC7255219 DOI: 10.1016/j.jpainsymman.2020.05.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND As health-care institutions mobilize resources to address the coronavirus disease 2019 (COVID-19) pandemic, palliative care may potentially be underutilized. It is important to assess the use of palliative care in response to the COVID-19 pandemic. METHODS This is a retrospective single-center study of patients with COVID-19 diagnosed via reverse transcriptase-polymerase chain reaction assay admitted between March 1, 2020, and April 24, 2020. An analysis of the utilization of palliative care in accordance with patient comorbidities and other characteristics was performed while considering clinical outcomes. Chi-square test was used to determine associations between categorical variables while t-tests were used to compare continuous variables. RESULTS The overall mortality rate was 21.5% (n = 52), and in 48% (n = 25) of these patients, palliative care was not involved. Fifty-nine percent (n = 24) of those who had palliative consults eventually elected for comfort measures and transitioned to hospice care. Among those classified as having severe COVID-19, only 40% (n = 31) had palliative care involvement. Of these patients with severe COVID-19, 68% (n = 52) died. Patients who got palliative care consults were of older age, had higher rates of intubation, a need for vasopressors, and were dead. CONCLUSION There was a low utilization rate of palliative care in patients with COVID-19. Conscious utilization of palliative care is needed at the time of COVID-19.
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Affiliation(s)
- Ali Haydar
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA.
| | - Kevin Bryan Lo
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Abhinav Goyal
- Department of Gastroenterology and Hepatology, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Fahad Gul
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Eric Peterson
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ruchika Bhargav
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Robert DeJoy
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Grace Salacup
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jerald Pelayo
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jeri Albano
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Zurab Azmaiparashvili
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Huma Ansari
- KeystoneCare Palliative Care, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA
| | - Gabriel Patarroyo Aponte
- Pulmonary and Critical Care and Sleep Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA; Sidney Kimmel College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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23
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Wallace CL, Wladkowski SP, Gibson A, White P. Grief During the COVID-19 Pandemic: Considerations for Palliative Care Providers. J Pain Symptom Manage 2020; 60:e70-e76. [PMID: 32298748 PMCID: PMC7153515 DOI: 10.1016/j.jpainsymman.2020.04.012] [Citation(s) in RCA: 320] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 11/22/2022]
Abstract
The COVID-19 pandemic is anticipated to continue spreading widely across the globe throughout 2020. To mitigate the devastating impact of COVID-19, social distancing and visitor restrictions in health care facilities have been widely implemented. Such policies and practices, along with the direct impact of the spread of COVID-19, complicate issues of grief that are relevant to medical providers. We describe the relationship of the COVID-19 pandemic to anticipatory grief, disenfranchised grief, and complicated grief for individuals, families, and their providers. Furthermore, we provide discussion regarding countering this grief through communication, advance care planning, and self-care practices. We provide resources for health care providers, in addition to calling on palliative care providers to consider their own role as a resource to other specialties during this public health emergency.
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Affiliation(s)
- Cara L Wallace
- School of Social Work, Saint Louis University, St. Louis, Missouri, USA.
| | | | - Allison Gibson
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Patrick White
- Division of Palliative Medicine, Department of Medicine, Washington University, St. Louis, Missouri, USA
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24
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Beyens MMJ, Verelst FR, Moorkens G, Twickler MT. Trials and tribulations of young residents fighting COVID-19. Eur J Clin Invest 2020; 50:e13336. [PMID: 32579706 PMCID: PMC7361137 DOI: 10.1111/eci.13336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Michiel Marcel Jozef Beyens
- Resident Internal Medicine, Faculty of Medicine and Health Sciences, Antwerp University Hospital, Antwerp University, Antwerp, Belgium.,AZ Monica, Deurne/Antwerp, Belgium
| | - Faro R Verelst
- Resident Internal Medicine, Faculty of Medicine and Health Sciences, Antwerp University Hospital, Antwerp University, Antwerp, Belgium.,AZ Monica, Deurne/Antwerp, Belgium
| | - Greta Moorkens
- Director of the Internal Medicine Residency Program, Faculty of Medicine and Health Sciences, Antwerp University Hospital, Antwerp University, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, Antwerp University Hospital, Antwerp University, Antwerp, Belgium
| | - Marcel ThB Twickler
- AZ Monica, Deurne/Antwerp, Belgium.,Department of Endocrinology, Diabetology and Metabolic Disease/Mentor training program Internal Medicine, AZ Monica, Antwerp/Deurne, Belgium
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25
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Celarier T, Lafaie L, Goethals L, Barth N, Gramont B, Ojardias E, Bongue B. Covid-19: Adapting the geriatric organisations to respond to the pandemic. Respir Med Res 2020; 78:100774. [PMID: 32563967 PMCID: PMC7289087 DOI: 10.1016/j.resmer.2020.100774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 12/28/2022]
Affiliation(s)
- T Celarier
- Department of Clinical Gerontology, University Hospital of Saint-Etienne, Saint-Etienne, France; Gérontopôle Auvergne Rhône-Alpes, Saint-Etienne, France; Chaire santé des Aînés, université Jean-Monnet, Saint-Etienne, France.
| | - L Lafaie
- Department of Clinical Gerontology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - L Goethals
- Chaire santé des Aînés, université Jean-Monnet, Saint-Etienne, France; SNA EPIS Laboratory EA 4607, université Jean-Monnet, Saint-Etienne, France
| | - N Barth
- Gérontopôle Auvergne Rhône-Alpes, Saint-Etienne, France; Chaire santé des Aînés, université Jean-Monnet, Saint-Etienne, France; SNA EPIS Laboratory EA 4607, université Jean-Monnet, Saint-Etienne, France
| | - B Gramont
- Department of Clinical Gerontology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - E Ojardias
- Department of Clinical Gerontology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - B Bongue
- Chaire santé des Aînés, université Jean-Monnet, Saint-Etienne, France; Support and Education Technic Centre of Health Examination Centres (CETAF), Saint-Etienne, France; SNA EPIS Laboratory EA 4607, université Jean-Monnet, Saint-Etienne, France
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26
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Will the COVID-19 Pandemic Change National Security and Healthcare in the Spectrum of Cardiovascular Disease? Curr Probl Cardiol 2020; 45:100645. [PMID: 32646545 PMCID: PMC7291989 DOI: 10.1016/j.cpcardiol.2020.100645] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/07/2020] [Indexed: 12/12/2022]
Abstract
COVID-19 pandemic changed the current state of healthcare, especially in terms of reorganization of resources. Chief complaints of patients admitted to hospitals changed drastically in the proceeding months, which worsened the treatment of many acute and chronic conditions involving cardiovascular system pathologies and resources were moved in order to fight COVID-19. Moreover, the pandemic had long-term effects not only on healthcare but also national security on global scale. The COVID-19 drastically changed perception of global health and safety, trust in healthcare professionals as well as patients’ willingness to seek medical help. The long-term effect of the epidemic, in terms of its impact cardiovascular disease progression and prognosis remain to be observed. The current paper discusses the impact of COVID-19 on healthcare and national security based on the currently available data.
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27
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Michels G, Heppner HJ. [Prioritization of geriatric patients in care homes and residential homes in the context of the COVID pandemic]. MMW Fortschr Med 2020; 162:48-51. [PMID: 32405839 PMCID: PMC7220613 DOI: 10.1007/s15006-020-0477-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Aus notfallmedizinischer Sicht sollten geriatrische Patienten in Pflege- und Seniorenheimen bereits vor einem „Massenanfall von infizierten Personen” eine Priorisierung auf der Basis des ACP(Advance Care Planning)-Konzepts erfahren.
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Affiliation(s)
- Guido Michels
- Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital gGmbH, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Str.8, D-52249, Eschweiler, Deutschland.
| | - Hans-Jürgen Heppner
- Institut für Biomedizin des Alterns, Universität Friedrich-Alexander-Universität Erlangen-Nürnberg und HELIOS Klinikum Schwelm, Schwelm, Deutschland
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28
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Salins N, Mani RK, Gursahani R, Simha S, Bhatnagar S. Symptom Management and Supportive Care of Serious COVID-19 Patients and their Families in India. Indian J Crit Care Med 2020; 24:435-444. [PMID: 32863637 PMCID: PMC7435102 DOI: 10.5005/jp-journals-10071-23400] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Coronavirus disease-19 (COVID-19) pandemic is causing a worldwide humanitarian crisis. Old age, comorbid conditions, end-stage organ impairment, and advanced cancer, increase the risk of mortality in serious COVID-19. A subset of serious COVID-19 patients with serious acute respiratory illness may be triaged not to receive aggressive intensive care unit (ICU) treatment and ventilation or may be discontinued from ventilation due to their underlying conditions. Those not eligible for aggressive ICU measures should receive appropriate symptom management. Early warning scores (EWS), oxygen saturation, and respiratory rate, can facilitate categorizing COVID-19 patients as stable, unstable, and end of life. Breathlessness, delirium, respiratory secretions, and pain, are the key symptoms that need to be assessed and palliated. Palliative sedation measures are needed to manage intractable symptoms. Goals of care should be discussed, and advance care plan should be made in patients who are unlikely to benefit from aggressive ICU measures and ventilation. For patients who are already in an ICU, either ventilated or needing ventilation, a futility assessment is made. If there is a consensus on futility, a family meeting is conducted either virtually or face to face depending on the infection risk and infection control protocol. The family should be sensitively communicated about the futility of ICU measures and foregoing life-sustaining treatment. Family meeting outcomes are documented, and consent for foregoing life-sustaining treatment is obtained. Appropriate symptom management enables comfort at the end of life to all serious COVID-19 patients not receiving or not eligible to receive ICU measures and ventilation. How to cite this article: Salins N, Mani RK, Gursahani R, Simha S, Bhatnagar S. Symptom Management and Supportive Care of Serious COVID-19 Patients and their Families in India. Indian J Crit Care Med 2020;24(6):435–444.
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Affiliation(s)
- Naveen Salins
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Mahe, Manipal, Karnataka, India
| | - Raj Kumar Mani
- Department of Critical Care and Pulmonology, Batra Hospital and Medical Research Centre, Delhi, India
| | - Roop Gursahani
- Department of Neurology, PD Hinduja National Hospital, Mumbai, Maharashtra, India
| | - Srinagesh Simha
- Department of Palliative Care, Karunashraya, Bengaluru, Karnataka, India
| | - Sushma Bhatnagar
- Department of Onco-anesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
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