1
|
Allsopp K, Varese F, French P, Young E, White H, Chung P, Davey J, Hassan AA, Wright SA, Barrett A, Bhutani G, McGuirk K, Shields G, Huntley F, Jordan J, Rowlandson A, Sarsam M, Ten Cate H, Walker H, Watson R, Willbourn J, Hind D. A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions. BMC Health Serv Res 2024; 24:430. [PMID: 38575960 PMCID: PMC10996192 DOI: 10.1186/s12913-024-10835-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND NHS England funded 40 Mental Health and Wellbeing Hubs to support health and social care staff affected by the COVID-19 pandemic. We aimed to document variations in how national guidance was adapted to the local contexts of four Hubs in the North of England. METHODS We used a modified version of Price's (2019) service mapping methodology. Service level data were used to inform the analysis. A mapping template was adapted from a range of tools, including the European Service Mapping Schedule, and reviewed by Hub leads. Key data included service model; staffing; and interventions. Data were collected between March 2021 - March 2022 by site research assistants. Findings were accuracy-checked by Hub leads, and a logic model developed to theorise how the Hubs may effect change. RESULTS Hub goals and service models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, and rapid access to mental health support (in-house and external). Implementation reflected a service context of a client group with high mental health need, and high waiting times at external mental health services. Hubs were predominantly staffed by experienced clinicians, to manage these mental health presentations and organisational working. Formulation-based psychological assessment and the provision of direct therapy were not core functions of the NHS England model, however all Hubs incorporated these adaptations into their service models in response to local contexts, such as extensive waiting lists within external services, and/or client presentations falling between gaps in existing service provision. Finally, a standalone clinical records system was seen as important to reassure Hub users of confidentiality. Other more nuanced variation depended on localised contexts. CONCLUSION This study provides a map for setting up services, emphasising early understandings of how new services will integrate within existing systems. Local and regional contexts led to variation in service configuration. Whilst additional Hub functions are supported by available literature, further research is needed to determine whether these functions should comprise essential components of staff wellbeing services moving forward. Future research should also determine the comparative effectiveness of service components, and the limits of permissible variation. STUDY REGISTRATION researchregistry6303.
Collapse
Affiliation(s)
- Kate Allsopp
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK.
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK.
| | - Filippo Varese
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - Paul French
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, Bonsall Street, Manchester, UK
- Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Ellie Young
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Hannah White
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK
| | - Priscilla Chung
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Jessica Davey
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Alysha A Hassan
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
| | - Sally-Anne Wright
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Alan Barrett
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
- School of Health Science, University of Salford, Mary Seacole Building, Frederick Road Campus, Broad St, Salford, UK
| | - Gita Bhutani
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Katherine McGuirk
- Greater Manchester Health and Social Care Partnership, 4th Floor, 3 Piccadilly Place, Manchester, UK
| | - Gemma Shields
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - Fay Huntley
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
- Doctorate of Clinical Psychology, School of Health in Social Science, Old Medical School, University of Edinburgh, Teviot Place, Room 2.2, Doorway 6, Edinburgh, UK
| | - Joanne Jordan
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Aleix Rowlandson
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - May Sarsam
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
| | - Hein Ten Cate
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Holly Walker
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Ruth Watson
- Greater Manchester Mental Health NHS Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester, M25 3BL, UK
| | - Jenni Willbourn
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Daniel Hind
- School of Health and Related Research, The Innovation Centre, University of Sheffield, 217 Portobello, Sheffield, UK
| |
Collapse
|
2
|
Vogt KS, Johnson J, Coleman R, Simms-Ellis R, Harrison R, Shearman N, Marran J, Budworth L, Horsfield C, Lawton R, Grange A. Can the Reboot coaching programme support critical care nurses in coping with stressful clinical events? A mixed-methods evaluation assessing resilience, burnout, depression and turnover intentions. BMC Health Serv Res 2024; 24:343. [PMID: 38491374 PMCID: PMC10941361 DOI: 10.1186/s12913-023-10468-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/12/2023] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Critical care nurses (CCNs) are routinely exposed to highly stressful situations, and at high-risk of suffering from work-related stress and developing burnout. Thus, supporting CCN wellbeing is crucial. One approach for delivering this support is by preparing CCNs for situations they may encounter, drawing on evidence-based techniques to strengthen psychological coping strategies. The current study tailored a Resilience-boosting psychological coaching programme [Reboot] to CCNs. Other healthcare staff receiving Reboot have reported improvements in confidence in coping with stressful clinical events and increased psychological resilience. The current study tailored Reboot for online, remote delivery to CCNs (as it had not previously been delivered to nurses, or in remote format), to (1) assess the feasibility of delivering Reboot remotely, and to (2) provide a preliminary assessment of whether Reboot could increase resilience, confidence in coping with adverse events and burnout. METHODS A single-arm mixed-methods (questionnaires, interviews) before-after feasibility study design was used. Feasibility was measured via demand, recruitment, and retention (recruitment goal: 80 CCNs, retention goal: 70% of recruited CCNs). Potential efficacy was measured via questionnaires at five timepoints; measures included confidence in coping with adverse events (Confidence scale), Resilience (Brief Resilience Scale), depression (PHQ-9) and burnout (Oldenburg-Burnout-Inventory). Intention to leave (current role, nursing more generally) was measured post-intervention. Interviews were analysed using Reflexive Thematic Analysis. RESULTS Results suggest that delivering Reboot remotely is feasible and acceptable. Seventy-seven nurses were recruited, 81% of whom completed the 8-week intervention. Thus, the retention rate was over 10% higher than the target. Regarding preliminary efficacy, follow-up measures showed significant increases in resilience, confidence in coping with adverse events and reductions in depression, burnout, and intention to leave. Qualitative analysis suggested that CCNs found the psychological techniques helpful and particularly valued practical exercises that could be translated into everyday practice. CONCLUSION This study demonstrates the feasibility of remote delivery of Reboot and potential efficacy for CCNs. Results are limited due to the single-arm feasibility design; thus, a larger trial with a control group is needed.
Collapse
Affiliation(s)
- K S Vogt
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK.
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK.
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Liverpool, L69 7ZA, UK.
| | - J Johnson
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK
- School of Population Health, University of New South Wales, Sydney, 2052, Australia
| | - R Coleman
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- School of Health and Wellbeing: College of Medical, Veterinary and Life Sciences, University of Glasgow, Clarice Pears Building, Glasgow, G12 8TB, UK
| | - R Simms-Ellis
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - R Harrison
- School of Population Health, University of New South Wales, Sydney, 2052, Australia
- Centre for Health Systems and Safety Research: Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - N Shearman
- Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS1 3EX, UK
- Mid Yorkshire Teaching NHS Trust, Wakefield, UK
| | - J Marran
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - L Budworth
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Yorkshire & Humber Patient Safety Research Collaboration, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - C Horsfield
- West Yorkshire Adult Critical Care Network, Leeds Teaching Hospitals, Leeds, UK
| | - R Lawton
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - A Grange
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
| |
Collapse
|
3
|
Bedoya Giraldo JD, Pulido Ángel J, García Valencia J, Aguirre Acevedo DC, Cardeño Castro CA. Factors associated with the intensity of anxiety and depression symptoms in health workers of two centres of reference for COVID 19 patient care in Antioquia, Colombia - A latent class analysis. Rev Colomb Psiquiatr (Engl Ed) 2023; 52:352-361. [PMID: 38008668 DOI: 10.1016/j.rcpeng.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/20/2021] [Indexed: 11/28/2023]
Abstract
OBJECTIVE To classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes. METHODS Cross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression. RESULTS 486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR = 0.94; 95%CI, 0.91-0.96), change of residence to avoid exposing relatives (OR = 4.01; 95%CI, 1.99-8.09), and a history of depressive disorder (OR = 3.10; 95%CI, 1.27-7.56), and anxiety (OR = 5.5; 95%CI, 2.36-12.90). Factors associated with class II were age (OR = 0.97; 95%CI, 0.95-0.99), history of depressive disorder (OR = 3.41; 95%CI, 1.60-7.25), living with someone at risk of death from COVID-19 (OR = 1.86; 95%CI, 1.19-2.91), family member being healthcare staff (OR = 1.58; 95%CI, 1.01-2.47), and change of residence to avoid exposing relatives (OR = 1.99; 95%CI, 1.11-3.59). CONCLUSIONS Three classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.
Collapse
Affiliation(s)
- Jesús David Bedoya Giraldo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia.
| | - Juliana Pulido Ángel
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Jenny García Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia; Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Carlos Alberto Cardeño Castro
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia; Hospital Universitario San Vicente Fundación, Medellín, Antioquia, Colombia
| |
Collapse
|
4
|
Gaines AF, Rangel TL, Freedberg R, Doucette S, Stengem D, Timmerman R, Roney J, Arenivar P, Patterson A, Long J, Sumner S, Bock D, Mendelson S, Saul T, West A, Leavitt RE, Colorafi K. Relationships Between Perceived Importance of Chaplain Presence and Health Professionals' Emotional Well-Being in the United States. J Relig Health 2023; 62:1546-1560. [PMID: 37010707 PMCID: PMC10068192 DOI: 10.1007/s10943-023-01809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
Hospital-based chaplains receive specialized training to provide spiritual support to patients and healthcare staff during difficult health transitions. However, the impact of perceived chaplain importance on healthcare staff's emotional and professional well-being is unclear. Healthcare staff (n = 1471) caring for patients in an acute care setting within a large health system answered demographic and emotional health questions in Research Electronic Data Capture (REDCap). Findings suggest that as perceived levels of chaplain importance increase, burnout may decrease and compassion satisfaction may improve. Chaplain presence in the hospital setting may support healthcare staff emotional and professional well-being following occupational stressors including COVID-19-related surges.
Collapse
Affiliation(s)
- Adam F Gaines
- Providence Sacred Heart Medical Center, Spiritual Care, 101 W 8th Ave, Spokane, WA, 99204, USA.
| | - Teresa L Rangel
- Professional Development, Providence Eastern Washington and Montana Region, Spokane, WA, USA
| | - Rachel Freedberg
- Neurology, Providence Sacred Heart Medical Center, Spokane, WA, USA
| | - Sheila Doucette
- Cardiology Services, Providence Portland Medical Center, Portland, OR, USA
| | - Danell Stengem
- Magnet Department, Providence St. Patrick Hospital, Missoula, MT, USA
| | - Rosemary Timmerman
- Professional Nursing Support Department, Providence Alaska Region, Anchorage, AK, USA
| | - Jamie Roney
- Nursing Research, Providence New Mexico and Texas Region, Lubbock, TX, USA
| | - Patrick Arenivar
- Cardiothoracic Surgery Telemetry Unit, Providence Covenant Medical Center, Lubbock, TX, USA
| | - Angela Patterson
- Pediatric Emergency Department, Providence Covenant Childrens Hospital, Lubbock, TX, USA
| | - JoAnn Long
- College of Nursing, Lubbock Christian University, Lubbock, TX, USA
| | - Sarah Sumner
- Intensive Care, Providence St. Joseph Health Medical Center-Burbank, Burbank, CA, USA
| | - Dawn Bock
- Professional Practice and Innovation, Santa Rosa Memorial Hospital, Santa Rosa, CA, USA
| | - Sherri Mendelson
- Nursing Research, Providence Holy Cross Hospital, Mission Hills, CA, USA
| | - Trisha Saul
- Professional Development, Providence Southern California Region, Irvine, CA, USA
| | - AnneMarie West
- Professional Development, Providence Oregon Region, Portland, OR, USA
| | - Robert E Leavitt
- Palliative Care, Providence Sacred Heart Medical Center, Spokane, WA, USA
| | - Karen Colorafi
- Professional Development, Providence-Gonzaga School of Anesthesia, Spokane, WA, USA
| |
Collapse
|
5
|
Jack FJG, Kotronoulas G. The Perceptions of Healthcare Staff Regarding Moral Injury and the Impact on Staff Life and Work During COVID-19: A Scoping Review of International Evidence. J Relig Health 2023:1-25. [PMID: 37027110 PMCID: PMC10080521 DOI: 10.1007/s10943-023-01803-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
The COVID-19 response introduced legal restrictions on social distancing globally, affecting healthcare staff personally and professionally. These restrictions suspended routine hospital visiting, which may have left staff feeling they had to compromise on the care they provided. Such conflict may be experienced as moral injury. This scoping review aimed to synthesise international evidence, to answer this question: "Have COVID-19 restrictions affected healthcare staff's experiences of moral injury? If so, how?" Nine studies met the search criteria. Although healthcare staff seemed to be aware of the risks and effects of moral injury, they were still reluctant to "name" it. Healthcare staff's own emotional and spiritual needs were mostly ignored. Although psychological support is often the recommended approach by organisations, a greater focus on spiritual and emotional support is recommended.
Collapse
Affiliation(s)
- Fiona J. G. Jack
- NHS Fife–Department of Spiritual Care, Queen Margaret Hospital, Whitefield Road, Dunfermline, Fife, KY12 OSU Scotland, UK
| | - Grigorios Kotronoulas
- School of Medicine Dentistry and Nursing, Nursing and Health Care School, College of Medical, Veterinary and Life Sciences, University of Glasgow, 57-61 Oakfield Avenue, Glasgow, G12 8LL Scotland, UK
| |
Collapse
|
6
|
Wainwright L, Senker S, Canvin K, Sheard L. "It was really poor prior to the pandemic. It got really bad after": A qualitative study of the impact of COVID-19 on prison healthcare in England. Health Justice 2023; 11:6. [PMID: 36749526 PMCID: PMC9903265 DOI: 10.1186/s40352-023-00212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The impact of COVID-19 has been exceptional, particularly on the National Health Service which has juggled COVID affected patients alongside related staff shortages and the existing (and growing) health needs of the population. In prisons too, healthcare teams have been balancing patient needs against staffing shortfalls, but with additional strains unique to the prison population. Such strains include drastic lockdown regimes and prolonged isolation, the need to consider health alongside security, known health inequalities within prisoner groups, and an ageing and ethnically diverse population (both groups disproportionately affected by COVID). The aim of this paper is to contribute to emerging research on the impact of COVID-19 on prison healthcare. METHODS We conducted 44 in depth interviews (over phone or video) across three groups: prison leavers, healthcare staff and decision makers, between July and December 2021. Framework analysis was undertaken. RESULTS Three themes were found. First, we found that Covid-19 had a significant impact on prison healthcare which involved reduced access and changes to how healthcare was delivered. This affected the health of prisoners by exacerbating existing conditions, new conditions being undiagnosed and mental health needs increasing. Second, the pandemic impacted on healthcare staff through creation of stress, frustration and exhaustion due to minimal staffing levels in an already under-resourced system. Third, an emerging conflict was witnessed. People in prison felt neglected regarding their healthcare needs but staff reported doing the best they could in an unprecedented situation. Healthcare staff and decision makers felt that prison healthcare was seen as a poor relation when compared with healthcare in the community, with no extra resource or staffing for Covid-19 testing or vaccinations. CONCLUSION The Covid-19 pandemic has significantly impacted almost all aspects of prison healthcare in the UK. This includes delivery of healthcare by staff, receipt of it by people in prison and the management, planning and commissioning of it by decision makers. These three groups of people were all affected detrimentally but in vastly different ways, with some participants describing a sense of trauma. Health needs that were exacerbated or went unmet during Covid urgently need to be addressed in order to reduce health inequalities. In order for welfare and wellbeing to be maintained, and in some cases repaired, both prisoners and staff need to feel heard and recognised.
Collapse
Affiliation(s)
- Lucy Wainwright
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Sarah Senker
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK
| | - Krysia Canvin
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Worsley Building, Leeds, LS2 9JT, UK
| | - Laura Sheard
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK.
| |
Collapse
|
7
|
Yolci A, Schenk L, Sonntag PT, Peppler L, Schouler-Ocak M, Schneider A. Observed and personally experienced discrimination: findings of a cross-sectional survey of physicians and nursing staff. Hum Resour Health 2022; 20:83. [PMID: 36494666 PMCID: PMC9733037 DOI: 10.1186/s12960-022-00779-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discrimination against hospital staff based on ascribed features is prevalent in healthcare systems worldwide. Detrimental effects on health and quality of patient care have been shown. Our study aims to describe and analyse the discrimination experiences of both physicians and nurses, specifically for the German hospital context. METHODS A cross-sectional online survey on observed and personally experienced discrimination at work addressed staff from 22 hospitals of two organizations in Germany. Sociodemographic and occupational as well as institutional characteristics served as independent variables. In multivariable analyses, block- and stepwise logistic regressions were calculated for the two dependent variables (witness and victim of discrimination). Sensitivity analyses with imputed data for missings were performed. RESULTS N = 800 healthcare professionals (n = 243 physicians, n = 557 nurses; response rate: 5.9%) participated in the survey. 305 respondents (38.1%) were witnesses of discrimination, while 108 respondents (13.5%) were victims of discrimination in their wards. Reasons for observed discriminatory acts were predominantly attributed to the ethnicity of the person concerned, their appearance and language, whereas personally affected staff most frequently cited gender as a reason, followed by ethnicity, and physical appearance. In multivariable models, cultural competence significantly increased the likelihood of witnessing discrimination (β = .575; p = .037). In terms of the likelihood of being a victim of discrimination, in addition to cultural competence (β = 2.838; p = < .001), the interaction of the effects of gender and professional group was statistically significant (β = .280; p = .010). CONCLUSIONS Given the extent of experienced and observed discrimination, appropriate institutional responses are needed. Further research on discriminatory structures in the German-speaking health care system should focus on discrimination at the intersection of ethnicity, gender and occupation.
Collapse
Affiliation(s)
- Arda Yolci
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Pia-Theresa Sonntag
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Lisa Peppler
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Germany
| | - Anna Schneider
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| |
Collapse
|
8
|
Mahat S, Rafferty AM, Vehviläinen-Julkunen K, Härkänen M. Negative emotions experienced by healthcare staff following medication administration errors: a descriptive study using text-mining and content analysis of incident data. BMC Health Serv Res 2022; 22:1474. [PMID: 36463187 PMCID: PMC9719256 DOI: 10.1186/s12913-022-08818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/09/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Medication errors regardless of the degree of patient harm can have a negative emotional impact on the healthcare staff involved. The potential for self-victimization of healthcare staff following medication errors can add to the moral distress of healthcare staff. The stigma associated with errors and their disclosure often haunts healthcare professionals, leading them to question their own professional competence. This paper investigates the negative emotions expressed by healthcare staff in their reported medication administration error incidents along with the immediate responses they received from their seniors and colleagues after the incident. METHOD This is a retrospective study using a qualitative descriptive design and text mining. This study includes free-text descriptions of medication administration error incidents (n = 72,390) reported to National Reporting & Learning System in 2016 from England and Wales. Text-mining by SAS text miner and content analysis was used to analyse the data. RESULTS Analysis of data led to the extraction of 93 initial codes and two categories i.e., 1) negative emotions expressed by healthcare staff which included 4 sub-categories of feelings: (i) fear; (ii) disturbed; (iii) sadness; (iv) guilt and 2) Immediate response from seniors and colleagues which included 2 sub-categories: (i) Reassurance and support and (ii) Guidance on what to do after an error. CONCLUSION Negative emotions expressed by healthcare staff when reporting medication errors could be a catalyst for learning and system change. However, negative emotions when internalized as fear, guilt, or self-blame, could have a negative impact on the mental health of individuals concerned, reporting culture, and opportunities for learning from the error. Findings from this study, hence, call for future research to investigate the impact of negative emotions on healthcare staff well-being and identify ways to mitigate these in practice.
Collapse
Affiliation(s)
- Sanu Mahat
- grid.9668.10000 0001 0726 2490Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1c, Kuopio, Finland
| | - Anne Marie Rafferty
- grid.13097.3c0000 0001 2322 6764King’s College London: Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, James Clerk Maxwell Building, 57 Waterloo Road, SE1 8WA London, UK
| | - Katri Vehviläinen-Julkunen
- grid.9668.10000 0001 0726 2490Department of Nursing Science, University of Eastern Finland, Kuopio, Yliopistonranta 1, 70210 Finland ,grid.410705.70000 0004 0628 207XKuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, Finland
| | - Marja Härkänen
- grid.9668.10000 0001 0726 2490Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1c, Kuopio, Finland
| |
Collapse
|
9
|
Hunt J, Gammon J, Williams S, Daniel S, Rees S, Matthewson S. Patient safety culture as a space of social struggle: understanding infection prevention practice and patient safety culture within hospital isolation settings - a qualitative study. BMC Health Serv Res 2022; 22:1446. [PMID: 36447284 PMCID: PMC9707411 DOI: 10.1186/s12913-022-08703-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/19/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In recent times, infection prevention and patient safety have become a global health policy priority with thought being given to understanding organisational culture within healthcare, and of its significance in initiating sustained quality improvement within infection prevention and patient safety. This paper seeks to explore the ways in which engagement of healthcare workers with infection prevention principles and practices, shape and inform patient safety culture within the context of hospital isolation settings; and vice-versa. RESEARCH METHODS In this paper, we utilise focus group interviews at two hospital sites within one health board in order to engage healthcare staff in elaborating on their understandings of infection prevention practices and patient safety culture within isolation settings in their organisation. Focus group transcripts were analysed inductively using thematic analysis in order to identify and develop emerging empirical themes. RESULTS Positioned against a background of healthcare restructuring and ever-increasing uncertainty, our study found two very different hospitals in regard to patient safety culture and infection prevention practice. While one hospital site embodies a mixed picture in regard to patient safety culture, the second hospital is best characterised as being highly fragmented. The utilisation of focus group interviews revealed themes that capture the ways in which interviewees position and understand the work they perform within the broader structural, political and cultural context, and what that means for infection prevention practice and patient safety culture. CONCLUSION Drawing on the insights of Bourdieu, this paper theorises the field of patient safety as a space of social struggle. Patient safety is thus positioned within its structural, cultural and political context, rather than as merely an epidemiological dilemma.
Collapse
Affiliation(s)
- Julian Hunt
- grid.4827.90000 0001 0658 8800Faulty of Medicine, Health and Life Sciences, Swansea University, Swansea, Wales UK
| | - John Gammon
- grid.4827.90000 0001 0658 8800Faulty of Medicine, Health and Life Sciences, Swansea University, Swansea, Wales UK
| | - Sharon Williams
- grid.4827.90000 0001 0658 8800Faulty of Medicine, Health and Life Sciences, Swansea University, Swansea, Wales UK
| | - Sharon Daniel
- grid.428852.10000 0001 0449 3568Hywel Dda University Health Board, Carmarthen, Wales UK
| | - Sue Rees
- grid.428852.10000 0001 0449 3568Hywel Dda University Health Board, Carmarthen, Wales UK
| | - Sian Matthewson
- grid.428852.10000 0001 0449 3568Hywel Dda University Health Board, Carmarthen, Wales UK
| |
Collapse
|
10
|
Gökalp K, Kemer AS. Mothers' and children's thoughts on COVID-19: A qualitative study. J Pediatr Nurs 2022; 67:38-43. [PMID: 35926292 PMCID: PMC9341397 DOI: 10.1016/j.pedn.2022.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE This study aimed to investigate the thoughts of preschool children and their mothers about COVID-19. DESIGN AND METHODS This qualitative study was descriptive phenomenology design. Data were collected and analyzed through individual interviews from 26 people (13 mothers and 13 children) using a Personal Information Form and an Interview Form.After the thematic analysis, four main themes were created for the children and their mothers. RESULTS The main themes created for mothers and children were: "Effects of the COVID-19 pandemic process, Protection, Family relations, Perspective of healthcare staff". The COVID-19 pandemic has affected the physical, psycho-social, and economic health, spirituality and family relationships of mothers. It became evident that children knew the terms related to the COVID-19 pandemic. Children dreamt of activities they missed and stated that at the end of the COVID-19 pandemic, they would go to the park, the pool, shopping centers, to school, and on vacation. Most of the mothers and children followed the rules of protection. In addition, mothers and children stated that their perspectives on healthcarestaff changed positively after the pandemic started. CONCLUSIONS Considering that COVID-19 affects individuals bio-psycho-socially, it is crucial for health professionals to know the thoughts of individuals, families and children about COVID-19 to increase their awareness of potential problems.
Collapse
Affiliation(s)
- Kübra Gökalp
- Department of Psychiatric Nursing, Nursing Faculty, Atatürk University, Erzurum, Turkey.
| | - Ayşegül Sarioglu Kemer
- Department of Emergency Aid and Disaster Management, School of Applied Sciences, Trabzon University, Trabzon, Turkey
| |
Collapse
|
11
|
Zeschick N, Warkentin L, Kühlein T, Steininger P, Überla K, Hueber S, Sebastião M. Active monitoring of adverse reactions following COVID-19 and other vaccinations: a feasibility study as part of the CoVaKo project. Pilot Feasibility Stud 2022; 8:134. [PMID: 35780172 PMCID: PMC9250275 DOI: 10.1186/s40814-022-01088-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Corona-Vakzin-Konsortium project (CoVaKo) analyses the efficacy and safety of COVID-19 vaccines in a real-world setting, as well as breakthrough infections in Bavaria, Germany. A subproject of CoVaKo aims to identify adverse reactions of the COVID-19 vaccine and compare these to adverse reactions of other vaccines in an online survey. In a preceding feasibility study, the study materials were tested for comprehensibility, visual design, and motivation to participate, as well as for their ability to be implemented and carried out in primary care practices and vaccination centres. Methods We used a mixed-methods research design. First, three focus groups consisting of general population participants were organised to evaluate the study materials and survey. Second, a test roll-out was conducted in vaccination centres and primary care practices that involved implementing and quantitatively evaluating the online survey. Third, interviews were conducted with participating general practitioners and heads of vaccination centres four weeks after the test roll-out. Results Parts of the information and registration form proved incomprehensible, specifically regarding the recruitment material and/or online survey. For example, headings were misleading given that, relative to other vaccinations, the COVID-19 vaccination was overemphasised in the title. Participants requested additional information regarding the procedure and completion time. Within 31 days, 2199 participants, who received either a COVID-19 vaccination (99%) or at least one of the control vaccinations (1%), registered for the study. Participants (strongly) agreed that the registration process was easy to understand, that the completion time was reasonable, and that the technical setup was straightforward. Physicians and heads of the vaccination centres perceived the study as easy to integrate into their workflow. The majority expressed willingness to participate in the main study. Conclusions Our study indicated that identifying and documenting adverse reactions following vaccinations using an online survey is feasible. Testing materials and surveys provided valuable insight, enabling subsequent improvements. Participation from health professionals proved essential in ensuring the practicality of procedures. Lastly, adapting the study’s organisation to external fluctuating structures and requirements confirmed necessary for a successful implementation, especially due to dynamic changes in the nation’s COVID-19 vaccination strategies. Trial registration The trial was retrospectively registered at the “Deutsches Register Klinischer Studien” (DRKS-ID: DRKS00025881) on Oct 14, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01088-y.
Collapse
Affiliation(s)
- Nikoletta Zeschick
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany.
| | - Lisette Warkentin
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Thomas Kühlein
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Susann Hueber
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Maria Sebastião
- Institute of General Practice, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| |
Collapse
|
12
|
Tezcan B, Eraydin C, Karabacak BG. Protective equipment-related pressure ulcers in healthcare workers during COVID-19 pandemic: A systematic review. J Tissue Viability 2022; 31:213-20. [PMID: 35210162 DOI: 10.1016/j.jtv.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/29/2022] [Accepted: 02/14/2022] [Indexed: 01/17/2023]
Abstract
AIM This systematic review was carried out to examine pressure ulcers in healthcare staff due to the use of protective equipment during COVID-19 pandemic and the precautions taken to prevent these injuries. METHOD Relevant studies were retrospectively searched. Seven English keywords identified from MESH were used while searching. The search was carried out in five international databases by trying various combinations of these words during February 15-25, 2021. This systematic review was updated by rescanning databases on December 20, 2021 and a total of 611 studies were attained. RESULTS 17 studies which met the study inclusion criteria, which were conducted mostly through online survey method in different study designs and which included a total of 24,889 healthcare professionals were examined. The incidence of PPE-related pressure ulcers was found to be between 30% and 92.8%. Grade I pressure ulcers were the most common (44.1%-82%). The incidence of skin problems except PPE-related pressure ulcers such as itching, redness and dry skin was found to be between 42.8-88.1%. Risk factors that frequently played a role in the development of PPE-related pressure ulcers and other skin problems were longer use of PPE and sweating. PPE-related pressure ulcers and other skin problems were more frequent over the nose (nasal bone/nasal bridge), ears, forehead and cheeks. PPE-related itching, redness and dry skin mostly occurred. Several dressing applications were found to be effective in the prevention of PPE-related pressure ulcers and other skin problems that might develop especially on the facial region. CONCLUSION PPE-related pressure ulcers and other skin problems were found to be higher among healthcare professionals. Data regarding the sealing of dressing applications against viral transmission in the prevention of PPE-related pressure ulcers and other skin problems are limited. It is estimated that future studies will be performed to prevent device-related pressure ulcers in healthcare workers. It is suggested that there is a need to conduct studies with larger samples where expert researchers make observations for pressure ulcers in order to determine the prevalence and incidence of PPE-related pressure ulcers.
Collapse
|
13
|
Cahill J, Kay A, Howard V, Mulcahy B, Forde M, George S, Ziampra E, Duffy F, Lacey G, Fitzpatrick F. Personal protective equipment training & lived experience for healthcare staff during COVID-19. Clin Infect Pract 2022; 14:100142. [PMID: 35345552 PMCID: PMC8941945 DOI: 10.1016/j.clinpr.2022.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/25/2022] [Accepted: 03/17/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives To describe the lived experience of healthcare staff during the Coronavirus Disease 2019 (COVID-19) pandemic relating to the use of personal protective equipment (PPE) and investigate risks associated with PPE use, error mitigation and acceptability of mindfulness incorporation into PPE practice. Methods A qualitative human factors' study at two Irish hospitals occurred in late 2020. Data was collected by semi-structured interview and included role description, pre-COVID-19 PPE experience, the impact of COVID-19 on lived experience, risks associated with PPE use, contributory factors to errors, error mitigation strategies and acceptability of incorporating mindfulness into PPE practice. Results Of 45 participants, 23 of whom were nursing staff (51%), 34 (76%) had previously worn PPE and 25 (56%) used a buddy system. COVID-19 lived experience impacted most on social life/home-work interface (n=36, 80%). Nineteen staff (42%) described mental health impacts. The most cited risk concerned 'knowledge of procedures' (n=18, 40%). Contributory factors to PPE errors included time (n=15, 43%) and staffing pressures (n=10, 29%). Mitigation interventions included training/education (n=12, 40%). The majority (n=35, 78%) supported mindfulness integration into PPE practice. Conclusions PPE training should address healthcare staff lived experiences and consider incorporation of mindfulness and key organisational factors contributing to safety.
Collapse
Affiliation(s)
- J Cahill
- School of Psychology, Trinity College Dublin, Ireland
| | - A Kay
- School of Psychology, Trinity College Dublin, Ireland
| | - V Howard
- School of Psychology, Trinity College Dublin, Ireland
| | | | - M Forde
- Bon Secours Hospital, Cork, Ireland
| | - S George
- Bon Secours Hospital, Cork, Ireland
| | - E Ziampra
- Department of Infection Prevention and Control, Beaumont Hospital, Dublin, Ireland
| | - F Duffy
- Department of Infection Prevention and Control, Beaumont Hospital, Dublin, Ireland
| | - G Lacey
- Surewash Ltd, Dublin, Ireland
- Department of Electronic Engineering, Maynooth University, Maynooth, Co Kildare, Ireland
| | - F Fitzpatrick
- Department of Microbiology, Beaumont Hospital, Dublin, Ireland
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
14
|
Vogt KS, Grange A, Johnson J, Marran J, Budworth L, Coleman R, Simms-Ellis R. Study protocol for the online adaptation and evaluation of the 'Reboot' (Recovery-boosting) coaching programme, to prepare critical care nurses for, and aid recovery after, stressful clinical events. Pilot Feasibility Stud 2022; 8:63. [PMID: 35300720 PMCID: PMC8927745 DOI: 10.1186/s40814-022-01014-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background Critical care nurses (CCNs) are routinely exposed to highly stressful events, exacerbated during the COVID-19 pandemic. Supporting resilience and wellbeing of CCNs is therefore crucial to prevent burnout. One approach for delivering this support is by preparing critical care nurses for situations they may encounter, drawing on evidence-based techniques to strengthen relevant psychological coping strategies. As such, the current study seeks to tailor a Resilience-boosting psychological coaching programme [Reboot] for CCNs, based on cognitive behavioural therapy (CBT) principles and the Bi-Dimensional Resilience Framework (BDF), and (1) to assess the feasibility of delivering Reboot via online, remote delivery to CCNs, and (2) to provide a preliminary assessment of whether Reboot could increase resilience and confidence in coping with adverse events. Methods Eighty CCNs (n=80) will be recruited to the 8-week Reboot programme, comprised of two group workshops and two individual coaching calls. The study uses a single-arm before-after feasibility study design and will be evaluated with a mixed-methods approach, using online questionnaires (all participants) and telephone interviews (25% of participants). Primary outcomes will be confidence in coping with adverse events (the Confidence scale) and resilience (the Brief Resilience Scale) measured at four time points. Discussion Results will determine whether it is feasible to deliver and evaluate a remote version of the Reboot coaching programme to CCNs, and will indicate whether participating in the programme is associated with increases in confidence in coping with adverse events, resilience and wellbeing (as indicated by levels of depression).
Collapse
Affiliation(s)
- K S Vogt
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK. .,Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK.
| | - A Grange
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - J Johnson
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK.,Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK.,School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, Australia
| | - J Marran
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - L Budworth
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - R Coleman
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - R Simms-Ellis
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK.,Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| |
Collapse
|
15
|
Morrow A, Walker K, Calder-MacPhee N, Ozakinci G. The active ingredients of physical activity and / or dietary workplace-based interventions to achieve weight loss in overweight and obese healthcare staff: a systematic review. J Behav Med 2022; 45:331-349. [PMID: 35132501 DOI: 10.1007/s10865-021-00279-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/27/2021] [Indexed: 01/14/2023]
Abstract
This systematic review aims to synthesize the active ingredients, and identify a list of promising behaviour change techniques (BCTs), likely to be present within physical activity and / or dietary interventions in achieving weight loss in overweight and obese healthcare staff. Four electronic databases were searched in February 2021: PsychINFO, CINAHL, PubMed and MEDLINE (no start date-2021). Studies were eligible for inclusion if they: (1) described a quasi-experimental or cluster, cohort or randomised control trial; (2) implemented workplace-based physical activity and / or dietary interventions versus a less intensive intervention or usual care; (3) targeted predominantly (> 50% of participants) overweight or obese healthcare professionals; and (4) reported a weight loss related outcome and included data on that outcome at least 3 months after the intervention began. Three reviewers used the Behaviour Change Technique Taxonomy v1 to extract BCTs with the aim of identifying a list of "promising" BCTs, which were those that were present in interventions that reported a statistically significant difference in weight loss. Nine studies were included in the review. The majority (n = 7) reported a significant reduction in weight post-intervention. A combined physical activity and dietary intervention (n = 8) was the most common type of intervention. Twenty-five BCTs were identified as "promising". Instruction on how to perform the behaviour (n = 9), behaviour practice/rehearsal (n = 8) and self-monitoring of behaviour (n = 6) were the most promising BCTs. The contents of behaviour change interventions are complex and rely on accurate reporting of intervention components and BCTs to allow concrete and robust assumptions to be made regarding which factors are most effective at achieving a desired outcome. Fundamentally the lack of research exploring the effectiveness of physical activity and dietary interventions on weight loss in overweight and obese healthcare staff and the poor quality of existing research, warrant more investigation.
Collapse
Affiliation(s)
- Alison Morrow
- NHS Fife, Cameron House, Windygates, Leven, Fife, KY8 5RG, Scotland.
| | - Kimberley Walker
- Iona Hub, The State Hospital, Carstairs, Lanark, ML11 8RP, Scotland
| | | | - Gozde Ozakinci
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland
| |
Collapse
|
16
|
Woodhead C, Stoll N, Harwood H, Alexis O, Hatch SL. "They created a team of almost entirely the people who work and are like them": A qualitative study of organisational culture and racialised inequalities among healthcare staff. Sociol Health Illn 2022; 44:267-289. [PMID: 34866199 PMCID: PMC7614856 DOI: 10.1111/1467-9566.13414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/06/2021] [Accepted: 11/11/2021] [Indexed: 06/13/2023]
Abstract
Racially and ethnically minoritised healthcare staff groups disproportionately experience and witness workplace discrimination from patients, colleagues and managers. This is visible in their under-representation at senior levels and over-representation in disciplinary proceedings and is associated with adversities such as greater depression, anxiety, somatic symptoms, low job satisfaction and sickness absence. In the UK, little progress has been made despite the implementation of measures to tackle racialised inequities in the health services. So, what is it about the health service organisational context which shapes and maintains such inequities, and what role does discrimination, bullying and harassment play? Drawing on qualitative interviews with 48 healthcare staff in London (UK), we identify how micro-level bullying, prejudice, discrimination and harassment behaviours, independently and in combination, exploit and maintain meso-level racialised hierarchies. Within teams, the high diversity-low inclusion dynamic shaped and was perpetuated by in- and outgroup inclusion and exclusion processes (including "insidious dismissal") often employing bullying or microaggressions. These were linked to intersecting factors, such as race, ethnicity, migration, language and religion, and could increase segregation. For racially and ethnically minoritised groups, ingroup maintenance, moving teams or leaving were also ways of coping with organisational inequities. We discuss implications for tackling racialised workplace inequities.
Collapse
Affiliation(s)
- Charlotte Woodhead
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Nkasi Stoll
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Hannah Harwood
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Obrey Alexis
- Department of Nursing, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| |
Collapse
|
17
|
Singh L, Kanstrup M, Gamble B, Geranmayeh A, Göransson KE, Rudman A, Dahl O, Lindström V, Hörberg A, Holmes EA, Moulds ML. A first remotely-delivered guided brief intervention to reduce intrusive memories of psychological trauma for healthcare staff working during the ongoing COVID-19 pandemic: Study protocol for a randomised controlled trial. Contemp Clin Trials Commun 2022; 26:100884. [PMID: 35036626 PMCID: PMC8752164 DOI: 10.1016/j.conctc.2022.100884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/26/2021] [Accepted: 01/07/2022] [Indexed: 01/10/2023] Open
Abstract
Addressing the mental health needs of healthcare staff exposed to psychologically traumatic events at work during the COVID-19 pandemic is a pressing global priority. We need to swiftly develop interventions to target the psychological consequences (e.g., persistent intrusive memories of trauma). Interventions for healthcare staff must be brief, flexible, fitted around the reality and demands of working life under the pandemic, and repeatable during ongoing/further trauma exposure. Intervention delivery during the pandemic should be remote to mitigate risk of infection; e.g., here using a blend of digitalized self-administered materials (e.g., video instructions) and guided (remote) support from a researcher. This parallel groups, two-arm, randomised controlled trial (RCT) with healthcare staff working during the COVID-19 pandemic is the first evaluation of whether a digitalized form of a brief cognitive task intervention, which is remotely-delivered (guided), reduces intrusive memories. Healthcare staff who experience intrusive memories of work-related traumatic event(s) during the COVID-19 pandemic (≥2 in the week before inclusion) will be randomly allocated (1:1) to receive either the cognitive task intervention or an active (attention placebo) control, and followed up at 1-week, 1-month, 3-months, and 6-months post-intervention. The primary outcome will be the number of intrusive memories reported during Week 5; secondary and other outcomes include the number of intrusive memories reported during Week 1, and other intrusive symptoms. Findings will inform further development and dissemination of a brief cognitive task intervention to target intrusive memories.
Collapse
Affiliation(s)
- Laura Singh
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Swedish Collegium for Advanced Study, Uppsala, Sweden
| | - Marie Kanstrup
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Functional Area Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | - Beau Gamble
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Anahita Geranmayeh
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katarina E Göransson
- Emergency and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Ann Rudman
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Oili Dahl
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Veronica Lindström
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department for Health Promoting Science Sophiahemmet University Stockholm, Sweden.,Samariten, Ambulance Stockholm, Sweden
| | - Anna Hörberg
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michelle L Moulds
- School of Psychology, The University of New South Wales, UNSW Sydney, Australia
| |
Collapse
|
18
|
Giraldo JDB, Ángel JP, Valencia JG, Acevedo DCA, Castro CAC. [Factors associated with the intensity of anxiety and depression symptoms in health workers of two centres of reference for COVID 19 patient care in Antioquia, Colombia - a latent class analysis]. Rev Colomb Psiquiatr 2021; 52:S0034-7450(21)00147-5. [PMID: 34658447 PMCID: PMC8511653 DOI: 10.1016/j.rcp.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/20/2021] [Indexed: 06/13/2023]
Abstract
Objective: To classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes.Methods:Cross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression.Results: 486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR=0.94; 95%CI, 0.91-0.96), change of residence to avoid exposing relatives (OR=4.01; 95%CI, 1.99-8.09), and a history of depressive disorder (OR=3.10; 95%CI, 1.27-7.56), and anxiety (OR=5.5; 95%CI, 2.36-12.90). Factors associated with class II were age (OR=0.97; 95%CI, 0.95-0.99), history of depressive disorder (OR=3.41; 95%CI, 1.60-7.25), living with someone at risk of death from COVID-19 (OR=1.86; 95%CI, 1.19-2.91), family member being healthcare staff (OR=1.58; 95%CI, 1.01-2.47), and change of residence to avoid exposing relatives (OR=1.99; 95%CI, 1.11-3.59).Conclusions: Three classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.
Collapse
Affiliation(s)
| | - Juliana Pulido Ángel
- Hospital Universitario San Vicente Fundación, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Jenny García Valencia
- Instituto de Investigaciones Médicas, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Daniel Camilo Aguirre Acevedo
- Instituto de Investigaciones Médicas, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Alberto Cardeño Castro
- Hospital Universitario San Vicente Fundación, Universidad de Antioquia, Medellín, Antioquia, Colombia
- Instituto de Investigaciones Médicas, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| |
Collapse
|
19
|
Tasdemir Yigitoglu G, Yilmaz A, Yilmaz H. The effect of Covid-19 on sleep quality, anxiety and depression on healthcare staff at a tertiary hospital in Turkey. Arch Psychiatr Nurs 2021; 35:504-10. [PMID: 34561066 DOI: 10.1016/j.apnu.2021.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/30/2021] [Accepted: 07/03/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The Covid-19 pandemic has forced healthcare staff into an unprecedented situation, such as making tough decisions and practising under enormous pressure. AIM This study was designed to investigate the effect of Covid-19 on sleep quality, anxiety and depression in healthcare staff at a tertiary hospital. METHODS This descriptive and cross-sectional study recruited healthcare staff working at a tertiary hospital. Those who had given their informed consent participated in this study between April 17 and May 17, 2020. Data were collected using the introductory information form, the Pittsburg Sleep Quality Index (PSQI), and the Hospital Anxiety Depression Scale (HADS). The data were then analyzed on the Statistical Package for the Social Sciences (SPSS) v.24. RESULTS The mean scores of the respondents derived from the HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scales were 7.89 ± 4.60 and 7.22 ± 4.13, respectively. Their depression levels were established to be at risk, though their anxiety levels were not. The mean PSQI score turned out to be 8.42 ± 2.30 for the participants, most of whom (92.9%) experienced poor sleep quality. Total sleep quality of the respondents exhibited a moderate positive correlation with HADS-A scores and a weak positive correlation with HADS-D scores (p < 0.05). CONCLUSION Our major conclusion from the collected data is that healthcare staff suffered from poor sleep quality, and that their depression levels, but not anxiety levels, were at risk. Providing appropriate information about the health care of patients diagnosed with Covid-19 as well as offering regular psychoeducation-psychological support services and resting areas can reduce the susceptibility of healthcare staff to anxiety and depression and improve their overall sleep quality.
Collapse
|
20
|
Jovarauskaite L, Dumarkaite A, Truskauskaite-Kuneviciene I, Jovaisiene I, Andersson G, Kazlauskas E. Internet-based stress recovery intervention FOREST for healthcare staff amid COVID-19 pandemic: study protocol for a randomized controlled trial. Trials 2021; 22:559. [PMID: 34419114 PMCID: PMC8380103 DOI: 10.1186/s13063-021-05512-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The demand for care during the COVID-19 pandemic has affected the mental health of healthcare workers (HCWs), thus increasing the need for psychosocial support services. Internet-based interventions have previously been found to reduce occupational stress. The study aims to test the effects of an Internet-based stress recovery intervention-FOREST-among HCWs. METHODS A randomized controlled trial (RCT) parallel group design with three measurement points will be conducted to assess the efficacy of an Internet-based stress recovery intervention FOREST for nurses. The FOREST intervention is a 6-week Internet-based CBT and mindfulness-based program which comprises of six modules: (1) Introduction, (2) Detachment (relaxation and sleep), (3) Distancing, (4) Mastery (challenge), (5) Control, and (6) Keeping the change alive. We will compare the intervention against a waiting list group at pre-test, post-test, and follow-up. Stress recovery, PTSD, complex PTSD, moral injury, the level of stress, depression, anxiety, and psychological well-being will be measured. DISCUSSION The study will contribute to the development of mental healthcare programs for the HCWs. Based on the outcomes of the study, the FOREST intervention can be further developed or offered to healthcare staff as a tool to cope with occupational stress. TRIAL REGISTRATION ClinicalTrials.gov NCT04817995 . Registered on 30 March 2021.
Collapse
Affiliation(s)
- Lina Jovarauskaite
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania.
| | - Austeja Dumarkaite
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania
| | - Inga Truskauskaite-Kuneviciene
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania
| | - Ieva Jovaisiene
- Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio Str. 21, LT-03101, Vilnius, Lithuania
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania
| |
Collapse
|
21
|
Zhou Y, Zhou Y, Song Y, Ren L, Ng CH, Xiang YT, Tang Y. Tackling the mental health burden of frontline healthcare staff in the COVID-19 pandemic: China's experiences. Psychol Med 2021; 51:1955-1956. [PMID: 32398180 PMCID: PMC7417977 DOI: 10.1017/s0033291720001622] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Yifang Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yuning Zhou
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yanzhuo Song
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Luyu Ren
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| |
Collapse
|
22
|
González-Plaza E, Polo Velasco J, Rodríguez Berenguer S, Giménez Peñalba Y, Javierre Mateos A, Arranz Betegón Á, Massó Cros R. [Anxiety level of the healthcare workers of an obstetric unit during the COVID-19 pandemic]. Clin Invest Ginecol Obstet 2022; 49:100704. [PMID: 34230736 DOI: 10.1016/j.gine.2021.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/28/2021] [Indexed: 11/22/2022]
Abstract
Background Work-related stress, fear of becoming infected, and the lack of means to combat the COVID-19 pandemic, added to the situation of lockdown at home could lead to a strong impact on mental health.The objective was to determine the level of anxiety through the State-Trait Anxiety Inventory, STAI completed by the professionals of a delivery room who treated COVID-19-positive pregnant women. Material and methods Descriptive cross-sectional study in an obstetric area in Barcelona from March 14th to May 24th, 2020. Study population: healthcare staff over 18 years old, without diagnosed anxiety disorders prior to the pandemic.The main parameters to study were the level of «state anxiety» and «trait anxiety» according to the STAI questionnaire.Descriptive and inferential statistics were performed. The level of statistical significance used was p<.05. Results Seventy-seven professionals participated in this study.The mean score for «state anxiety» was 26.3 points (p-value = .067) and for «strait anxiety», 14.3 points (p-value = .091).It was observed that the professionals who had children (p-value = .048) and the professionals who stated that their family economic income had decreased (p-value = .026) showed higher average scores of «state anxiety». A positive association was observed between years of working experience and the level of «state anxiety», observing statistically significant differences, p-value = .030. Conclusions The professionals who had suffered a reduction in their income together with those who lived with children presented higher scores of «state anxiety».
Collapse
|
23
|
Bayraktar M, Kaya E, Ozturk A, İbahim BMS. Antimicrobial susceptibility of bacterial pathogens isolated from healthcare workers' cellphones. Infect Dis Now 2021; 51:596-602. [PMID: 34091094 DOI: 10.1016/j.idnow.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/07/2021] [Accepted: 05/27/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate bacterial isolates, antibiotic susceptibility, and disease transmission risk in healthcare workers using cellphones. METHODS A total of 70 cellphones were received from the hospital staff. Samples were collected from the phones with a sterile cotton swab moistened with physiological saline solution. Samples were inoculated in a bacteriological culture medium and incubated at 37.5°C for 24-48hours. Identification of microorganisms was performed by traditional methods and VITEK 2 device. Kirby-Bauer disk diffusion method was used to determine antibiotic susceptibility. RESULTS A total of 26 species and 170 microorganisms were isolated from 66 cellphones from which bacterial growths were obtained: coagulase-negative staphylococci (n=63, 37%) (most commonly Staphylococcus epidermidis: 25/63), Micrococcus luteus (n=25, 14.7%), Tetracoccus (n=24, 14.1%), Kocuria spp. (n=24, 14.1%), Corynebacterium diphtheriae (n=7, 4.1%), Leuconostoc mesenteroides (n=5, 3.0%), S. aureus (n=4, 2.3%), Enterococcus spp. (n=5, 2.9%), Acinetobacter spp. (n=7, 4.1%), Klebsiella pneumoniae (n=2, 1.2%), Actinomyces spp. (n=1, 0.6%), Pseudomonas aeruginosa (n=1, 0.6%), Morganella morganii (n=1, 0.6%), and Alcaligenes faecalis (n=1, 0.6%). Gram-positive isolates were all susceptible to the antibiotics used, whereas Gram-negative isolates were all resistant to ceftazidime. CONCLUSION Hands and/or cellphones of healthcare staff can be contaminated with various types of microorganisms. We recommend proper hand washing and disinfection to prevent bacterial pathogens spread within the hospital.
Collapse
|
24
|
Marconi E, Chiesa S, Dinapoli L, Lepre E, Tagliaferri L, Balducci M, Frascino V, Casà C, Chieffo DPR, Gambacorta MA, Valentini V. A radiotherapy staff experience of gratitude during COVID-19 pandemic. Tech Innov Patient Support Radiat Oncol 2021; 18:32-34. [PMID: 33969234 PMCID: PMC8096377 DOI: 10.1016/j.tipsro.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023] Open
Abstract
• Medical staff from oncology units are at high risk of burnout during COVID-19 pandemic. • The sense of belonging to the group and the contacting emotions play a central role in reducing these risks. • Gratitude is related to well-involving people who practice and receive it. • During lockdown, we adopted gratitude-focused “inter-group contact” tool.
Collapse
Affiliation(s)
- Elisa Marconi
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Loredana Dinapoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Corresponding author at: Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8 (RM) 00168 Roma, Italy.
| | | | - Luca Tagliaferri
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Mario Balducci
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - Vincenzo Frascino
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Calogero Casà
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | | | - Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
| |
Collapse
|
25
|
Robbins T, Kyrou I, Laird S, Morgan N, Anderson N, Imray C, Patel K, Sankar S, Randeva H, Jones C. Healthcare staff perceptions and misconceptions regarding antibody testing in the United Kingdom: implications for the next steps for antibody screening. J Hosp Infect 2020; 111:102-106. [PMID: 33309938 PMCID: PMC7834281 DOI: 10.1016/j.jhin.2020.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Healthcare workers have been at increased risk of exposure, infection and serious complications from COVID-19. Antibody testing has been used to identify staff members who have been previously infected by SARS-CoV-2, and has been rolled out rapidly in the United Kingdom. A number of comment and editorial articles have been published that raise concerns about antibody testing in this context. We present perceptions of National Health Service (NHS) healthcare workers in relation to SARS-CoV-2 antibody testing. METHODS An electronic survey regarding perceptions towards SARS-CoV-2 antibody testing was distributed to all healthcare workers at a major NHS tertiary hospital following implementation of antibody testing. RESULTS In total, 560 healthcare workers completed the survey (80% female; 25% of Black and Minority Ethnic background; 58% from frontline clinical staff). Exploring whether they previously had COVID-19 was the primary reported reason for choosing to undergo antibody testing (85.2%). In case of a positive antibody test, 72% reported that they would feel relieved, whilst 48% felt that they would be happier to work in a patient-facing area. Moreover, 12% responded that a positive test would mean "social distancing is less important", with 34% of the responders indicating that in this case they would be both less likely to catch COVID-19 and happier to visit friends/relatives. CONCLUSIONS NHS staff members primarily seek out SARS-CoV-2 antibody testing for an appropriate reason. Based on our findings and given the lack of definite data regarding the extent of immunity protection from a positive SARS-CoV-2 antibody test, significant concerns may be raised regarding the reported interpretation by healthcare workers of positive antibody test results. This needs to be further explored and addressed to protect NHS staff and patients.
Collapse
Affiliation(s)
- T Robbins
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK.
| | - I Kyrou
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - S Laird
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - N Morgan
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - N Anderson
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - C Imray
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - K Patel
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - S Sankar
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - H Randeva
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - C Jones
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| |
Collapse
|
26
|
Kantele A, Lääveri T, Kareinen L, Pakkanen SH, Blomgren K, Mero S, Patjas A, Virtanen J, Uusitalo R, Lappalainen M, Järvinen A, Kurkela S, Jääskeläinen AJ, Vapalahti O, Sironen T. SARS-CoV-2 infections among healthcare workers at Helsinki University Hospital, Finland, spring 2020: Serosurvey, symptoms and risk factors. Travel Med Infect Dis 2020; 39:101949. [PMID: 33321195 PMCID: PMC7833655 DOI: 10.1016/j.tmaid.2020.101949] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 12/12/2022]
Abstract
Background Exposure, risks and immunity of healthcare workers (HCWs), a vital resource during the SARS-CoV-2 pandemic, warrant special attention. Methods HCWs at Helsinki University Hospital, Finland, filled in questionnaires and provided serum samples for SARS-CoV-2-specific antibody screening by Euroimmun IgG assay in March–April 2020. Positive/equivocal findings were confirmed by Abbott and microneutralization tests. Positivity by two of the three assays or RT-PCR indicated a Covid-19 case (CoV+). Results The rate of CoV(+) was 3.3% (36/1095) and seropositivity 3.0% (33/1095). CoV(+) was associated with contact with a known Covid-19 case, and working on a Covid-19-dedicated ward or one with cases among staff. The rate in the Covid-19-dedicated ICU was negligible. Smoking and age <55 years were associated with decreased risk. CoV(+) was strongly associated with ageusia, anosmia, myalgia, fatigue, fever, and chest pressure. Seropositivity was recorded for 89.3% of those with prior documented RT-PCR-positivity and 2.4% of those RT-PCR-negative. The rate of previously unidentified cases was 0.7% (8/1067) and asymptomatic ones 0% (0/36). Conclusion Undiagnosed and asymptomatic cases among HCWs proved rare. An increased risk was associated with Covid-19-dedicated wards. Particularly high rates were seen for wards with liberal HCW-HCW contacts, highlighting the importance of social distancing also among HCWs.
Collapse
Affiliation(s)
- Anu Kantele
- Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Finland; Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Finland; Meilahti Vaccine Research Center, MeVac, Helsinki University Hospital and University of Helsinki, Finland.
| | - Tinja Lääveri
- Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Finland
| | - Lauri Kareinen
- Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Finland; Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Sari H Pakkanen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Finland; Meilahti Vaccine Research Center, MeVac, Helsinki University Hospital and University of Helsinki, Finland
| | - Karin Blomgren
- Meilahti Vaccine Research Center, MeVac, Helsinki University Hospital and University of Helsinki, Finland
| | - Sointu Mero
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Finland
| | - Anu Patjas
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Finland; Meilahti Vaccine Research Center, MeVac, Helsinki University Hospital and University of Helsinki, Finland
| | - Jenni Virtanen
- Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Finland; Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Ruut Uusitalo
- Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Finland; Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland; Department of Geosciences and Geography, Faculty of Science, University of Helsinki, Finland
| | - Maija Lappalainen
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Asko Järvinen
- Infectious Diseases, Inflammation Center, Helsinki University Hospital and University of Helsinki, Finland
| | - Satu Kurkela
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Anne J Jääskeläinen
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Olli Vapalahti
- Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Finland; Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland; HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Tarja Sironen
- Department of Virology, Medicum, Faculty of Medicine, University of Helsinki, Finland; Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| |
Collapse
|
27
|
Pudszuhn A, Voegeler S, Berger C, Treskatsch S, Angermair S, Hansen S, Hofmann VM. [Elective tracheostomy in COVID-19 patients: experience with a standardized interdisciplinary approach]. HNO 2020; 68:838-846. [PMID: 32840646 PMCID: PMC7445822 DOI: 10.1007/s00106-020-00917-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Berichtet wird über die Erfahrungen mit einer interdisziplinären klinikinternen SOP (Standard Operation Procedure) zur Tracheostomie (TS) bei „Coronavirus-Disease“(COVID-19)-Patienten, unter Berücksichtigung der allgemeinen nationalen und internationalen Empfehlungen. Der interdisziplinär festgelegte operative Zeitpunkt der TS aufgrund einer prolongierten invasiven Beatmung und frustranen Weaning-Versuchen betraf Phasen sowohl hoher als auch niedriger Erkrankungsaktivität. Es wurden 5 TS bei Patienten mit einem Durchschnittsalter von 70,6 Jahren durchgeführt. Neben den Standard-COVID-19-Schutzmaßnahmen für das medizinische Personal zur Vermeidung einer nosokomialen COVID-19-Infektion führt die SOP-unterstützte Kommunikation während der TS zu einer periprozeduralen Sicherheit aller Beteiligten. COVID-19-Erkrankungen des medizinischen Personals der beteiligten Abteilungen sind bisher nicht bekannt.
Collapse
Affiliation(s)
- A Pudszuhn
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
| | - S Voegeler
- Klinik für Anästhesiologie und Intensivmedizin, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - C Berger
- Klinik für Anästhesiologie und Intensivmedizin, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - S Treskatsch
- Klinik für Anästhesiologie und Intensivmedizin, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - S Angermair
- Klinik für Anästhesiologie und Intensivmedizin, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - S Hansen
- Institut für Hygiene und Umweltmedizin, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - V M Hofmann
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland
| |
Collapse
|
28
|
Abstract
PURPOSE Health research in the UK is being impeded by a stretched NHS system. The purpose of this paper is to use the Great Fire of Rome as an allegory to understand the difficulties encountered by health researchers when attempting to conduct research within a healthcare system that is currently in crisis. DESIGN/METHODOLOGY/APPROACH The paper draws on both the authors' own and other research teams' experiences from the published literature in order to demonstrate that this difficulty is a widespread problem for the health research community in the UK. FINDINGS Recruitment and engagement issues across different research studies and clinical environments are often ascribed as being related to individual contexts or settings. Rather, the authors propose that these problems are actually writ large across nearly the entire NHS. The authors offer ideas for what can be done to alleviate the worst of this situation - a change in culture and ways of working alongside employing more pragmatic, rapid methods to engage exceptionally busy healthcare staff. ORIGINALITY/VALUE The paper offers a provocative viewpoint that instead of seeking to individualise recruitment and engagement issues in relation to the local context, the research community should publicly acknowledge the universality of this problem in order to bring about meaningful change.
Collapse
Affiliation(s)
- Laura Sheard
- Bradford Institute for Health Research, Bradford, UK
| | | |
Collapse
|
29
|
Lai KSP, Watt C, Ionson E, Baruss I, Forchuk C, Sukhera J, Burhan AM, Vasudev A. Breath Regulation and yogic Exercise An online Therapy for calm and Happiness (BREATH) for frontline hospital and long-term care home staff managing the COVID-19 pandemic: A structured summary of a study protocol for a feasibility study for a randomised controlled trial. Trials 2020; 21:648. [PMID: 32665041 PMCID: PMC7359429 DOI: 10.1186/s13063-020-04583-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/04/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Objective 1: To determine if it is feasible to conduct an RCT of online Sudarshan Kriya Yoga (SKY) for frontline hospital and long-term care home staff under the constraints imposed by the COVID-19 pandemic and need for remote trial monitoring. Objective 2: To assess whether online versions of SKY and/or Health Enhancement Program (HEP) result in improvement in self-rated measures of insomnia, anxiety, depression, and resilience. TRIAL DESIGN This is an open-label feasibility randomized controlled trial (RCT), comparing an online breath based yogic intervention SKY versus an online control mind-body intervention HEP in frontline hospital and long-term care home staff managing the COVID-19 pandemic. PARTICIPANTS Participants will include frontline hospital and long-term care home staff that are involved in the management of COVID-19 patients in London, Ontario, Canada. Participants will be willing and able to attend via online video conferencing software to participate in the study interventions. Participants must have an adequate understanding of English and be able to sit without physical discomfort for 60 minutes. INTERVENTION AND COMPARATOR Sudarshan Kriya Yoga (SKY): The online version of SKY will be delivered by at least one certified Canadian SKY teacher, with at least one back up teacher at all times, under the supervision of Ms. Ronnie Newman, Director of Research and Health Promotion, Art of Living Foundation, USA. The online version of SKY for healthcare workers has a total duration of 3 hours. Phase I will consist of 5 self-paced online modules of 4-10 minutes each to learn the breath control techniques. Participants will be sent an online survey in REDCap requesting that they self-confirm completion of the Phase I modules. In Phase II, 2 interactive online sessions of 1 hour each will be held on consecutive days with a certified SKY teacher, during which participants will learn the fast, medium and slow breaths. For ease of scheduling, multiple time windows will be offered for Phase II. There will be at least one back up teacher at all times. Both Phase I and II will be completed in the first week. Health Enhancement Program (HEP): The active control arm, HEP, will consist of time-matched online self-paced modules for Phase I. Phase II will consist of mindfulness-based meditation sessions delivered by mental health staff. HEP will be an active treatment program that incorporates mind-body interventions. HEP will consist of time-matched online self-paced modules with psychoeducation on healthy active living as well as interactive modules comprising of guided de-stressing exercises including music therapy, mindfulness and progressive muscle relaxation. Weekly follow up sessions will be offered to all recruited participants for 30 minutes each for the subsequent 4 weeks in both study arms. MAIN OUTCOMES The following feasibility outcomes will be measured at the end of the study: (1) rate of participant recruitment, (2) rate of retention, (3) completeness of data entry, (4) cost of interventions, and (5) unexpected costs. Such measures will be collected on a daily basis through-out the study and tabulated 5 weeks later at the end of the study. RANDOMISATION Participants will be randomized after they have electronically signed the consent form and the research staff have confirmed eligibility. We will use REDCap to perform randomization in a 1:1 ratio as well as allocation concealment. REDCap is widely used by health researchers worldwide to significantly reduce data entry and study management errors to improve data fidelity. BLINDING (MASKING) All study participants will be blinded to the study hypotheses so as to prevent any expectation bias. Group allocation will be masked during analysis. NUMBERS TO BE RANDOMISED (SAMPLE SIZE) This study will randomize a total of 60 participants in a 1:1 ratio to either SKY or HEP interventions. TRIAL STATUS Protocol version number 2.0 (June 5, 2020). Recruitment is currently ongoing (starting June 25, 2020). We anticipate to complete recruitment by June 30, 2021 and complete the study by September 30, 2021. TRIAL REGISTRATION ClinicalTrials.gov protocol ID NCT04368676 (posted April 30, 2020). FULL PROTOCOL The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
Collapse
Affiliation(s)
- Ka Sing Paris Lai
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| | - Christine Watt
- Department of Psychiatry, Parkwood Institute of Mental Health, 550 Wellington Rd, London, ON N6C 5J1 Canada
| | - Emily Ionson
- Department of Psychiatry, Parkwood Institute of Mental Health, 550 Wellington Rd, London, ON N6C 5J1 Canada
| | - Imants Baruss
- Department of Psychology, King’s University College at Western University, 266 Epworth Ave, London, ON N6A 2M3 Canada
| | - Cheryl Forchuk
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| | - Javeed Sukhera
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| | - Amer M. Burhan
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| | - Akshya Vasudev
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| |
Collapse
|
30
|
Santana-López BN, Santana-Padilla YG, Santana-Cabrera L, Martín-Santana JD, Molina-Cabrillana MJ. [Perceptions of intensive care professionals about hand hygiene compared with observational studies]. J Healthc Qual Res 2020; 35:225-235. [PMID: 32593593 DOI: 10.1016/j.jhqr.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/25/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
OBJETIVE To identify perceptions and knowledge about the adherence to hand hygiene of the healthcare staff of an intensive care unit, correlating them with compliance data on adherence to hand hygiene through observational studies MATERIAL AND METHOD: A quantitative methodology has been combined, based on the completion of a personal survey, and a qualitative methodology based on direct observation. Units of Intensive Care of Adults (A-ICU) and Pediatrics (P-ICU) of a tertiary hospital. There were 187 health professionals. Personal and work data of the professionals were collected, as well as questions related to their knowledge and perceptions about the hand hygiene. RESULTS Those 187 professionals, 75,9% from A-ICU, represented more than 80% of the study population, and 91.4% had received previous training on hand hygiene. Regarding knowledge, 35% of the A-ICU professionals and almost 50% from the P-ICU consider that hand washing is more effective than hand friction with alcohol-based solutions for the elimination of microorganisms. They have a better perception that they correctly perform the hand washing (89.32% ICU-P and 82.93% ICU-A), than when we compare them to the adherence rates obtained by direct observation (ICU-P 73.8% and ICU-A 51.4%, P=0.0001). CONCLUSIONS Despite having previous training on hand hygiene, they have incomplete knowledge and, although they overestimate the problem of the healthcare-associated infections, they have a perception that does not fit with reality.
Collapse
Affiliation(s)
- B N Santana-López
- Servicio de Medicina Intensiva, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Y G Santana-Padilla
- Servicio de Medicina Intensiva, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - L Santana-Cabrera
- Servicio de Medicina Intensiva, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
| | - J D Martín-Santana
- Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - M J Molina-Cabrillana
- Servicio de Medicina Intensiva, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| |
Collapse
|
31
|
Ishikawa M, Nomura M, Miyoshi M, Nishi N, Yokoyama T, Miura H. A self-reported measurement scale on a potential component of competency in the healthcare staff engaged in the prevention and control of non-communicable disease in Fiji. BMC Health Serv Res 2019; 19:838. [PMID: 31727066 PMCID: PMC6857309 DOI: 10.1186/s12913-019-4695-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 10/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background According to the World Health Organization, an estimated 80% or more deaths in Pacific island countries, including Fiji, were related to non-communicable diseases (NCDs). Although competency-based approaches have been effective for developing healthcare workers’ capabilities, there are only a few reports on competency scales of healthcare workers for NCD prevention. We aimed to develop a self-reported measurement scale on a potential component of competency in the healthcare staff engaged in the prevention and control of NCDs in Fiji. Methods There were 378 Ministry of Health and Medical Services staff members working on NCD prevention and control in Fiji included in this study, which was a cross-sectional survey of social factors, working situation factors, and competency. Exploratory factor analysis was conducted to assess potential competency components, whereas Cronbach’s α coefficient and analysis of variance were used to assess the validity and reliability of the scale items, respectively. Multivariate regression analyses were conducted to analyze the respondents’ factor scores relative to social status and work situations. Results The factor analysis revealed 16 items that identified competency in four work types: 1) work management, 2) monitoring and evaluation, 3) community partnership, and 4) community diagnosis. The monitoring and evaluation roles were related to ethnic background, community partnership was related to religion, and community diagnosis was related to academic qualifications. Conclusions Based on the results, we developed a competency scale for the four work types. This scale can help healthcare workers engage in better management of residents with NCDs in Fiji.
Collapse
Affiliation(s)
- M Ishikawa
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - M Nomura
- Department of International Health and Collaboration, National Institute of Public Health, 3-6 Wako, Saitama, 351-0197, Japan
| | - M Miyoshi
- Department of Nutrition, Faculty of Health Sciences, Aomori University of Health and Welfare, 58-1, Mase, Hamadate, Aomori, 030-8505, Japan
| | - N Nishi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - T Yokoyama
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - H Miura
- Department of International Health and Collaboration, National Institute of Public Health, 3-6 Wako, Saitama, 351-0197, Japan
| |
Collapse
|
32
|
Khan NN, Puthussery S. Stakeholder perspectives on public-private partnership in health service delivery in Sindh province of Pakistan: a qualitative study. Public Health 2019; 170:1-9. [PMID: 30884348 DOI: 10.1016/j.puhe.2019.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 01/16/2019] [Accepted: 02/04/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to explore the perspectives of stakeholders on public-private partnership (PPP) in healthcare service delivery in Sindh province of Pakistan including the reasons for adopting such policies and the barriers for its implementation. STUDY DESIGN This was a qualitative primary study. METHODS Semistructured in-depth interviews were conducted with 13 stakeholders, including officials from provincial government and district administration (legislators, district managers, deputy commissioners and assistant commissioners) and representatives from private sector organisations with direct or indirect role in implementation of PPP policy, selected using purposive sampling methods. Data were analysed using a thematic approach. RESULTS Participants had very limited in-depth understanding about the concept of PPP. They considered multifaceted corruption in the health system and the success of existing PPP initiatives as the main reasons for the PPP policy adoption. Resistance from healthcare staff was perceived as the main barrier for implementation of PPP. There was a common perception that better monitoring capacity in the private sector management can be a cause of concern for public sector employees who may have become used to less efficient working. A common theme found in the narratives was the possible apprehensions from healthcare staff about the loss of their jobs. CONCLUSION Our findings indicated lack of effective engagement with key stakeholders and the resistance from healthcare staff as the key barriers for PPP implementation in Sindh, Pakistan. These findings provide useful insights for the successful implementation of such initiatives in Pakistan as well as in other similar settings.
Collapse
Affiliation(s)
- N N Khan
- Centre of Excellence in Women and Child Health, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - S Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Putteridge Bury Campus, Hitchin Road, Luton, LU2 8LE, UK.
| |
Collapse
|
33
|
Almalki O, Alshehri MA, El-Sodany AM, El-Fiky AAR. The awareness of healthcare staff towards post-stroke cognitive impairment: a cross sectional study. J Phys Ther Sci 2018; 30:883-887. [PMID: 29950785 PMCID: PMC6016295 DOI: 10.1589/jpts.30.883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 03/28/2018] [Indexed: 01/19/2023] Open
Abstract
[Purpose] This study aimed to determine the awareness amongst healthcare staff of
post-stroke cognitive impairment in a university teaching hospital and supporting stroke
rehabilitation unit. [Subjects and Methods] A cross sectional study was employed to
collect data from 20 healthcare staff about post-stroke cognitive impairment. This study
was conducted in Ireland at two sites, the Acute Stroke unit in Cork University Hospital,
and the Stroke Rehabilitation unit and Assessment and Treatment Centre in St. Finbarr’s
Hospital. [Results] Approximately 75% of participants felt that they had knowledge about
post-stroke cognitive deficits, with around 50% of them having patients with persistent
cognitive decline between 40% and 60%. Most participants (70%) agreed that cognitive
function should be routinely assessed and the majority (85%) discussed the potential
impact of post-stroke cognitive deficits with patients and their families. However, some
participants need to be aware of post-stroke cognitive deterioration. [Conclusion]
Although there was evidence of good practice, a small number of healthcare staff felt that
they did not have sufficient knowledge about post-stroke cognitive deficits. Thus, further
professional education should be provided to improve the knowledge of healthcare staff
about potential cognitive impairments after stroke.
Collapse
Affiliation(s)
- Obaid Almalki
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork: Cork, Ireland
| | | | | | - Amir Abdel-Raouf El-Fiky
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Saudi Arabia
| |
Collapse
|
34
|
Strauss C, Gu J, Pitman N, Chapman C, Kuyken W, Whittington A. Evaluation of mindfulness-based cognitive therapy for life and a cognitive behavioural therapy stress-management workshop to improve healthcare staff stress: study protocol for two randomised controlled trials. Trials 2018; 19:209. [PMID: 29606143 PMCID: PMC5879876 DOI: 10.1186/s13063-018-2547-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/14/2018] [Indexed: 11/30/2022] Open
Abstract
Background Healthcare workers experience higher levels of work-related stress and higher rates of sickness absence than workers in other sectors. Psychological approaches have potential in providing healthcare workers with the knowledge and skills to recognise stress and to manage stress effectively. The strongest evidence for effectiveness in reducing stress in the workplace is for stress-management courses based on cognitive behavioural therapy (CBT) principles and mindfulness-based interventions (MBIs). However, research examining effects of these interventions on sickness absence (an objective indicator of stress) and compassion for others (an indicator of patient care) is limited, as is research on brief CBT stress-management courses (which may be more widely accessible) and on MBIs adapted for workplace settings. Methods/design This protocol is for two randomised controlled trials with participant preference between the two trials and 1:1 allocation to intervention or wait-list within the preferred choice. The first trial is examining a one-day CBT stress-management workshop and the second trial an 8-session Mindfulness-Based Cognitive Therapy for Life (MBCT-L) course, with both trials comparing intervention to wait-list. The primary outcome for both trials is stress post-intervention with secondary outcomes being sickness absence, compassion for others, depression symptoms, anxiety symptoms, wellbeing, work-related burnout, self-compassion, presenteeism, and mindfulness (MBCT-L only). Both trials aim to recruit 234 staff working in the National Health Service in the UK. Discussion This trial will examine whether a one-day CBT stress-management workshop and an 8-session MBCT-L course are effective at reducing healthcare staff stress and other mental health outcomes compared to wait-list, and, whether these interventions are effective at reducing sickness absence and presenteeism and at enhancing wellbeing, self-compassion, mindfulness and compassion for others. Findings will help inform approaches offered to reduce healthcare staff stress and other key variables. A note of caution is that individual-level approaches should only be part of the solution to reducing healthcare staff stress within a broader focus on organisational-level interventions and support. Trial registration ISRCTN Registry, ISRCTN11723441. Registered on 16 June 2017. Protocol Version 1: 24 April 2017. Trial Sponsor: Sussex Partnership NHS Foundation Trust (ResearchGovernance@sussexpartnership.nhs.uk). Electronic supplementary material The online version of this article (10.1186/s13063-018-2547-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Clara Strauss
- School of Psychology, University of Sussex, Pevensey Building, Falmer, BN1 9QH, UK. .,Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK.
| | - Jenny Gu
- School of Psychology, University of Sussex, Pevensey Building, Falmer, BN1 9QH, UK.,Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Nikki Pitman
- Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Cavita Chapman
- Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK.,Health Education England Kent, Surrey and Sussex, Crawley, West Sussex, UK
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, OX3 7JX, UK
| | - Adrian Whittington
- Sussex Partnership NHS Foundation Trust, R&D Department, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK.,Health Education England Kent, Surrey and Sussex, Crawley, West Sussex, UK
| |
Collapse
|
35
|
Tajeu GS, Halanych J, Juarez L, Stone J, Stepanikova I, Green A, Cherrington AL. Exploring the Association of Healthcare Worker Race and Occupation with Implicit and Explicit Racial Bias. J Natl Med Assoc 2017; 110:464-472. [PMID: 30129512 DOI: 10.1016/j.jnma.2017.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/31/2017] [Accepted: 12/01/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Racial bias is associated with suboptimal healthcare treatment for minorities. Research focuses on bias among physicians rather than non-physician healthcare staff (e.g., receptionists). Patients spend considerable amounts of time with non-physician staff. Therefore, we investigate differences in implicit and explicit racial bias by healthcare staff race and occupation using the Implicit Association Test and Modern Racism Scale, respectively. METHODS Staff (n = 107) were recruited using the Alabama based Primary Care Research Coalition. Occupation was categorized into "medical doctors/registered nurses" (MD/RN) and "non-MD/RN" (e.g., receptionists). RESULTS Implicit bias scores were higher among whites compared with blacks (0.62, -0.04, respectively; p < 0.01). Among whites, non-MD/RNs demonstrated more pro-white implicit bias compared with MD/RNs (0.67, 0.44, respectively; p < 0.01). Whites had higher explicit bias scores than blacks (17.7, 12.3, respectively; p < 0.01). CONCLUSION Non-MD/RNs should not be overlooked for cultural competency training, and efforts are needed to reduce racial bias among healthcare workers identified as having higher levels of bias.
Collapse
Affiliation(s)
- Gabriel S Tajeu
- Department of Health Services Administration and Policy, Temple University, Philadelphia, PA, USA.
| | - Jewell Halanych
- Department of Internal Medicine, Montgomery Campus of the University of Alabama School of Medicine, Montgomery, AL, USA
| | - Lucia Juarez
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeff Stone
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Irena Stepanikova
- Department of Sociology, University of Alabama at Birmingham and Research Centre for Toxic Compounds in the Environment, Masaryk University, Birmingham, AL, Czech Republic
| | - Alexander Green
- The Disparities Solutions Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea L Cherrington
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
36
|
Wilkinson H, Whittington R, Perry L, Eames C. Examining the relationship between burnout and empathy in healthcare professionals: A systematic review. Burn Res 2017; 6:18-29. [PMID: 28868237 PMCID: PMC5534210 DOI: 10.1016/j.burn.2017.06.003] [Citation(s) in RCA: 205] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/31/2017] [Accepted: 06/15/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Empathy and burnout are two related yet distinct constructs that are relevant to clinical healthcare staff. The nature of their relationship is uncertain and this review aimed to complete a rigorous, systematic exploration of the literature investigating the relationship between burnout and empathy in healthcare staff. DESIGN A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. DATA SOURCES Search terms (Burnout OR Burn-out OR "Burn out") AND (Empathy OR Empath*) enabled identification of studies investigating burnout and empathy in healthcare staff, using five electronic data bases (MEDLINE, PsycINFO, CINAHL Plus, PubMed, and SCOPUS). Manual searching amongst reference lists of eligible articles was also completed. REVIEW METHODS Databases were searched for studies published in the English language, from inception to February 2017. Key inclusion criteria were: 1) participants who were nurses or medical professionals, 2) full written manuscript in English, 3) use of the Maslach Burnout Inventory to assess burnout and a standardized outcome measure for empathy, 4) quantitative methodology exclusively. RESULTS Ten eligible studies were reviewed. Of those, seven were conducted in countries where English was not the first language. Eight of the studies provided empirical support for a negative relationship between empathy and burnout. One study provided support for a positive relationship between burnout and empathy. One study reported contradictory evidence with positive and negative correlations between different subscales of the empathy and burnout measures. In general, the quality of the studies was assessed to be good. However, some of the studies failed to provide information pertaining to sample size, with the reporting of data less than adequate from one study. CONCLUSIONS There was consistent evidence for a negative association between burnout and empathy. This review avoided a common English-speaking country bias of some areas of the literature. Given that all of the studies reviewed were cross sectional, further research is necessary to establish causality.
Collapse
Affiliation(s)
- Helen Wilkinson
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, L69 3GB, UK
| | - Richard Whittington
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, L69 3GB, UK
- Broset Forensic Department, St. Olav’s University Hospital, Trondheim, 7440, Norway
- Department of Mental Health, Norges Teknisk- Naturvitenskapelige Universitet (NTNU), Trondheim, 7491, Norway
| | - Lorraine Perry
- Mersey Care NHS Foundation Trust, Liverpool, L34 1PJ, UK
| | - Catrin Eames
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, L69 3GB, UK
| |
Collapse
|
37
|
Leedo E, Beck AM, Astrup A, Lassen AD. The effectiveness of healthy meals at work on reaction time, mood and dietary intake: a randomised cross-over study in daytime and shift workers at an university hospital. Br J Nutr 2017; 118:121-9. [PMID: 28820084 DOI: 10.1017/S000711451700191X] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Our dietary habits affect both cognitive performance and mood. The aim of the study was to examine the effect of increased availability of healthy meals and water at work on healthcare staff. The study used an 8-week randomised cross-over design. A total of sixty physicians, nurses and nursing assistants, including sixteen working on shifts, were recruited. The participants received a self-selected keyhole-labelled (Nordic nutrition label) lunch, snack and bottled water during each shift throughout the intervention period. Reaction time (Go/No-Go test), mood-related scores (POMS) and dietary intake were assessed at run-in, and at the end of the intervention and the control periods. The intake of fat (P=0·030) and PUFA (P=0·003) was lower, and the intake of carbohydrate (P=0·008), dietary fibre (P=0·031) and water (P<0·001) was greater in the intervention period than in the control period. The intervention had no effect on reaction time or any of the mood-related scores in the group as a whole. In shift-working participants, the intervention period resulted in a 31·1 % lower Fatigue-Inertia Score (P=0·003), a 15·3 % higher Vigour-Activity Score (P=0·041) and a 42·7 % lower Total Mood Disturbance Score (P=0·017), whereas the only dietary component that significantly improved was water intake (P=0·034), when compared with the control period. Providing healthy meals, snacks and water during working hours seems to be an effective way of improving employees' dietary intake. Moreover, increased intake of water may be associated with beneficial effects on fatigue, vigour and total mood in shift-working healthcare staff.
Collapse
|
38
|
Gavine A, MacGillivray S, Renfrew MJ, Siebelt L, Haggi H, McFadden A. Education and training of healthcare staff in the knowledge, attitudes and skills needed to work effectively with breastfeeding women: a systematic review. Int Breastfeed J 2017; 12:6. [PMID: 28167998 PMCID: PMC5288894 DOI: 10.1186/s13006-016-0097-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 12/21/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Current evidence suggests that women need effective support to breastfeed, but many healthcare staff lack the necessary knowledge, attitudes and skills. There is therefore a need for breastfeeding education and training for healthcare staff. The primary aim of this review is to determine whether education and training programs for healthcare staff have an effect on their knowledge and attitudes about supporting breastfeeding women. The secondary aim of this review was to identify whether any differences in type of training or discipline of staff mattered. METHODS A systematic search of the literature was conducted using the Cochrane Pregnancy and Childbirth Group's trial register. Randomised controlled trials comparing breastfeeding education and training for healthcare staff with no or usual training and education were included if they measured the impact on staff knowledge, attitudes or compliance with the Baby Friendly Hospital Initiative (BFHI). RESULTS From the 1192 reports identified, four distinct studies were included. Three studies were two-arm cluster-randomised trials and one was a two-arm individual randomised trial. Of these, three contributed quantitative data from a total of 250 participants. Due to heterogeneity of outcome measures meta-analysis was not possible. Knowledge was included as an outcome in two studies and demonstrated small but significant positive effects. Attitudes towards breastfeeding was included as an outcome in two studies, however, results were inconsistent both in terms of how they were measured and the intervention effects. One study reported a small but significant positive effect on BFHI compliance. Study quality was generally deemed low with the majority of domains being judged as high or unclear risk of bias. CONCLUSIONS This review identified a lack of good evidence on breastfeeding education and training for healthcare staff. There is therefore a critical need for research to address breastfeeding education and training needs of multidisciplinary healthcare staff in different contexts through large, well-conducted RCTs.
Collapse
Affiliation(s)
- Anna Gavine
- Evidence Synthesis Training and Research Group, School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Steve MacGillivray
- Evidence Synthesis Training and Research Group, School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Mary J. Renfrew
- Mother and Infant Research Unit, School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Lindsay Siebelt
- Mother and Infant Research Unit, School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Haggi Haggi
- Mother and Infant Research Unit, School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | - Alison McFadden
- Mother and Infant Research Unit, School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| |
Collapse
|
39
|
Abstract
BACKGROUND Staff who provide end-of-life care to children not only have to deal with their own sense of loss but also that of bereaved families. There is a dearth of knowledge on how they cope with these challenges. AIM The aim of this review is to explore the experiences of healthcare professionals who provide end-of-life care to children in order to inform the development of interventions to support them, thereby improving the quality of paediatric care for both children and their families. DATA SOURCES Searches included CINAHL, MEDLINE, Web of Science, EMBASE, PsychINFO and The Cochrane Library in June 2015, with no date restrictions. Additional literature was uncovered from searching reference lists of relevant studies, along with contacting experts in the field of paediatric palliative care. DESIGN This was a systematic mixed studies review. Study selection, appraisal and data extraction were conducted by two independent researchers. Integrative thematic analysis was used to synthesise the data. RESULTS The 16 qualitative, 6 quantitative and 8 mixed-method studies identified included healthcare professionals in a range of settings. Key themes identified rewards and challenges of providing end-of-life care to children, the impact on staff's personal and professional lives, coping strategies and key approaches to help support staff in their role. CONCLUSION Education focusing on the unique challenges of providing end-of-life care to children and the importance of self-care, along with timely multidisciplinary debriefing, are key strategies for improving healthcare staff's experiences, and as such the quality of care they provide.
Collapse
Affiliation(s)
- Tracey McConnell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David Scott
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Sam Porter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
40
|
Wilson C, Bungay H, Munn-Giddings C, Boyce M. Healthcare professionals' perceptions of the value and impact of the arts in healthcare settings: A critical review of the literature. Int J Nurs Stud 2015; 56:90-101. [PMID: 26696399 DOI: 10.1016/j.ijnurstu.2015.11.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Internationally there is growing interest in the use of the arts in the healthcare context evidenced by the number of research studies reported in the nursing and medical literature. Establishing successful projects in healthcare environments will to some extent be reliant on the cooperation of staff working in these settings: healthcare professionals and their cultural values will be the lynchpin in the relationship between the artists organising the activities and the patients. This review appraises healthcare professionals' perceptions of the value of the arts in healthcare settings, and the impact of the arts on healthcare professionals. METHODS A critical review of the literature between 2004 and 2014 was undertaken. The following databases were searched: MedLine, CINAHL, AMED, Web of Science and ASSIA. Searches included words from three categories: arts activities; healthcare settings, and healthcare providers. Studies were included if they were written in English, explored the attitudes of healthcare professionals on the use of the arts in healthcare settings or the impact of arts activities on healthcare staff. Studies conducted in community venues and/or reporting on arts therapies (art, drama or music) were excluded. An initial 52 studies were identified and following screening for relevance and quality 27 articles were reviewed. Arts interventions were diverse and included music listening, visual arts, reading and creative writing, and dance. RESULTS Despite some methodological limitations of the reviewed studies it was found that the majority of staff believed that engaging in arts interventions has a positive impact on patients' health and well-being. The findings suggest that arts interventions are perceived to have an impact on patients' stress, mood, pain levels, and sleep. Furthermore, staff believed that the arts can enhance communication between staff and patients, helping to build rapport and strengthen interactions. The majority of reported staff outcomes were positive, with arts activities in healthcare settings found to: decrease stress, improve mood, improve job performance, reduce burnout, improve patient/staff relationships, improve the working environment and improve well-being. CONCLUSIONS This review fills a gap in the literature, providing the first review of healthcare professional's views of the arts in healthcare settings and the impact of arts activities on healthcare staff. The largely positive perceptions of staff will aid in the implementation of arts activities in healthcare settings, which will enhance care and benefit both patients and healthcare staff.
Collapse
Affiliation(s)
- Ceri Wilson
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ, United Kingdom.
| | - Hilary Bungay
- Faculty of Medical Science, Anglia Ruskin University, Young Street, Cambridge CB1 2LZ, United Kingdom.
| | - Carol Munn-Giddings
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ, United Kingdom.
| | - Melanie Boyce
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ, United Kingdom.
| |
Collapse
|