Internal communication within the healthcare system during the COVID-19 pandemic in Latvia

Background

Effective communication among health care providers is a key for responding to the rapidly changing health care needs, improving work efficiency, and ensuring patient safety, particularly during the crisis of the COVID-19 pandemic. This study explores the communication-related experiences of healthcare professionals during the first wave of the COVID-19 pandemic in Latvia.

Methods

Semi-structured interviews with 7 chairman of healthcare facilities, 19 general practitioners, and 15 specialists were conducted from September to December 2020. Interviews were recorded and transcribed. Thematic analysis revealed five themes related to internal communication among health care providers. The study was a component of the National research programme VPP-COVID-2020/1-0011.

Results

The 1st theme, ‘Initial chaos paralyzing the system', illustrated the disorderly format of delivering the information that created confusion and anxiety. The 2nd theme, ‘Overwhelming amount of information', revealed the challenge to process new information received daily and from various sources. The 3rd theme, ‘Decentralized decision-making' highlighted the lack of clearly communicated algorithms for specific patients' groups, leaving the decision-making to the health care providers. The 4th theme, ‘Collegial support of the peers”, emerged as a crucial coping mechanism and information channel, substituting for the lack of official information. The 5th theme, ‘Opportunity for growth', consolidated suggestions from health care professionals for improving internal communication in future.

Conclusions

Internal communication as experienced among healthcare professionals was overwhelming and insufficient at the same time. It created an environment promoting closer collaboration among different specialists and suggestions for necessary improvements.

Key messages

Understanding and perception of communication among health care providers in different healthcare system levels were central that affected the health care actions tackling the COVID-19 emergency.

Effective communication within the healthcare system is critical during the pandemic. Messages should be clear, evidence-informed, and transparent for targeted action of the health care workforce.

Difficulties in getting to sleep, late bedtime and sleep duration among adolescents in Latvia

Background

Sleep is important for adolescent general wellbeing and different sleep domains like difficulties in getting to sleep, bedtime resistance and sleep duration can be studied. This study investigates the prevalence of weekly difficulties in getting to sleep in association with bedtime and sleep duration on schooldays and weekends among adolescents in Latvia.

Methods

Data from the HBSC Survey 2017/2018 of Latvia with 4412 respondents aged 11, 13 and 15 years were used for statistical analysis. Sleep duration less than 7h was classified as insufficient and bedtime at 0:00 or later as delayed bedtime. Age-adjusted logistic regression and adolescents without weekly difficulties in getting to sleep as a reference was used for studying the associations.

Results

On average, 43.6% of adolescents (38.0% boys and 49.1% girls) reported weekly difficulties in getting to sleep. Of those, 26.5% reported sleep duration <7h on schooldays but 5.6% on weekends. On average, difficulties in getting to sleep was associated with the increased odds of insufficient sleep duration on schooldays (OR = 2.16; 95%CI 1.84-2.54) and weekends (OR = 1.66; 95%CI 1.23-2.24), with higher odds in girls than boys. Delayed bedtime was significantly more prevalent among adolescents with sleep difficulties than for those without (33.7% vs 20.6%). The sleep duration <7h was more prevalent among those adolescents having sleep difficulties and delayed bedtime than in those with sleep difficulties and bedtime before 0:00, both on schooldays (72.1% vs 3.2%) and weekends (7.9% vs 0%).

Conclusions

Difficulties in getting to sleep among adolescents are highly prevalent and increases the odds of insufficient sleep duration, especially in girls. Delayed bedtime seems to modify the association between the difficulties in getting to sleep and sleep duration.

Key messages

Adolescents with difficulties in getting to sleep are at risk of delayed bedtimes and insufficient sleep duration. Further studies to explore the underlying mechanisms linking difficulties in getting to sleep and delayed bedtime are required.

The model of boosting the cross-sectoral cooperation for health and wellbeing in cities

In health promotion practice, resources often are limited, and problems are complex. Cross-sectoral cooperation is a collaborative effort in which partners from different sectors pool their resources to provide joint solutions for better health promotion; however, the general framework on how to proceed the cooperation is often missing. The Interreg Baltic Sea Region project “Urban Labs for Better Health for All in the Baltic Sea Region” (Healthy Boost) aims to boost the cross-sectoral cooperation for health and wellbeing in cities and associated partners from nine countries in the Baltic Sea Region by developing and testing the Model for the cross-sectoral cooperation.

The Model was developed searching the published scientific literature and considering the results of a self-assessment of cross-sectoral cooperation for health promotion in the Healthy Boost partner cities. Discussions on the Model draft were organized by using face-to-face meetings and e-tools in order to develop the Model for piloting.

Theoretical frameworks of cross-sectoral collaboration, including organization theory, public administration theory, leadership and strategic management theory, were used to select the major components for the Model. The partners' self-assessment results identified the gaps in several strategic and operational domains of cooperation, such as (1) leadership, (2) communication, (3) coordination, (4) motivation, and (5) risk identification. In the first Model draft, the starting point for cross-sectoral cooperation was the stages (mapping, planning, implementation, assessment) of cooperation; however, municipalities preferred to focus on domains which were developed under the stages of cooperation process in the final Model. Both evidence-based knowledge and participation of municipalities are crucial when developing the Model cross-sectoral cooperation. The Model should guide all partners for better cooperation by using a systematic approach.

Key messages

The Model to promote cross sectoral cooperation is being developed for testing in health promotion practice by the cities of the Baltic Sea Region. The developed Model of cross-sectoral cooperation provides relevant guiding questions for the key domains of cooperation that should boost the municipalities for better health promotion.

Self-reported recurrent pain and medicine use behaviours among 15-year olds: results from the international study

BACKGROUND

There is considerable variation in adolescent pain prevalence across epidemiological studies, with limited information on pain-related behaviours among adolescents, including medicine use. The aims of this study were (1) to examine the prevalence of recurrent pain among 15-year-old adolescents internationally; (2) to investigate the association between recurrent pain and medicine use behaviours among boys and girls; and (3) to evaluate the consistency of these associations across countries.

METHODS

The World Health Organization (WHO) collaborative international Health Behaviour in School-aged Children 2009/2010 study collects data about self-reported aches and medicine use from 36,762 15-year-old adolescents from 22 countries/regions in Europe and the United States. Multi-level multivariate logistic regression, stratified by gender, was used to analyse the association between recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep.

RESULTS

More than 30% of adolescents reported recurrent headache, almost 30% recurrent backache and approximately 20% recurrent stomachache. Although pain prevalence and medicine use for aches were much higher for girls, the association between pain and medicine use was similarly strong for both genders. Adolescents with recurrent pain are more likely to use medicines also for non-corresponding pain, nervousness and difficulties in getting to sleep. The association between recurrent pain and medicine use was consistent across countries despite large-country differences in the prevalence of recurrent pain and medicine use.

CONCLUSIONS

Recurrent pain in adolescence is common cross-nationally. Adolescents with recurrent pain are more likely to use medicine in general. Recurrent pain and medicine use should be addressed in adolescent health policies.