Health service COVID-19 wellbeing and support initiatives: a mixed-methods evaluation

BACKGROUND

Health services implemented a range of initiatives during the COVID-19 pandemic to support employee wellbeing and assist employees to manage the professional and personal challenges they experienced. However, it is not known if such initiatives were acceptable to employees or met their needs.

AIMS

To evaluate the wellbeing and support initiatives implemented at an Australian health service during the COVID-19 pandemic from the perspectives of employees (both users and non-users) and key stakeholders.

METHODS

A mixed-methods design (survey, interviews and data audit) to investigate employees' and key stakeholders' perceptions, experiences and use of the wellbeing and support initiatives implemented at a large tertiary metropolitan health service in Melbourne, Australia.

RESULTS

Ten employees participated in an interview and 907 completed a survey. The initiatives were well used and appreciated by staff. There was no significant difference in the proportion of clinical staff who had used the initiatives compared to non-clinical staff (44% versus 39%; P=0.223). Survey respondents reported the initiatives improved their mental health (n = 223, 8%), ability to cope with COVID-19 related stress and anxiety (n = 206, 79%), do their work (n = 200, 77%) and relationships with colleagues (n = 174, 67%). Staff would like many of the initiatives (with some modifications) to continue after the COVID-19 pandemic.

CONCLUSIONS

The findings suggest a high level of staff satisfaction with the implemented wellbeing and support initiatives, and confirm the need for, and importance of, developing and implementing initiatives to support health service staff during outbreaks of infectious diseases such as the COVID-19 pandemic.

Maternal mental health and partner delivered massage: a pilot study

Background

Mental health problems place a significant burden on the health system and are an important public health issue. Many pregnant women experience anxiety and depression, which can negatively impact health outcomes for both mother and baby. Partner-delivered massage may provide a cost effective and accessible approach to support the mental wellbeing of pregnant women.

Methods

A feasibility randomised controlled trial was conducted to compare partner-delivered relaxation massage (intervention) with a self-directed stress management program (control), for pregnant women with mild anxiety. Women attended an initial workshop at 28-32 weeks gestation, followed by the completion of either the self-directed massage or stress management program. Qualitative feasibility and acceptability data (primary outcomes) were collected via online participant diaries and post-birth interviews. Anxiety, depression and stress symptoms (secondary outcomes) were assessed using the Depression and Anxiety Stress Scale (DASS-21).

Results

14 women/partner dyads attended the partner- delivered massage group and 13 women attended the self-directed stress management group. Participants from both groups reported the programs were feasible and acceptable. Mean scores on all DASS-21 subscales significantly decreased over time in both the intervention and the control group.

Conclusions

The partner-delivered massage program was feasible and acceptable. Both programs decreased women's symptoms of anxiety, depression and stress, with no significant between-group differences identified. An adequately powered, experimental study is needed to determine the effectiveness of partner-delivered relaxation massage.

Key messages

Many women experience anxiety and depression during pregnancy and this can have a negative impact on both mother and baby. Partner-delivered relaxation massage, at least once a week in the third trimester, may help reduce women’s symptoms of anxiety, depression and stress.

Fertility concerns and related information needs and preferences of women with PCOS

STUDY QUESTION

What are the fertility and childbearing concerns and related information needs and preferences of women with polycystic ovary syndrome (PCOS)?

SUMMARY ANSWER

Women with PCOS have concerns about fertility and childbearing mainly because they believe that it will be difficult for them to conceive, and identify a need for evidence-based information and preconception care so that they can make informed decisions about having children and achieve their reproductive goals.

WHAT IS KNOWN ALREADY

Women with chronic conditions seek reproductive health information from a range of sources, including their healthcare provider, the internet, other women with the condition, patient associations and support groups, and scientific publications. Little is known about the fertility concerns and information needs of women with PCOS or their preferences for how and when to receive information about the effect of their condition and its treatment on fertility and childbearing.

STUDY DESIGN SIZE DURATION

A qualitative study of 13 women of reproductive age with self-reported PCOS living in Australia participated in an online discussion group conducted from May to June 2018. Women were recruited via targeted advertisements on social media.

PARTICIPANTS/MATERIALS SETTING METHODS

In a closed-group moderated discussion, participants responded to questions about fertility concerns and the related information needs and preferences of women with PCOS. Non-identifiable demographic information was sought via a separate online anonymous survey. The discussion transcript was analysed thematically.

MAIN RESULTS AND THE ROLE OF CHANCE

Women identified a number of concerns about childbearing including whether they could become pregnant, how to prepare for pregnancy and what they should do before trying to conceive given their PCOS. Women reported seeking information about fertility and PCOS from a range of sources, and views about the most useful types and sources of fertility information for women with PCOS varied.

LIMITATIONS REASONS FOR CAUTION

Due to the small sample size and recruitment of participants via advertisements on Facebook, women who participated in the study may not be representative of women with PCOS in the general population. Women currently contemplating childbearing or who have recently had children or fertility difficulties may also have been more likely to participate in the study. Women in this study self-reported PCOS, and this may not necessarily reflect a confirmed diagnosis of PCOS. No formal diagnostic criteria were used to confirm their PCOS status.

WIDER IMPLICATIONS OF THE FINDINGS

Women with PCOS would benefit from evidence-based information in a range of formats to help them make informed decisions about childbearing and achieving their reproductive goals. Preconception care, including counselling and information about appropriate interventions and self-management strategies to optimise health and improve chances of conception, may be of particular assistance to women with PCOS.

STUDY FUNDING/COMPETING INTERESTS

The Victorian Assisted Reproductive Treatment Authority (VARTA) commissioned researchers at Monash University to generate evidence to guide the development of resources to assist women with PCOS make informed fertility and childbearing decisions and achieve their reproductive goals. The authors have no conflict of interests to declare.

TRIAL REGISTRATION NUMBER

Not applicable.

Effects of particulate matter exposure and medication use on asthmatics

The health risk associated with low-level air pollution exposure is still uncertain. The association between exposure and pulmonary function was assessed with personal sampling. Small, portable multipollutant samplers were used to assess personal exposure to particulate matter. Thirty-six asthmatic subjects participated in the study for up to 20 d in both summer (n = 10 d) and winter (n = 10 d); pulmonary function was assessed at the beginning and end of each sampling day, and medication use was recorded. A within-individual longitudinal analysis of the relationship between pulmonary function and particulate matter revealed an effect of season. In winter, pulmonary function increased as particulate exposure increased, which was explained by a confounding effect of medication use. Therefore, in addition to exposure, season of the year and medication use are factors that must be considered.