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Siebenhofer A, Scott AM, Avian A, Terebessy A, Mergenthal K, Schaffler-Schaden D, Bachler H, Huter S, Zelko E, Murray A, Guppy M, Piccoliori G, Streit S, Jeitler K, Flamm M. COVI-Prim international: Similarities and discrepancies in the way general practices from seven different countries coped with the COVID-19 pandemic. Front Public Health 2022; 10:1072515. [PMID: 36600939 PMCID: PMC9806865 DOI: 10.3389/fpubh.2022.1072515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives General practitioners (GPs) are frequently patients' first point of contact with the healthcare system and play an important role in identifying, managing and monitoring cases. This study investigated the experiences of GPs from seven different countries in the early phases of the COVID-19 pandemic. Design International cross-sectional online survey. Setting General practitioners from Australia, Austria, Germany, Hungary, Italy, Slovenia and Switzerland. Participants Overall, 1,642 GPs completed the survey. Main outcome measures We focused on how well-prepared GPs were, their self-confidence and concerns, efforts to control the spread of the disease, patient contacts, information flow, testing procedures and protection of staff. Results GPs gave high ratings to their self-confidence (7.3, 95% CI 7.1-7.5) and their efforts to control the spread of the disease (7.2, 95% CI 7.0-7.3). A decrease in the number of patient contacts (5.7, 95% CI 5.4-5.9), the perception of risk (5.3 95% CI 4.9-5.6), the provision of information to GPs (4.9, 95% CI 4.6-5.2), their testing of suspected cases (3.7, 95% CI 3.4-3.9) and their preparedness to face a pandemic (mean: 3.5; 95% CI 3.2-3.7) were rated as moderate. GPs gave low ratings to their ability to protect staff (2.2 95% CI 1.9-2.4). Differences were identified in all dimensions except protection of staff, which was consistently low in all surveyed GPs and countries. Conclusion Although GPs in the different countries were confronted with the same pandemic, its impact on specific aspects differed. This partly reflected differences in health care systems and experience of recent pandemics. However, it also showed that the development of structured care plans in case of future infectious diseases requires the early involvement of primary care representatives.
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Affiliation(s)
- Andrea Siebenhofer
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria,Institute of General Practice, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QL, Australia
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria,*Correspondence: Alexander Avian
| | - András Terebessy
- Department of Public Health-Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Karola Mergenthal
- Institute of General Practice, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | - Dagmar Schaffler-Schaden
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Herbert Bachler
- Institute of General Practice, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Huter
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Erika Zelko
- Faculty of Medicine, Johannes Kepler University of Linz, Linz, Austria
| | - Amanda Murray
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QL, Australia
| | - Michelle Guppy
- School of Rural Medicine and New England GP Research Network, University of New England, Armidale, NSW, Australia
| | - Giuliano Piccoliori
- Institute for Special Training in General Medicine, Institute of General Practice, Claudiana Bozen, Bolzano, Italy
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Klaus Jeitler
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria,Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Maria Flamm
- Institute for General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
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McGill N, Weller-Newton J, Lees C. A new survey tool for evaluating pandemic preparedness in health services. BMC Health Serv Res 2022; 22:708. [PMID: 35624506 PMCID: PMC9136193 DOI: 10.1186/s12913-022-08067-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
Background Rapid decision-making with limited resources and prior research to draw upon posed challenges for health service leaders globally when preparing for COVID-19. How do health services prepare for a pandemic and evaluate if the preparation has been effective? This study aimed to explore health workers’ perceptions and knowledge regarding preparedness for COVID-19 at a regional health service in Australia. Methods A 32-item online survey was developed to evaluate preparedness across five scales: 1) Clinical, 2) Communication, 3) Environment, 4) Human Resources, and 5) General Preparedness. Data were analyzed using parametric and non-parametric statistics and qualitative content analysis. Results Ninety-three employees completed the survey, with most working in clinical roles (58.1%). Respondents largely felt the health service was well-prepared (84.0%) and they were personally prepared (74.4%) to respond to COVID-19. Clinical and communication scale scores varied by role type. Respondents faced personal risk and resource shortages impacted their sense of safety; others felt adequately supported. Conclusions A coordinated “whole hospital response”, accessible and inclusive communication, education, adequate resourcing, and employee wellbeing supports are necessary when preparing health services for sentinel events. This survey tool offers health services an approach to evaluating pandemic preparation. Continued advocacy for resources and wellbeing needs of health workers is paramount in future preparations.
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Affiliation(s)
- Nicole McGill
- Department of Rural Health; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 49 Graham St, Shepparton, Victoria, Australia. .,Department of Education, Training and Research, Echuca Regional Health, 226 Service St, Echuca, Victoria, Australia.
| | - Jennifer Weller-Newton
- Department of Rural Health; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 49 Graham St, Shepparton, Victoria, Australia
| | - Catherine Lees
- Department of Education, Training and Research, Echuca Regional Health, 226 Service St, Echuca, Victoria, Australia
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Dutour M, Kirchhoff A, Janssen C, Meleze S, Chevalier H, Levy-Amon S, Detrez MA, Piet E, Delory T. Family medicine practitioners' stress during the COVID-19 pandemic: a cross-sectional survey. BMC FAMILY PRACTICE 2021; 22:36. [PMID: 33583410 PMCID: PMC7882249 DOI: 10.1186/s12875-021-01382-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/04/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic has shaken the world in early 2020. In France, General Practitioners (GPs) were not involved in the care organization's decision-making process before and during the first wave of the COVID-19 pandemic. This omission could have generated stress for GPs. We aimed first to estimate the self-perception of stress as defined by the 10-item Perceived Stress Score (PSS-10), at the beginning of the pandemic in France, among GPs from the Auvergne-Rhône-Alpes, a french administrative area severely impacted by COVID-19. Second, we aimed to identify factors associated with a self-perceived stress (PSS-10 ≥ 27) among socio-demographic characteristics of GPs, their access to reliable information and to personal protective equipment during the pandemic, and their exposure to well established psychosocial risk at work. METHODS We conducted an online cross-sectional survey between 8th April and 10th May 2020. The self-perception of stress was evaluated using the PSS-10, so to see the proportion of "not stressed" (≤20), "borderline" (21 ≤ PSS-10 ≤ 26), and "stressed" (≥27) GPs. The agreement to 31 positive assertions related to possible sources of stress identified by the scientific study committee was measured using a 10-point numeric scale. In complete cases, factors associated with stress (PSS-10 ≥ 27) were investigated using logistic regression, adjusted on gender, age and practice location. A supplementary analysis of the verbatims was made. RESULTS Overall, 898 individual answers were collected, of which 879 were complete. A total of 437 GPs (49%) were stressed (PSS-10 ≥ 27), and 283 GPs (32%) had a very high level of stress (PSS-10 ≥ 30). Self-perceived stress was associated with multiple components, and involved classic psychosocial risk factors such as emotional requirements. However, in this context of health crisis, the primary source of stress was the diversity and quantity of information from diverse sources (614 GPs (69%, OR = 2.21, 95%CI [1.40-3.50], p < 0.001). Analysis of verbatims revealed that GPs felt isolated in a hospital-based model. CONCLUSION The first wave of the pandemic was a source of stress for GPs. The diversity and quantity of information received from the health authorities were among the main sources of stress.
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Affiliation(s)
- Marion Dutour
- Infectious disease department, Annecy-Genevois hospital, Annecy, France.
| | - Anna Kirchhoff
- Infectious disease department, Annecy-Genevois hospital, Annecy, France
| | - Cécile Janssen
- Infectious disease department, Annecy-Genevois hospital, Annecy, France
| | - Sabine Meleze
- Institut national d'études démographiques (Ined), UR 14, Aubervillers, France
| | | | | | | | - Emilie Piet
- Infectious disease department, Annecy-Genevois hospital, Annecy, France
| | - Tristan Delory
- Institut national d'études démographiques (Ined), UR 14, Aubervillers, France
- Clinical research unit, Annecy-Genevois hospital, Annecy, France
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Oyedele T, Ladeji A, Adeyemo Y, Abah A, Coker M. Assessment of knowledge, practice, and level of preparedness of dentists practicing in Nigeria toward COVID-19 pandemic. SAUDI JOURNAL OF ORAL SCIENCES 2021. [DOI: 10.4103/sjos.sjoralsci_59_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Edeghere O, Fowler T, Wilson F, Caspa R, Raichand S, Kara E, Janmohamed Rampling S, Olowokure B. Knowledge, attitudes, experience and behaviour of frontline health care workers during the early phase of 2009 influenza A(H1N1) pandemic, Birmingham, UK. J Health Serv Res Policy 2014; 20:26-30. [PMID: 25392369 DOI: 10.1177/1355819614554243] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES During the early ('containment') phase of the influenza A(H1N1) pandemic, when the severity of the pandemic was unclear, health care workers (HCWs) across the UK were deployed to swab and prescribe antiviral drugs to suspected cases. This study describes the knowledge, attitudes, experience and behaviour of frontline HCWs in Birmingham, West Midlands, during this period. METHODS During June 2009, a 25-item semi-structured questionnaire was used to survey HCWs who undertook defined clinical duties as part of the public health response during the early phase of the pandemic. Participants were clinical staff based in a primary care out-of-hours service provider. RESULTS The response rate was 50% (n = 20). All respondents provided direct clinical care that necessitated prolonged close contact with potentially infectious cases. Knowledge and use of personal protective equipment and infection control procedures was consistently high. However, the main source of infection control advice was local guidance. Uptake of, and attitude towards, vaccination as a preventive measure and antiviral prophylaxis was poor. CONCLUSIONS HCWs were prepared to provide an essential health care response during the pandemic even when the severity of disease was unclear. However, more needs to be done to change health care workers' negative attitudes towards taking antivirals and receiving influenza vaccination.
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Affiliation(s)
- Obaghe Edeghere
- Consultant Epidemiologist, Field Epidemiology Service, Public Health England, Birmingham, UK
| | - Tom Fowler
- Locum Consultant Epidemiologist, Field Epidemiology Service, Public Health England, Birmingham, UK Honorary Research Fellow, Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, UK
| | - Fay Wilson
- CEO/Group Medical Director, Birmingham and District General Practitioner Emergency Room, Birmingham, UK
| | - Richard Caspa
- Post-graduate Intern, Field Epidemiology Service, Public Health England, Birmingham, UK
| | - Smitri Raichand
- Post-graduate Intern, Field Epidemiology Service, Public Health England, Birmingham, UK
| | - Edna Kara
- previously Post-graduate Intern, Field Epidemiology Service, Public Health England, Birmingham, UK; currently Scientist (Epidemiology); Immunisation, Hepatitis and Blood Safety department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | | | - Babatunde Olowokure
- previously Consultant Regional Epidemiologist, Field Epidemiology Service, Public Health England, Birmingham, UK; currently Director of Surveillance, Disease Prevention and Control. Caribbean Institute of Public Health, Trinidad & Tobago
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Tomizuka T, Kanatani Y, Kawahara K. Insufficient preparedness of primary care practices for pandemic influenza and the effect of a preparedness plan in Japan: a prefecture-wide cross-sectional study. BMC FAMILY PRACTICE 2013; 14:174. [PMID: 24252688 PMCID: PMC3840630 DOI: 10.1186/1471-2296-14-174] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/18/2013] [Indexed: 11/10/2022]
Abstract
Background Cases of emerging infectious diseases, including H5N1 influenza, H7N9 influenza, and Middle East Respiratory Syndrome, have been reported in recent years, and the threat of pandemic outbreaks persists. In Japan, primary care is the frontline against emerging infectious diseases in communities. Although the importance of pandemic preparedness in primary care has been highlighted previously, few studies have thus far investigated the preparedness among primary care practices (PCPs) or differences in the preparedness of different institutional settings. We examined PCP preparedness and response to the 2009 influenza pandemic in Japan, and explored the role of a pandemic preparedness plan during the pandemic. Methods We used a survey questionnaire to assess how well individual PCPs in Okinawa, Japan, were prepared for the 2009 influenza pandemic. The questionnaire was mailed to all eligible PCPs (N = 465) in Okinawa, regardless of their institutional setting. In addition, we assessed the differences in the preparedness of clinics and hospitals and determined whether the national preparedness plan affected individual preparedness and response. Data were analyzed using descriptive and logistic regression analyses. Results A total of 174 (37.4%) PCPs responded to our survey. In general, high-level personal protective equipment (PPE) such as N95 masks (45.4%), gowns (30.5%), and eye protection (21.3%) was stocked at a low rate. Clinic-based PCPs were significantly less prepared than hospital-based PCPs to provide N95 masks (OR 0.34), gowns (OR 0.15), and eye protection (OR 0.18). In addition, only 32.8% of PCPs adopted an adequate business continuity plan (BCP). After controlling for institutional setting, reading the national preparedness plan was significantly associated with establishment of a BCP (OR 5.86), and with knowledge of how to transfer a swab specimen to a local medical laboratory (OR 5.60). Conclusions With regard to PPE availability, PCPs (especially clinic-based PCPs) were not adequately prepared for the influenza pandemic. Awareness of the national pandemic preparedness plan is likely to promote prefecture-wide implementation of BCPs and surveillance activity.
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Affiliation(s)
- Taro Tomizuka
- Department of Health Policy Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
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Facing the threat of influenza pandemic - roles of and implications to general practitioners. BMC Public Health 2010; 10:661. [PMID: 21044300 PMCID: PMC2988738 DOI: 10.1186/1471-2458-10-661] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 11/02/2010] [Indexed: 11/10/2022] Open
Abstract
The 2009 pandemic of H1N1 influenza, compounded with seasonal influenza, posed a global challenge. Despite the announcement of post-pandemic period on 10 August 2010 by theWHO, H1N1 (2009) virus would continue to circulate as a seasonal virus for some years and national health authorities should remain vigilant due to unpredictable behaviour of the virus. Majority of the world population is living in countries with inadequate resources to purchase vaccines and stockpile antiviral drugs. Basic hygienic measures such as wearing face masks and the hygienic practice of hand washing could reduce the spread of the respiratory viruses. However, the imminent issue is translating these measures into day-to-day practice. The experience from Severe Acute Respiratory Syndrome (SARS) in Hong Kong has shown that general practitioners (GPs) were willing to discharge their duties despite risks of getting infected themselves. SARS event has highlighted the inadequate interface between primary and secondary care and valuable health care resources were thus inappropriately matched to community needs. There are various ways for GPs to contribute in combating the influenza pandemic. They are prompt in detecting and monitoring epidemics and mini-epidemics of viral illnesses in the community. They can empower and raise the health literacy of the community such as advocating personal hygiene and other precautious measures. GPs could also assist in the development of protocols for primary care management of patients with flu-like illnesses and conduct clinical audits on the standards of preventive and treatment measures. GPs with adequate liaison with public health agencies would facilitate early diagnosis of patients with influenza. In this article, we summarise the primary care actions for phases 4-6 of the pandemic. We shall discuss the novel roles of GPs as alternative source of health care for patients who would otherwise be cared for in the secondary care level. The health care system would thus remain sustainable during the public health crisis.
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Basta NE, Edwards SE, Schulte J. Assessing Public Health Department Employees' Willingness to Report to Work During an Influenza Pandemic. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2009; 15:375-83. [DOI: 10.1097/phh.0b013e3181a391e2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Patel MS, Phillips CB, Pearce C, Kljakovic M, Dugdale P, Glasgow N. General practice and pandemic influenza: a framework for planning and comparison of plans in five countries. PLoS One 2008; 3:e2269. [PMID: 18509538 PMCID: PMC2386973 DOI: 10.1371/journal.pone.0002269] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2008] [Accepted: 04/12/2008] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although primary health care, and in particular, general practice will be at the frontline in the response to pandemic influenza, there are no frameworks to guide systematic planning for this task or to appraise available plans for their relevance to general practice. We aimed to develop a framework that will facilitate planning for general practice, and used it to appraise pandemic plans from Australia, England, USA, New Zealand and Canada. METHODOLOGY/PRINCIPAL FINDINGS We adapted the Haddon matrix to develop the framework, populating its cells through a multi-method study that incorporated the peer-reviewed and grey literature, interviews with general practitioners, practice nurses and senior decision-makers, and desktop simulation exercises. We used the framework to analyse 89 publicly-available jurisdictional plans at similar managerial levels in the five countries. The framework identifies four functional domains: clinical care for influenza and other needs, public health responsibilities, the internal environment and the macro-environment of general practice. No plan addressed all four domains. Most plans either ignored or were sketchy about non-influenza clinical needs, and about the contribution of general practice to public health beyond surveillance. Collaborations between general practices were addressed in few plans, and inter-relationships with the broader health system, even less frequently. CONCLUSIONS This is the first study to provide a framework to guide general practice planning for pandemic influenza. The framework helped identify critical shortcomings in available plans. Engaging general practice effectively in planning is challenging, particularly where governance structures for primary health care are weak. We identify implications for practice and for research.
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Affiliation(s)
- Mahomed S Patel
- College of Medicine and Health Sciences, Australian National University, Canberra, Australian Capital Territory, Australia.
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