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Hirani R, Noruzi K, Khuram H, Hussaini AS, Aifuwa EI, Ely KE, Lewis JM, Gabr AE, Smiley A, Tiwari RK, Etienne M. Artificial Intelligence and Healthcare: A Journey through History, Present Innovations, and Future Possibilities. Life (Basel) 2024; 14:557. [PMID: 38792579 PMCID: PMC11122160 DOI: 10.3390/life14050557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
Artificial intelligence (AI) has emerged as a powerful tool in healthcare significantly impacting practices from diagnostics to treatment delivery and patient management. This article examines the progress of AI in healthcare, starting from the field's inception in the 1960s to present-day innovative applications in areas such as precision medicine, robotic surgery, and drug development. In addition, the impact of the COVID-19 pandemic on the acceleration of the use of AI in technologies such as telemedicine and chatbots to enhance accessibility and improve medical education is also explored. Looking forward, the paper speculates on the promising future of AI in healthcare while critically addressing the ethical and societal considerations that accompany the integration of AI technologies. Furthermore, the potential to mitigate health disparities and the ethical implications surrounding data usage and patient privacy are discussed, emphasizing the need for evolving guidelines to govern AI's application in healthcare.
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Affiliation(s)
- Rahim Hirani
- School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; (R.H.)
- Graduate School of Biomedical Sciences, New York Medical College, Valhalla, NY 10595, USA
| | - Kaleb Noruzi
- School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; (R.H.)
| | - Hassan Khuram
- College of Medicine, Drexel University, Philadelphia, PA 19129, USA
| | - Anum S. Hussaini
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Esewi Iyobosa Aifuwa
- School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; (R.H.)
| | - Kencie E. Ely
- Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, NV 89106, USA
| | - Joshua M. Lewis
- School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; (R.H.)
| | - Ahmed E. Gabr
- School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; (R.H.)
| | - Abbas Smiley
- School of Medicine and Dentistry, University of Rochester, Rochester, NY 14642, USA
| | - Raj K. Tiwari
- School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; (R.H.)
- Graduate School of Biomedical Sciences, New York Medical College, Valhalla, NY 10595, USA
| | - Mill Etienne
- School of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA; (R.H.)
- Department of Neurology, New York Medical College, Valhalla, NY 10595, USA
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Aras FM, Gümüşsoy S. Emotional burnout, job satisfaction, and intention to leave among pre-hospital emergency healthcare workers during the COVID-19 pandemic. Work 2024:WOR230589. [PMID: 38489210 DOI: 10.3233/wor-230589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND With the onset of the COVID-19 pandemic, pre-hospital emergency healthcare workers (PHEHW) assumed critical responsibilities in controlling and preventing the spread of the virus. OBJECTIVE This descriptive study aimed to explore the emotional burnout, job satisfaction, and intention to leave among PHEHW during the COVID-19 pandemic. METHODS The study was conducted with 401 emergency medical technicians and paramedics. The Sociodemographic Data Form, the Emotional Burnout Scale, the Job Satisfaction Scale, the Intention to Leave the Profession Scale were used to collect data. The findings were assessed with a significance level set at p < 0.05 and a 95% confidence interval. RESULTS The participants demonstrated moderate scores in emotional burnout, job satisfaction, and intention to leave the profession. The analysis revealed a negative correlation, indicating that as emotional burnout increased, job satisfaction decreased, and the intention to leave the profession heightened. Notably, the participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, underwent COVID-19 testing, and experienced the loss of a healthcare worker due to COVID-19 exhibited higher levels of burnout. Furthermore, those who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and lost a healthcare worker due to COVID-19 reported lower levels of job satisfaction. Additionally, participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and experienced the loss of a healthcare worker due to COVID-19 displayed a greater intention to leave the profession. CONCLUSIONS It is important to implement improvement initiatives that will increase the motivation and job satisfaction of PHEHW. These include the regulation of working hours and shifts, augmenting staff numbers, enhancing working conditions, improving salaries, and implementing strategies aimed at fostering motivation and job satisfaction.
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Affiliation(s)
- Fatih Mehmet Aras
- Pre-Hospital Emergency Health Services And Disaster Management Graduate Program, Health Sciences Institute, Department of Disaster Medicine, Ege University, Bornova, Türkiye
| | - Süreyya Gümüşsoy
- Atatürk Health Care Vocational School, Ege University, Bornova, Türkiye
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Kidholm K, Jensen LK, Johansson M, Montori VM. Telemedicine and the assessment of clinician time: a scoping review. Int J Technol Assess Health Care 2023; 40:e3. [PMID: 38099431 PMCID: PMC10859839 DOI: 10.1017/s0266462323002830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVES Telemedicine may improve healthcare access and efficiency if it demands less clinician time than usual care. We sought to describe the degree to which telemedicine trials assess the effect of telemedicine on clinicians' time and to discuss how including the time needed to treat (TNT) in health technology assessment (HTA) could affect the design of telemedicine services and studies. METHODS We conducted a scoping review by searching clinicaltrials.gov using the search term "telemedicine" and limiting results to randomized trials or observational studies registered between January 2012 and October 2023. We then reviewed trial registration data to determine if any of the outcomes assessed in the trials measured effect on clinicians' time. RESULTS We found 113 studies and of these 78 studies of telemedicine met the inclusion criteria and were included. Nine (12 percent) of the 78 studies had some measure of clinician time as a primary outcome, and 11 (14 percent) as a secondary outcome. Four studies compared direct measures of TNT with telemedicine versus usual care, but no statistically significant difference was found. Of the sixteen studies including indirect measures of clinician time, thirteen found no significant effects, two found a statistically significant reduction, and one found a statistically significant increase. CONCLUSIONS This scoping review found that clinician time is not commonly measured in studies of telemedicine interventions. Attention to telemedicine's TNT in clinical studies and HTAs of telemedicine in practice may bring attention to the organization of clinical workflows and increase the value of telemedicine.
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Affiliation(s)
- Kristian Kidholm
- Center for Innovative Medical Technology, Odense University Hospital and University of Southern Denmark, Denmark
| | - Lise Kvistgaard Jensen
- Center for Innovative Medical Technology, Odense University Hospital and University of Southern Denmark, Denmark
| | - Minna Johansson
- Global Center for Sustainable Healthcare, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Victor M Montori
- Department of Medicine, Mayo Clinic, Knowledge and Evaluation Research Unit, Rochester, MN, USA
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Singh A, Schooley B, Patel N. Effects of User-Reported Risk Factors and Follow-Up Care Activities on Satisfaction With a COVID-19 Chatbot: Cross-Sectional Study. JMIR Mhealth Uhealth 2023; 11:e43105. [PMID: 38096007 PMCID: PMC10727483 DOI: 10.2196/43105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 06/19/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic influenced many to consider methods to reduce human contact and ease the burden placed on health care workers. Conversational agents or chatbots are a set of technologies that may aid with these challenges. They may provide useful interactions for users, potentially reducing the health care worker burden while increasing user satisfaction. Research aims to understand these potential impacts of chatbots and conversational recommender systems and their associated design features. OBJECTIVE The objective of this study was to evaluate user perceptions of the helpfulness of an artificial intelligence chatbot that was offered free to the public in response to COVID-19. The chatbot engaged patients and provided educational information and the opportunity to report symptoms, understand personal risks, and receive referrals for care. METHODS A cross-sectional study design was used to analyze 82,222 chats collected from patients in South Carolina seeking services from the Prisma Health system. Chi-square tests and multinomial logistic regression analyses were conducted to assess the relationship between reported risk factors and perceived chat helpfulness using chats started between April 24, 2020, and April 21, 2022. RESULTS A total of 82,222 chat series were started with at least one question or response on record; 53,805 symptom checker questions with at least one COVID-19-related activity series were completed, with 5191 individuals clicking further to receive a virtual video visit and 2215 clicking further to make an appointment with a local physician. Patients who were aged >65 years (P<.001), reported comorbidities (P<.001), had been in contact with a person with COVID-19 in the last 14 days (P<.001), and responded to symptom checker questions that placed them at a higher risk of COVID-19 (P<.001) were 1.8 times more likely to report the chat as helpful than those who reported lower risk factors. Users who engaged with the chatbot to conduct a series of activities were more likely to find the chat helpful (P<.001), including seeking COVID-19 information (3.97-4.07 times), in-person appointments (2.46-1.99 times), telehealth appointments with a nearby provider (2.48-1.9 times), or vaccination (2.9-3.85 times) compared with those who did not perform any of these activities. CONCLUSIONS Chatbots that are designed to target high-risk user groups and provide relevant actionable items may be perceived as a helpful approach to early contact with the health system for assessing communicable disease symptoms and follow-up care options at home before virtual or in-person contact with health care providers. The results identified and validated significant design factors for conversational recommender systems, including triangulating a high-risk target user population and providing relevant actionable items for users to choose from as part of user engagement.
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Affiliation(s)
- Akanksha Singh
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Benjamin Schooley
- IT & Cybersecurity, Department of Electrical and Computer Engineering, Brigham Young University, Provo, UT, United States
| | - Nitin Patel
- Hackensack Meridian Health, Hackensack, NJ, United States
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Zabaleta-Del-Olmo E, Santesmases-Masana R, Martín-Payo R, Romero-Collado À, Zamora-Sánchez JJ, Urpí-Fernández AM, Gonzalez-Del-Rio M, Lumillo-Gutiérrez I, Sastre-Rus M, Jodar-Fernández L, Hernández-Martínez-Esparza E. Research on missed nursing care during the COVID-19 pandemic: A scoping review. Worldviews Evid Based Nurs 2023; 20:559-573. [PMID: 37743584 DOI: 10.1111/wvn.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/18/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care. AIM This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic. METHODS This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer. RESULTS We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes. LINKING EVIDENCE TO ACTION Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.
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Affiliation(s)
- Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain
- Barcelona Primary Care Directorate, Barcelona Regional Management, Institut Català de la Salut, Barcelona, Spain
| | - Rosalía Santesmases-Masana
- School of Nursing, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rubén Martín-Payo
- Faculty of Medicine and Health Sciences, Universidad de Oviedo, Oviedo, Spain
- PRECAM Research Group, ISPA-Asturias, Oviedo, Spain
| | | | - Juan-José Zamora-Sánchez
- Barcelona Primary Care Directorate, Barcelona Regional Management, Institut Català de la Salut, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ana-María Urpí-Fernández
- Barcelona Primary Care Directorate, Barcelona Regional Management, Institut Català de la Salut, Barcelona, Spain
- School of Nursing, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marina Gonzalez-Del-Rio
- Nursing Research Unit, Hospital Univrsitari Dr. Josep Trueta, Girona, Spain
- Neurodegeneration and Neuroinflammation Research Group, Girona, Spain
- Biomedical Research Institute (IDIBGI), Girona, Spain
- Girona Neuroimmunology and Multiple Sclerosis Unit, Neurology Department, Dr Josep Trueta Hospital and Santa Caterina Hospital, Girona-Salt, Spain
| | - Iris Lumillo-Gutiérrez
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain
- Chronic Disease Management Team, Baix Llobregat Centre Primary Care Service, Costa de Ponent Primary Care Directorate, Metropolitana Sud Regional Management, Institut Català de la Salut, Cornellà de Llobregat, Barcelona, Spain
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Meritxell Sastre-Rus
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Gimbernat School of Nursing, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lina Jodar-Fernández
- Montbaig Primary Care Centre, Delta Primary Care Service, Costa de Ponent Primary Care Directorate, Metropolitana Sud Regional Management, Institut Català de la Salut, Barcelona, Spain
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Seddik SA, Abdelhai R, Aboushady AT, Nawwar AE, El Essawy RA, Hegazy AA. Violence against healthcare workers during the COVID-19 pandemic: a cross-sectional survey at Cairo University Hospital. Front Public Health 2023; 11:1277056. [PMID: 38045967 PMCID: PMC10693415 DOI: 10.3389/fpubh.2023.1277056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/19/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Healthcare workers have a significant chance of experiencing violence, with physical violence impacting anywhere from 8 to 38% of healthcare professionals throughout their careers. Besides physical abuse, many healthcare workers are subject to verbal aggression or threats, with patients and visitors being the most frequent sources of such incidents. Methods This research examines the work atmosphere of healthcare professionals at Kasr Al-Aini University Hospital in Cairo, Egypt, during the pandemic. The study aims to evaluate the frequency of violence toward healthcare workers and health professionals training through a cross-sectional survey conducted among them. The research was conducted on Egyptian healthcare workers over 6 months, from November 2020 until the end of January 2021, using convenience sampling in a cross-sectional study. Over half of the respondents reported experiencing violence. Results Among those who experienced violence, 93% reported verbal aggression, 43% reported physical and verbal abuse, and 59% claimed that violence increased during the pandemic. Additionally, 97% of those who experienced violence reported it occurring within the 4 months following the survey. About 42.5% of the respondents were female, and nearly 65% were over 30. 82% of the respondents did not receive training on handling violence while performing their job. Conclusion This study highlights the high prevalence of verbal assaults in healthcare settings, primarily by patients' families or acquaintances. Despite reporting such incidents, most respondents did not see any significant government action. Furthermore, the COVID-19 pandemic did not significantly change the frequency of violent incidents, indicating that the root causes of violence are systemic and extend beyond the pandemic. These findings underscore the need for systemic changes in healthcare organizations to address and prevent violence against healthcare workers.
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Affiliation(s)
- Salma Abdelrehim Seddik
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rehab Abdelhai
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | | | - Amira Aly Hegazy
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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Malgaroli M, Tseng E, Hull TD, Jennings E, Choudhury TK, Simon NM. Association of Health Care Work With Anxiety and Depression During the COVID-19 Pandemic: Structural Topic Modeling Study. JMIR AI 2023; 2:e47223. [PMID: 38875560 PMCID: PMC11041488 DOI: 10.2196/47223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 06/28/2023] [Accepted: 09/07/2023] [Indexed: 06/16/2024]
Abstract
BACKGROUND Stressors for health care workers (HCWs) during the COVID-19 pandemic have been manifold, with high levels of depression and anxiety alongside gaps in care. Identifying the factors most tied to HCWs' psychological challenges is crucial to addressing HCWs' mental health needs effectively, now and for future large-scale events. OBJECTIVE In this study, we used natural language processing methods to examine deidentified psychotherapy transcripts from telemedicine treatment during the initial wave of COVID-19 in the United States. Psychotherapy was delivered by licensed therapists while HCWs were managing increased clinical demands and elevated hospitalization rates, in addition to population-level social distancing measures and infection risks. Our goal was to identify specific concerns emerging in treatment for HCWs and to compare differences with matched non-HCW patients from the general population. METHODS We conducted a case-control study with a sample of 820 HCWs and 820 non-HCW matched controls who received digitally delivered psychotherapy in 49 US states in the spring of 2020 during the first US wave of the COVID-19 pandemic. Depression was measured during the initial assessment using the Patient Health Questionnaire-9, and anxiety was measured using the General Anxiety Disorder-7 questionnaire. Structural topic models (STMs) were used to determine treatment topics from deidentified transcripts from the first 3 weeks of treatment. STM effect estimators were also used to examine topic prevalence in patients with moderate to severe anxiety and depression. RESULTS The median treatment enrollment date was April 15, 2020 (IQR March 31 to April 27, 2020) for HCWs and April 19, 2020 (IQR April 5 to April 27, 2020) for matched controls. STM analysis of deidentified transcripts identified 4 treatment topics centered on health care and 5 on mental health for HCWs. For controls, 3 STM topics on pandemic-related disruptions and 5 on mental health were identified. Several STM treatment topics were significantly associated with moderate to severe anxiety and depression, including working on the hospital unit (topic prevalence 0.035, 95% CI 0.022-0.048; P<.001), mood disturbances (prevalence 0.014, 95% CI 0.002-0.026; P=.03), and sleep disturbances (prevalence 0.016, 95% CI 0.002-0.030; P=.02). No significant associations emerged between pandemic-related topics and moderate to severe anxiety and depression for non-HCW controls. CONCLUSIONS The study provides large-scale quantitative evidence that during the initial wave of the COVID-19 pandemic, HCWs faced unique work-related challenges and stressors associated with anxiety and depression, which required dedicated treatment efforts. The study further demonstrates how natural language processing methods have the potential to surface clinically relevant markers of distress while preserving patient privacy.
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Affiliation(s)
- Matteo Malgaroli
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, United States
| | - Emily Tseng
- Ann S Bowers College of Computing and Information Science, Cornell University, Ithaca, NY, United States
| | - Thomas D Hull
- Research and Development, Talkspace, New York, NY, United States
| | - Emma Jennings
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, United States
| | - Tanzeem K Choudhury
- Ann S Bowers College of Computing and Information Science, Cornell University, Ithaca, NY, United States
| | - Naomi M Simon
- Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, United States
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Valiee S, Zarei Jelyani Z, Kia M, Jajarmizadeh A, Delavari S, Shalyari N, Ahmadi Marzaleh M. Strategies for maintaining and strengthening the health care workers during epidemics: a scoping review. HUMAN RESOURCES FOR HEALTH 2023; 21:60. [PMID: 37528378 PMCID: PMC10394761 DOI: 10.1186/s12960-023-00844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION During epidemics such as COVID-19, healthcare workers (HCWs) face several challenges, leading to a shortage and weakening of human resources. To address this issue, employing effective strategies is essential in maintaining and strengthening human resources during outbreaks. This study aimed to gather and classify strategies that could retain and strengthen human health resources during epidemics. METHODS In this scoping review, all studies published about strategies for maintaining and strengthening HCWs in epidemics were collected from 4 international databases, including PubMed, Embase, Scopus, and Web of Science. The English language articles published after 2000 up until June 2022 recommended specific strategies regarding the research question. Then, they were analyzed and classified according to thematic analysis based on Braun and Clarke 6 phases protocols. RESULTS In total, 9405 records were screened, of which 59 articles were included, and their full texts were reviewed. Fifty factors were identified and classified into five themes: Instruction, Protection, Supporting, Caring, and Communication. Most of the suggestions were conducted in high-income countries and related to the Supporting theme. DISCUSSION The majority of strategies discussed in the literature addressed only one or two aspects of human resources. This study provides a holistic perspective on these issues by providing a thematic map of different strategies for strengthening and maintaining HCWs during epidemics. Considering the multidimensionality of human nature, it is suggested that policymakers and managers of health systems provide facilities that simultaneously address a wide range of needs.
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Affiliation(s)
- Sadra Valiee
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences Shiraz, Shiraz, Iran
| | - Zahra Zarei Jelyani
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences Shiraz, Shiraz, Iran
| | - Mohammad Kia
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences Shiraz, Shiraz, Iran
| | - Ali Jajarmizadeh
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sajad Delavari
- School of Health Management and Information Sciences, Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naseh Shalyari
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Etz RS, Solid CA, Gonzalez MM, Britton E, Stange KC, Reves SR. Telemedicine in Primary Care: Lessons Learned About Implementing Health Care Innovations During the COVID-19 Pandemic. Ann Fam Med 2023; 21:297-304. [PMID: 37487734 PMCID: PMC10365867 DOI: 10.1370/afm.2979] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 07/26/2023] Open
Abstract
PURPOSE During the COVID-19 pandemic, telemedicine emerged as an important tool in primary care. Technology and policy-related challenges, however, revealed barriers to adoption and implementation. This report describes the findings from weekly and monthly surveys of primary care clinicians regarding telemedicine during the first 2 years of the pandemic. METHODS From March 2020 to March 2022, we conducted electronic surveys using convenience samples obtained through social networking and crowdsourcing. Unique tokens were used to confidentially track respondents over time. A multidisciplinary team conducted quantitative and qualitative analyses to identify key concepts and trends. RESULTS A total of 36 surveys resulted in an average of 937 respondents per survey, representing clinicians from all 50 states and multiple specialties. Initial responses indicated general difficulties in implementing telemedicine due to poor infrastructure and reimbursement mechanisms. Over time, attitudes toward telemedicine improved and respondents considered video and telephone-based care important tools for their practice, though not a replacement for in-person care. CONCLUSIONS The implementation of telemedicine during COVID-19 identified barriers and opportunities for technology adoption and highlighted steps that could support primary care clinics' ability to learn, adapt, and implement technology.
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Affiliation(s)
- Rebecca S Etz
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Richmond, Virginia
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | | | - Martha M Gonzalez
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Richmond, Virginia
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Erin Britton
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Kurt C Stange
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Richmond, Virginia
- Center for Community Health Integration, Case Western Reserve University, Cleveland, Ohio
| | - Sarah R Reves
- Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Richmond, Virginia
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
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Cunha AS, Pedro AR, Cordeiro JV. Facilitators and barriers to access hospital medical specialty telemedicine consultations during the COVID-19 pandemic: Systematic Review. J Med Internet Res 2023. [PMID: 37262124 DOI: 10.2196/44188] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND COVID-19 pandemic accelerated the digital transition in healthcare, which required a rapid adaptation of stakeholders. Telemedicine has emerged as an ideal tool to ensure continuity of care by allowing remote access to specialized medical services. However, its rapid implementation has exacerbated disparities in healthcare access, especially for the most vulnerable populations. OBJECTIVE To characterize the determinants factors (facilitators and barriers) of access to hospital medical specialty telemedicine consultations during the COVID-19 pandemic; to identify the main opportunities and challenges (technological, ethical, legal and/or social) generated by the use of telemedicine in the context of the COVID-19 pandemic. METHODS A systematic review was conducted according to PRISMA guidelines. Four databases (Scopus, Web of Science, PubMed and Cochrane COVID-19 Study Register) were searched for empirical studies published between January 3rd, 2020, and December 31st, 2021, using established criteria. The protocol of this review was registered and published in PROSPERO (CRD42022302825). A methodological quality assessment was performed, and results were integrated into a thematic synthesis. The identification of main opportunities and challenges was done by interpreting and aggregating the thematic synthesis results. RESULTS Of the 106 studies identified, 9 met the inclusion criteria and the intended quality characteristics. All studies were originally from the United States of America (USA). The following facilitating factors of telemedicine use were identified: health insurance coverage; prevention of SARS-CoV-2 infection; access to Internet services; access to technological devices; better management of work-life balance; and savings in travel costs. We identified the following barriers to telemedicine use: lack of access to Internet services; lack of access to technological devices; racial and ethnic disparities; low digital literacy; low income; age; language barriers; health insurance coverage; concerns about data privacy and confidentiality; geographic disparities; and need for complementary diagnostic tests or for the delivery of test results. CONCLUSIONS The facilitating factors and barriers identified in this systematic review present different opportunities and challenges, including those of technological nature (access to technological devices and internet services, level of digital literacy), sociocultural and demographic nature (ethnic and racial disparities, geographical disparities, language barriers, age), socioeconomic nature (income level and health insurance coverage), and ethical and legal nature (data privacy and confidentiality). To expand telemedicine access to hospital-based specialty medical consultations and provide high-quality care to all, including the most vulnerable communities, the challenges identified must be thoroughly researched and addressed with informed and dedicated responses. CLINICALTRIAL
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Affiliation(s)
- Ana Soraia Cunha
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Avenida Padre Cruz, Lisbon, PT
| | - Ana Rita Pedro
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal, Lisbon, PT
| | - João Valente Cordeiro
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal, Lisbon, PT
- Interdisciplinary Centre of Social Sciences (CICS.NOVA), Universidade NOVA de Lisboa, Lisbon, Portugal, Lisbon, PT
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11
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Kim J, Linos E, Fishman DA, Dove MS, Hoch JS, Keegan TH. Factors Associated with Online Patient-Provider Communications Among Cancer Survivors in the United States during COVID: A Cross-Sectional Study. JMIR Cancer 2023; 9:e44339. [PMID: 37074951 DOI: 10.2196/44339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/05/2023] [Accepted: 04/17/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Online Patient-Provider Communication (OPPC) is crucial in enhancing access to health information, self-care, and related health outcomes among cancer survivors. The necessity of OPPC increased during SARS/COVID-19 (COVID), yet investigations in vulnerable subgroups have been limited. OBJECTIVE Thus, this study aimed to assess the prevalence of OPPC and sociodemographic and clinical characteristics associated with OPPC among cancer survivors and adults without a history of cancer during COVID vs. pre-COVID. METHODS Nationally representative cross-sectional survey data (Health Information National Trends Survey, HINTS 5 2017-2020) was used among cancer survivors (n= 1,900) and adults without a history of cancer (n= 13, 292). COVID included data from February to June 2020. We calculated the prevalence of three types of OPPC, defined as using email/internet, tablet/smartphone, or Electronic Health Records (EHR) for patient-provider communication, in the past 12 months. To investigate the associations of sociodemographic and clinical factors with OPPC, multivariable-adjusted weighted logistic regression was performed to obtain odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS The average prevalence of OPPC increased from pre-COVID to COVID among cancer survivors (39.7% vs. 49.7%, email/internet; 32.2% vs. 37.9%, tablet/smartphone; 19.0% vs. 30.0%, EHR). Cancer survivors (OR=1.32, 95% CI 1.06-1.63) were slightly more likely to use email/internet communications than adults without a history of cancer prior to COVID. Among cancer survivors, email/internet (OR=1.61, 1.08-2.40) and EHR (OR=1.92, 1.22-3.02) were more likely to be used during COVID than pre-COVID. During COVID, subgroups of cancer survivors, including Hispanics (OR=0.26, 0.09-0.71 vs. non-Hispanic Whites), or those with the lowest income (OR=6.14, 1.99-18.92 $50,000 to <$75,000; OR=0.42, 1.56-11.28 ≥ $75,000 vs. <$20,000), with no usual source of care (OR=6.17, 2.12-17.99), or reporting depression (OR=0.33, 0.14-0.78) were less likely to use email/internet and those who were the oldest (OR=9.33, 2.18-40.01 age 35-49; OR=3.58, 1.20-10.70 age 50-64; OR=3.09, 1.09-8.76 age 65-74 vs. ≥75), unmarried (OR=2.26, 1.06-4.86) or had public/no health insurance (ORs=0.19-0.21 Medicare, Medicaid, or Other, vs. private) were less likely to use tablet/smartphone to communicate with providers. Cancer survivors with a usual source of care (OR=6.23, 1.66-23.39) or healthcare office visits within a year (ORs=7.55-8.25) were significantly more likely to use EHR to communicate. While not observed in cancer survivors, lower education level was associated with lower OPPC among adults without a history of cancer during COVID. CONCLUSIONS Our findings identified vulnerable subgroups of cancer survivors who were left behind in online patient-provider communications which are becoming an increasing part of healthcare. Those vulnerable subgroups of cancer survivors with lower OPPC should be helped through multidimensional interventions to prevent further inequities. CLINICALTRIAL Not applicable.
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Affiliation(s)
- Jiyeong Kim
- Department of Public Health Sciences, School of Medicine, University of California, Davis, 1 Shields Ave, Davis, US
| | - Eleni Linos
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, US
- Department of Dermatology, School of Medicine, Stanford University, Stanford, US
| | - Debra A Fishman
- Health Management and Education, UC Davis Health Cardiac Rehabilitation, Davis, US
| | - Melanie S Dove
- Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, Davis, US
| | - Jeffrey S Hoch
- Division of Health Policy and Management, Department of Public Health Sciences, Center for Healthcare Policy and Research, University of California, Davis, Davis, US
| | - Theresa H Keegan
- Division of Hematology and Oncology, UC Davis Comprehensive Cancer Center, Sacramento, US
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Chechter M, Dutra da Silva GM, E Costa RAP, Miklos TG, Antonio da Silva N, Lorber G, Vasconcellos Mota NR, Dos Santos Cortada AP, de Nazare Lima da Cruz L, de Melo PMP, de Souza BC, Emmerich FG, de Andrade Zanotto PM, Aaron Scheinberg M. Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study. Heliyon 2023; 9:e15337. [PMID: 37073324 PMCID: PMC10089670 DOI: 10.1016/j.heliyon.2023.e15337] [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: 09/06/2022] [Revised: 01/30/2023] [Accepted: 04/03/2023] [Indexed: 04/20/2023] Open
Abstract
We performed a pilot open-label, non-randomized controlled clinical trial in a clinic in São Paulo, Brazil in the beginning of the COVID-19 pandemic. "This medical pilot project was carried out during the pandemic of a new and unknown agent. It was necessary to find a new and safe therapeutic approach for pathogens with high potential for severity and contamination. The repositioning of safe and accessible pre-existing and approved medications and the telemedicine approach improved treated covid patients' symptoms and reduced the risk of disease transmission. The emergency application of a new medical technology was the major limitation of the study. This innovative care model is a low-cost safe strategy, and we understand that applicability can be expanded to other regions in emergency situations." The 187 patients of the study (mean age of 37.6 ± 15,6 years) were divided into four groups: (1) asymptomatic, (2) mild symptoms, (3) moderate symptoms and (4) severe symptoms and were followed up for five days. A drug intervention was performed in group 3 and the patients of Group 4 were oriented to seek hospital care. Of all the patients, 23.0% were asymptomatic, 29.4% reported mild symptoms, 43.9% moderate symptoms and 3.7% severe symptoms. Three patients were hospitalized and discharged after recovery. Our results indicate that the use of telemedicine with diagnosis and drug treatment is a safe and effective strategy to reduce overload of health services and the exposure of healthcare providers and the population. The patients that initiated the treatment in the early stages of the disease presented satisfactory clinical response, reducing the need of face-to-face consultations and hospitalizations. The patients who followed the protocol treatment for COVID-19 with hydroxychloroquine and azithromycin for five days presented statistically significant improvement of clinical symptoms when compared to moderate patients who opted for not following the protocol (p < 0.05) and to all no treatment patients (p < 0.001).
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Affiliation(s)
| | | | | | - Thomas Gabriel Miklos
- Department of Obstetrics and Gynecology - Santa Casa of Sao Paulo Medical School, Sao Paulo (FCMSCSP), Brazil
| | | | | | | | | | | | | | | | | | - Paolo Marinho de Andrade Zanotto
- Laboratory of Molecular Evolution and Bioinformatics (LEMB), Department of Microbiology, Institute of Biomedical Sciences (ICB-II), University of Sao Paulo, Sao Paulo, Brazil
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Ali Y, Khan HU. A Survey on harnessing the Applications of Mobile Computing in Healthcare during the COVID-19 Pandemic: Challenges and Solutions. COMPUTER NETWORKS 2023; 224:109605. [PMID: 36776582 PMCID: PMC9894776 DOI: 10.1016/j.comnet.2023.109605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/17/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic ravaged almost every walk of life but it triggered many challenges for the healthcare system, globally. Different cutting-edge technologies such as Internet of things (IoT), machine learning, Virtual Reality (VR), Big data, Blockchain etc. have been adopted to cope with this menace. In this regard, various surveys have been conducted to highlight the importance of these technologies. However, among these technologies, the role of mobile computing is of paramount importance which is not found in the existing literature. Hence, this survey in mainly targeted to highlight the significant role of mobile computing in alleviating the impacts of COVID-19 in healthcare sector. The major applications of mobile computing such as software-based solutions, hardware-based solutions and wireless communication-based support for diagnosis, prevention, self-symptom reporting, contact tracing, social distancing, telemedicine and treatment related to coronavirus are discussed in detailed and comprehensive fashion. A state-of-the-art work is presented to identify the challenges along with possible solutions in adoption of mobile computing with respect to COVID-19 pandemic. Hopefully, this research will help the researchers, policymakers and healthcare professionals to understand the current research gaps and future research directions in this domain. To the best level of our knowledge, this is the first survey of its type to address the COVID-19 pandemic by exploring the holistic contribution of mobile computing technologies in healthcare area.
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Affiliation(s)
- Yasir Ali
- Higher Education Department, Khyber Pakhtunkhwa, Government Degree College Kotha Swabi, KP, Pakistan
- Higher Education Department, Shahzeb Shaheed Government Degree College Razzar, Swabi, KP, Pakistan
| | - Habib Ullah Khan
- Accounting and Information, College of Business and Economics, Qatar University, Doha Qatar
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14
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Yılmaz Çelebi M, Kıymet E, Böncüoğlu E, Şahinkaya Ş, Cem E, Düzgöl M, Akaslan Kara A, Ötiken Arıkan K, Besin D, Bayram SN, Devrim İ. Follow-Up of Cases with the Telemedicine Method During the COVID-19 Pandemic: An Alternative Strategy for Reduction of Hospital Workload and Hospital-Related Transmissions. Telemed J E Health 2023; 29:454-458. [PMID: 35833790 DOI: 10.1089/tmj.2021.0613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study evaluated the effect of telemedicine use in children with COVID-19 to reduce the workload of health care facilities. Methods: This study was conducted at Dr. Behçet Uz Children's Hospital between October and December 2020. The complaints of the children who were called because of positivity for severe acute respiratory syndrome-CoV-2-PCR were questioned and also the duration of talk was recorded. Children were classified according to their symptoms. Cases with severe symptoms were invited to the hospital and were hospitalized according to their clinical findings. Results: The median age of 506 patients reached was 10.8 ± 5.5. Phone calls lasted <3 min in 498 (98.6%) cases. Only 33 (6.5%) patients with severe symptoms were invited to the hospital, and 6 (18.2%) of these cases were hospitalized. Conclusion: During the pandemic, interviews with patients through telephone may help to reduce the patient burden and to prevent the contact of healthy individuals.
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Affiliation(s)
- Miray Yılmaz Çelebi
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Elif Kıymet
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Elif Böncüoğlu
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Şahika Şahinkaya
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Ela Cem
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Mine Düzgöl
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Aybüke Akaslan Kara
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Kamile Ötiken Arıkan
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Dorukhan Besin
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - Süleyman Nuri Bayram
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
| | - İlker Devrim
- Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz, Children's Hospital, İzmir, Turkey
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Follow-Up, Safety, and Satisfaction with Tele-bariatric Follow-Up Implemented During the COVID-19 French Lockdown: a 2-Year Follow-Up Study. Obes Surg 2023; 33:1083-1091. [PMID: 36757646 PMCID: PMC9910261 DOI: 10.1007/s11695-023-06485-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic was initially responsible for a global restricted access to healthcare resources including the follow-up of at-risk populations such as bariatric patients. We substituted face-to-face bariatric follow-up outpatient clinics (FTFC) with teleclinics (TC) during the lockdown. MATERIAL AND METHODS We retrospectively reviewed data collected on all patients scheduled for TC during the French lockdown period (March 15 to May 15, 2020) (N = 87). Our aims were to present the patients' outcomes at one and 2 years post-TC implementation and describe patient/practitioner satisfaction. RESULTS Seven (8%) patients required FTFC, and 80 (92%) underwent TC (study population) for preoperative bariatric assessment (N = 3) and postoperative follow-up (N = 77) after 23.6 ± 29 months following surgery. TC was performed with video and audio (N = 46; 57.5%) or audio alone when video was impossible (N = 34; 42.5%). Sixteen (20%) patients presented at least one complication identified at the first TC and were managed accordingly. There were no readmissions at 30/90 days post-TC. At 1-year after the first TC, overall follow-up rate was 94.9% (TC: 73% vs FTFC: 27%). Patients surveyed on the main advantages of TC over FTFC (N = 46) cited: saving time (97.8%) at a mean 3.9 ± 6.4 h saved per TC, work-advantages (94.3%), and comparable relevance of TC (84.8%). At 2 years post-TC implementation, follow-up rate was 93.5% and satisfaction rate was 80%, with 33% of patients preferring to return to FTFC. CONCLUSIONS TC is a satisfactory substitute for FTFC, enabling continued bariatric follow-up during and beyond the pandemic setting without compromising patient safety. However, the modest satisfaction outcomes at 2 years highlight a need to discuss follow-up preferences in order to achieve optimal outcomes.
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Salazar de Pablo G, Pascual-Sánchez A, Panchal U, Clark B, Krebs G. Efficacy of remotely-delivered cognitive behavioural therapy for obsessive-compulsive disorder: An updated meta-analysis of randomised controlled trials. J Affect Disord 2023; 322:289-299. [PMID: 36395988 DOI: 10.1016/j.jad.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 09/12/2022] [Accepted: 11/06/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Despite remotely-delivered cognitive behavioural therapy (CBT) being an emerging field, the evidence of its efficacy in obsessive-compulsive disorder (OCD) is limited. We aimed to estimate the efficacy of remotely-delivered CBT for OCD, compared to face-to-face CBT and non-CBT control conditions. METHODS Randomised clinical trials (RCTs) identified through a systematic literature search of PubMed, Ovid/PsychINFO and Web of Science until 21/06/2021. Eligible studies included individuals with OCD evaluating at least one form of remotely-delivered CBT versus a control condition. Random-effects meta-analyses, sub-analyses, meta-regressions, heterogeneity analyses, publication bias assessment and quality assessment. RESULTS Twenty-two RCTs were included (n = 1796, mean age = 27.7 years, females = 59.1 %). Remotely-delivered CBT was more efficacious than non-CBT control conditions for OCD symptoms (g = 0.936 95 % CI = 0.597-1.275, p < .001), depressive symptoms (g = 0.358, 95 % CI = 0.125-0.590, p = .003) and anxiety symptoms (g = 0.468, 95 % CI = 0.135-0.800, p = .006). There were no significant differences in efficacy between remotely-delivered CBT and face-to-face CBT for OCD symptoms (g = -0.104 95 % CI = -0.391-0.184, p = .479), depressive symptoms (g = 0.138, 95 % CI = -0.044-0.320, p = .138), anxiety symptoms (g = 0.166, 95 % CI = -0.456-0.780, p = .601) or quality of life (g = 0.057, 95 % CI = -0.178-0.292, p = .489). Higher baseline severity of OCD symptoms was associated with a lower efficacy of remotely-delivered CBT compared to face-to-face CBT (β = -0.092, p = .036). The quality of the included studies was mostly identified as "low risk of bias" (45.5 %) or "some concerns" (45.5 %). LIMITATIONS Heterogeneity and limited evidence for some outcomes. CONCLUSIONS Remotely-delivered CBT appears efficacious in reducing OCD symptoms and other relevant outcomes and is therefore a viable option for increasing treatment access. Preliminary evidence suggests some individuals with severe OCD may benefit more from face-to-face than remotely-delivered CBT.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Ana Pascual-Sánchez
- Division of Psychiatry, Department of Brain Sciences, Imperial College, London, UK
| | - Urvashi Panchal
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Bruce Clark
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK
| | - Georgina Krebs
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Clinical, Educational and Health Psychology, University College London, UK
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Rosa WE, Lynch KA, Hadler RA, Mahoney C, Parker PA. "It Took Away and Stripped a Part of Myself": Clinician Distress and Recommendations for Future Telepalliative Care Delivery in the Cancer Context. Am J Hosp Palliat Care 2023; 40:235-243. [PMID: 35574961 PMCID: PMC9663759 DOI: 10.1177/10499091221101883] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to the rapid expansion of telehealth service delivery. We explored the experiences of a multidisciplinary palliative care team delivering telepalliative care for oncology inpatients during a 10-weeks COVID-19 surge in New York City. METHODS/PARTICIPANTS We conducted semi-structured qualitative interviews with a targeted sample, employing a phenomenological approach with applied thematic text analysis. An interdisciplinary coding team iteratively coded data using a mix of a priori and inductive codes. Team members first independently reviewed each category, then met to reach consensus on recurring themes. The sample (n = 11) included a chaplain (n = 1), social worker (n = 1), pharmacist (n = 1), physicians (n = 3), physician assistant (n = 1), and nurse practitioners (n = 4). RESULTS Participants described multidimensional clinician distress as a primary experience in delivering telepalliative care during the COVD-19 surge, characterized by competing loyalties (e.g., institutional obligations, ethical obligations to patients, resentment and distrust of leadership) and feelings of disempowerment (e.g., guilt in providing subpar support, decisional regret, loss of identity as a provider). Participants provided explicit recommendations to improve telepalliative care delivery for acute oncology inpatients in the future. CONCLUSION Palliative care clinicians experienced personal and professional distress providing inpatient telepalliative care during this COVID-19 surge. Clinician strain providing telehealth services must be explored further as the pandemic and utilization of telehealth evolves. Telepalliative care planning must include attention to clinician wellbeing to sustain the workforce and promote team cohesion, and a focus on infrastructure needed to deliver high-quality, holistic care for oncology patients and their families when in-person consultation is impossible.
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Affiliation(s)
- William E. Rosa
- Communication Skills Training Program and Research Laboratory, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathleen A. Lynch
- Patient-Reported Outcomes, Community-Engagement, and Language Core, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rachel A. Hadler
- Department of Anesthesiology, University of Iowa Hospital and Clinics, Iowa City, IA, USA
| | - Cassidy Mahoney
- Communication Skills Training Program and Research Laboratory, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Patricia A. Parker
- Communication Skills Training Program and Research Laboratory, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Shokri F, Bahrainian S, Tajik F, Rezvani E, Shariati A, nourigheimasi S, Shahrebabaki ES, Ebrahimi M, Shamoon F, Heidary M. The potential role of telemedicine in the infectious disease pandemic with an emphasis on COVID-19: A narrative review. Health Sci Rep 2023; 6:e1024. [PMID: 36620507 PMCID: PMC9811063 DOI: 10.1002/hsr2.1024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 01/05/2023] Open
Abstract
Background and Aims Due of its low cost, rapid speed, data record, and vast communication coverage, information and communication technology might be useful for health-related fields in times of crisis. By providing medical or hygienic services to a patient who lives elsewhere using communication methods like email, fax, cellphones, applications, and wireless gadgets, telemedicine can aid in the better management of diseases. Reviewing the potential role of telemedicine in the pandemic of infectious diseases with a focus on the Coronavirus disease 2019 (COVID-19) epidemic was the main goal of this study. Methods "Google Scholar," "PubMed," "Science Direct," and "Scopus" databases were searched to collect the papers that identify the advantages and disadvantages of telemedicine in the disease pandemic. Searched keywords include: telepharmacy, telemedicine, remote communication, pandemic(s), epidemic, distant care, distant communication, phone consulation, video conference communication and patient education. Results Information and communication technology are crucial, especially when dealing with pandemics of infectious diseases like COVID-19. Less "in-person" patient visits to hospitals as a result of telemedicine eventually means less labor for the medical staff, less viral exposure for patients, and ultimately less disease spread. By establishing a bidirectional reciprocal relationship between patients and healthcare providers although they are in separate geographical areas, it can improve patient health status. Conclusion Governments are currently facing a significant budgetary burden because to the COVID-19 pandemic. Since patients are not sent to medical facilities in person, which could be a source of infection, telemedicine reduces disease spread while saving money.
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Affiliation(s)
- Fazlollah Shokri
- Department of Medical GeneticsFaculty of Medicine, Shahid Beheshti University of Medical SciencesTehranIran
| | - Sara Bahrainian
- Department of Food and Drug ControlSchool of Pharmacy, Ahvaz Jundishapur University of Medical SciencesAhvazIran
| | - Fatemeh Tajik
- Faculty of Medicine, Iran University of Medical SciencesTehranIran
| | - Elaheh Rezvani
- Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical SciencesIslamic Azad UniversityTehranIran
| | - Aref Shariati
- Molecular and medicine research center, Khomein University of Medical SciencesKhomeinIran
| | | | - Elahe Saberi Shahrebabaki
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung DiseasesShahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Ebrahimi
- Faculty of Pharmacy, Tehran University of Medical SciencesTehranIran
| | - Farhan Shamoon
- Student Research Committee, Sabzevar University of Medical SciencesSabzevarIran
| | - Mohsen Heidary
- Cellular and Molecular Research Center, Sabzevar University of Medical SciencesSabzevarIran
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Montazeri M, Galavi Z, Ahmadian L. The role of mobile health in prevention, diagnosis, treatment and self-care of COVID-19 from the healthcare professionals' perspectives. Digit Health 2023; 9:20552076231171969. [PMID: 37152239 PMCID: PMC10159248 DOI: 10.1177/20552076231171969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/10/2023] [Indexed: 05/09/2023] Open
Abstract
Background To facilitate disease management, understanding the attitude of healthcare professionals regarding the use of this tool can help mobile health (mHealth) program developers develop appropriate interventions. Aims To assess the perspective of healthcare professionals regarding the contribution of mobile-based interventions in the prevention, diagnosis, self-care, and treatment (PDST) of COVID-19. Methods This is a survey study conducted in 2020 in Iran with 81 questions. In this study mHealth functionalities were categorized into four dimensions including innovative, monitoring and screening, remote services, and education and decision-making. The data were analyzed using descriptive statistics, ANOVA, and the Kruskal-Wallis test to compare the attitudes of the different job groups. Results In total, 123 providers participated, and 87.4% of them reported that mHealth technology is moderate to most helpful for the management of COVID-19. Healthcare professionals believed that mHealth technology could be most helpful in self-care and least helpful in the diagnosis of COVID-19. Regarding the functionalities of the mobile application, the results showed that the use of patient decision aids can be most helpful in self-care and the use of computer games can be least helpful in treatment. The participants believed that mHealth is more effective in monitoring and screening dimensions and less effective in providing remote services. Conclusions This study showed that healthcare professionals believed that mHealth technology could have a better contribution to self-care for patients with COVID-19. Therefore, it is better to plan and invest more in the field of self-care to help patients to combat COVID-19. The results of this study revealed which mhealth functionalities work better in four domains of prevention, treatment, self-care, and diagnosis of COVID-19. This can help healthcare authorities to implement appropriate IT-based interventions to combat COVID-19.
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Affiliation(s)
- Mahdieh Montazeri
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
| | - Zahra Galavi
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
| | - Leila Ahmadian
- Department of Health Information Sciences, Faculty
of Management and Medical Information Sciences, Kerman University of Medical
Sciences, Kerman, Iran
- Leila Ahmadian, Department of Health
Information Sciences, Faculty of Management and Medical Information Sciences,
Kerman University of Medical Sciences, Haft-bagh Highway, PO Box 7616911320,
Kerman, Iran. Emails: ,
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Bouza E, Martin M, Alés JE, Aragonés N, Barragán B, de la Cámara R, Pozo JLD, García-Gutiérrez V, García-Sanz R, Gracia D, Guillem V, Jiménez-Yuste V, Martin-Delgado MC, Martínez J, López R, Rodríguez-Lescure Á, Galiana JR, Sureda AM, Tejerina-Picado F, Trilla A, Zapatero A, Palomo E, San-Miguel J. Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023; 36:1-25. [PMID: 36322133 PMCID: PMC9910677 DOI: 10.37201/req/087.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.
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Affiliation(s)
- Emilio Bouza
- CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), España. Patrono de la Fundación de Ciencias de la Salud. Servicio de Microbiología y Enfermedades Infecciosas Hospital General Universitario Gregorio Marañón. Catedrático de Medicina. Universidad Complutense. Madrid.,Correspondence: Emilio Bouza MD, PhD. Instituto de Investigación Sanitaria Gregorio Marañón. C/ Dr. Esquerdo, 46 28007 Madrid, España E-mail:
| | - Miguel Martin
- Universidad Complutense de Madrid. Jefe de Servicio de Oncología del Hospital Gregorio Marañón de Madrid
| | | | | | | | | | - José Luis Del Pozo
- Servicio de Enfermedades Infecciosas. Servicio de Microbiología. Clínica Universidad de Navarra. Pamplona España
| | | | - Ramón García-Sanz
- Laboratorio de HLA y biología molecular en hematología, Universidad de Salamanca. Sociedad Española de Hematología y Hemoterapia
| | | | - Vicente Guillem
- Servicio de Oncología Médica del Instituto Valenciano de Oncología (IVO)
| | | | - Mari Cruz Martin-Delgado
- Servicio Medicina Intensiva Hospital Universitario Torrejón. Universidad Francisco de Vitoria. Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva
| | - Joaquín Martínez
- Servicio de Hematología y Hemoterapia, Hospital 12 de Octubre, Madrid. Universidad Complutense. Madrid
| | - Rafael López
- Oncología Médica del Hospital Clínico Universitario, Santiago de Compostela
| | | | | | - Ana María Sureda
- Servicio de Hematología en Hospital Universitario Quiron Dexeus, Grupo Español de Trasplante y Terapia Celular, Electa del EBMT
| | | | - Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología del Hospital Clínic de Barcelona. Catedrático de Medicina (Salud Pública) Universidad de Barcelona
| | | | | | - Jesús San-Miguel
- Medicina Clínica y Traslacional de la Clínica Universidad de Navarra
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21
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Luna P, Lee M, Vergara Greeno R, DeLucia N, London Y, Hoffman P, Burg M, Harris K, Spatz ES, Mena-Hurtado C, Smolderen KG. Telehealth care before and during COVID-19: trends and quality in a large health system. JAMIA Open 2022; 5:ooac079. [PMID: 36204596 PMCID: PMC9531686 DOI: 10.1093/jamiaopen/ooac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 07/26/2022] [Accepted: 09/29/2022] [Indexed: 11/14/2022] Open
Abstract
Objective COVID-19 accelerated telehealth use to ensure care delivery, but there is limited data on the patient perspective. This study aimed to examine telehealth visit uptake before and during COVID-19 and correlates of patient satisfaction and interest in future telehealth visits. Materials and Methods This was a cross-sectional observational study between October 2019 and April 2020. Participants included patients who completed satisfaction surveys following telehealth visits. Results A total of 8930 patients completed the satisfaction survey using 4-point Likert Scales. Multivariable, hierarchical, cumulative logit models were constructed to examine correlates of satisfaction with quality of care and interest in future telehealth visits. Most patients were satisfied with the patient portal, video quality, and instructions (92.7%-96.8%). Almost half reported saving 1-2 h (46.9%). Correlates positively associated with quality of care and interest in future telehealth visits were ease of patient portal (odds ratio [OR], 1.43, 95% confidence interval [CI], 1.30-1.58; OR, 1.56, 95% CI, 1.41-1.73, respectively), video quality (OR, 1.62, 95% CI, 1.50-1.75; OR, 1.26, 95% CI, 1.16-1.37, respectively), instructions (OR, 5.62, 95% CI, 5.05-6.26; OR, 1.80, 95% CI, 1.62-2.01, respectively), and time saved (>4 h: OR, 1.69, 95%,CI, 1.22-2.34; OR, 3.49, 95% CI, 2.47-4.93, respectively). Being seen after the COVID-19 surge in telehealth (OR, 0.76, 95% CI, 0.63-0.93) or by providers with higher visit volume (OR, 0.71, 95% CI, 0.60-0.85) was associated with lower interest in future telehealth visits. Conclusions Patients expressed relatively high satisfaction levels with telehealth. Better technical quality, quality of instructions, and greater time saved were associated with higher satisfaction ratings. To maintain interest in future telehealth use and improve the patient experience, we must enhance the quality of telehealth delivery platforms and instructions provided to patients.
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Affiliation(s)
- Paulina Luna
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Megan Lee
- Yale University School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Pamela Hoffman
- Department of Child Psychiatry, Yale University, New Haven, Connecticut, USA
| | - Matthew Burg
- Department of Internal Medicine—Cardiology, Yale University, New Haven, Connecticut, USA
| | - Kristie Harris
- Department of Internal Medicine—Cardiology, Yale University, New Haven, Connecticut, USA
| | - Erica S Spatz
- Department of Internal Medicine—Cardiology, Yale University, New Haven, Connecticut, USA
| | - Carlos Mena-Hurtado
- Department of Internal Medicine—Cardiology, Yale University, New Haven, Connecticut, USA
| | - Kim G Smolderen
- Corresponding Author: Kim G. Smolderen, PhD, Department of Internal Medicine, Section of Cardiovascular Medicine, Vascular Medicine Outcomes Program (VAMOS), Yale University, 789 Howard Ave, New Haven, CT 06520, USA;
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22
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Muacevic A, Adler JR, Brauer B, Nabaty R, Opara IN, Levine DL. Patient Satisfaction With Medical and Social Concerns Addressed During Telemedicine Visits. Cureus 2022; 14:e32529. [PMID: 36654607 PMCID: PMC9839388 DOI: 10.7759/cureus.32529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose The use of telemedicine dramatically increased during the COVID-19 pandemic. Assessing patient satisfaction with this mode of healthcare delivery is an important metric of success as it is broadly implemented across various settings. Of additional importance are the ways social determinants of health impact health outcomes, with the first step in determining the scale of this impact being the identification of contributing factors. This study assesses patient satisfaction with the medical and social aspects of the care they receive via telemedicine at a university-affiliated primary care training clinic in Detroit, Michigan. Methods A survey was designed to assess patient satisfaction with the technical aspects of the visit, the visit itself, and with the social determinants screening tool used. During July 2020, 167 patients who had at least one telemedicine visit with a primary care physician from the clinic in the preceding months were contacted to assess their impression of the service provided. The responses were used to evaluate patient satisfaction with the comprehensive care provided via the telemedicine visit. Results Of the 167 patients contacted, 79 (47%) completed the survey. Respondents' age ranged from 18-74 years, with 66% identifying as female and 34% as male. For many, this was their first experience with telemedicine. The vast majority expressed comfort in sharing details about their health concerns via telemedicine, with only 3% reporting they were "uncomfortable." More than half of the patients (60%) felt some level of comfort with telemedicine after their first encounter; 14% stated that they were still uncomfortable, and 26% were neutral. Most of the patients (88%) asserted their willingness to participate in future telemedicine visits. Just under two-thirds (63%) of participants "strongly agreed" that concerns related to their social determinants of health were addressed, and 59% "strongly agreed" that the resources provided by their physician were helpful. Conclusion This survey evaluates multiple dimensions of patient satisfaction with their physician using technology to deliver a telemedicine visit instead of an in-office visit. Telemedicine was well received, with high satisfaction for addressing medical and social concerns. The results of this study support the use of telemedicine to assess social determinants of health in an underserved minoritized patient population and will help physicians optimize future interactions with patients through telemedicine.
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Postpandemic Stress Disorder among Health Care Personnel: A Cross-Sectional Study (Silesia, Poland). Behav Neurol 2022; 2022:1816537. [DOI: 10.1155/2022/1816537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/16/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Postpandemic stress disorder (PPSD) is an unofficial term that refers to posttraumatic stress disorder (PTSD), a mental disorder resulting from increased stress, anxiety, and trauma associated with unpleasant life experiences. Many scientific studies indicate that symptoms of increased stress, job burnout, anxiety, and depressive disorders are associated with medical personnel performing their professional duties around COVID-19 patients. Objective. The purpose of this study was to assess the prevalence of symptoms that may indicate the presence of PPSD symptoms—depression, anxiety, and stress—in medical personnel. Material and Methods. The survey included 300 people, representatives of medical personnel. The group was divided into two sections. The first section numbered 150 and consisted of personnel in direct contact with COVID-19 patients (FR); the second group also consisted of 150 medical professionals, who but no longer directly involved in helping with COVID-19 cases (SR). The survey was conducted by indirect survey method using CAWI (computer-assisted web interview). The survey used a questionnaire technique. A proprietary tool enriched with standardized psychometric scales: BDI, GAD-7, FCV-19S, and PSS-10 was used. Kruskal-Wallis and Mann–Whitney
statistical tests were used in the statistical processing of the data. The probability level was 0.05. Results. Statistical inference made it clear that mental health problems that may indicate trauma are mainly present in the FR group. These symptoms decreased slightly in comparison between periods 2020 and 2021 (
). Conclusions. The COVID-19 pandemic significantly increased the prevalence of depression, anxiety, and stress among first responders. To ensure the psychological well-being of first responders, early assessment and care of mild depression, anxiety, and stress should be promoted to prevent the development of moderate and severe forms.
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Nam S, Lee N, Kim EY. Living with a Pandemic from Psycho-Social Perspectives: A Narrative Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:2472-2483. [PMID: 36561263 PMCID: PMC9745413 DOI: 10.18502/10.18502/ijph.v51i11.11164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022]
Abstract
This narrative review aims to identify psycho-social issues related to the COVID-19 pandemic, especially among vulnerable populations. Through understanding the psychosocial meanings underneath, the suffering from the pandemic and the transformative experiences toward better society could be substantiated. Searching relevant studies and literature on psycho-social impacts in relation to COVID-19 was conducted from psycho-social points of view. Vulnerable populations such as the mentally ill, the poor, refugees, immigrants, the elderly, and other stigmatized groups were focused on. Reflections and plans on the worsened health disparities and increased stresses among vulnerable groups will help our society to be healthier and safer.
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Affiliation(s)
- Soohyun Nam
- Department of Nursing, Hallym Polytechnic University, Chuncheon, Republic of Korea
| | - Nami Lee
- Human Rights Center, Seoul National University Hospital, Seoul, Republic of Korea, Department of Public Health Center, Seoul National University Hospital, Seoul, Republic of Korea,Corresponding Author:
| | - Eun-Yong Kim
- Department of Human Systems Medicine, Seoul National University Medical School, Seoul, Republic of Korea
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Afshan G, Ahmed F, Anwer N, Shahid S, Khuhro MA. COVID-19 stress and wellbeing: A phenomenological qualitative study of Pakistani Medical Doctors. Front Psychol 2022; 13:920192. [PMID: 36312191 PMCID: PMC9602938 DOI: 10.3389/fpsyg.2022.920192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/13/2022] [Indexed: 12/01/2022] Open
Abstract
The COVID-19 stress and increased job pressure have largely affected healthcare professionals’ various life domains. This study particularly explores the effect of stress caused by treating COVID-19 patients on medical doctors’ wellbeing. To explore this phenomenon, we interviewed 12 doctors treating COVID-19 patients in hospitals of metropolitan cities in Pakistan. The thematic analysis using NVivo V.12 Plus software of interviews resulted in four major themes, COVID-19 Stressors, Effects of Stress, Nature and Personality, Stress Relievers, and Stress Coping Strategies. Physicians were physically and emotionally stressed as a result of the intense work. Although they were carrying a lot of pain and hurt on their insides, participants demonstrated a sense of professional determination to overcome obstacles. Physicians are currently dealing with their emotional issues, and they should have access to complete professional help to ensure their wellbeing. The COVID-19 pandemic’s mental health effects are anticipated to last far longer than the physical health effects. This study is well-positioned to investigate frontline physicians’ opinions and attitudes concerning the COVID-19 and its impact on their daily lives and mental health. This research will help implement context-specific innovative mental health solutions to help the frontline workers.
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Affiliation(s)
- Gul Afshan
- Department of Business Administration, Sukkur IBA University, Sukkur, Pakistan
- *Correspondence: Gul Afshan,
| | - Farooque Ahmed
- Department of Business Administration, Sukkur IBA University, Sukkur, Pakistan
| | - Naveed Anwer
- Lahore Business School, University of Lahore, Lahore, Punjab, Pakistan
| | - Sehrish Shahid
- Australian Institute of Business, Adelaide, SA, Australia
| | - Mansoor Ahmed Khuhro
- Department of Business Administration, Shaheed Benazir Bhutto University Shaheed Benazirabad, Sanghar, Pakistan
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Naqvi SZ, Ahmad S, Rocha IC, Ramos KG, Javed H, Yasin F, Khan HD, Farid S, Mohsin A, Idrees A. Healthcare Workers' Knowledge and Attitude Toward Telemedicine During the COVID-19 Pandemic: A Global Survey. Cureus 2022; 14:e30079. [PMID: 36381792 PMCID: PMC9640220 DOI: 10.7759/cureus.30079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2022] [Indexed: 03/31/2023] Open
Abstract
Introduction Telemedicine is the utilization of communication technologies to provide healthcare services remotely. It has an increasingly pivotal role in enabling medical professionals to extend the provision of care to patients facing geographical barriers. The benefits of telemedicine have become more apparent during the coronavirus pandemic. To maximize its application, it is crucial to ascertain the understanding and attitudes of healthcare professionals toward its use. The aim of this study is to collect data and evaluate the current knowledge and perceptions of medical staff toward the use of telemedicine. Methods In this cross-sectional study, we conducted a global survey of 1091 healthcare workers. Data were collected through a questionnaire after an extensive literature review. Frequency, percentages, and cumulative percentages were calculated to portray the profile of the participants. Results Of the respondents, the majority had heard about (90.9%), witnessed (65.3%), or were familiar with (74.6%) how telemedicine is used in practice. Seventy-two point two percent (72.2%) were familiar with the tools that may be used in this technology. The familiarity with telemedicine was noted to be consistently higher in those with a medical degree and experience of less than five years. Furthermore, attitudes toward providing healthcare remotely were generally positive with 80% thinking that telemedicine reduced staff workload, 80.6% reporting that it reduces the unnecessary transportation cost, and 83% believing that it saves clinicians' time. However, 20% of respondents said that telemedicine increases staff workload and 40.5% of healthcare workers believed telemedicine threatens information confidentiality and patient privacy. Conclusion Although telemedicine is a novel and emerging practice in many countries, it appears to have a promising contribution to healthcare services. This is particularly important during a pandemic, as it ensures effective healthcare with the maintenance of social distancing measures. Moreover, the respondents of this study showed good knowledge and positivity in their attitude toward telemedicine.
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Affiliation(s)
| | | | - Ian C Rocha
- Medicine, Centro Escolar University, Manila, PHL
| | | | | | | | - Hadin D Khan
- Medicine, Shalamar Medical and Dental College, Lahore, PAK
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Synchronous Telemedicine Model in Urogynecology: Are Patients Willing to Continue Telemedicine in the Post-COVID-19 Pandemic Era? UROGYNECOLOGY (HAGERSTOWN, MD.) 2022; 28:679-686. [PMID: 35703276 PMCID: PMC9512138 DOI: 10.1097/spv.0000000000001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
IMPORTANCE Following the recent expansion of telemedicine during the COVID-19 pandemic, this remote model of care in female pelvic medicine and reconstructive surgery will likely remain and continue to evolve. OBJECTIVE This study was conducted to assess patients' perceptions of and willingness to participate in a synchronous telemedicine visit beyond the COVID-19 pandemic for women with pelvic floor disorders. STUDY DESIGN We conducted a cross-sectional study of women who completed a synchronous telemedicine visit from March 16 through May 22, 2020, at a urogynecology practice in an academic medical center. An electronic survey was distributed to women after all telemedicine visits. Demographic data, visit type, and survey responses were analyzed. RESULTS Two hundred two women received the survey, and 135 women completed it (response rate of 66.8%). The mean age of the respondents was 62.9 ± 16.4 years, and the 3 most common visit diagnoses were overactive bladder (43.7%), stress urinary incontinence (22.2%), and pelvic organ prolapse (21.4%). Most survey participants (88.9%) found that the quality of their telemedicine visits was better than expected, and 89.6% reported that they would like to continue telemedicine care. Our survey showed that 19.4% of women reported difficulty with technology. CONCLUSIONS We found that most women presenting for synchronous telemedicine urogynecology care had a positive visit experience and would continue to use telemedicine for their care. Further developmental work needs to be done on improving the ease of technology as well as availability of telemedicine in the care of women affected by pelvic floor disorders.
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Vipler B, Snyder B, McCall-Hosenfeld J, Haidet P, Peyrot M, Stuckey H. Transformative learning of medical trainees during the COVID-19 pandemic: A mixed methods study. PLoS One 2022; 17:e0274683. [PMID: 36112640 PMCID: PMC9481004 DOI: 10.1371/journal.pone.0274683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a transformative effect on individuals across the world, including those in healthcare. Transformative learning is an educational theory in which an individual’s worldview is fundamentally altered through conscious reflection (Cognitive Rational), insights (Extrarational), or social reform (Social Critique). We utilized transformative learning theory to characterize the experiences of medical trainees during the pandemic. Methods We used the Transformative Learning Survey in September and October 2020 to evaluate the processes and outcomes of transformative learning in health professions students and housestaff at an academic medical center during the pandemic. We analyzed survey scores for three process domains and four outcome subdomains. We inductively coded the survey’s two open-ended questions and performed qualitative and mixed-methods analyses. Results The most prominent TL outcome was Self-Awareness, Acting Differently was intermediate, and Openness and Worldview Shifts were lowest. Cognitive Rational and Social Critique processes were more prominent than Extrarational processes. Students were more likely than housestaff to undergo transformative learning through the Social Critique process (p = 0.025), in particular the sub-processes of Social Action (p = 0.023) and Ideology Critique (p = 0.010). Qualitative analysis via the aggregation of codes identified four responses to the pandemic: negative change, positive change, existential change, or no change. Negative changes (67.7%) were most common, with students reporting more of these changes than housestaff (74.8% vs 53.6%; p < 0.01). Only 8.4% of reported changes could be defined as transformative Conclusions Through the theoretical lens of transformative learning, our study provides insight into the lives of learners during the pandemic. Our finding that medical students were more likely to use Social Critique processes has multiple parallels in the literature. If leaders in academic medicine desire to create enlightened change agents through transformative learning, such education must continue throughout graduate medical education and beyond.
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Affiliation(s)
- Benjamin Vipler
- Division of Hospital Medicine, University of Colorado Hospital, Aurora, CO, United States of America
- Division of General Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA, United States of America
- * E-mail:
| | - Bethany Snyder
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA, United States of America
| | - Jennifer McCall-Hosenfeld
- Division of General Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA, United States of America
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| | - Paul Haidet
- Division of General Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA, United States of America
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
- Department of Humanities, Penn State College of Medicine, Hershey, PA, United States of America
| | - Mark Peyrot
- Department of Sociology, Loyola University Maryland, Baltimore, MD, United States of America
| | - Heather Stuckey
- Division of General Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA, United States of America
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA, United States of America
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Mirhosseini S, Heshmati Nabavi F, Behnam Vashani H, Vaghee S. Evaluating the effect of online psychoeducational support group on perceived stress in family caregivers of COVID-19 survivors. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221126219. [PMID: 36069743 DOI: 10.1177/00302228221126219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to determine the effect of an online psychoeducational support group on the perceived stress of caregivers of coronavirus disease 2019 (COVID-19) survivors. METHODS This randomized clinical trial included 70 caregivers of COVID-19 survivors discharged from Imam Reza Hospital in Mashhad, Iran in 2021. The intervention group received a psychoeducational support training program for stress management through six online group sessions (each 35-45 minutes) in a week. An expert psychiatric nurse provided this program on WhatsApp immediately after the patient's discharge from the hospital. The participants completed the Perceived Stress Scale (PSS-14) before starting the intervention and 1 week after that. Data analysis was conducted by descriptive and inferential statistics, including Chi-square, Fisher's exact test, independent, and paired t-test. RESULTS Both groups were homogeneous in terms of demographic variables of survivors and caregivers. In terms of the PSS, there was no significant difference between the two groups before the intervention (p=0.28). The pre- and post-intervention scores of PSS in the intervention group were 39.57 ± 5.89 and 35.48 ± 5.68, respectively, indicating a significant decrease (p<0.001). Also, the pre- and post-intervention differences between the intervention and control groups were -4.08 ± 3.52 and -0.11 ± 2.66, respectively, indicating a greater decrease in the total PSS of the intervention group (p < 0.001). CONCLUSION The family caregivers of COVID-19 survivors suffered from psychological distress during their patient care. It is recommended to perform online psychoeducational support group interventions for these individuals based on psychological and educational support program.
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Affiliation(s)
| | - Fatemeh Heshmati Nabavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Behnam Vashani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Vaghee
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Scarlata E, Baroni M, Giordano F. MusicTeamCare (MTC): Theory and practice of clinical intervention for music therapists offering remote support to clients during emergencies. BRITISH JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1177/13594575221117968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic meant that people’s lives and work changed significantly across the world. Governments took measures such as social distancing, lockdowns and quarantine protocols to stem the spread of the pandemic. This had a significant impact on music therapy clinical practice, generating reflections and adaptations among the worldwide music therapy community, with several studies still underway. A number of professional music therapy organisations have explored methods for carrying out remote interventions. MusicTeamCare is an approach developed by three Italian Certified Music Therapists that could offer access to support in emergency and crisis situations. This approach is rooted in receptive music therapy theory, with particular reference to Guided Imagery and Music (GIM). MusicTeamCare was used for the first time in March to April 2020, with healthcare workers in Italy who were treating COVID-19 patients. This article outlines theoretical framework, development and evaluation phases of MusicTeamCare. Detailed explanations are given of the theoretical framework, methods of musical analysis, assessment and evaluation strategies, criteria for constructing the playlists and interactive triangulation between the Music Therapists in the research team.
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Affiliation(s)
- Elide Scarlata
- PHD Student, Department of Music, Art and Culture Studies, University of Jyvaskyla, Finland
| | | | - Filippo Giordano
- Department of Emergency and Organs Transplant, University of Bari, Italy
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Mehta A, Awuah WA, Ng JC, Kundu M, Yarlagadda R, Sen M, Nansubuga EP, Abdul-Rahman T, Hasan MM. Elective surgeries during and after the COVID-19 pandemic: Case burden and physician shortage concerns. Ann Med Surg (Lond) 2022; 81:104395. [PMID: 35999832 PMCID: PMC9388274 DOI: 10.1016/j.amsu.2022.104395] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
The COVID-19 pandemic had a significant impact on several aspects of global healthcare systems, particularly surgical services. New guidelines, resource scarcity, and an ever-increasing demand for care have posed challenges to healthcare professionals, resulting in the cancellation of many surgeries, with short and long-term consequences for surgical care and patient outcomes. As the pandemic subsides and the healthcare system attempts to reestablish a sense of normalcy, surgical recommendations and advisories will shift. These changes, combined with a growing case backlog (postponed surgeries + regularly scheduled surgeries) and a physician shortage, can have serious consequences for physician health and, as a result, surgical care. Several initiatives are already being implemented by governments to ensure a smooth transition as surgeries resume. Newer and more efficient steps aimed at providing adequate surgical care while preventing physician burnout, on the other hand, necessitate a collaborative effort from governments, national medical boards, institutions, and healthcare professionals. This perspective aims to highlight alterations in surgical recommendations over the course of the pandemic and how these changes continue to influence surgical care and patient outcomes as the pandemic begins to soften its grip. The COVID-19 pandemic had a significant impact on several aspects of surgical care. New surgical recommendations amidst an ever-increasing demand for care pose, short and long-term consequences for surgical care and patient outcomes. As the pandemic subsides, these changes, combined with a growing case backlog and a physician shortage, can have serious consequences for physician health and, as a result, surgical care.
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Williams HE, Aiyar L, Dinulos MB, Flannery D, McClure ML, Lloyd-Puryear MA, Sanghavi K, Trotter TL, Viskochil D. Considerations for policymakers for improving health care through telegenetics: A points to consider statement of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2022; 24:2211-2219. [PMID: 36040445 DOI: 10.1016/j.gim.2022.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Heather E Williams
- Department of Pathology and Cell Biology, Columbia University, New York, NY; School of Management, Yale University, New Haven, CT
| | - Lila Aiyar
- Genomics Section, Hawaii Department of Health, Honolulu, HI
| | - Mary Beth Dinulos
- Departments of Pediatrics and Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - David Flannery
- Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH
| | | | - Michele A Lloyd-Puryear
- Retired from Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Kunal Sanghavi
- The Jackson Laboratory for Genomic Medicine, The Jackson Laboratory, Farmington, CT
| | - Tracy L Trotter
- Department of Pediatrics, John Muir Health, San Francisco, CA
| | - David Viskochil
- Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT
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- American College of Medical Genetics and Genomics, Bethesda, MD
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Kumar A, Lall N, Pathak A, Joshi D, Mishra VN, Chaurasia RN, Singh VK. A questionnaire-based survey of acceptability and satisfaction of virtual neurology clinic during COVID-19 lockdown: a preliminary study. Acta Neurol Belg 2022; 122:1297-1304. [PMID: 35796999 PMCID: PMC9261122 DOI: 10.1007/s13760-022-02004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/09/2022] [Indexed: 11/24/2022]
Abstract
Introduction Telemedicine during this pandemic acts as a lifeline for many non-COVID patients especially with chronic neurological diseases. The aim of present study was to evaluate cost effectiveness and level of satisfaction amongst patients from teleneurology outpatient department (OPD). Methods An online cross-sectional survey, having questions both in Hindi and English was conducted via telemedicine facility at Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Demographic variables, illness details, travel distance and time taken, travel expenditure, level of satisfaction and preferred choice among tele OPD versus in-person OPD once pandemic ends were recorded. Results Total 1388 patients filled the online COVID-19 teleneurology survey google form. Mean age was 39.21 ± 16.72 years. Majority (N = 824, 59%) were males. Six hundred (43%) patients’ educational qualification were ≤ 10th standard. Majority of patients (N = 840, 60.5%) belonged to the rural background. Headache (N = 424, 30.5%) followed by backache (N = 220, 16%), stroke (N = 176, 13%) and seizure (N = 148, 11%) were the common illnesses. Travel time of > 5 hours was saved in 496 (36%) patients and travel expenditure of > Rs100 in 796 (57%) patients. About 96% (N = 1332) felt satisfied with the treatment advice via teleconsultation. Discussion Teleneurology facility is not only feasible but also affordable and acceptable in various neurological conditions. The chief reasons being no waiting time, saving of travelling time and travel expenditure with good satisfaction.
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Affiliation(s)
- Anand Kumar
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, UP, India
| | - Neha Lall
- Department of Radiotherapy and Radiation Medicine, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, India
| | - Abhishek Pathak
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, UP, India
| | - Deepika Joshi
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, UP, India
| | - Vijaya Nath Mishra
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, UP, India
| | - Rameshwar Nath Chaurasia
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, UP, India
| | - Varun Kumar Singh
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, UP, India.
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Parikh N, Chaudhuri A, Syam SB, Singh P. Fostering Resilient Health Systems in India: Providing Care for PLHIV Under the Shadow of COVID-19. Front Public Health 2022; 10:836044. [PMID: 35712311 PMCID: PMC9194090 DOI: 10.3389/fpubh.2022.836044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The novel coronavirus or COVID-19 has resulted in major human casualties, and extreme socio-economic crises causing catastrophic disturbances to health systems and communities alike. This study qualitatively explores the challenges experienced by healthcare providers while providing services to people living with HIV (PLHIV) during the pandemic outbreak and subsequent lockdown in India. The paper also explores strategies developed and adopted to provide continued care for PLHIV. Methods Using an empirical phenomenological approach, qualitative in-depth telephonic interviews were conducted with 19 HIV care providers from five states in India. The recorded interviews were transcribed and analyzed using inductive thematic analysis with the help of Dedoose software. Results From the analysis of participants' narratives, three main themes emerged: (1) Challenges of working during a pandemic; (2) Remodeling care delivery to ensure continuity of services; (3) Resilience. Discussion Our findings highlight the challenges that providers faced, despite which, adaptive efforts were made to continue providing quality care for PLHIV through ingenious and innovative strategies. To foster resilient health systems, health workers are the primary stakeholders. We recommend formal social protection, comprehensive primary healthcare support, and sufficient capacity building for health workers for their self-care and pandemic preparedness.
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Al-Hadi Hasan A, Waggas D. Psychological wellbeing and associated factors among nurses exposed to COVID 19: Findings from a cross sectional study. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 76:103025. [PMID: 35572806 PMCID: PMC9085385 DOI: 10.1016/j.ijdrr.2022.103025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/28/2022] [Accepted: 05/01/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND The coronavirus pandemic known as COVID-2019 poses a global concern. The psychological well-being of front-line nurses and other healthcare providers is a major concern. AIMS This study evaluated the psychological well-being and the associated factors among nurses in Dr. Soliman Fakeeh Hospital during the COVID-19 pandemic. METHODS The cross-sectional survey was conducted during the peak period of COVID 19 among 367 nurses recruited from Dr. Soliman Fakeeh Hospital. The online survey was used with the snowballing sampling technique to collect the participants' socio-demographic data and assess their psychological status using DASS-21; in addition, the major traumatic event was assessed by Impact of Event Scale-Revised, and self-efficacy was evaluated. RESULTS 67.7% of the 367 respondents experienced moderate or severe psychological problem; 46.1% reported moderate to severe depressive symptoms; 48.0% moderate to severe anxiety symptoms; and 48.4% moderate to severe stress levels. The psychological status and influence of a major traumatic event and self-efficacy were statistically significant different among nurses according to age, gender, working experience, marital status, working in a COVID 19 unit or with suspected cases. CONCLUSIONS Nurses had a significantly increased risk of developing psychological problems, negatively impacted by the major traumatic event and poor self-efficacy.
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Affiliation(s)
- Abd Al-Hadi Hasan
- Associate Professor, Psychiatric and Mental Health Nursing, Nursing Department, Fakeeh College for Medical Sciences, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
| | - Dania Waggas
- Asssitant Profesor Pharmacology, Medicine Program, Fakeeh College for Medical Sciences, MBBS Department, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
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Wujcik D, Dudley WN, Dudley M, Gupta V, Brant J. Electronic Patient Symptom Management Program to Support Patients Receiving Cancer Treatment at Home During the COVID-19 Pandemic. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:931-936. [PMID: 35339378 PMCID: PMC8941492 DOI: 10.1016/j.jval.2022.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Remote patient monitoring became critical for patients receiving cancer treatment during the COVID-19 pandemic. We sought to test feasibility of an electronic patient symptom management program implemented during a pandemic. We collected and analyzed the real-world data to inform practice quality improvement and understand the patient experience. METHODS Eligible patients had breast, lung, or ovarian cancers, multiple myeloma, or acute myeloid leukemia and 12 weeks of planned chemotherapy. Patients were notified that a symptom survey with common symptoms derived from the National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events was available to complete using a smart phone, tablet, or computer. Patients recorded their symptoms and results were sent to the provider. Patients received care guidelines for mild/moderate severity symptoms and a phone call from the provider for severe reports. RESULTS A total of 282 patients generated > 119 088 data points. Patients completed 2860 of 3248 assigned surveys (88%), and 152 of 282 patients (54%) had symptom reports that generated an immediate notification to the provider. Longitudinal data were analyzed to determine whether previous reports predicted a notification alert and whether symptoms resolved after the alert was addressed. CONCLUSIONS An electronic patient symptom management program was implemented in the midst of the COVID-19 pandemic. Enrollment of 282 patients and a high survey completion (88%) demonstrated feasibility/acceptance. Patients reported symptoms at severe levels of 54% of the time and received self-management instructions and provider phone calls that resolved or decreased the severity of the symptom. A standard approach and validated instrument provide opportunities for improving and benchmarking outcomes.
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Karimi L, Raei M, Parandeh A. Association Between Dimensions of Professional Burnout and Turnover Intention Among Nurses Working in Hospitals During Coronavirus Disease (COVID-19) Pandemic in Iran Based on Structural Model. Front Public Health 2022; 10:860264. [PMID: 35692308 PMCID: PMC9174661 DOI: 10.3389/fpubh.2022.860264] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose This study was done to assess the dimensions of professional burnout and turnover intention among nurses working in hospitals during the coronavirus disease 2019 (COVID-19) pandemic in Iran based on a structural model. Methods This cross-sectional study was performed among 170 nurses working in two referral hospitals of COVID-19 in Tehran Province, Iran, from September to December 2020. Data were collected using the sociodemographic form, Maslach Burnout Inventory (MBI), and Turnover Intention Questionnaire. Data were analyzed with SPSS and Amos software version 22 using independent t-test, ANOVA, and structural equation model. Results The mean scores for burnout in emotional fatigue, depersonalization, and personal accomplishment dimensions were 25.38 ± 7.55, 9.47 ± 4.40, and 34.94 ± 7.80, respectively, moreover for the turnover intention, the score was 6.51 ± 3.17. The reduced personal accomplishment was identified as a positive predictor of turnover intention (p = 0.01). Work position and interest in attending the organization were significantly correlated with the turnover intention (p < 0.05). Conclusions There is an immediate need to prepare nurses to cope better with the COVID-19 outbreak. Work-related stressors during the COVID-19 pandemic have led to an increase in nurses' burnout and turnover intention. Identifying and managing the factors related to professional burnout will make it possible to prevent the nurses' turnover intention in such critical situations.
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Affiliation(s)
- Leila Karimi
- Department of Community Health, Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehdi Raei
- Department of Epidemiology and Biostatistics, Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Akram Parandeh
- Department of Community Health, Medicine, Quran and Hadith Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
- *Correspondence: Akram Parandeh
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Yeluru H, Newton HL, Kapoor R. Physician Burnout Through the Female Lens: A Silent Crisis. Front Public Health 2022; 10:880061. [PMID: 35685758 PMCID: PMC9171323 DOI: 10.3389/fpubh.2022.880061] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Physician burnout, the emotional exhaustion and depersonalization that arises from job fatigue and dissatisfaction, is a rapidly growing problem. Although burnout has been a recognized problem for decades, our healthcare system has yet to devise a sustainable solution. Additionally, burnout does not affect all physicians in the same way- women physicians have disproportionately higher rates of burnout than male physicians. Burnout poses a tremendous risk to our public's health with its severe and debilitating effects on both physician and patient health alike. We must intervene as early as medical school and residency at both the systemic and individual levels to combat burnout. Clinical leadership training might be one sustainable approach to begin addressing burnout in female physicians.
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Affiliation(s)
| | - Heather L. Newton
- Eastern Virginia Medical School, Norfolk, VA, United States
- *Correspondence: Heather L. Newton
| | - Rupa Kapoor
- Eastern Virginia Medical School, Norfolk, VA, United States
- Children's Hospital of the King's Daughters, Norfolk, VA, United States
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Chen J, Jie L, Su X, Zhang X, Guo D, Wang J, Deng M, Cui M, Gao M, Zhang H, Song Y. COVID-19 Pandemic and the Operation of a Tertiary Hospital in Tianjin-The Impact of Internet Healthcare on Hospital Business Indicators. Front Public Health 2022; 10:892773. [PMID: 35669752 PMCID: PMC9163548 DOI: 10.3389/fpubh.2022.892773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To explore the impact of the COVID-19 pandemic on hospital business and the contribution of Internet healthcare to hospital operations during the epidemic by analyzing the degree of impact on major business indicators. Methods The three-year period from 2019 to 2021 was compared and analyzed, and the main medical business indicators such as outpatient and emergency visits, inpatients, operations, patient improvement rate, cure rate and fatality rate in tertiary hospitals were compared and analyzed, and the impact of the epidemic on medical services and hospital operation was analyzed. degree and the impact of Internet medical development on medical service capacity. Results During the outbreak of COVID-19, the number of hospital outpatient and emergency visits, inpatients, and operations decreased significantly; after the normalization of the epidemic, the main medical business indicators such as outpatient and emergency visits, inpatients, and operations gradually returned to pre-epidemic levels; patient improvement rate, the cure rate and mortality rate and other indicators did not change significantly. During the epidemic period, the number of visits to the Internet outpatient clinic has increased significantly, which has significantly improved the hospital's medical service capacity. Conclusion With the normalization of epidemic prevention and control, the main business indicators of Tianjin tertiary hospitals have gradually recovered. The operation of Internet medical care during the epidemic has changed the management and operation mode of the hospital to a certain extent, improved the main business indicators of the hospital, and eased the pressure on the hospital's economic operation.
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Affiliation(s)
- Jia Chen
- Department of Out-Patient and Emergency, General Hospital of Tianjin Medical University, Tianjin, China
| | - Liu Jie
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Xiao Su
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Dandan Guo
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiajing Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Meili Deng
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mingrui Cui
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Meijian Gao
- Department of Out-Patient and Emergency, General Hospital of Tianjin Medical University, Tianjin, China
| | - Hong Zhang
- College of Management, Tianjin Normal University, Tianjin, China
- College of Management, Sehan University, Yeongam-gun, South Korea
| | - Yijun Song
- Department of General Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
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Kumar A, Parihar A, Panda U, Parihar DS. Microfluidics-Based Point-of-Care Testing (POCT) Devices in Dealing with Waves of COVID-19 Pandemic: The Emerging Solution. ACS APPLIED BIO MATERIALS 2022; 5:2046-2068. [PMID: 35473316 PMCID: PMC9063993 DOI: 10.1021/acsabm.1c01320] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/11/2022] [Indexed: 02/08/2023]
Abstract
Recent advances in microfluidics-based point-of-care testing (POCT) technology such as paper, array, and beads have shown promising results for diagnosing various infectious diseases. The fast and timely detection of viral infection has proven to be a critical step for deciding the therapeutic outcome in the current COVID-19 pandemic, which in turn not only enhances the patient survival rate but also reduces the disease-associated comorbidities. In the present scenario, rapid, noninvasive detection of the virus using low cost and high throughput microfluidics-based POCT devices embraces the advantages over existing diagnostic technologies, for which a centralized lab facility, expensive instruments, sample pretreatment, and skilled personnel are required. Microfluidic-based multiplexed POCT devices can be a boon for clinical diagnosis in developing countries that lacks a centralized health care system and resources. The microfluidic devices can be used for disease diagnosis and exploited for the development and testing of drug efficacy for disease treatment in model systems. The havoc created by the second wave of COVID-19 led several countries' governments to the back front. The lack of diagnostic kits, medical devices, and human resources created a huge demand for a technology that can be remotely operated with single touch and data that can be analyzed on a phone. Recent advancements in information technology and the use of smartphones led to a paradigm shift in the development of diagnostic devices, which can be explored to deal with the current pandemic situation. This review sheds light on various approaches for the development of cost-effective microfluidics POCT devices. The successfully used microfluidic devices for COVID-19 detection under clinical settings along with their pros and cons have been discussed here. Further, the integration of microfluidic devices with smartphones and wireless network systems using the Internet-of-things will enable readers for manufacturing advanced POCT devices for remote disease management in low resource settings.
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Affiliation(s)
- Avinash Kumar
- Department of Mechanical Engineering,
Indian Institute of Information Technology Design & Manufacturing
Kancheepuram, Chennai 600127, India
| | - Arpana Parihar
- Industrial Waste Utilization, Nano and Biomaterials,
CSIR-Advanced Materials and Processes Research Institute
(AMPRI), Hoshangabad Road, Bhopal, Madhya Pradesh 462026,
India
| | - Udwesh Panda
- Department of Mechanical Engineering,
Indian Institute of Information Technology Design & Manufacturing
Kancheepuram, Chennai 600127, India
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Vipler B, Green M, McCall-Hosenfeld J, Haidet P, Tisdell E. A Graphic Transformation: A Qualitative Study of Transformative Learning in Medical Trainees during COVID-19 Using Comics as Data Presentation. TEACHING AND LEARNING IN MEDICINE 2022:1-16. [PMID: 35567316 DOI: 10.1080/10401334.2022.2062362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 03/21/2022] [Indexed: 06/15/2023]
Abstract
Phenomenon: Transformative learning is a theory in which individuals construct new or revised interpretations of the meaning of an experience. COVID-19 offers a rare opportunity to better understand how individuals respond to and make meaning within the shared context of an extraordinary event. We aimed to examine if and how residents and fellows engaged in transformative learning when caring for COVID-19 positive patients during the initial peak of the pandemic (Spring 2020).Approach: We conducted an interpretive qualitative study to identify themes pertaining to transformative learning. We used semi-structured interviews of residents and fellows who were directly or indirectly involved in the care of COVID-19 positive patients admitted to the inpatient wards or the intensive care units during the first peak of the pandemic (defined as March 11th - May 28th, 2020) at our Mid-Atlantic academic health system. We used the medium of comics to depict select interviewees' experiences during the pandemic as a novel way to represent themes from the interviews.Findings: Three main themes arose from our qualitative analysis. These included "a sense of guilt," "the impact on training," and "venues and processes for reflection." In comparing their experiences with colleagues and friends at other institutions with higher COVID-19 case volume, trainees reflected on how they felt lucky, and this led to guilt, although not necessarily transformation. The impact of COVID-19 on the training environment had transformative potential. Trainees challenged their previously held assumptions on the necessity of various surgeries, in-person visits, and physical examination maneuvers when COVID-19 posed a barrier. Finally, while trainees recalled multiple situations throughout the pandemic when they believed they were engaging in reflection, such reflection did not appear to reach so deep as to alter participants' underlying assumptions until the research interview itself, suggesting that transformation was incomplete.Insights: Our purposive sample of residents and fellows who cared for COVID-19 positive patients during the initial peak of the pandemic made meaning of their experience in multiple ways. The largest shift in worldview due to the pandemic appeared to be related to the instrumental utility of certain common medical practices or procedures. This, in turn, was the most prominent influence on how these trainees felt they would practice in the future, and translated to a shift in how they appraised evidence. However, lack of opportunity for reflection may have adversely impacted the ability for transformation to take place. Given that multiple trainees showed appreciation for the critical reflection venue that was the research interview, academic leadership should ensure similar venues exist during training, even after the pandemic ends.
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Affiliation(s)
- Benjamin Vipler
- Division of Hospital Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Division of General Internal Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Michael Green
- Department of Humanities, Pennsylvania State University College of Medicine, Hershey, PA, USA
- Division of General Internal Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Jennifer McCall-Hosenfeld
- Division of General Internal Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Paul Haidet
- Department of Humanities, Pennsylvania State University College of Medicine, Hershey, PA, USA
- Division of General Internal Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Elizabeth Tisdell
- Lifelong Learning and Adult Education, Pennsylvania State University - Harrisburg, Middletown, PA, USA
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Mangialavori S, Riva F, Froldi M, Carabelli S, Caimi B, Rossi P, Delle Fave A, Calicchio G. Psychological Distress and Resilience among Italian Healthcare Workers of Geriatric Services during the COVID-19 Pandemic. Geriatr Nurs 2022; 46:132-136. [PMID: 35700680 PMCID: PMC9135690 DOI: 10.1016/j.gerinurse.2022.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic exposed healthcare workers (HW) to heavy workload and psychological distress. This study was aimed to investigate distress levels among Italian physicians, nurses, rehabilitation professionals and healthcare assistants working in geriatric and long-term care services, and to explore the potential role of resilience as a protective resource. The General Health Questionnaire-12, the Connor-Davidson Resilience Scale, and a demographic survey were completed by 708 Italian HWs. Distress and resilience levels were compared between professionals through ANOVA; the contribution of sex, age, professional role, and resilience to distress was explored through regression analyses. Physicians reported significantly higher resilience and distress levels than rehabilitation professionals and healthcare assistants respectively. Women, HWs aged above 45, physicians, and participants reporting low resilience levels were at higher risk for distress. Findings suggest the importance of supporting HW's resilience to counterbalance the pandemic related distress.
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Affiliation(s)
- Sonia Mangialavori
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Fabiana Riva
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Marco Froldi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy; Department of Clinical and Community Sciences, Università degli Studi di Milano, Milan, Italy
| | - Simona Carabelli
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Barbara Caimi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Pierluigi Rossi
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Calicchio
- Institute of Geriatric Rehabilitation Pio Albergo Trivulzio, Milan, Italy; Department of Clinical and Community Sciences, Università degli Studi di Milano, Milan, Italy
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Riaz MM, Mahmood SBZ, Nasir N. Telemedicine for Rheumatology Patients in Covid-19 Pandemic: Perspectives of Patients. J Patient Exp 2022; 9:23743735221092635. [PMID: 35441090 PMCID: PMC9008472 DOI: 10.1177/23743735221092635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Telemedicine use for patients with autoimmune rheumatic conditions during the
pandemic mandates better characterization. We conducted a telephonic survey on
patients who consulted rheumatologists remotely to determine their attitudes
toward telemedicine. The study was conducted at Aga Khan University Hospital, a
tertiary care hospital in Pakistan which is a lower-middle-income country.
Descriptive analyses were performed. Fifty patients visited tele-rheumatology
clinic, 35 (70.0%) were female with a mean (SD) age of 47.6 (18.1) years.
Majority (27, 54.0%) learned about telemedicine from hospital website and
outpatient clinic desk or helpline. Lack of examination was the biggest concern
with teleconsultation (18, 22.2%). Most patients (38, 76.0%) agreed to continue
teleconsultation beyond the pandemic. Telemedicine is preferable for providing
rheumatology outpatient service during and after the pandemic.
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Affiliation(s)
| | | | - Noreen Nasir
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Chiner-Vives E, Cordovilla-Pérez R, de la Rosa-Carrillo D, García-Clemente M, Izquierdo-Alonso JL, Otero-Candelera R, Pérez-de Llano L, Sellares-Torres J, de Granda-Orive JI. Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases. Arch Bronconeumol 2022; 58 Suppl 1:39-50. [PMID: 35501222 PMCID: PMC9012323 DOI: 10.1016/j.arbres.2022.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic. Till now, it affected 452.4 million (Spain, 11.18 million) persons all over the world with a total of 6.04 million of deaths (Spain, 100,992). It is observed that 75% of hospitalized COVID-19 patients have at least one COVID-19 associated comorbidity. It was shown that people with underlying chronic illnesses are more likely to get it and grow seriously ill. Individuals with COVID-19 who have a past medical history of cardiovascular disorder, cancer, obesity, chronic lung disease, diabetes, or neurological disease had the worst prognosis and are more likely to develop acute respiratory distress syndrome or pneumonia. COVID-19 can affect the respiratory system in a variety of ways and across a spectrum of levels of disease severity, depending on a person's immune system, age and comorbidities. Symptoms can range from mild, such as cough, shortness of breath and fever, to critical disease, including respiratory failure, shock and multi-organ system failure. So, COVID-19 infection can cause overall worsening of these previous respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease, etc. This review aims to provide information on the impact of the COVID-19 disease on pre-existing lung comorbidities.
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Affiliation(s)
- Eusebi Chiner-Vives
- Multidisciplinary Sleep Unit, Respiratory Department, Sant Joan University Hospital, Sant Joan d'Alacant, Alicante, Spain
| | - Rosa Cordovilla-Pérez
- Respiratory Department, Salamanca University Hospital, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | | | - Marta García-Clemente
- Lung Management Area, HUCA, Institute for Health Research of the Principality of Asturias (ISPA), Oviedo, Asturias, Spain
| | - José Luis Izquierdo-Alonso
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain; Respiratory Medicine, University Hospital of Guadalajara, Guadalajara, Spain
| | | | - Luis Pérez-de Llano
- Respiratory Department, Lucus Augusti University Hospital, EOXI Lugo, Monforte, CERVO, Lugo, Spain
| | - Jacobo Sellares-Torres
- Interstitial Lung Diseases Working Group, Respiratory Department, Clinic-University Hospital-IDIBAPS, Barcelona, Spain
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Fernández N, Prada S, Villanueva-Congote J, Rodríguez S. Evaluación del desgaste laboral (burnout) y ansiedad en personal de salud burante la pandemia por Covid-19. Rev Urol 2022. [DOI: 10.1055/s-0042-1748051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Resumen
Objetivo La pandemia por Covid-19 ha tenido consecuencias en la sanidad mental del personal de salud, una población vulnerable que se encuentra en la primera línea de atención contra el virus. Los horarios de trabajo, así como el miedo de contagiarse y contagiar a la familia, generan niveles elevados de ansiedad y desgaste laboral. El objetivo de este estudio es evaluar la presencia de desgaste laboral y ansiedad en el personal de salud durante la pandemia de Covid-19.
Métodos Se aplicaron prospectivamente el Maslach Burnout Inventory y la escala de ansiedad de Hamilton de manera electrónica a 566 trabajadores de salud en Colombia durante marzo y abril del 2020. Adicionalmente, se evaluaron la edad, el nivel educativo, el estado civil, la ocupación, la fuente de ingresos, el tipo de contratación, el número de empleos, y las horas de trabajo del personal anteriormente mencionado.
Resultados En total, se evaluaron 566 profesionales de la salud, de los cuales 60,8% eran mujeres, y el 39.2%, hombres. La muestra comprendía 85,3% de médicos, 9,2% de enfermeros, y el 5.5% restante correspondió a personal administrativo, odontólogos y paramédicos. De estos, 19,3% tenía 3 o más empleos. En términos de desgaste laboral, se evidenciaron altos niveles de agotamiento emocional y despersonalización, con bajos niveles de realización personal. Adicionalmente, se evidenció ansiedad leve.
Conclusiones Unas de las consecuencias más importantes de la pandemia por Covid-19 son los efectos a nivel de desgaste laboral y ansiedad en el personal de salud. Dados nuestros resultados, es esencial resaltar la importancia de un acompañamiento psicológico al personal de salud en tiempos de miedo e incertidumbre.
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Affiliation(s)
- Nicolás Fernández
- División de Urología, Seattle Children's Hospital, University of Washington, Seattle, Washington, Estados Unidos
| | - Stefania Prada
- División de Urología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Juliana Villanueva-Congote
- Oficina de investigación Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Santiago Rodríguez
- División de Urología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
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Koç Yekedüz M, Doğulu N, Sürücü Kara İ, Öncül Ü, Bakirarar B, Kullu P, Ar Y, Köse E, Eminoğlu FT. Pros and Cons of Telemedicine for Inherited Metabolic Disorders in a Developing Country During the COVID-19 Pandemic. Telemed J E Health 2022; 28:1604-1612. [PMID: 35363077 DOI: 10.1089/tmj.2021.0610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: The COVID-19 pandemic has led to considerable changes in the health care system. Experts suggested that individuals protect themselves through social isolation during the pandemic, and consequently, the importance of telemedicine came to be understood for patients with chronic diseases. Telemedicine started to be used in developing countries where the appropriate infrastructure was lacking earlier. The present study investigates the level of satisfaction of patients with inherited metabolic disorders (IMDs) with telemedicine. Methods: This prospective study was conducted by making use of a new video appointment program that ensures the privacy of the patients in video-based consultations. The sociodemographic characteristics of the patients, their clinical status, their views on the telemedicine system, and their levels of satisfaction were questioned. Results: Overall, 174 patients were included in the study. The most common diagnoses were aminoacidopathies, lipid metabolism disorders, biotinidase deficiency, and lysosomal/peroxisomal diseases. More than half of the parents (67.6%) who lived in another city reported accommodation issues when coming to the hospital, and most believed telemedicine would save them time (93.1%) and money for travel (81.6%). The lack of laboratory and radiological tests (83.9%) was stated as the main disadvantage by most parents. Almost all the parents (96.6%) stated that they would opt for telemedicine if it became available in daily practice. The overall satisfaction rate was 94.6 (±10.1)/100. Conclusions: The present research is the most extensive cohort study to date assessing telemedicine in patients with IMDs and it highlights the importance of telemedicine, especially in developing countries during the COVID-19 pandemic.
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Affiliation(s)
- Merve Koç Yekedüz
- Department of Pediatric Metabolism Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Neslihan Doğulu
- Department of Pediatric Metabolism Faculty of Medicine, Ankara University, Ankara, Turkey
| | - İlknur Sürücü Kara
- Department of Pediatric Metabolism Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ümmühan Öncül
- Department of Pediatric Metabolism Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Pinar Kullu
- Department of Computer Engineering, Ankara University, Ankara, Turkey
| | - Yilmaz Ar
- Department of Computer Engineering, Ankara University, Ankara, Turkey
| | - Engin Köse
- Department of Pediatric Metabolism Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Fatma Tuba Eminoğlu
- Department of Pediatric Metabolism Faculty of Medicine, Ankara University, Ankara, Turkey
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Yang BJ, Yen CW, Lin SJ, Huang CH, Wu JL, Cheng YR, Hsieh CC, Hsiao FH. Emergency nurses' burnout levels as the mediator of the relationship between stress and posttraumatic stress disorder symptoms during COVID-19 pandemic. J Adv Nurs 2022; 78:2861-2871. [PMID: 35307874 PMCID: PMC9111628 DOI: 10.1111/jan.15214] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/06/2022] [Accepted: 01/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Bey-Jing Yang
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.,Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Wei Yen
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shou-Ju Lin
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Hua Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jhong-Lin Wu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yih-Ru Cheng
- Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Chen Hsieh
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.,School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Karaliuniene R, Nagendrappa S, Jatchavala C, Ojeahere MI, Ullah I, Bytyçi DG, Ogunnubi OP, Cherro M, Shalbafan M, Noël C, Gonzalez-Diaz JM, Vadivel R, Pereira-Sanchez V, Abu Slaih M, Shoib S, de Filippis R. Support the frontliners – good initiatives during the COVID-19 pandemic for healthcare workers across the world: is this what we really need? BJPsych Int 2022. [DOI: 10.1192/bji.2022.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Healthcare workers have faced an unprecedented workload in overstretched health facilities during the COVID-19 pandemic, and we describe various initiatives to support them. Psychological, financial and peer support, accommodation and meal services, proper personal protective equipment, applause and gratitude in the community, spiritual and religious life, child care and volunteering were identified. The potential effects of the COVID-19 pandemic – permanent stress, burnout and other mental health problems among healthcare professionals – can be expected to grow. Continued monitoring is essential to bolster resilience among healthcare workers and prevent the possible consequences for their mental health.
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Rico FME, Fernández LP. Seguridad de medicamentos durante la pandemia Covid-19 en las enfermeras de atención primaria. Aten Primaria 2022; 54:102352. [PMID: 35525081 PMCID: PMC8938186 DOI: 10.1016/j.aprim.2022.102352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022] Open
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On the use of telemedicine in the context of COVID-19: legal aspects and a systematic review of technology. RESEARCH ON BIOMEDICAL ENGINEERING 2022. [PMCID: PMC7954684 DOI: 10.1007/s42600-021-00133-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose The aim of this study was to carry out a systematic review of telemedicine technology and to discuss the role of legislation in the application of telemedicine technology within the scope of COVID-19. Methods The search for papers was conducted in the databases Cochrane Central, MEDLINE, and Embase. The keywords considered for this systematic review were (coronavirus OR “2019-nCoV” OR 2019nCoV OR nCoV2019 OR “nCoV-2019” OR “COVID-19” OR COVID19 OR “HCoV-19” OR HCoV19 OR CoV OR “2019 novel*” OR Ncov OR “n-cov” OR “SARS-CoV-2” OR “SARSCoV-2” OR “SARSCoV2” OR “SARSCoV2” OR SARSCov19 OR “SARS-Cov19” OR “SARS-Cov-19” OR “severe acute respiratory syndrome*” OR ((corona* OR corono*) AND (virus* OR viral* OR virinae*))) AND ((telemedicine OR telehealth OR “remote assessment” OR telemonitoring)). The review process was carried out by six independent reviewers, using the PRISMA-P method. Results As a result, a total of 34 papers were selected, which addressed the study of telemedicine technologies used in times of endemics, epidemics, and pandemics, focusing on COVID-19. Conclusion Telemedicine allows for care in remote areas and at a lower cost to the patient and, in the current situation, it can reduce the number of contagions as well as the occupation of beds in health facilities. Telemedicine may suffer from limitations, mainly due to current legislation, but in this pandemic era of COVID-19, several countries around the world have made their laws more flexible to allow more widespread use of telemedicine.
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