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Tabet M, Kirby RS, Boyd R, Xaverius P. Family-Centered Care and Delayed or Missed Pediatric Preventive Care due to the COVID-19 Pandemic. Acad Pediatr 2024; 24:848-855. [PMID: 38432513 DOI: 10.1016/j.acap.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To examine the association between family-centered care and its components with delayed or missed preventive care due to the COVID-9 pandemic among US children. METHODS This is a cross-sectional study using nationally representative data from the 2021 National Survey of Children's Health (NSCH). Children were eligible if they received health care services in the past 12 months (n = 42,649; 79.3%). We excluded children with missing data, for a final sample of 40,511 (93.7% of the eligible sample). Children were deemed to have received family-centered care if caregivers responded "always" or "usually" to all five measures of family-centered care. Poisson regression was used to ascertain weighted prevalence ratios (PRs) and 95% confidence intervals (CIs). Predisposing, enabling, and need factors of health care services use were evaluated as potential confounders. RESULTS Approximately 86.7% of children received family-centered care during the pandemic, with significant racial and ethnic differences, findings consistent with pre-pandemic data. In multivariable analyses adjusted for the child's race and age, family-centered care was associated with a 30% reduced likelihood of delayed or missed preventive care (95% CI: 0.64-0.78). Individual components of family-centered care were associated with a 26%-43% reduced likelihood of delayed or missed preventive care. CONCLUSIONS Family-centered care and its components were associated with a reduced likelihood of delayed or missed pediatric preventive care. Our findings highlight the important role of health care providers in curbing the negative effects of the COVID-19 pandemic on pediatric preventive care utilization and emphasize the need to expand family-centered care among racial and ethnic minority groups.
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Affiliation(s)
- Maya Tabet
- College of Global Population Health (M Tabet and R Boyd), University of Health Sciences and Pharmacy in St. Louis, St. Louis, Mo.
| | - Russell S Kirby
- Chiles Center (RS Kirby), College of Public Health, University of South Florida, Tampa, Fla
| | - Ri'enna Boyd
- College of Global Population Health (M Tabet and R Boyd), University of Health Sciences and Pharmacy in St. Louis, St. Louis, Mo
| | - Pamela Xaverius
- Parkinson's School of Health Sciences and Public Health (P Xaverius), Loyola University Chicago, Maywood, Ill
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2
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Trotta F, Petrosino F, Pucciarelli G, Alvaro R, Vellone E, Bartoli D. Reliability and validity of the training satisfaction questionnaire for family members (TSQ-FM) entering the ICU during an isolation disease outbreak. Heart Lung 2024; 66:37-45. [PMID: 38574598 DOI: 10.1016/j.hrtlng.2024.03.004] [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: 10/07/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The presence of family members in an isolated ICU during an isolation disease outbreak is restricted by hospital policies because of the infectious risk. This can be overcome by conferring to family members the skill and the ability to safely don and doff the personal protective equipment (PPE) through a nurse-led training intervention and assess their satisfaction, to respond to the need to define a safe, effective and quality care pathway focused on Family-Centered Care (FCC) principles. OBJECTIVE the study aimed to build a valid and reliable instrument for clinical practice to assess family members' satisfaction to allow ICU nurses to restore family integrity in any case of infectious disease outbreak that requires isolation. METHODS A cross-sectional study was conducted to test the psychometric properties. The questionnaire was constructed based on a literature review on the needs of family members in the ICU. 76 family members were admitted to a COVID-ICU. Cronbach's coefficient, Geomin rotated loading, and EFA were applied to assess the reliability and validity of the instrument. RESULTS The Kaiser-Mayer-Olkin (KMO) measure was 0.662, the Bartlett sphericity test showed a significant p-value (χ²=448.33; df=45; p < 0.01), Cronbach's alpha coefficient was.896. A further CFA analysis confirmed that all fit indices were acceptable. The results showed satisfactory validity and reliability, which could be generalized and extended to any outbreak of isolation disease. CONCLUSIONS This study provides a valid and reliable instrument for clinical practice to maintain family integrity in the dyadic relationship between the patient and the family member, even during an emergency infectious disease outbreak that requires isolation.
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Affiliation(s)
- Francesca Trotta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Francesco Petrosino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Bartoli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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3
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Abudereheman M, Lian Z, Ainitu B. Weighted gene co-expression network analysis and whole genome sequencing identify potential lung cancer biomarkers. Front Oncol 2024; 14:1355527. [PMID: 38854719 PMCID: PMC11157001 DOI: 10.3389/fonc.2024.1355527] [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: 12/14/2023] [Accepted: 05/08/2024] [Indexed: 06/11/2024] Open
Abstract
Background Tuberculosis (TB) leads to an increased risk of lung cancer (LC). However, the carcinogenetic mechanism of TB remains unclear. We constructed gene co-expression networks and carried out whole-exome sequencing (WES) to identify key modules, hub genes, and the most recurrently mutated genes involved in the pathogenesis of TB-associated LC. Methods The data used in this study were obtained from the Gene Expression Omnibus (GEO) and WES. First, we screened LC-related genes in GSE43458 and TB-related genes in GSE83456 by weighted gene co-expression network analysis (WGCNA). Subsequently, we screened differentially expressed genes related to LC and TB in GSE42834. We also performed WES of 15 patients (TB, n = 5; LC, n = 5; TB+LC, n = 5), constructed mutational profiles, and identified differences in the profiles of the three groups for further investigation. Results We identified 278 hub genes associated with tumorigenesis of pulmonary TB. Moreover, WES identified 112 somatic mutations in 25 genes in the 15 patients. Finally, four common genes (EGFR, HSPA2, CECR2, and LAMA3) were confirmed in a Venn diagram of the 278 hub genes and the mutated genes from WES. KEGG analysis revealed various pathway changes. The PI3K-AKT signaling pathway was the most enriched pathway, and all four genes are included in this pathway. Thus, these four genes and the PI3K-AKT signaling pathway may play important roles in LC. Conclusion Several potential genes and pathways related to TB-associated LC were identified, including EGFR and three target genes not found in previous studies. These genes are related to cell proliferation, colony formation, migration, and invasion, and provide a direction for future research into the mechanisms of LC co-occurring with TB. The PI3K-AKT signaling pathway was also identified as a potential key pathway involved in LC development.
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Affiliation(s)
| | | | - Baidurula Ainitu
- Oncology Department, The Eighth Affiliated Hospital of XinJiang Medical University, Urumqi, China
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Wu QL, Brannon GE. Collaborative Care and Healthcare Usage in Families with Pediatric Patients During COVID-19: A Secondary Analysis of National Survey of Children's Health (NSCH) Data. HEALTH COMMUNICATION 2024; 39:1053-1065. [PMID: 37069500 DOI: 10.1080/10410236.2023.2201746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
One of the most detrimental side effects of the COVID-19 pandemic is the needed but not received care. Forgone health care affects the general public, but particularly children with special care needs. Previous research focused on non-modifiable factors, such as demographic background and insurance coverage. Based on Politi and Street's model of collaborative decision-making, we explored how two modifiable communication factors contributed to the prevention of forgone pediatric care during the COVID-19 pandemic. Using a nationally representative sample (n = 10845) from the 2020 National Survey of Children's Health (NSCH) survey, we found that health-care providers' family-centered communication and shared decision-making may reduce the possibility of forgone care through improved satisfaction with providers' communication. For children with mental health needs, providers' family-centered communication may also stimulate family's capacity to openly communicate, leading to better involvement in care and timely health care seeking. This helps to address COVID-related uncertainty, prevent higher health-care expenditures, and reduce negative health outcomes.
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Ramirez P, Mueller A, Shelton K, Dudzinski DM, Colbert A, Jacobsen J, Greenwald JL, Ludmir J. Family Perceptions of Virtual Family-Centered Rounds in a Quaternary Cardiac Intensive Care Unit. J Intensive Care Med 2024; 39:499-504. [PMID: 38374623 DOI: 10.1177/08850666241233495] [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: 02/21/2024]
Abstract
Background: Family-centered rounds (FCR) reduce the risk of psychological comorbidities of family members and improve the quality of communication between providers and families. Materials and methods: We conducted a pilot quality improvement study analyzing family perceptions of virtual FCR. Family members of previously admitted cardiac ICU patients who participated in at least one session of virtual FCR between April 2020 and June 2021 at Massachusetts General Hospital were surveyed post-ICU discharge. Results: During the study, 82 family members enrolled and participated in virtual FCR with 29 completing the post-admission telephone survey. Many cardiac ICU patients were male (n = 53), and a majority were discharged home (43%) with the patient's wives being the most common respondents to the questionnaire (n = 18). Across all questions in the survey, more than 75% of the respondents perceived the highest level of care in trust, communication, relationship, and compassion with their provider. Participants perceived the highest level of care in trust (96%), explanation (88%), as well as care and understanding (89%). Conclusions: Family members of cardiac ICU patients positively rated the quality of communication and perceived a high level of trust and communication between their providers on the virtual format.
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Affiliation(s)
- Paolo Ramirez
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Cardiology Division, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA, USA
| | - Ariel Mueller
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Ken Shelton
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - David M Dudzinski
- Cardiology Division, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA, USA
| | - Annie Colbert
- Cardiology Division, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA, USA
| | - Juliet Jacobsen
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Jonathan Ludmir
- Cardiology Division, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA, USA
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Orewa GN, Feldman SS, Kennedy KC, Hall AG, Cheng YH, Malone AA, Grimes EO, Hearld KR. Improving Communication with Family Members during a Global Pandemic: Effect on Patient Experience. South Med J 2024; 117:182-186. [PMID: 38569604 DOI: 10.14423/smj.0000000000001670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Communication with patients and their families/caregivers to facilitate informed decision making is an integral part of patient/family-centered care. Due to the high coronavirus disease 2019 (COVID-19) infection rates and limited personal protective equipment, healthcare systems were forced to restrict patient visitors, limit patient-provider interactions, and implement other changes in treatment protocols that disturbed traditional communications and risked eroding patient/family-centered care and adversely affected patient satisfaction. This article focuses on changes in patient experience in two dedicated COVID-19 units of an academic medical center located in the US South as a result of the enhanced communication process implemented specifically during the COVID-19 pandemic. METHODS This retrospective quality improvement project used data from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, fielded between January 1, 2021 and August 31, 2021, to understand the role of a proactive communication initiative in patient satisfaction. RESULTS Our results show that HCAHPS scores for hospital unit hospital unit 4 (HSP4) in all categories increased over time, with the greatest improvements seen in the responsiveness of staff and care transition; however, HCAHPS scores for hospital unit HSP3 remained stable, with a small increase in responsiveness of staff. CONCLUSIONS Our findings suggest that communication is a critical factor in patient satisfaction, demonstrating the efficacy of a swift and innovative initiative to improve communication with family/caregivers, which may have been linked to better patient experiences. Developing communication strategies is crucial for enhancing patient satisfaction.
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Affiliation(s)
- Gregory N Orewa
- From the Department of Public Health, University of Texas at San Antonio, San Antonio
| | - Sue S Feldman
- Health Service Administration, University of Alabama at Birmingham, Birmingham
| | | | - Allyson G Hall
- Health Service Administration, University of Alabama at Birmingham, Birmingham
| | - Yu H Cheng
- UAB Hospital Medicine, University of Alabama at Birmingham, Birmingham
| | - Arnaz A Malone
- Stanford Medicine Children's Health, Stanford, California
| | | | - Kristine Ria Hearld
- Health Service Administration, University of Alabama at Birmingham, Birmingham
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Soleimani M, Fakhr‐Movahedi A, Yarahmadi S. Family engagement in the care of infectious patients in intensive care units: A hybrid concept analysis. Nurs Open 2024; 11:e2117. [PMID: 38429918 PMCID: PMC10907824 DOI: 10.1002/nop2.2117] [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: 07/31/2023] [Revised: 01/06/2024] [Accepted: 02/07/2024] [Indexed: 03/03/2024] Open
Abstract
AIM This study aims to define and investigate characteristics, antecedents, and consequences of the concept of family engagement in caring for patients with infectious diseases hospitalised in intensive care units. DESIGN This is a three-phase hybrid model study (theoretical, fieldwork, and analytical phase). METHODS The York University Guidelines were used in the theoretical phase, and ultimately, 16 pieces of literature related to the subject under study from 2011 to 2021 were reviewed. The content analysis was used for fieldwork phases; eight participants were interviewed. Then, the theoretical and fieldwork findings were compared, integrated, and analysed. RESULTS This concept has characteristics such as; awareness, belief, perception, and willingness of the nurse to engage the family; a sense of responsibility, willingness, and sacrifice of the family; the physical or virtual presence of the family; triangular interaction between the nurse, patient, and family; perception and identifying the goals; education and information transfer; team collaboration; delegation of responsibility to the family; decision making; and protection of the family. Antecedents include the availability of infrastructure; patient, family, and nurse conditions; and the quality implementation of engagement. The consequences include positive consequences related to the patient, family, nursing, and society, as well as some negative consequences. This study provided a comprehensive perception of family engagement in the care of patients with infectious diseases in intensive care units and defined it more clearly, showing its characteristics, antecedents, and consequences. PATIENT OR PUBLIC CONTRIBUTION Eight participants were interviewed, including five nurses, two family caregivers, and one patient.
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Affiliation(s)
- Mohsen Soleimani
- Nursing Care Research Center, School of Nursing and MidwiferySemnan University of Medical SciencesSemnanIran
| | - Ali Fakhr‐Movahedi
- Nursing Care Research Center, School of Nursing and MidwiferySemnan University of Medical SciencesSemnanIran
| | - Sajad Yarahmadi
- Social Determinants of Health Research Center, School of Nursing and MidwiferyLorestan University of Medical SciencesKhorramabadIran
- Student Research CommitteeSemnan University of Medical SciencesSemnanIran
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Johansson M, Wåhlin I, Magnusson L, Hanson E. The use and application of intensive care unit diaries: An instrumental multiple case study. PLoS One 2024; 19:e0298538. [PMID: 38422059 PMCID: PMC10903823 DOI: 10.1371/journal.pone.0298538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
AIMS AND OBJECTIVES The study aim was to explore the use of an Intensive Care Unit (ICU) diary within four different ICUs units in Sweden and thereby contribute to practice guidelines regarding the structure, content and use of an ICU diary. BACKGROUND ICU diaries are used to aid psychological recovery among critical care patients, but differences remain in diary writing both within and across countries. Few studies have focused on the combined views and experiences of ICU patients, family members and nursing staff about the use of ICU diaries. DESIGN An instrumental multiple case study design was employed. METHODS Three focus groups interviews were carried out with 8 former patients and their family members (n = 5) from the research settings. Individual interviews were carried out with 2 patients, a family member and a nurse respectively. Observations, field notes, documentary analysis and conversations with nursing staff were also conducted. Consolidated criteria for reporting qualitative research (COREQ) was followed. RESULTS The qualitative findings firstly consisted of a matrix and descriptive text of the four ICU contexts and current practices. This highlighted that there were similarities regarding the aims and objectives of the diaries. However, differences existed across the case study sites about how the ICU diary was developed and implemented. Namely, the use of photographs and when to commence a diary. Second, a thematic analysis of the qualitative data regarding patients' and family members' use of the ICU diary, resulted in four themes: i) the diary was used to take in and fully understand the situation; ii) the diary was an opportunity to assimilate warm, personalised and human care; iii) the diary was used to manage existential issues; and iv) the diary was a tool in daily activities. CONCLUSIONS Analysis of the instrumental case study data led to the identification of core areas for inclusion in ICU diary practice guidelines.
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Affiliation(s)
- Maria Johansson
- Intensive Care Department, County Hospital, Region Kalmar County, Kalmar, Sweden
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Ingrid Wåhlin
- Intensive Care Department, County Hospital, Region Kalmar County, Kalmar, Sweden
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Research Section, Region Kalmar County, Kalmar, Sweden
| | - Lennart Magnusson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Elizabeth Hanson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Swedish Family Care Competence Centre, Kalmar, Sweden
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Walker W, Jones J, Astley M. In-hospital end-of-life care: an appreciative analysis of bereaved family feedback. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:126-131. [PMID: 38335107 DOI: 10.12968/bjon.2024.33.3.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Experience feedback data is increasingly recognised as being helpful in improving healthcare services, and in meeting patient and family needs. This end-of-life care project, based on the principles of appreciative inquiry, sought to learn from the experiences of bereaved people whose relative had died in an acute hospital setting. Informal feedback, offered during a routine telephone call, was thematically analysed and interpreted in an appreciative manner. Confirmatory representations of caring practices and behaviours were identified, categorised and disseminated in a way that enabled staff to come to know and understand end-of-life care at its best, rather than as a set of problematised events. The findings served as a benchmark for individuals and teams to assess and progress their practice reflectively. The authors conclude that staff receptiveness to informal bereaved family feedback may be enhanced by focusing on the positive qualities of end-of-life care within existing practices.
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Affiliation(s)
- Wendy Walker
- Reader in Nursing (End-of-life Care and Bereavement), The Royal Wolverhampton NHS Trust
| | - Jennifer Jones
- Specialist Nurse-Bereavement/Lead Medical Examiner Officer, The Royal Wolverhampton NHS Trust
| | - Melanie Astley
- Clinical Nurse Specialist-Palliative Care, The Royal Wolverhampton NHS Trust
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Lobb E, Maccallum F, Phillips JL, Agar M, Hosie A, Breen LJ, Tieman J, DiGiacomo M, Luckett T, Philip J, Ivynian S, Chang S, Dadich A, Harlum J, Gilmore I, Kinchin I, Grossman C, Glasgow N. The COVID-19 Pandemic: Bereavement Experiences Between Hospital and Home Deaths in Palliative Care. J Pain Symptom Manage 2024; 67:147-156. [PMID: 37972719 DOI: 10.1016/j.jpainsymman.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Australian COVID-19 public health measures reduced opportunities for people to communicate with healthcare professionals and be present at the death of family members/friends. AIM To understand if pandemic-specific challenges and public health measures during the COVID-19 pandemic impacted end-of-life and bereavement experiences differently if the death, supported by palliative care, occurred in a hospital or at home. DESIGN A cross-sectional online survey was completed by bereaved adults during 2020-2022. Analyses compared home and in-patient palliative care deaths and bereavement outcomes. Additional analyses compared health communication outcomes for those identified as persons responsible or next of kin. SETTING/PARTICIPANTS Of 744 bereaved people; 69% (n = 514) had a death in hospital and 31% (n = 220) at home. RESULTS The COVID-19 public health measures influenced people's decision to die at home. Compared to hospital deaths, the home death group had higher levels of grief severity and grief-related functional impairment. Only 37% of bereaved people received information about bereavement and support services. 38% of participants who were at least 12 months postdeath scored at a level suggestive of possible prolonged grief disorder. Levels of depression and anxiety between the two groups were not significantly different. CONCLUSIONS These findings highlight the need for health services to recognize bereavement as fundamental to palliative and health care and provide pre- and post death grief and bereavement care to ensure supports are available particularly for those managing end-of-life at home, and that such supports are in place prior to as well as at the time of the death.
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Affiliation(s)
- Elizabeth Lobb
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology (E.L.), Sydney, New South Wales, Australia; Department of Palliative Care, Calvary Health Care (E.L.), Kogarah, New South Wales, Australia.
| | - Fiona Maccallum
- School of Psychology (F.M.), University of Queensland, Queensland, Australia
| | - Jane L Phillips
- School of Nursing, Faculty of Health (J.L.P.), Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Meera Agar
- Research Institute for Innovative Solutions for Wellbeing and Health (M.A.), IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Annmarie Hosie
- School of Nursing, Midwifery, Health Sciences & Physiotherapy (A.H.), The University of Notre Dame Australia & St Vincent's Health Network Sydney, Darlinghurst, New South Wales, Australia
| | - Lauren J Breen
- Curtin School of Population Health (L.J.B.), enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Jennifer Tieman
- Research Centre for Palliative Care (J.T.), Death and Dying (RePaDD), College of Nursing and Health Science I RePaDD, Bedford Park, South Australia, Australia
| | - Michelle DiGiacomo
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Tim Luckett
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Jennifer Philip
- Department of Medicine, St Vincent's Hospital (J.P.), University of Melbourne, Parkville, Victoria, Australia
| | - Serra Ivynian
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Sungwon Chang
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Ann Dadich
- Western Sydney University, School of Business (A.D.), Parramatta, New South Wales, Australia
| | - Janeane Harlum
- District Palliative Care Manager & Service Development (J.H.), District Palliative Care Service, Liverpool Hospital, New South Wales, Australia
| | - Imelda Gilmore
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney (T.L., S.I., S.C., I.G.), Ultimo, New South Wales, Australia
| | - Irina Kinchin
- Centre for Health Policy and Management, Discipline of Public Health & Primary Care, School of Medicine (I.K.), Trinity College Dublin, the University of Dublin, Dublin, Ireland
| | | | - Nicholas Glasgow
- Australian National University College of Health and Medicine (N.G.), Canberra ACT, Australia
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Marinkov A, Dimova R, Karalilova R, Keskinova D, Bahariev D, Batalov K, Popova V, Batalov Z, Batalov A. The COVID-19 pandemic's impact on rheumatic disease patients' satisfaction with access to medical services. Rheumatol Int 2024; 44:157-164. [PMID: 37776498 DOI: 10.1007/s00296-023-05413-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 10/02/2023]
Abstract
The COVID-19 hurt various lifestyle aspects, especially the treatment and follow-up of patients with chronic diseases such as autoimmune inflammatory rheumatic diseases (RD). The new circumstances changed the frequency of medical examinations and the way patients with rheumatic diseases are followed up. The objective is to study the impact of COVID-19 on RD patients' satisfaction with access to medical services. A national multicenter observational cross-sectional anonymous online survey was conducted on patients with RD using a specially developed web-based platform and structured questionnaire https://rheumatologycovid19.bg/ . The study was carried out with the support of intra-university project №6/2022 MU-Plovdiv. 1288 patients participated, with an average age of 47.03 (SD ± 12.80 years), of whom 992 (81.6%) were women. The questionnaire contained 41 questions grouped into 5 panels. Descriptive statistics were used-mean, alternative analysis, logistic regression and Decision Tree using the CRT (classification and regression trees) method. The study found that RD patients' satisfaction with access to medical services was influenced by communication type and the frequency of visits to the rheumatologist, difficulties in prescribing and finding medicines and the presence of comorbidities. The likelihood of patients' satisfaction with their rheumatologist was 5.5 and 3 times higher for in-person and other means of communication, respectively, compared to those without any communication. The relative share of patients who communicated by phone was larger (59%) compared to pre-pandemic (41%), where direct contact with the physician prevailed (80%). The results of the study confirmed the need to optimize remote access to medical care for patients with RD during the pandemic.
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Affiliation(s)
- Aleksandar Marinkov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Rositsa Dimova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, 4002, Bulgaria.
| | - Rositsa Karalilova
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Donka Keskinova
- Department of Applied and Institutional Sociology, Faculty of Philosophy and History, University of Plovdiv Paisiy Hilendarski, Plovdiv, Bulgaria
| | - Dimitar Bahariev
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
- Medical University of Plovdiv, Plovdiv, 4002, Bulgaria
| | - Konstantin Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Velichka Popova
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Zguro Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
| | - Anastas Batalov
- Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Clinic of Rheumatology, UMHAT "Kaspela", Medical University of Plovdiv, 64 Sofia Str, Plovdiv, 4002, Bulgaria
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12
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Buonaccorso L, De Panfilis L, Chochinov HM, Martucci G, Massari M, Cocchi M, Bassi MC, Tanzi S. The meaning of dignity in care during the COVID-19 pandemic: a qualitative study in acute and intensive care. BMC Palliat Care 2023; 22:192. [PMID: 38037061 PMCID: PMC10688038 DOI: 10.1186/s12904-023-01311-4] [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: 05/10/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND The pandemic Era has forced palliative care professionals to use a dignity-in-care approach in different settings from the classic ones of palliative care: acute and intensive care. We explored the meanings of dignity for patients, their family members, and clinicians who have experienced COVID-19 in the acute and intensive care setting. METHODS A qualitative, prospective study by means of semi-structured interviews with patients hospitalized for COVID-19, family members, and clinicians who care for them. FINDINGS Between March 2021 and October 2021, we interviewed 16 participants: five physicians, three nurses, and eight patients. None of the patients interviewed consented for family members to participate: they considered it important to protect them from bringing the painful memory back to the period of their hospitalization. Several concepts and themes arose from the interviews: humanity, reciprocity, connectedness, and relationship, as confirmed by the literature. Interestingly, both healthcare professionals and patients expressed the value of informing and being informed about clinical conditions and uncertainties to protect dignity. CONCLUSIONS Dignity should be enhanced by all healthcare professionals, not only those in palliative care or end-of-life but also in emergency departments.
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Affiliation(s)
| | - Ludovica De Panfilis
- Legal Medicine and Bioethics, Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy
| | - Harvey Max Chochinov
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
- Paul Albrechtsen Research, Cancer Care Manitoba, University of Manitoba, Winnipeg, Canada
| | | | - Marco Massari
- Infectious Diseases Unit, Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy
| | - Monica Cocchi
- Hospital Infections Office, Hospital Medical Directorate, Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Tanzi
- Palliative Care Unit, Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy
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13
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Nematifard T, Norouzi Tabrizi K, Arsalani N, Fallahi-Khoshknab M, Borimnejad L. The barriers to family-centered care in the pediatric rehabilitation ward: A qualitative study. J Pediatr Nurs 2023; 73:120-129. [PMID: 37666025 DOI: 10.1016/j.pedn.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/19/2023] [Accepted: 08/19/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Family-centered care (FCC) is one of the fundamental principles of care provision to children with disability (CWD). It is based on the collaboration of healthcare providers, patients, and families. However, there is limited information about the barriers to FCC in pediatric rehabilitation settings in Iran. This study aimed at exploring the barriers to FCC in the pediatric rehabilitation ward. METHODS This descriptive qualitative study was conducted in 2022. Participants were nine rehabilitation staff and twelve mothers of hospitalized CWD purposively selected from the pediatric rehabilitation ward of hospital Rofeideh, Tehran, Iran. Rehabilitation staff were three nurses, a head nurse, a nursing manager, a medical specialist, a social worker, a physical therapist, and an occupational therapist. Eleven semi-structured interviews and three focus group discussions were conducted for data collection, and conventional content analysis proposed by Graneheim and Lundman (2004) was used for data analysis. RESULTS The three main categories of the barriers to FCC in the pediatric rehabilitation ward were family-related barriers (subcategories: knowledge about child rehabilitation, sociocultural background, and participation), staff-related barriers (subcategories: knowledge, ethical concerns, and collaboration), and organizational barriers (subcategories: factors related to FCC policies, managerial factors, environmental factors, and factors related to the coronavirus disease 2019 pandemic). CONCLUSION The barriers to FCC in the pediatric rehabilitation ward are very diverse due to the long-term course of child disability and long-term interaction of families with rehabilitation centers. Data collection from both families and rehabilitation staff helped acquire an in-depth understanding about these barriers. More in-depth explorations of family-related barriers such as sociocultural factors are essential to determine the reasons for family resistance to healthcare providers' recommendations to develop more effective care plans.
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Affiliation(s)
- Taban Nematifard
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kian Norouzi Tabrizi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Narges Arsalani
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Leili Borimnejad
- Nursing and midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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14
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Kihara A, Kambayashi T, Shimonouchi Y, Mabuchi M, Nagai A, Kanzaki I, Fukagawa M. The Impact of Visitor Restrictions During COVID-19 Pandemic on Bereaved Family Members of Patients in Palliative Care Units. Am J Hosp Palliat Care 2023; 40:1279-1284. [PMID: 36803015 PMCID: PMC9941005 DOI: 10.1177/10499091231159522] [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] [Indexed: 02/21/2023] Open
Abstract
COVID-19 pandemic has impacted the families of patients in Palliative Care Units because of the visitor restrictions which were introduced to reduce the risk of infection. This study investigates how the bereaved families of the patients who died in end-of-life care during the pandemic evaluate the visitor restrictions and how the lack of direct communication with the patient affected them. We conducted a quantitative survey using an anonymous self-administered questionnaire. Participants were the bereaved families of patients who died in a Palliative Care Unit from April 2020 to March 2021. Their perspectives on the negative impact of COVID-19 pandemic on visitations, visitor restrictions, the quality of medical care in the month before the death of the patient, and online visitations were recorded in the survey. The results show that most participants experienced a negative impact on visitations. However, most respondents felt that the restrictions were unavoidable. According to visitor permissions in patients' last days, bereaved families were satisfied with the medical care provided for the patient and the amount of time spent with the patient in his/her last days. The importance of direct meetings during the last days of the patients' life for their family members was presented. We suggest further research to find measures which enable visitation in palliative care units, as caregiving from family and friends and maintaining COVID safety regulations are equally significant in end-of-life care.
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Affiliation(s)
- Ayumi Kihara
- Palliative Care Unit, Kyoto Min-iren Asukai Hospital, Kyoto, Japan
| | | | | | - Makiko Mabuchi
- Palliative Care Unit, Kyoto Min-iren Asukai Hospital, Kyoto, Japan
| | - Ayumi Nagai
- Palliative Care Unit, Kyoto Min-iren Asukai Hospital, Kyoto, Japan
| | - Iku Kanzaki
- Palliative Care Unit, Kyoto Min-iren Asukai Hospital, Kyoto, Japan
| | - Miyuki Fukagawa
- Palliative Care Unit, Kyoto Min-iren Asukai Hospital, Kyoto, Japan
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15
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Wang CH, Chen YK, Tsao SH, Lee CH. Trends in Palliative Care Research During the COVID-19 Pandemic. Am J Hosp Palliat Care 2023; 40:1271-1278. [PMID: 36503251 PMCID: PMC9748525 DOI: 10.1177/10499091221145202] [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: 10/13/2023] Open
Abstract
To demonstrate the trends and variety of research on palliative care during the COVID-19 pandemic. A systematic search of the Web of Science database. Since the outbroke of the COVID-19 pandemic, the adjustment of palliative care systems is warranted to maintain a high quality of care. The COVID-19 -related palliative care studies account for approximately 4% of all publications on palliative care. However, there is a dearth of research investigating the nature of these studies. A total of 293 studies were included. Of the included studies, those related to system improvement were the most common (181/293, 61.8%), followed by those related to patient care (79/293, 27.0%), bereavement support for patients or family members (19/293, 6.5%), and the mental health of frontline practitioners (14/293, 4.8%). From these studies, 82, 137, and 74 studies were published in 2020, 2021, and 2022 (until August 1), respectively. The research trends of palliative care demonstrate the flexibility and rapid response of the global palliative care system to the COVID-19 pandemic and show how the palliative care system is evolving. While most studies are interested in system improvement, patient care, and bereavement support, the mental health of frontline practitioners has received less attention. Our findings provide palliative care practitioners with current valuable information and highlight possible future trends.
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Affiliation(s)
- Chien-Ho Wang
- Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yu-Kai Chen
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Han Tsao
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Hsing Lee
- Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
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16
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Rana R, Pham A, Laing N, Pottash M. Visitation restriction and decision making: Healthcare surrogate experiences. PATIENT EDUCATION AND COUNSELING 2023; 115:107884. [PMID: 37454476 DOI: 10.1016/j.pec.2023.107884] [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: 04/17/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES We sought to discover whether hospital visitation restrictions imposed during COVID, and remaining at some institutions, influenced surrogate decision-making. METHODS Thematic analysis of semi-structured interviews of people who served as healthcare surrogates for patients admitted to the intensive care unit with a palliative care consultation in January of 2021 at a large tertiary care hospital. RESULTS Thirteen healthcare surrogates agreed to be interviewed out of the fifty-six who were identified and invited to participate. The following themes emerged: 1) Decision-making was delayed as surrogates desire to make decisions in conjunction with the patient; 2) visitation restriction disrupted processes of grief and end-of-life rituals; 3) it prevented healing that occurs with closeness to loved ones; 4) visitation permission was poorly communicated and inconsistent; 5) virtual connection was inconsistent and proved ineffective in context; 6) communication was often stressful and confusing. CONCLUSION From the point of view of healthcare surrogates, visitation restriction disrupted the normal process of decision-making by impeding important healing and grief rituals, and making connection difficult, despite policies and technology that was meant to assist. PRACTICE IMPLICATIONS Visitation restriction carries risk such as delaying decision-making and the perceived healing benefits of visitation.
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Affiliation(s)
- Rimsha Rana
- Georgetown University School of Medicine, Washington, DC, USA
| | | | - Nina Laing
- Division of Palliative Medicine, Department of Medicine. MedStar Washington Hospital Center, Washington, DC, USA
| | - Michael Pottash
- Division of Palliative Medicine, Department of Medicine. MedStar Washington Hospital Center, Washington, DC, USA; Department of Medicine, Georgetown University School of Medicine, Washington, DC, USA.
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17
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Natale P, Zhang J, Scholes-Robertson N, Cazzolli R, White D, Wong G, Guha C, Craig J, Strippoli G, Stallone G, Gesualdo L, Jaure A. The Impact of the COVID-19 Pandemic on Patients With CKD: Systematic Review of Qualitative Studies. Am J Kidney Dis 2023; 82:395-409.e1. [PMID: 37330133 PMCID: PMC10270732 DOI: 10.1053/j.ajkd.2023.04.001] [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: 02/13/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
RATIONALE & OBJECTIVE COVID-19 disproportionately affects people with comorbidities, including chronic kidney disease (CKD). We describe the impact of COVID-19 on people with CKD and their caregivers. STUDY DESIGN A systematic review of qualitative studies. SETTING & STUDY POPULATIONS Primary studies that reported the experiences and perspectives of adults with CKD and/or caregivers were eligible. SEARCH STRATEGY & SOURCES MEDLINE, Embase, PsycINFO, CINAHL searched from database inception to October 2022. DATA EXTRACTION Two authors independently screened the search results. Full texts of potentially relevant studies were assessed for eligibility. Any discrepancies were resolved by discussion with another author. ANALYTICAL APPROACH A thematic synthesis was used to analyze the data. RESULTS Thirty-four studies involving 1,962 participants were included. Four themes were identified: exacerbating vulnerability and distress (looming threat of COVID-19 infection, intensifying isolation, aggravating pressure on families); uncertainty in accessing health care (overwhelmed by disruption of care, confused by lack of reliable information, challenged by adapting to telehealth, skeptical about vaccine efficacy and safety); coping with self-management (waning fitness due to decreasing physical activity, diminishing ability to manage diet, difficulty managing fluid restrictions, minimized burden with telehealth, motivating confidence and autonomy); and strengthening sense of safety and support (protection from lockdown restrictions, increasing trust in care, strengthened family connection). LIMITATIONS Non-English studies were excluded, and inability to delineate themes based on stage of kidney and treatment modality. CONCLUSIONS Uncertainty in accessing health care during the COVID-19 pandemic exacerbated vulnerability, emotional distress, and burden, and led to reduced capacity to self-manage among patients with CKD and their caregivers. Optimizing telehealth and access to educational and psychosocial support may improve self-management and the quality and effectiveness of care during a pandemic, mitigating potentially catastrophic consequences for people with CKD. PLAIN-LANGUAGE SUMMARY During the COVID-19 pandemic, patients with chronic kidney disease (CKD) faced barriers and challenges to accessing care and were at an increased risk of worsened health outcomes. To understand the perspectives about the impact of COVID-19 among patients with CKD and their caregivers, we conducted a systematic review of 34 studies involving 1,962 participants. Our findings demonstrated that uncertainty in accessing care during the COVID-19 pandemic exacerbated the vulnerability, distress, and burden of patients and impaired their abilities for self-management. Optimizing the use of telehealth and providing education and psychosocial services may mitigate the potential consequences for people with CKD during a pandemic.
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Affiliation(s)
- Patrizia Natale
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari, Italy; Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Jing Zhang
- Centre for Kidney Research, Children's Hospital at Westmead, Australia; Renal Medicine, Westmead Hospital, Westmead, Australia
| | - Nicole Scholes-Robertson
- Centre for Kidney Research, Children's Hospital at Westmead, Australia; College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Rosanna Cazzolli
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Australia
| | - David White
- American Association of Kidney Patients, Tampa, Florida
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Australia; Renal Medicine, Westmead Hospital, Westmead, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Giovanni Strippoli
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari, Italy
| | - Giovanni Stallone
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Allison Jaure
- Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Australia
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18
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Uysal N, Vaizoğlu D. The Effect of Video Call with Family Members on Physiological Parameters of Critically Ill Patients in Intensive Care Unit: A Quasi-experimental Study. Indian J Crit Care Med 2023; 27:732-736. [PMID: 37908419 PMCID: PMC10613864 DOI: 10.5005/jp-journals-10071-24549] [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: 06/20/2023] [Accepted: 09/08/2023] [Indexed: 11/02/2023] Open
Abstract
Aim and background There are not enough studies on the direct effect of virtual patient visits on patients' vital signs in intensive care. The aim of this study is to determine the effect of video calls made between conscious patients and their families on the patient's vital signs and to determine the level of satisfaction. Materials and methods The research was carried out quasi-experimentally. Study data were collected from 135 patients and their relatives. The data were collected from the vital signs monitoring form and the Glasgow Coma Scale (GCS). Satisfaction with the video call was measured with a score scale between 0 and 5. Video calls were conducted by an intensive care unit (ICU) nurse every day between 13:00 and 15:00 for 5 days. Physiological parameters were measured 30 minutes before, during, and 30 minutes after the video calls. Results The mean patient pulse rate (PR) value was 92.04 ± 12.87, respiratory rate (RR) value was 22.89 ± 3.63, and GCS total score was 14.01 ± 0.12 during the call. There was a statistically significant difference between these values measured during the video calls and the values measured before and after the interview (p < 0.00). The mean score of patient satisfaction with the video call was 4.80 ± 0.44; for relatives, the mean score was 4.87 ± 0.33. Conclusion This study revealed that video calls with family members affected PR, RR, and GCS of patients hospitalized in ICU. Clinical significance Video calls can be implemented in all ICUs where visits are restricted. This practice is well recognized by both families and patients. How to cite this article Uysal N, Vaizoğlu D. The Effect of Video Call with Family Members on Physiological Parameters of Critically Ill Patients in Intensive Care Unit: A Quasi-experimental Study. Indian J Crit Care Med 2023;27(10):732-736.
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Affiliation(s)
- Nurcan Uysal
- Department of Nursing, Usküdar University Faculty of Health Sciences, Istanbul, Turkey
| | - Doğancan Vaizoğlu
- Department of Nursing, Istinye University Faculty of Health Sciences, Istanbul, Turkey
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19
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Sun AH, Ménard A, Farrell E, Filip A, Katz A, Orosz Z, Hsu AT. Perceptions of Palliative and End-Of-Life Care Capacity Among Frontline Staff and Administrators in Long-Term Care Homes During the COVID-19 Pandemic in Ontario, Canada: A Mixed-Methods Evaluation. J Am Med Dir Assoc 2023; 24:1586-1593. [PMID: 37488030 PMCID: PMC10293894 DOI: 10.1016/j.jamda.2023.06.010] [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: 12/09/2022] [Revised: 05/18/2023] [Accepted: 06/12/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has greatly affected the morbidity and mortality of residents in long-term care (LTC) homes. However, not much is known about its impact on staff's perception of their capacity to provide palliative and end-of-life (EOL) care for LTC residents over the course of the pandemic. We investigated changes in self-reported confidence among LTC workers and their experience in providing palliative and EOL care to residents before and during the COVID-19 pandemic. DESIGN Mixed-methods evaluation using a survey (n = 19) and semistructured interviews (n = 28). SETTING AND PARTICIPANTS Frontline workers from 9 LTC homes who participated in Communication at End-of-Life Program in Ontario, Canada, between August 2019 and March 2020. METHODS The survey captured LTC staff's confidence level, including attitudes toward death and dying; relationships with residents and families; and participation in palliative and EOL care. The interviews identified facilitators and barriers to providing palliative and EOL care during the pandemic. RESULTS The COVID-19 pandemic negatively impacted frontline LTC staff's confidence in their role as palliative care providers. Participants also reported notable challenges to providing resident-centered palliative and EOL care. Specifically, visitation restriction has led to increased loneliness and isolation of residents and impeded staff's ability to build supportive relationships with families. Furthermore, staffing shortages due to the single-site work restriction and illness increased workload. Psychological stress caused by a fear of COVID-19 infection and transmission also hindered staff's capacity to provide good palliative and EOL care. CONCLUSIONS AND IMPLICATIONS Frontline LTC staff-even those who felt competent in their knowledge and skills in providing palliative and EOL care after receiving training-reported notable difficulties in providing resident-centered palliative and EOL care during the COVID-19 pandemic.
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Affiliation(s)
- Annie H Sun
- Bruyère Research Institute, Ottawa, Ontario, Canada; Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Alixe Ménard
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Emily Farrell
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Angelina Filip
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Andrea Katz
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Zsofia Orosz
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Amy T Hsu
- Bruyère Research Institute, Ottawa, Ontario, Canada; Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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20
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Rivas S, Albertos A. Potential connection between positive frustration in family leisure time and the promotion of adolescent autonomy. Front Psychol 2023; 14:1258748. [PMID: 37799524 PMCID: PMC10547906 DOI: 10.3389/fpsyg.2023.1258748] [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: 07/14/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Family relationships during leisure time in adolescence have the potential to promote positive development, particularly in terms of autonomy. However, the scientific literature that links specifically positive family leisure to the development of adolescent autonomy is scarce, and lower when analyzing the role of frustration in leisure time. Grounded in Self-Determination Theory (SDT) this article examines the potential relationship between positive frustration in family leisure time and the promotion of adolescent autonomy. For that purpose, the manuscript addresses four objectives to be discussed consecutively: (1) to delimit the concept of adolescent autonomy and point out the difficulty of parental support; (2) to explore positive frustration, a concept aligned with Csikszentmihalyi's theory of flow, as a construct that can promote socio-emotional development in adolescence; (3) to describe the components of family leisure; and (4) to understand how the experience of optimal frustration may be linked to the development of adolescent autonomy during family leisure time. From this central question, several additional inquiries emerge: the interplay of frustration and failure in adolescence, the importance of parents and adolescents spending quality time together, the enjoyment in structured family leisure time, the autonomy-supportive parenting in leisure time activities in relation to daily activities, the need to strengthen adolescent bonds developed in infancy, and the complexity of paternal and maternal autonomy granting.
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Affiliation(s)
- Sonia Rivas
- School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
- Institute for Culture and Society, Universidad de Navarra, Pamplona, Spain
| | - Aranzazu Albertos
- School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
- Institute for Culture and Society, Universidad de Navarra, Pamplona, Spain
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21
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Vinarski-Peretz H, Mashiach-Eizenberg M, Idilbi N, Halperin D. Service Climate and Nurses' Collaboration with Families of Older Patients in the Care Process during Hospitalization. Healthcare (Basel) 2023; 11:2485. [PMID: 37761682 PMCID: PMC10531144 DOI: 10.3390/healthcare11182485] [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: 08/21/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
This study focuses on the concrete role of the presence of a ward's service climate in cultivating nurses' collaboration with family members. Accordingly, this study examined the moderating role of the service climate in the link between nurses' attitudes toward the family and their collaboration with family members in the care process. This is the second article of a series of studies we conducted among health staff in Israeli public hospitals. Relying on the patient- and family-centered care approach and using a cross-sectional study of 179 nurses from 13 internal medicine, surgical and geriatric wards at a large public hospital in Israel, we conducted a multiple regression analysis to test the contribution of all relationship variables to predicting nurses' collaborative behavior with the family in the care process during elderly hospitalization. The findings indicate that service climate had a conditional moderating effect on the relationship between nurses' perception of the family as a burden and their collaboration with the family in nursing care. Namely, in the absence of a targeted service climate, nurses form perceptions about the families as a burden, which in turn affects their distinct non-collaboration, and vice versa.
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Affiliation(s)
- Hedva Vinarski-Peretz
- M.A. Program in Public Administration and Public Policy, Department of Political Science, Yezreel Valley Academic College, Yezreel Valley 1930600, Israel
- Department of Health Systems Management, Yezreel Valley Academic College, Yezreel Valley 1930600, Israel; (M.M.-E.); (D.H.)
| | - Michal Mashiach-Eizenberg
- Department of Health Systems Management, Yezreel Valley Academic College, Yezreel Valley 1930600, Israel; (M.M.-E.); (D.H.)
| | - Nasra Idilbi
- Department of Nursing, Yezreel Valley Academic College, Yezreel Valley 1930600, Israel;
- Nursing Research Unit, Galilee Medical Center, Nahariya 22100, Israel
| | - Dafna Halperin
- Department of Health Systems Management, Yezreel Valley Academic College, Yezreel Valley 1930600, Israel; (M.M.-E.); (D.H.)
- Department of Community Gerontology, Yezreel Valley Academic College, Yezreel Valley 1930600, Israel
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22
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de Souza DM, Fernandes RDF, Costa CTDS, Borghi CA, Rossato LM. From theory to practice: the inclusion of hospitalized children's families in painful procedures. Rev Esc Enferm USP 2023; 57:e20230152. [PMID: 37624383 PMCID: PMC10453425 DOI: 10.1590/1980-220x-reeusp-2023-0152en] [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: 05/23/2023] [Accepted: 06/29/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE To understand nursing team professionals' strategies to include the family in painful procedures performed on hospitalized children. METHOD An exploratory-descriptive, qualitative study, carried out with nursing professionals. Data were collected through semi-structured interviews, guided by a script of topics, transcribed and submitted to thematic content analysis, in the light of Symbolic Interactionism, discussed considering the Family-Centered Care philosophy assumptions. RESULTS Two central categories emerged, "Theoretical perspective: the family as a care agent in painful procedures" and "Practical perspective: experiences, challenges and strategies in painful procedures for family inclusion", with their respective subcategories. CONCLUSION Nursing professionals have theoretical knowledge about family inclusion in painful procedures based on the assumptions: Family-Centered Care: dignity and respect; information sharing; joint participation; and family collaboration. However, knowledge is not applied in clinical practice; consequence of the interaction between beliefs and attitudes unfavorable to family presence.
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Affiliation(s)
- Danton Matheus de Souza
- Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brazil
| | | | | | | | - Lisabelle Mariano Rossato
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil
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Strayer AL, King BJ. COVID-19 and Elective Spine Surgery: The Older Persons' Experience of Going It Alone. J Neurosci Nurs 2023; 55:113-118. [PMID: 37318188 PMCID: PMC10332507 DOI: 10.1097/jnn.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
ABSTRACT BACKGROUND: Older people with debilitating degenerative spine disease may benefit from surgery. However, recovery is described as a circuitous process. In general, they describe feeling powerless and receiving depersonalized care during hospitalization. Institution of hospital no-visitor policies to reduce COVID-19 spread may have caused additional negative consequences. The purpose of this secondary analysis was to understand experiences of older people who underwent spine surgery during early COVID-19. METHODS: Grounded theory guided this study of people 65 years or older undergoing elective spine surgery. Fourteen individuals were recruited for 2 in-depth interviews at 2 time points: T1 during hospitalization and T2, 1 to 3 months post discharge. All participants were affected by pandemic-imposed restrictions with 4 interviews at T1 with no visitors, 10 with a 1-visitor policy, and 6 interviews at T2 rehabilitation setting with no visitors. Discriminate sampling of data in which participants described their experiences with COVID-19 visitor restrictions was used. Open and axial coding (consistent with grounded theory) was used for data analysis. RESULTS: Three categories, worry and waiting , being alone , and being isolated , emerged from the data. Participants had delays ( waiting ) in getting their surgery scheduled, which produced worry that they would lose more function, become permanently disabled, have increased pain, and experience more complications such as falls. Participants described being alone during their hospital and rehabilitation recovery, without physical or emotional support from family and limited nursing staff contact. Being isolated often occurred from institution policy, restricting participants to their rooms leading to boredom and, for some, panic. CONCLUSIONS: Restricted access to family after spine surgery and during recovery resulted in emotional and physical burden for participants. Our findings support neuroscience nurses advocating for family/care partner integration into patient care delivery and investigation into the effect of system-level policies on patient care and outcomes.
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Lee J, Bifano SM, Bombacie MJ, Lakhaney D, Steinberg DM, Gangopadhyay M, Porter R, Stenglein SL, Gold MA. The Development of a Multidisciplinary Support Network to Support Hospitalized Pediatric Patients, Their Families, and Hospital Staff During the COVID-19 Pandemic. Med Acupunct 2023; 35:180-185. [PMID: 37609551 PMCID: PMC10440643 DOI: 10.1089/acu.2023.0011] [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: 08/24/2023] Open
Abstract
Background The COVID-19 pandemic led to emotional and behavioral challenges for hospitalized pediatric patients, their families, and staff. Visitor restrictions, closure of patient lounges and playrooms, masking requirements, and enhanced isolation rules resulted in limited access to typical sources of psychosocial support during this traumatic event. Complementary and integrative health therapies such as acupuncture and related therapies are well suited to provide the humanitarian support patients and families need during times of crisis. Objective The Multidisciplinary Support Network (i.e., Network) was formed to redesign the delivery of acupuncture and other integrative therapies alongside psychosocial support for hospitalized children, their families, and staff. Intervention Network members represented a broad range of previously siloed disciplines including integrative therapies, art therapy, child life, nursing, pastoral care, adolescent medicine, pediatric hospital medicine, psychology, and child and adolescent psychiatry. The Network aimed to identify gaps in service and create resources to support children and families during this challenging time. Results The Network compiled existing complementary and integrative services, provided training on integrative therapies to staff, pediatric trainees, and faculty, developed the Comfort Box containing items to provide symptom relief including pain, anxiety and difficulty sleeping, as well as closed-circuit programming, a pediatric companionship program connecting medical student volunteer companions with pediatric patients, and a well-being workbook. Conclusion Collaborative teamwork across disciplines using integrative therapies was key to humanitarian efforts to support hospitalized children and their families during this crisis.
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Affiliation(s)
- Jennifer Lee
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Susanne M. Bifano
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Michelle J. Bombacie
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Divya Lakhaney
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Dara M. Steinberg
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Maalobeeka Gangopadhyay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Rechelle Porter
- UCSF Benioff Children's Hospital of Oakland California, Oakland, CA, USA
| | - Stacy L. Stenglein
- Morgan Stanley Children's Hospital, NewYork-Presbyterian, New York, NY, USA
| | - Melanie A. Gold
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
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Mousaei FM, Mirhosseini S, Mafi MH, Günaydın N, Zendehtalab HR. Effect of support based on family centered empowerment model on care burden in family caregivers of patients with multiple sclerosis. Front Public Health 2023; 11:1115311. [PMID: 37521993 PMCID: PMC10372413 DOI: 10.3389/fpubh.2023.1115311] [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: 12/03/2022] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Family caregivers of patients with multiple sclerosis (MS) are at risk of care burden that may lead to a detrimental effect on their quality of life (QoL), physical and mental well-being. This study aimed to determine the effect of the family-centered empowerment model (FCEM) on the care burden of caregivers of patients with MS. Methods This quasi-experimental study was conducted using convenience sampling on 60 caregivers of patients referring to the Multiple Sclerosis Clinic in Ghaem Hospital, Mashhad, Iran. The participants were assigned to FCEM and control groups based on the days they were referred to the MS clinic. Data collection tools included the Zarit Caregiver Burden Inventory (CBI), completed in the intervention and control groups before and 1 month after the intervention. The support based on FCEM was provided during eight 45-60-min sessions, and the control group received the medical center's routine training. Data were analyzed by Chi-square, independent t-test, analysis of covariance, and repeated measure tests. Results The results of the present study showed that all demographic characteristics were homogeneous at the baseline. Before the intervention, no significant difference was observed between the two groups regarding mean scores of care burden. Based on the repeated measure test, there was no significant treatment and time interaction in changes in care burden. Conclusion The FCEM has no significant effect in alleviating the care burden. It is recommended to observe the necessary considerations regarding the context of this type of intervention and to carry out further investigations in different intervals.
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Affiliation(s)
| | - Seyedmohammad Mirhosseini
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hossein Mafi
- School of Nursing and Midwifery, Research Institute for Prevention of Non – Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nevin Günaydın
- Department of Psychiatric Nursing, Health Sciences Faculty, Ordu University, Ordu, Turkey
| | - Hamid Reza Zendehtalab
- Department of Community Health of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Ambrosio L, Morris J, Lambrick D, Faulkner J, Compton E, Portillo MC. Physical activity and mental health experiences of people living with long term conditions during COVID-19 pandemic: A qualitative study. PLoS One 2023; 18:e0285785. [PMID: 37428782 PMCID: PMC10332610 DOI: 10.1371/journal.pone.0285785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/01/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION Regular physical activity is a strategy that is effective in the physical management of long term conditions. The COVID-19 pandemic, led to disruption of physical activity routines for many people with long term conditions. It is important, to understand the experiences of people with long term conditions regarding physical activity during COVID-19 to enable future identification of strategies to mitigate the impact of restrictions on health. OBJECTIVE To explore perceptions and experiences of people with long term conditions of the impact of the UK Government physical distancing restrictions on their physical activity participation during the COVID-19 pandemic. METHODS A qualitative study, with in depth videoconference semi-structured interviews were conducted between January and April 2022, with 26 adults living with at least one long term condition in the UK. Data were managed in analytical matrices within Excel and data analysis was conducted using thematic analysis. RESULTS Two main themes were developed, explaining how participants managed their physical activity during COVID19 lockdowns, and based on those experiences, what they considered should be in place should another lockdown occur:1) COVID-19 and physical activity: Losses, opportunities and adapting to new formats; and 2) Micro, meso, and macro contexts: creating the right conditions for physical activity support in future pandemics. CONCLUSIONS This study provides information on how people with long term conditions managed their condition during the COVID-19 pandemic and generates new understanding of how physical activity routines changed. These findings will be used to inform stakeholder engagement meetings with individuals with long term conditions and local, regional, and national policy makers, to co-produce recommendations that will help people living with long term conditions remain active during and after COVID-19 and other pandemics.
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Affiliation(s)
- Leire Ambrosio
- NIHR ARC Wessex, Health and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Jacqui Morris
- School of Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Danielle Lambrick
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - James Faulkner
- Department of Sport, Exercise and Health, University of Winchester, United Kingdom
| | - Eric Compton
- Person with Long Term Conditions, Public and Patient Involvement, Southampton, United Kingdom
| | - Mari Carmen Portillo
- NIHR ARC Wessex, Health and Life Sciences, University of Southampton, Southampton, United Kingdom
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Kılıç C, Pak Güre MD, Karataş M, Duyan V. Seeking New Meaning in the Shadow of the COVID-19 Pandemic: A Qualitative Research of Spiritual Issues and Experiences among Students in Turkish Society. JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01850-3. [PMID: 37386346 DOI: 10.1007/s10943-023-01850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/01/2023]
Abstract
Spirituality is one aspect to consider given the COVID-19 pandemic. However, the number of in-depth qualitative studies on spirituality-related issues and experiences is limited. The present study investigated the spiritual problems and experiences of students during the COVID-19 pandemic. The study was carried out with 342 Muslim students undertaking a distance education program at a state university in Turkey. The study was carried out using the non-probability sampling method. The data was collected using Qualtrics through a questionnaire consisting of open-ended questions related to spirituality during COVID-19. The data was analyzed using MAXQDA. The findings consisted of three categories, including spirituality during the pandemic, attitudes and behaviors related to the pandemic with a focus on spirituality, and feelings and thoughts about spirituality during the pandemic. There were fourteen subcategories, including resilience, meaning of life, coping mechanisms, acceptance, doubts, cleanliness, solidarity, risky behaviors, digitalization, religious rituals, inner peace, death, emotions, and hope. To meet the spiritual needs of students, it can be recommended to provide a suitable place for worship, to maintain the relations of individuals with religious centers and to direct them to spiritual counseling services.
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Affiliation(s)
- Cengiz Kılıç
- Open Education Faculty, University of Ataturk, Erzurum, Turkey
| | - Merve Deniz Pak Güre
- Department of Social Work, University of Başkent, Fatih Sultan Mahallesi, Eskişehir Yolu 18, Etimesgut, Ankara, 06790, Turkey
| | - Mustafa Karataş
- Department of Social Work, University of Kütahya Health Sciences, Kütahya, Turkey
| | - Veli Duyan
- Department of Social Work, University of Ankara, Fatih Caddesi No:197/A Keçiören, Ankara, Turkey.
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Yuan C, Xiao Y, Wang F, Wang Y, Wang Y, Lin F. The effect of video visitation on intensive care unit patients and family members outcomes during the COVID-19 pandemic: A randomised controlled trial. Intensive Crit Care Nurs 2023; 76:103394. [PMID: 36731263 PMCID: PMC9852363 DOI: 10.1016/j.iccn.2023.103394] [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: 09/13/2021] [Revised: 12/19/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate the effect of video visitation on intensive care patients' and family members' outcomes during the COVID-19 pandemic. DESIGN This is a randomised controlled trial. SETTING An adult intensive care unit in a tertiary hospital in Beijing, China. METHODS A total of 121 adults, who were >18 years of age, conscious, able to communicate verbally, and admitted to the intensive care unit for over 24 hours were randomised into the intervention (video visitation) (n = 65) and control (n = 56) Groups. A total of 98 family members participated. Patient primary outcomes included anxiety and depression, measured using the Hospital Anxiety and Depression Scale. Secondary outcomes included patient delirium and family anxiety assessed using the Confusion Assessment Method scale and Self-Rating Anxiety Scale, respectively; and patient and family satisfaction, measured using a questionnaire routinely used in the hospital. RESULTS There were no statistically significant differences between the groups in patients' anxiety (t = 1.328, p = 0.187) and depression scores (t = 1.569, p = 0.119); and no statistically significant differences in delirium incidence between the groups (7.7 % vs 7.1 %, p > 0.05). There were no significant differences in changes in family members' anxiety scores (t = 0.496, p = 0.621). A statistically significant difference in satisfaction was found between the two group patients (86.1 % vs 57.2 % of patients were satisfied with using video visitation, p < 0.05), and the result of family members' satisfaction was also statistically significant (88 % vs 62.5 % of family members were satisfied with using video visitation, p < 0.05). CONCLUSION Video visitation did not seem to influence anxiety, but the use of video visitation can improve the patient and their family members' satisfaction. Future research is needed to determine the feasibility of embedding video visitation into routine practice, and the optimal frequency and length of video visitation in relation to patients' and family members' outcomes. IMPLICATIONS FOR CLINICAL PRACTICE Video visitation improved patient and family members' satisfaction. Therefore, clinicians should consider using video visitation when face to face visit is restricted. Video visVitation did not reduce patient anxiety significantly in this study maybe because the average length of intensive care stay was too short. Future research is needed on its effect on long term intensive care patients.
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Affiliation(s)
- Cui Yuan
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China,Corresponding authors
| | - Yanyan Xiao
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Fang Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yi Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yaqing Wang
- Department of Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Frances Lin
- School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia,Corresponding authors
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Dudeck S, Hibler E, Gill K, Shantz T, Kovick L, Cypress B, Caboral-Stevens M. A Concept Analysis of Family Presence During COVID-19. Dimens Crit Care Nurs 2023; 42:137-145. [PMID: 36996358 DOI: 10.1097/dcc.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND In 2020, the COVID-19 pandemic required health care organizations throughout the United States to implement strict visitor restriction policies to mitigate the spread of the virus. These policy changes had a direct impact on family presence (FP) in hospital settings. PURPOSE The aim of this study was to conduct a concept analysis of FP during the COVID-19 pandemic. METHODS Walker and Avant's 8-step method was used. RESULTS Four defining attributes of FP during COVID-19 were derived based on a review of the literature: being there or with, seeing is believing, during challenging times, and subjective advocates. The COVID-19 pandemic was the main antecedent of the concept. The consequences and empirical referents were discussed. Model, borderline, and contrary cases were developed. CONCLUSION This concept analysis provided an understanding of the concept of FP during COVID-19, which is imperative to optimizing patient care outcomes, as literature identified a support person or system as an extension of the care team that facilitates successful care management. Whether by advocating for their patients to have a support person present during team rounds, or by stepping in as the patient's main support system in the absence of family, nurses must find a way to do what is best for their patients even during the unprecedented times of a global pandemic.
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Aledreesi TM, Alrewaished M. Assessing the Satisfaction and Usability of Patient Families in the ICU With the Use of the Telehealth Communication Application myVisit. Cureus 2023; 15:e38078. [PMID: 37113462 PMCID: PMC10129043 DOI: 10.7759/cureus.38078] [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: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND During the Covid-19 pandemic, there were many restrictions on family meetings, especially on patients' families meeting their dear ones in hospitals. We aimed to evaluate patients' family members' experience using the mobile application myVisit which was developed in KAMC, to connect patients in the ICU to their families and allow them to talk to them securely. METHODOLOGY We conducted a cross-sectional study with mixed qualitative and quantitative methods, using the technique of thematic analysis for a qualitative approach to assess user satisfaction responses and a quantitative approach to using a validated survey and comparing our findings in both methods to determine existing usability issues and potential improvements. The survey included two sections, closed and open-ended questions, which were distributed online to 63 patient family members. RESULTS The response rate was 85%, the overall mean score for the first part of the closed questions (advantages of using myVisit telehealth) was 4.32 and for the second part of the scale on the ease of use of the system (advantages of using myVisit telehealth) was 3.52. Three useful topics were generated concerning the open questions, covering 220 codes from the participants' responses. In general, there is a great interest in technology and its ability to improve people's lives, especially in the medical field and cases where things do not go normally, as well as in exceptional circumstances. CONCLUSIONS The overall evaluation of the myVisit application was positive in terms of the idea and content, as usability of the system is very good at 71%, plus the users' opinions of the myVisit application are that it saves time at 96%, and save money and effort for the patient's family 74%.
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Affiliation(s)
- Thamer M Aledreesi
- Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Health Informatics, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Meshal Alrewaished
- Health Informatics, Ministry of National Guard Health Affairs, Riyadh, SAU
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Amin N, Haque R, Rahman MZ, Rahman MZ, Mahmud ZH, Hasan R, Islam MT, Sarker P, Sarker S, Adnan SD, Akter N, Johnston D, Rahman M, Liu P, Wang Y, Shirin T, Rahman M, Bhattacharya P. Dependency of sanitation infrastructure on the discharge of faecal coliform and SARS-CoV-2 viral RNA in wastewater from COVID and non-COVID hospitals in Dhaka, Bangladesh. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 867:161424. [PMID: 36623655 PMCID: PMC9822545 DOI: 10.1016/j.scitotenv.2023.161424] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 05/25/2023]
Abstract
The detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA in wastewater can be used as an indicator of the presence of SARS-CoV-2 infection in specific catchment areas. We conducted a hospital-based study to explore wastewater management in healthcare facilities and analyzed SARS-CoV-2 RNA in the hospital wastewater in Dhaka city during the Coronavirus disease (COVID-19) outbreak between September 2020-January 2021. We selected three COVID-hospitals, two non-COVID-hospitals, and one non-COVID-hospital with COVID wards, conducted spot-checks of the sanitation systems (i.e., toilets, drainage, and septic-tank), and collected 90 untreated wastewater effluent samples (68 from COVID and 22 from non-COVID hospitals). E. coli was detected using a membrane filtration technique and reported as colony forming unit (CFU). SARS-CoV-2 RNA was detected using the iTaq Universal Probes One-Step kit for RT-qPCR amplification of the SARS-CoV-2 ORF1ab and N gene targets and quantified for SARS-CoV-2 genome equivalent copies (GEC) per mL of sample. None of the six hospitals had a primary wastewater treatment facility; two COVID hospitals had functional septic tanks, and the rest of the hospitals had either broken onsite systems or no containment of wastewater. Overall, 100 % of wastewater samples were positive with a high concentration of E. coli (mean = 7.0 log10 CFU/100 mL). Overall, 67 % (60/90) samples were positive for SARS-CoV-2. The highest SARS-CoV-2 concentrations (median: 141 GEC/mL; range: 13-18,214) were detected in wastewater from COVID-hospitals, and in non-COVID-hospitals, the median SARS-CoV-2 concentration was 108 GEC/mL (range: 30-1829). Our results indicate that high concentrations of E. coli and SARS-CoV-2 were discharged through the hospital wastewater (both COVID and non-COVID) without treatment into the ambient water bodies. Although there is no evidence for transmission of SARS-CoV-2 via wastewater, this study highlights the significant risk posed by wastewater from health care facilities in Dhaka for the many other diseases that are spread via faecal oral route. Hospitals in low-income settings could function as sentinel sites to monitor outbreaks through wastewater-based epidemiological surveillance systems. Hospitals should aim to adopt the appropriate wastewater treatment technologies to reduce the discharge of pathogens into the environment and mitigate environmental exposures.
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Affiliation(s)
- Nuhu Amin
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Institute for Sustainable Futures, University of Technology Sydney, 235 Jones St, Ultimo, NSW, 2007, Australia.
| | - Rehnuma Haque
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; School of Medicine, Stanford University, Stanford, CA, USA
| | - Md Ziaur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammed Ziaur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Zahid Hayat Mahmud
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rezaul Hasan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Tahmidul Islam
- COVID-19 Research@KTH, Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, Teknikringen 10B, SE 114 28 Stockholm, Sweden; WaterAid, Bangladesh
| | - Protim Sarker
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Supriya Sarker
- Directorate General of Health Services (DGHS), Bangladesh
| | | | - Nargis Akter
- Water, Sanitation & Hygiene (WASH) section, UNICEF, Bangladesh
| | - Dara Johnston
- Water, Sanitation & Hygiene (WASH) section, UNICEF, Bangladesh
| | - Mahbubur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh
| | - Pengbo Liu
- Center for Global Safe Water, Sanitation, and Hygiene, Emory University, Atlanta, GA, USA
| | - Yuke Wang
- Center for Global Safe Water, Sanitation, and Hygiene, Emory University, Atlanta, GA, USA
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh
| | - Mahbubur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Prosun Bhattacharya
- COVID-19 Research@KTH, Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, Teknikringen 10B, SE 114 28 Stockholm, Sweden
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Sáez-López P, Pérez Fernandez E, Arredondo Provecho AB. Repercusión de la restricción de visitas familiares por la pandemia en la evolución clínica del paciente geriátrico hospitalizado. Rev Esp Geriatr Gerontol 2023; 58:108-114. [PMID: 36990823 DOI: 10.1016/j.regg.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 03/29/2023]
Abstract
The restriction of family accompaniment of hospitalised patients has consequences for the patient, family and professionals. The aim of this study was to analyse the opinion of healthcare professionals on the family presence in the care and recovery of hospitalised geriatric patients. A descriptive, observational, multicentre study was carried out by means of a survey addressed to professionals from hospitals in Madrid. A total of 314 professionals (43.6% nurses, 26.1% nursing assistants, 15.6% doctors) from different hospitals responded. Eighty percent (95%CI: 75%-84%) stated that the restriction of visits hindered the patient's recovery and 84% (95%CI: 80%-88%) stated that the family care cannot be substituted by professionals, although it can be improved through training and increased staffing (91%). Seventy percent think that when patients are alone, they eat and drink less, suffer more bronchial aspiration and delirium, and have greater difficulty in hygiene and mobilisation. Healthcare professionals recognised that the care provided by patients' relatives facilitates their recovery.
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Affiliation(s)
- Pilar Sáez-López
- Unidad de Geriatría, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Registro Nacional de Fracturas de Cadera, España; Instituto de Investigación IdiPaz, Hospital Universitario La Paz, Madrid, España
| | - Elia Pérez Fernandez
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - Ana Belén Arredondo Provecho
- Medicina Preventiva y Salud Pública, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Universidad Rey Juan Carlos, Móstoles, Madrid, España.
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Impact of the COVID-19 Pandemic on the Experiences of Hospitalized Patients: A Scoping Review. J Patient Saf 2023; 19:e46-e52. [PMID: 36459699 PMCID: PMC9940789 DOI: 10.1097/pts.0000000000001084] [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] [Indexed: 12/04/2022]
Abstract
OBJECTIVE This study aimed to identify the factors that exerted an impact on the experiences of hospitalized patients during the COVID-19 pandemic from the quality and safety perspectives. METHOD A scoping review that followed the 5 stages described by Arksey and O'Malley was used. A systematized search of original studies was conducted in 9 databases: PubMed/MEDLINE, BDENF, CINAHL, LILACS, SciELO, Embase, Scopus, Web of Science, and Google Scholar. The factors that exerted an impact on patients' experiences were summarized, considering the perspective of quality and patient safety in health institutions. The factors were categorized using the Content Analysis technique. RESULTS A total of 6950 studies were screened, and 32 met the eligibility criteria. The main factors that exerted an impact on the patients' experience were as follows: caregiver/family concern with the patients' well-being during hospitalization, search for alternative communication and interaction means between the patients and their family, and changes in health care organization. The restrictions inherent to the policy regarding visits and companions exerted a negative impact on the experiences, increasing the patients' feelings of loneliness and isolation. Negative impacts were also evidenced in the hospital admission and discharge process and in the limitation of treatment possibilities offered to the patients, because of contact restrictions. CONCLUSIONS The factors that exerted an impact on the patients' experiences permeate communication between professionals, patients, and family members, with implications for health care quality.
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Sugg HVR, Richards DA, Russell AM, Burnett S, Cockcroft EJ, Thompson Coon J, Cruickshank S, Doris FE, Hunt HA, Iles-Smith H, Kent M, Logan PA, Morgan LM, Morley N, Rafferty AM, Shepherd MH, Singh SJ, Tooze SJ, Whear R. Nurses' strategies for overcoming barriers to fundamental nursing care in patients with COVID-19 caused by infection with the SARS-COV-2 virus: Results from the 'COVID-NURSE' survey. J Adv Nurs 2023; 79:1003-1017. [PMID: 35467757 PMCID: PMC9111453 DOI: 10.1111/jan.15261] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/03/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Abstract
AIMS To identify strategies used by registered nurses and non-registered nursing care staff in overcoming barriers when providing fundamental nursing care for non-invasively ventilated inpatients with COVID-19. DESIGN Online survey with open-ended questions to collect qualitative data. METHODS In August 2020, we asked UK-based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non-invasively ventilated patients with COVID-19. We analysed data using Framework Analysis. RESULTS A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non-verbal communication with patients, using information technology to enable patients' significant others to communicate with staff and patients, and establishing clear information-sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self-care and using 'runners' and interdisciplinary input. 3) Addressing patients' well-being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients' wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks. CONCLUSIONS Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well-being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing. IMPACT As these strategies are unlikely to be exclusive to the COVID-19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.
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Affiliation(s)
- Holly V R Sugg
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - David A Richards
- College of Medicine and Health, University of Exeter, Exeter, UK.,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Sarah Burnett
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Emma J Cockcroft
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jo Thompson Coon
- College of Medicine and Health, University of Exeter, Exeter, UK.,The National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), Exeter, UK
| | | | - Faye E Doris
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Harriet A Hunt
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Heather Iles-Smith
- School of Health and Society, University of Salford, Salford, UK.,Northern Care Alliance NHS Group, Salford, UK
| | - Merryn Kent
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Philippa A Logan
- School of Medicine, University of Nottingham, Queens Medical centre, Nottingham, UK
| | - Leila M Morgan
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Naomi Morley
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Anne Marie Rafferty
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Maggie H Shepherd
- College of Medicine and Health, University of Exeter, Exeter, UK.,NIHR Exeter Clinical Research Facility, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Sally J Singh
- Department of Respiratory Science, University of Leicester, Leicester, UK.,University Hospitals of Leicester NHS Trust, Biomedical Research Centre - Respiratory, Glenfield Hospital, Leicester, UK
| | - Susannah J Tooze
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rebecca Whear
- College of Medicine and Health, University of Exeter, Exeter, UK
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Gonella S, Cornally N, Antal A, Tambone S, Martin P, Dimonte V, Di Giulio P. Family caregivers' experience of communication with nursing home staff from admission to end of life during the COVID-19 pandemic: A qualitative study employing a transitional perspective. Palliat Support Care 2023:1-12. [PMID: 36847131 DOI: 10.1017/s1478951523000019] [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: 03/01/2023]
Abstract
OBJECTIVES Family caregivers' (FCs) caregiving in nursing home (NH) moves across 3 main phases: transitioning relatives to long-term care, worsening of a relative's conditions, and end of life; each phase brings specific challenges that FCs must confront. Moreover, during the COVID-19 pandemic, strict mandatory visitor restrictions affected communication modalities. This study explored FCs' experience of communication with NH staff during the COVID-19 pandemic from admission to end of life. METHODS A descriptive qualitative study with inductive content analysis was performed in 7 Italian NHs from May to June 2021. NH managers purposively identified 25 FCs at different phases of their caregiving trajectory: transitional (i.e., admission in the previous 8 weeks, n = 8), deterioration-in-condition (i.e., acknowledged changes in care needs of their relative after trigger events, n = 10), and end-of-life phase (i.e., death expected in the next weeks or a few months, n = 7), who were interviewed. RESULTS Regardless the phase of caregiving trajectory, what mattered most to FCs was the opportunity to have regular and sensitive discussions with health-care professionals. The need of in-person communication increased nearing death. The COVID-19 pandemic enhanced FCs' need to interact with health-care professionals they trusted. Knowledge of residents' preferences mitigated FCs' turbulent emotions throughout the overall caregiving trajectory. SIGNIFICANCE OF RESULTS Findings suggest that in-person contacts should be prioritized and facilitated when possible, particularly at the end of life; nonetheless, meaningful communication can occur also through remote modalities. Investments in training health-care professionals about effective long-distance communication and supportive skills can help trusting relationships to be established. Open discussions about residents' care preferences should be encouraged.
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Affiliation(s)
- Silvia Gonella
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
- Direction of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Nicola Cornally
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Alexandra Antal
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Sara Tambone
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Peter Martin
- School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Valerio Dimonte
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
- Direction of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Paola Di Giulio
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
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Haun JN, Melillo C, Schneider T, Merzier MM, Klanchar SA, Fowler CA, Benzinger RC. User Testing of the Veteran Delegation Tool: Qualitative Inquiry. J Med Internet Res 2023; 25:e40634. [PMID: 36821364 PMCID: PMC9999259 DOI: 10.2196/40634] [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: 07/08/2022] [Revised: 12/05/2022] [Accepted: 12/31/2022] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Informal caregivers, or care partners, provide critical support to care recipients when managing health care. Veterans Health Administration (VHA) priorities identify care partners as vital in supporting veterans' care management. The Veteran Delegation Tool (VDT) is VHA's Health Insurance Portability and Accountability Act-compliant solution for care partners to comanage veterans' care through VHA's electronic health portal. Human-centered design approaches in VDT development are needed to inform enhancements aimed at promoting uptake and sustained use. OBJECTIVE The objective of this prospective descriptive quality improvement project was to use a human-centered design approach to examine VDT use perceptions and practical experiences. METHODS This project was conducted using a 4-phase approach: frame, discover, design, and deliver. The frame phase designed the protocol and prepared the VDT system for testing. This paper reports on the discover phase, which used semistructured and follow-up interviews and user testing to examine VDT's benefits, facilitators, and barriers. The discover phase data informed the design and deliver phases, which are underway. RESULTS Veterans (24/54, 44%), care partners (21/54, 39%), and individuals who represented dual roles (9/54, 17%)-namely veteran care partner (4/54, 7%), veteran clinical provider (2/54, 4%), and care partner provider (3/54, 6%)-participated in semistructured interviews in the discover phase. A subsample of these participants (3/54, 6%) participated in the follow-up interviews and user testing. Analysis of the semistructured interviews indicated convergence on the respondents' perceptions of VDT's benefits, facilitators, and barriers and recommendations for improving VDT. The perceived benefits were authorized access, comanagement of care needs on the web, communication with the clinical team, access to resources, and ease of burden. Perceived barriers were nonrecognition of the benefits of VDT, technical literacy access issues, increased stress in or burden on care partners, and personal health information security. Participant experiences across 4 VDT activity domains were upgrade to My HealtheVet Premium account, registration, sign-in, and use. User testing demonstrated users' challenges to register, navigate, and use VDT. Findings informed VDT development enhancements and recommendations. CONCLUSIONS Care partners need Health Insurance Portability and Accountability Act-compliant access to electronic health portals to assist with care management. VDT is VHA's solution, allowing communication among delegates, veterans, and clinical care teams. Users value VDT's potential use and benefits, while access and navigation improvements to ensure uptake and sustained use are needed. Future efforts need to iteratively evaluate the human-centered phases, design and deliver, of VDT to target audiences. Continued efforts to understand and respond to care partners' needs are warranted.
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Affiliation(s)
- Jolie N Haun
- James A Haley Veterans Hospital, Tampa, FL, United States.,College of Public Health, University of South Florida, Tampa, FL, United States
| | | | - Tali Schneider
- James A Haley Veterans Hospital, Tampa, FL, United States.,College of Public Health, University of South Florida, Tampa, FL, United States
| | | | | | - Christopher A Fowler
- James A Haley Veterans Hospital, Tampa, FL, United States.,Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
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Siddiqui S, Lutz G, Tabatabai A, Nathan R, Anders M, Gibbons M, Russo M, Whitehead S, Rock P, Scalea T, Kheirbek RE. Early Guided Palliative Care Communication for Patients With COVID-19 Receiving ECMO. Am J Crit Care 2023; 32:166-174. [PMID: 36775881 DOI: 10.4037/ajcc2023184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) combined with COVID-19 presents challenges (eg, isolation, anticipatory grief) for patients and families. OBJECTIVE To (1) describe characteristics and outcomes of patients with COVID-19 receiving ECMO, (2) develop a practice improvement strategy to implement early, semistructured palliative care communication in ECMO acknowledgment meetings with patients' families, and (3) examine family members' experiences as recorded in clinicians' notes during these meetings. METHODS Descriptive observation of guided, in-depth meetings with families of patients with COVID-19 receiving ECMO, as gathered from the electronic medical record of a large urban academic medical center. Most meetings were held within 3 days of initiation of ECMO. RESULTS Forty-three patients received ECMO between March and October 2020. The mean patient age was 44 years; 63% of patients were Hispanic/Latino, 19% were Black, and 7% were White. Documentation of the ECMO acknowledgment meeting was completed for 60% of patients. Fifty-six percent of patients survived to hospital discharge. Family discussions revealed 7 common themes: hope, reliance on faith, multiple family members with COVID-19, helping children adjust to a new normal, visitation restrictions, gratitude for clinicians and care, and end-of-life discussions. CONCLUSION Early and ongoing provision of palliative care is feasible and useful for highlighting a range of experiences related to COVID-19. Palliative care is also useful for educating patients and families on the benefits and limitations of ECMO therapy.
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Affiliation(s)
- Safanah Siddiqui
- Safanah Siddiqui is a fellow, Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston
| | - Gabriel Lutz
- Gabriel Lutz is an assistant professor, Department of Medicine, Division of Palliative Medicine, University of Maryland School of Medicine, Baltimore
| | - Ali Tabatabai
- Ali Tabatabai is an adjunct associate professor, Department of Medicine, Division of Education, University of Maryland School of Medicine
| | - Rachel Nathan
- Rachel Nathan is an assistant professor, Department of Medicine, Division of Palliative Medicine, University of Maryland School of Medicine
| | - Megan Anders
- Megan Anders is an associate professor, Department of Anesthesiology, University of Maryland School of Medicine
| | - Miranda Gibbons
- Miranda Gibbons is a clinical systems analyst, Department of Anesthesiology, University of Maryland School of Medicine
| | - Marguerite Russo
- Marguerite Russo is a nurse practitioner, University of Maryland Medical Center, and an adjunct associate professor, University of Maryland School of Nursing, Baltimore
| | - Sarah Whitehead
- Sarah Whitehead is a nurse practitioner, University of Maryland Medical Center
| | - Peter Rock
- Peter Rock is a professor, Department of Anesthesiology, University of Maryland School of Medicine
| | - Thomas Scalea
- Thomas Scalea is a professor, Department of Surgery, University of Maryland School of Medicine, and director of the R. Adams Cowley Shock Trauma Center, Baltimore
| | - Raya E Kheirbek
- Raya E. Kheirbek is a professor, Department of Medicine, Division of Palliative Medicine, University of Maryland School of Medicine
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Henke RM. Knowing Well, Being Well: well-being born of understanding: The COVID-19 Pandemic and Children: Implications for Future Health. Am J Health Promot 2023; 37:263-288. [PMID: 36646664 DOI: 10.1177/08901171221140641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Henke RM. The COVID-19 Pandemic and Children: Implications for Future Health. Am J Health Promot 2023; 37:263-264. [PMID: 36646663 DOI: 10.1177/08901171221140641a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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40
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Nash W, Childress A. Commentary on "Waiting for my foot to ring". ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:201. [PMID: 36696298 DOI: 10.1097/01.acm.0000919432.08790.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Woods Nash
- W. Nash is assistant professor, bioethics and medical humanities, Department of Behavioral and Social Sciences, University of Houston College of Medicine, Houston, Texas;
| | - Andrew Childress
- A. Childress is assistant professor, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas
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Miller EM, Porter JE, Barbagallo MS. Patient and family members' experiences with language and environment when receiving bad news: A qualitative exploratory study. Palliat Support Care 2023:1-7. [PMID: 36718557 DOI: 10.1017/s1478951522001845] [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: 02/01/2023]
Abstract
OBJECTIVES Receiving bad news about one's health can be devastating, yet little is known about how the therapeutic nature of the environment where bad news is delivered affects the experience. The current study aimed to explore how patients and their families were affected by the language and the built, natural, social, and symbolic environments when receiving bad news, through the Therapeutic Landscapes theoretical framework. METHODS Patients diagnosed with a life-limiting illness living in regional Victoria who had a hospital admission within 24 months and a diagnostic/prognostic conversation were invited to participate, as well as a family member who witnessed the conversation. Participants were recruited through social media and snowballing, resulting in 14 online semi-structured interviews being conducted between November 2021 and March 2022, audio-recorded, and transcribed verbatim. Reflexive thematic analysis was used to develop the themes. RESULTS Fourteen semi-structured interviews were conducted with women aged between 30 and 77 years. Interviews lasted between 45 and 120 minutes, with an average of 69 minutes, and were conducted online or via mobile phone. Four central themes were developed: "Hearing bad news for the first time," "Preferences for having hard conversations," "Creating a sense of safety for ongoing care," and "The therapeutic nature of the ward." SIGNIFICANCE OF RESULTS This body of work will help inform practice and future policy regarding bad news delivery and the design and aesthetics of environments where bad news is delivered. It is essential that bad news is delivered within a quiet, calm, and emotionally safe environment within a supportive therapeutic relationship.
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Affiliation(s)
- Elizabeth M Miller
- Collaborative Evaluation & Research Group (CERG), Federation University Australia, Churchill, VIC, Australia
| | - Joanne E Porter
- Collaborative Evaluation & Research Group (CERG), Federation University Australia, Churchill, VIC, Australia
| | - Michael S Barbagallo
- Collaborative Evaluation & Research Group (CERG), Federation University Australia, Churchill, VIC, Australia
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Hriberšek M, Eibensteiner F, Kapral L, Teufel A, Nawaz FA, Cenanovic M, Sai CS, Devkota HP, De R, Singla RK, Parvanov ED, Tsagkaris C, Atanasov AG, Schaden E. "Loved ones are not 'visitors' in a patient's life"-The importance of including loved ones in the patient's hospital stay: An international Twitter study of #HospitalsTalkToLovedOnes in times of COVID-19. Front Public Health 2023; 11:1100280. [PMID: 36778575 PMCID: PMC9909431 DOI: 10.3389/fpubh.2023.1100280] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
Background Hospitals are institutions whose primary task is to treat patients. Family-centered care, which considers loved ones as equal partners in patient care, has been gaining recognition in the adult care setting. Our aim was to record experiences of and opinions on communication between hospital-based healthcare providers and patients' loved ones, related but not limited to the rigorous mitigation measures implemented during the COVID-19 pandemic. Methods The Twitter profile @HospitalsTalkTo and hashtag #HospitalsTalkToLovedOnes were created to interact with the Twitter public between 7 June 2021 and 7 February 2022. Conversations surrounding #HospitalsTalkToLovedOnes were extracted and subjected to natural language processing analysis using term frequency and Markov chain analysis. Qualitative thematic analysis was performed on the 10% most interacted tweets and of tweets mentioning "COVID" from a personal experience-based subset. Results We collected 4412 unique tweets made or interacted by 7040 Twitter users from 142 different countries. The most frequent words were patient, hospital, care, family, loved and communication. Thematic analysis revealed the importance of communication between patients, patients' loved ones and hospitals; showed that patients and their loved ones need support during a patient's hospital journey; and that pediatric care should be the gold standard for adult care. Visitation restrictions due to COVID-19 are just one barrier to communication, others are a lack of phone signal, no space or time for asking questions, and a complex medical system. We formulate 3 recommendations to improve the inclusion of loved ones into the patient's hospital stay. Conclusions "Loved ones are not 'visitors' in a patient's life". Irrespective of COVID-19, patient's loved ones need to be included during the patient's hospital journey. Transparent communication and patient empowerment increase patient safety and improve the hospital experience for both the patients and their loved ones. Our findings underline the need for the concept of family-centered care to finally be implemented in adult nursing clinical practice.
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Affiliation(s)
- Mojca Hriberšek
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Fabian Eibensteiner
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria,Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Lorenz Kapral
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Anna Teufel
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Faisal A. Nawaz
- Department of Psychiatry, Al Amal Psychiatric Hospital, Dubai, United Arab Emirates
| | | | | | - Hari Prasad Devkota
- Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan,Pharmacy Program, Gandaki University, Pokhara, Nepal
| | - Ronita De
- Department of ICMR-NICED Virus Lab, Indian Council of Medical Research-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Rajeev K. Singla
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China,School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Emil D. Parvanov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria,Department of Translational Stem Cell Biology, Research Institute of the Medical University of Varna, Varna, Bulgaria
| | | | - Atanas G. Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria,Department of Biotechnology and Nutrigenomics, Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Magdalenka, Poland
| | - Eva Schaden
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria,Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria,*Correspondence: Eva Schaden ✉
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Samutachak B, Ford K, Tangcharoensathien V, Satararuji K. Role of social capital in response to and recovery from the first wave of COVID-19 in Thailand: a qualitative study. BMJ Open 2023; 13:e061647. [PMID: 36669841 PMCID: PMC9871865 DOI: 10.1136/bmjopen-2022-061647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 01/05/2023] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This study assesses the role of social capital among people and communities in response to the first wave of the pandemic in 2020. DESIGN Qualitative study using focus group discussions. SETTING Capital city (Bangkok) and the four regions (north, northeast, south and central) of Thailand. PARTICIPANTS 161 participants of 19 focus groups with diverse backgrounds in terms of gender, profession, education and geography (urban/rural; regions). They are selected for different levels of impact from the pandemic. FINDINGS The solidarity among the Thai people was a key contributing factor to societal resilience during the pandemic. Findings illustrate how three levels of social capital structure-family, community and local networks-mobilised resources from internal and external social networks to support people affected by the pandemic. The results also highlight different types of resources mobilised from the three levels of social capital, factors that affect resilience, collective action to combat the negative impacts of the pandemic, and the roles of social media and gender. CONCLUSION Social capital plays significant roles in the resilience of individuals, households and communities to respond to and recover from the impacts of the pandemic. In many instances, social capital is a faster and more efficient response than other kinds of formal support. Social capital can be enhanced by interactions and exchanges in the communities. While face-to-face social contacts are challenged by the need for social distancing and travel restrictions, social media steps in as alternative socialisation to enhance social capital.
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Affiliation(s)
- Bhubate Samutachak
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Kathleen Ford
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Kullatip Satararuji
- Graduate School of Communication Arts and Management Innovation, National Institute of Development Administration, Bangkok, Thailand
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Trauma-informed care for perinatal women during the COVID-19 pandemic: A survey of nurses and midwives in Turkey. Midwifery 2023; 116:103555. [PMID: 36434849 PMCID: PMC9657894 DOI: 10.1016/j.midw.2022.103555] [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: 02/17/2022] [Revised: 07/02/2022] [Accepted: 11/11/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES There is a paucity of evidence on the provision of trauma-informed care among nurses and midwives during the pandemic.Therefore, this online survey of Turkish nurses and midwives aimed to: describe reported maternal concerns and anxieties during the COVID-19 pandemic; and explore aspects of trauma-informed care for perinatal women during the COVID-19 pandemic (i.e., nurses' and midwives' knowledge, opinions, perceived competence, current practices, and implementation barriers). DESIGN A cross-sectional descriptive survey design. SETTING AND PARTICIPANTS A web-based survey conducted between June 2021 to December 2021. A total of 102 nurses and midwives comprised the final sample of this study. FINDINGS The safety of COVID-19 vaccine was both the most common maternal concern (73%) and the most frequently noted maternal source of anxiety (79%) reported to nurses and midwives by perinatal women. Most nurses and midwives were knowledgeable of, held favorable opinion about, and perceived moderate competence in trauma-informed care. The most frequently provided practice was encouraging mothers to make use of their own social support system (82%). Time constrains and lack of resources were perceived as somewhat to significant barriers to providing trauma-informed care during the pandemic. CONCLUSIONS Access to correct information related to COVID-19 vaccination is necessary to reduce maternal anxiety. Since perinatal nurses and midwives had favorable opinions concerning implementing trauma-informed care, successful strategies for mitigating the implementation barriers are essential to facilitate the provision of trauma-informed care during the pandemic.
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Chen R(T, Truong M, Watterson JR, Burrell A, Wong P. The impact of the intensive care unit family liaison nurse role on communication during the COVID-19 pandemic: A qualitative descriptive study of healthcare professionals' perspectives. Aust Crit Care 2023; 36:127-132. [PMID: 36351854 PMCID: PMC9510056 DOI: 10.1016/j.aucc.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 09/11/2022] [Accepted: 09/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has deeply impacted patient and family communication and patient- and family-centred care in the intensive care unit (ICU). A new role-the ICU Family Liaison Nurse (FLN)-was introduced in an Australian metropolitan hospital ICU to facilitate communication between patient and family and ICU healthcare professionals, although there is limited knowledge about the impact of this from the ICU healthcare professionals' perspectives. OBJECTIVE The aim of this study was to explore the impact of the ICU FLN role on communication with patients and their family during the COVID-19 pandemic, from the ICU healthcare professionals' perspectives. METHODS A qualitative descriptive study was conducted. Seven participants including ICU FLNs, ICU doctors, nurses, and social workers who worked with the ICU FLNs were interviewed. Thematic analysis was used to analyse the data. RESULTS Two main themes related to the ICU FLN role were identified. First, the COVID-19 pandemic posed challenges to patient and family communication, but it also created opportunities to improve patient and family communication. Second, the ICU FLN role brought beneficial impacts to the ICU healthcare professionals' workflow and work experience, as well as patient and family communication. The ICU FLN role has potential benefits that extend beyond the pandemic. CONCLUSION We found that during the COVID-19 pandemic, the ICU FLN role was acceptable, beneficial, and appreciated from the ICU healthcare professionals' perspectives. Further research should continue the evaluation of the ICU FLN role during and post the pandemic.
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Affiliation(s)
- Ruofei (Trophy) Chen
- Nursing and Midwifery, Monash University, Australia,Corresponding author at. Nursing and Midwifery, Monash University, Clayton Campus, VIC, 3800, Australia
| | - Mandy Truong
- Nursing and Midwifery, Monash University, Australia
| | - Jason R. Watterson
- Department of Intensive Care Medicine, Frankston Hospital, Peninsula Health, Australia,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Aidan Burrell
- Department of Intensive Care Medicine, The Alfred Hospital, Australia
| | - Pauline Wong
- Nursing and Midwifery, Monash University, Australia
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Wind G, Vedsegaard HW, Marsaa K, True TS, Konradsen H. The significance of the COVID-19 pandemic for family caregivers of non-COVID-19 patients in need of specialized palliative care at home: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2113021. [PMID: 35979626 PMCID: PMC9397423 DOI: 10.1080/17482631.2022.2113021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose It is well known that being a family caregiver of a palliative patient in general is rewarding as well as burdensome. The COVID-19 pandemic may have exacerbated this situation. We therefore explored the significance of the COVID-19 pandemic for family caregivers of non-COVID-19 patients in need of specialized palliative care at home. Methods Open-ended, semi-structured telephone interviews were conducted with 15 family caregivers of patients treated by a specialized palliative outpatient unit in a Danish hospital. Interviews were analysed using inductive thematic analysis. Results Four themes concerning the significance of the COVID-19 pandemic were identified: 1) being a family caregiver of a patient whose lifespan is already limited, 2) dealing with the risk of passing on COVID-19 oneself, 3) dealing with the risk of others passing on COVID-19 to the patient at home, and 4) living with modified specialized palliative care. Conclusion The COVID-19 pandemic had a radical impact on some family caregivers causing emotional despair. They feared not only infecting the patient with SARS-CoV-2 to cause an untimely death but also being unable to be there for the patient during hospitalization, especially in the patient’s final days.
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Affiliation(s)
- Gitte Wind
- Faculty of Health, University College Copenhagen, Denmark
| | | | | | | | - Hanne Konradsen
- Department of Gastroenterology, Herlev and Gentofte University Hospital, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Sweden
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Incidence and Risk of Lung Cancer in Tuberculosis Patients, and Vice Versa: A Literature Review of the Last Decade. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1702819. [PMID: 36578803 PMCID: PMC9792248 DOI: 10.1155/2022/1702819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Background The incidence and risk of both lung cancer (LC) and tuberculosis (TB) are increasing rapidly. These two diseases frequently exist together and can influence the incidence and risk of each other. The aim of the current review was to summarize the incidence and risk of LC in TB patients, and vice versa, short out research gap, and contemplate future research perspectives. Methodology. PubMed and Scopus databases, and Google Scholar search engine were searched for epidemiological studies that investigated the incidence and risk of TB and LC, published since January 2011 to April 2022, and written in English. We used the searching keyword "tuberculosis" combined with "lung cancer" and associated medical subject heading (MeSH) to retrieve eligible research articles. We retrieved information's regarding the diagnosis of TB and LC, confounders, the associations of TB and LC, and incidence and risks of each other. Results We found higher incidence rate and risks (1.64 to 6 times higher) of LC in TB patients in comparison to non-TB participants. However, the incidence rate and risks of TB in LC patients were comparatively low. Male patients were exhibited higher risks than female. The medical comorbidities, smoking habits, and age can also influence the associations and risks of LC in TB patients or vice versa. Conclusion Our summarized studies might suggest that existing active TB may increase the incidence and risk of LC. However, large prospective cohort study is warranted to explore the real scenario worldwide.
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Garnett A, Connelly D, Yous ML, Hung L, Snobelen N, Hay M, Furlan-Craievich C, Snelgrove S, Babcock M, Ripley J, Hamilton P, Sturdy-Smith C, O'Connell M. Nurse-Led Virtual Delivery of PIECES in Canadian Long-Term Care Homes to Support the Care of Older Adults Experiencing Responsive Behaviors During COVID-19: Qualitative Descriptive Study. JMIR Nurs 2022; 5:e42731. [PMID: 36446050 DOI: 10.2196/42731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/24/2022] [Accepted: 11/25/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Worldwide, the COVID-19 pandemic has resulted in profound loss of life among older adults living in long-term care (LTC) homes. As a pandemic response, LTC homes enforced infection control processes, including isolating older adults in their rooms, canceling therapeutic programs, and restricting family member visits. Social isolation negatively impacts older adults in LTC, which may result in increased rates of anxiety, depression, physical and cognitive decline, disorientation, fear, apathy, and premature death. Isolation of older adults can also cause an increase in responsive behaviors (eg, yelling, hitting, calling out) to express frustration, fear, restricted movement, and boredom. To respond to the challenges in LTC and support frontline staff, older adults, and family members, a novel registered practical nurse (RPN)-led delivery of the PIECES approach for addressing responsive behaviors among older adults with dementia using virtual training/mentoring was implemented in Canadian LTC homes. PIECES employs a person- and family/care partner-centered collaborative team-based approach to provide education and capacity-building for nurses; engages families as active participants in care; and embeds evidence-informed practices to provide person- and family-centered care to older adults with complex needs, including dementia. OBJECTIVE The aim of this study was to describe the experiences of LTC staff, family/care partners, and older adult research partners with implementation of a novel RPN-led virtual adaptation of the PIECES care-planning approach for responsive behaviors in two Canadian LTC homes during the COVID-19 pandemic. METHODS Using a qualitative descriptive design, two focus groups were held with three to four staff members (eg, RPNs, managers) per LTC home in Ontario. A third focus group was held with three PIECES mentors. Individual semistructured interviews were conducted with RPN champions, family/care partners, and older adult research partners. Research team meeting notes provided an additional source of data. Content analysis was performed. RESULTS A total of 22 participants took part in a focus group (n=11) or an in-depth individual interview (n=11). Participant experiences suggest that implementation of RPN-led virtual PIECES fostered individualized care, included family as partners in care, increased interdisciplinary collaboration, and improved staff practices. However, virtual PIECES, as delivered, lacked opportunities for family member feedback on older adult outcomes. Implementation facilitators included the provision of mentorship and leadership at all levels of implementation and suitable technological infrastructure. Barriers were related to availability and use of virtual communication technology (family members) and older adults became upset due to lack of comprehension during virtual care conferences. CONCLUSIONS These findings offer promising support to adopting virtual PIECES, a team approach to gather valuable family input and engagement to address residents' unmet needs and responsive behaviors in LTC. Future research should investigate a hybridized communication format to foster sustainable person- and family-centered care-planning practices to include active collaboration of families in individualized care plans.
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Affiliation(s)
- Anna Garnett
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Denise Connelly
- School of Physical Therapy, Western University, London, ON, Canada
| | - Marie-Lee Yous
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Lillian Hung
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Nancy Snobelen
- Registered Practical Nurses Association of Ontario (WeRPN), Mississauga, ON, Canada
| | - Melissa Hay
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
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Oh J, Min J, Kang C, Kim E, Lee JP, Kim H, Lee W. Excess mortality and the COVID-19 pandemic: causes of death and social inequalities. BMC Public Health 2022; 22:2293. [PMID: 36476143 PMCID: PMC9730675 DOI: 10.1186/s12889-022-14785-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND During the coronavirus diseases 2019 (COVID-19) pandemic, population's mortality has been affected not only by the risk of infection itself, but also through deferred care for other causes and changes in lifestyle. This study aims to investigate excess mortality by cause of death and socio-demographic context during the COVID-19 pandemic in South Korea. METHODS: Mortality data within the period 2015-2020 were obtained from Statistics Korea, and deaths from COVID-19 were excluded. We estimated 2020 daily excess deaths for all causes, the eight leading causes of death, and according to individual characteristics, using a two-stage interrupted time series design accounting for temporal trends and variations in other risk factors. RESULTS During the pandemic period (February 18 to December 31, 2020), an estimated 663 (95% empirical confidence interval [eCI]: -2356-3584) excess deaths occurred in South Korea. Mortality related to respiratory diseases decreased by 4371 (3452-5480), whereas deaths due to metabolic diseases and ill-defined causes increased by 808 (456-1080) and 2756 (2021-3378), respectively. The increase in all-cause deaths was prominent in those aged 65-79 years (941, 88-1795), with an elementary school education or below (1757, 371-3030), or who were single (785, 384-1174), while a decrease in deaths was pronounced in those with a college-level or higher educational attainment (1471, 589-2328). CONCLUSION No evidence of a substantial increase in all-cause mortality was found during the 2020 pandemic period in South Korea, as a result of a large decrease in deaths related to respiratory diseases that offset increased mortality from metabolic disease and diseases of ill-defined cause. The COVID-19 pandemic has disproportionately affected those of lower socioeconomic status and has exacerbated inequalities in mortality.
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Affiliation(s)
- Jieun Oh
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 08826 Republic of Korea
| | - Jieun Min
- grid.255649.90000 0001 2171 7754Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea ,grid.255649.90000 0001 2171 7754Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Cinoo Kang
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 08826 Republic of Korea
| | - Ejin Kim
- grid.31501.360000 0004 0470 5905Institute of Health and Environment and Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jung Pyo Lee
- grid.412479.dDepartment of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ho Kim
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 08826 Republic of Korea
| | - Whanhee Lee
- grid.262229.f0000 0001 0719 8572School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, 50612 Republic of Korea
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Abstract
PURPOSE OF REVIEW The coronavirus disease 2019 (COVID-19) pandemic has posed great challenges to intensive care units (ICUs) across the globe. The objective of this review is to provide an overview on how ICU surging was managed during COVID-19 pandemic, with a special focus on papers published in the last 18 months. RECENT FINDINGS From the onset of the COVID-19 pandemic, it was apparent that the biggest challenge was the inequity of access to an adequately equipped and staffed ICU bed. The first wave was overwhelming; large surge of patients required critical care, resources were limited and non-COVID-19 care processes were severely compromised. Various approaches were used to address ICU staffing shortage and to expand the physical ICU space capacity. Because of restrictions to family visitations in most ICUs, the pandemic posed a threat to communication and family-centered ICU care. The pandemic, especially during the first wave, was accompanied by a high level of apprehension in the community, many uncertainties about clinical course and therapy and an influx of speculations and misinformation. SUMMARY Although healthcare systems learned how to face some of the challenges with subsequent waves, the pandemic had persistent effects on healthcare systems.
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