The Psychological Effects of Physicians' Communication Skills on COVID-19 Patients

Effect of extended nursing based on self-efficacy theory on the anxiety of patients with intertrochanteric fracture

BACKGROUND

Extended care based on self-efficacy theory to elderly patients with intertrochanteric fractures will provide data reference to optimize the care plan of these patients, reduce patients' concurrent mental diseases, and improve prognosis.

AIM

To analyze the value of extended nursing based on the self-efficacy theory in older patients with intertrochanteric fractures.

METHODS

Older patients with intertrochanteric fractures (n = 88) admitted to our hospital between January 2021 and December 2024 were randomly divided into two groups - the control group (n = 44, routine nursing) and the observation group (n = 44, extended nursing) - via balloting and treated for 12 weeks. The mental state, pain severity, limb function, and self-nursing ability of all patients before and after nursing were analyzed.

RESULTS

After nursing, the Hamilton Anxiety Scale and General Self-Efficacy Scale scores of patients in the two groups improved. Notably, Hamilton Anxiety Scale and General Self-Efficacy Scale scores in the observation group were lower and higher, respectively, than those in the control group (P < 0.05). The pain severity in the observation group (2.64 ± 0.22) was lower than that in the control group (2.85 ± 0.41) (P < 0.05). The recovery rate of limb function was higher in the observation group than in the control group (P < 0.05). In addition, the self-nursing ability scores of the patients in both groups increased, with a significantly higher score in the observation group (P < 0.05).

CONCLUSION

Extended nursing based on the self-efficacy theory can significantly improve mental state, relieve pain, and promote the recovery of limb function and self-nursing ability in older patients with intertrochanteric fractures.

Healthcare workers' well-being and perspectives on support during the COVID-19 pandemic: a systematic review and meta-synthesis of qualitative studies

BACKGROUND

Since the outbreak of the COVID-19 pandemic, healthcare workers (HCWs) have faced multiple difficulties in their work and personal lives. However, most of the quantitative reviews have focused on the extent of the pandemic's impact on the HCWs and have thus failed to fully capture the HCWs' experiences and the complexity of the problems they encountered. Therefore, this qualitative systematic review elucidates the HCWs' challenges brought about by the pandemic, their perceptions of the existing support and the support that require further attention.

METHODS

The literature search spanned five databases: Scopus, PubMed, Web of Science, CINAHL and PsycInfo, targeting qualitative studies of HCWs' pandemic experiences from December 2019 to December 2023. These studies underwent strict quality and relevance assessment, emphasising critical appraisal and selection. Findings were unified through meta-synthesis, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered in PROSPERO.

RESULTS

This study analysed 29 qualitative studies on HCWs' experiences during the pandemic and their perceptions of support, identifying four themes of HCWs' physical and mental well-being, the impact of the pandemic on their professional and personal lives, their work environments and the support they received. These themes encompassed 8 main categories and 25 codes. The research revealed that the pandemic and work conditions negatively influenced their health, affecting their professional and personal lives. Current support has lessened the pandemic's effects on HCWs but should also address future requirements like long-term psychological support.

CONCLUSION

The studies identified the challenges faced by HCWs during the pandemic, and the existing support. However, due to the complex interactions between the work and environmental factors, the effectiveness of the existing support remains challenging. To improve their effectiveness, the future support should target the interactions between the HCWs and the work system.

PROSPERO REGISTRATION NUMBER

CRD42023426238.

Chain mediation model of consultation empathy, resilience and resignation coping on depression: a cross-sectional study among patients with COVID-19 in China

OBJECTIVES

This study aimed to explore the mediating role of resilience and resignation coping in the relationship between consultation empathy and depression in patients with COVID-19.

DESIGN

Cross-sectional study.

SETTING

Participants were recruited from a tertiary hospital in Guangzhou, Guangdong province.

PARTICIPANTS

A total of 215 patients were recruited for this study.

OUTCOME MEASURES

A total of 215 patients completed the Consultation and Relational Empathy Measure, Connor-Davidson Resilience Scale, Medical Coping Modes Questionnaire and Hospital Anxiety and Depression Scale. PROCESS 4.1 model 6 was used to analyse the moderated mediating effects.

RESULTS

Consultation empathy had a positive correlation with resilience (r=0.34, p<0.001), and a negative correlation with resignation (r=-0.288, p<0.001) and depression (r=-0.379, p<0.001). Resilience had a negative correlation with resignation (r=-0.463, p<0.001) and depression (r=-0.605, p<0.001). Resignation had a positive correlation (r=0.547, p<0.001) with depression. In the moderated mediating model, consultation empathy had significant indirect predictive effects on depression through resilience (95% CI -0.093 to -0.030) or resignation (95% CI -0.043 to -0.005). Consultation empathy had significant indirect predictive effects on depression through both resilience and resignation (95% CI -0.030 to -0.008).

CONCLUSIONS

Consultation empathy not only predicted depression directly, but also indirectly predicted depression through the chain mediating effects of resilience and resignation coping.

Barriers to Effective Communication between Patients, Relatives, and Health Care Professionals in the Era of COVID-19 Pandemic at Public Hospitals in Limpopo Province

Background: Effective communication between health care professionals, admitted patients, and their families is crucial to improving the health care outcomes and patient satisfaction. Hence, barriers to effective communication cause a lot of confusion, frustration, and misunderstanding. The study aimed to identify the perceived barriers to effective communication between patients, their families, and health care professionals during the COVID-19 pandemic in public hospitals in Limpopo Province. The study was conducted in rural areas of Vhembe District, Limpopo Province. Methodology: A qualitative exploratory descriptive method was adopted to explore and describe the barriers of effective communication among patients, relatives, and health care professionals during the COVID-19 pandemic in public hospitals in the Vhembe District. Eleven (11) participants were purposively selected. Unstructured in-depth individual interviews were used to collect data and analyzed using thematic analysis following Tesch’s eight steps. Results: The study findings revealed that there was ineffective communication by health care professionals. This was discussed under three themes that emerged: poor communication of diagnosis and prognosis and treatment outcomes; lack of accurate knowledge regarding the virus morphology, variant, and treatment protocols; and the inconsistencies in the dissemination of COVID-19 protocols. Conclusions: Full communication benefits both patients, relatives, and health care professionals as knowledge and understanding are enhanced through communication. Therefore, health care professionals should provide the patients and their relatives with full information about the disease and the visitation protocols to be followed. The study contribution was to explore barriers to effective communication to the patients and relatives by the health care professionals.

From summative MAAS Global to formative MAAS 2.0 - a workshop report

BACKGROUND

The MAAS Global (Maastricht History-taking and Advice Scoring List) is an internationally widely-used instrument in under- and postgraduate medical education. The focus is on the assessment of medical communication and clinical skills. The assessment tool, which has also been used in Germany since 2015, has a high-quality design (e.g. comprehensible structure, appropriate complexity), good psychometric properties and is very user-friendly. An update of MAAS Global, MAAS 2.0, was published in March 2021 with a new and greater focus on context and the formative.

METHOD

The revised version of the MAAS 2.0 assessment sheet was translated into German with the authors' permission. Open questions were discussed with the revision process project manager.

RESULTS

The revision was carried out with a view to focusing on the patient's frame of reference, removing ambiguities identified previously while using MAAS Global, and closer alignment with the underlying Calgary-Cambridge model. Furthermore, the scale used for the evaluation was modified and now uses a formative evaluation range without grade-related classification.

CONCLUSION

With the content reorientation of MAAS Global to MAAS 2.0, and the associated focus on frame of reference, context, the formative, the revision presented here sets new priorities for future evaluations in the context of under- and postgraduate medical education and the assessment of medical patient communication in general.

A systematic review: the dimensions to evaluate health care performance and an implication during the pandemic

BACKGROUND

The balanced scorecard (BSC) has been implemented to evaluate the performance of health care organizations (HCOs). BSC proved to be effective in improving financial performance and patient satisfaction.

AIM

This systematic review aims to identify all the perspectives, dimensions, and KPIs that are vital and most frequently used by health care managers in BSC implementations.

METHODS

This systematic review adheres to PRISMA guidelines. The PubMed, Embase, Cochrane, and Google Scholar databases and Google search engine were inspected to find all implementations of BSC at HCO. The risk of bias was assessed using the nonrandomized intervention studies (ROBINS-I) tool to evaluate the quality of observational and quasi-experimental studies and the Cochrane (RoB 2) tool for randomized controlled trials (RCTs).

RESULTS

There were 33 eligible studies, of which we identified 36 BSC implementations. The categorization and regrouping of the 797 KPIs resulted in 45 subdimensions. The reassembly of these subdimensions resulted in 13 major dimensions: financial, efficiency and effectiveness, availability and quality of supplies and services, managerial tasks, health care workers' (HCWs) scientific development error-free and safety, time, HCW-centeredness, patient-centeredness, technology, and information systems, community care and reputation, HCO building, and communication. On the other hand, this review detected that BSC design modification to include external and managerial perspectives was necessary for many BSC implementations.

CONCLUSION

This review solves the KPI categorization dilemma. It also guides researchers and health care managers in choosing dimensions for future BSC implementations and performance evaluations in general. Consequently, dimension uniformity will improve the data sharing and comparability among studies. Additionally, despite the pandemic negatively influencing many dimensions, the researchers observed a lack of comprehensive HCO performance evaluations. In the same vein, although some resulting dimensions were assessed separately during the pandemic, other dimensions still lack investigation. Last, BSC dimensions may play an essential role in tackling the COVID-19 pandemic. However, further research is required to investigate the BSC implementation effect in mitigating the pandemic consequences on HCO.