Barriers to accessing health services during the COVID-19 pandemic in Poland: A nationwide cross-sectional survey among 109,928 adults in Poland

Considerations and experiences with healthcare-seeking during the first COVID-19 lockdown in Denmark

AIM

To (1) examine considerations before and experiences with GP contact during the first COronaVIrus Disease 2019 (COVID-19) lockdown among Danish citizens; (2) analyse the associations with sex, age, chronic disease, and socioeconomic factors; and (3) explore changes in healthcare-seeking behaviour post-pandemic.

METHOD

A total of 100,000 Danes aged 20 years or older, randomly selected in the general population, were invited to participate in a survey examining considerations and experiences with healthcare seeking during the first COVID-19 lockdown. Data were collected in spring 2022 and linked to register data on socioeconomic factors. Descriptive statistics and multivariable logistic regression models were applied.

RESULTS

Of the 27,369 eligible individuals, 18% reported a need to contact their GP. Being worried about burdening the healthcare system was most frequently reported (45%), followed by being in doubt about acceptable contact reasons (33%), and concern about infection (24%). Although 44% of those who needed to contact their GP found the digital solutions advantageous, individuals frequently found it difficult to discuss symptoms by telehealth (29%) and that they were examined less thoroughly. Generally, women, younger people, and individuals with lower socioeconomic status were more likely to be worried and report difficulties with contact to general practice. Some 86% of the respondents reported no changes in healthcare-seeking behaviour post-pandemic.

CONCLUSION

The results may assist in the organisation of healthcare in case of future lockdowns. Yet, the COVID-19 pandemic has only slightly affected the healthcare-seeking behaviour in the Danish general population.

Religious affiliation and perceptions of healthcare access during and after COVID-19 in Poland

Introduction

In response to the unprecedented impact of the COVID-19 pandemic on healthcare systems and social life worldwide, this study examines the role of religion in shaping perceptions of healthcare access in Poland during and after the pandemic.

Methods

The research is based on anonymous surveys conducted among adult Poles during the third wave of the pandemic and in the post-pandemic period, with participants divided by the timing of their responses. The research employed a cross-sectional survey design with a validated questionnaire. Data collection occurred during the third wave of the pandemic and the post-pandemic period. The questionnaire incorporated demographic questions and assessed the significance of religion in respondents' lives using a Visual Analogue Scale (VAS) for healthcare accessibility.

Results

Participants (n = 541) were recruited through online and paper-based surveys, meeting the inclusion criteria of being aged 18 or older and residing in Poland. Findings indicate that Roman Catholic respondents rated healthcare accessibility higher than non-religious individuals, potentially due to social and community support. However, statistical analysis revealed no significant differences in actual healthcare access among groups, suggesting systemic factors played a larger role.

Discussion

These results highlight religion as a source of emotional support rather than a determinant of healthcare access.

Pediatric Chronic Kidney Disease During Pandemic Conditions-A Single-Center Experience

Background/Objectives: The prevalence of chronic kidney disease (CKD) is increasing worldwide, and this tendency is also visible in pediatric patients. The major clinical challenge is to achieve a diagnosis as early as possible, despite an overt clinical course, especially in the early stages of the disease. Unfavorable external conditions may disturb the proper treatment of chronically ill patients and delay the time of diagnosis. The recent COVID-19 pandemia might have altered the usual diagnostic pathways of different comorbidities, and CKD was probably one of them. However, there are no data on newly diagnosed CKD in children during the time of the pandemia, so our aim was to approach this problem. Methods: We analyzed medical records of 154 children with CKD who were hospitalized in the Department of Pediatric Nephrology in prepandemic (years 2015-2019) vs. pandemic and postpandemic (2020-2024) conditions, analyzing the eGFR value and stage of CKD at diagnosis, the underlying diseases leading to CKD, and sex-related differences. Results: The number of patients who were diagnosed with CKD in both time periods was comparable. Children hospitalized in the years 2020-2024 presented more often with advanced stages of CKD. The trend towards an increasing share of glomerulopathies, acute kidney injury, and unknown causes of CKD was noticeable under pandemic conditions. Conclusions: The COVID-19 pandemic could, probably owing to reduced access to primary healthcare and disrupted routine check-ups, delay the process of diagnosing CKD in children.

'Let the System Do Its Job and Families Handle the Rest'? Protective and Risk Factors Contributing to Pandemic Crisis Parental Burnout

Background: The work main purposes were to identify the sources of problems and demands causing parental burnout and to specify the resources/support factors during the COVID-19 pandemic. The study was based on the Balance Theory of Risk and Support/Resource Factors (BR2 Model) by Mikolajczak and Roskam. Methods: The study explored the predictive value of socio-economic variables, religiosity, the meaning of life, positivity, perceived social support, family functionality, and balance between risks and resources in parental burnout using the structural equation modelling method on a sample of 337 parents. Results: The presence of children's learning difficulties and behavioural problems are the most important risk factors and aggravate parental burnout, and the presence of a meaning of life, support coming from the family, family affection, and relationship lengths are the main protective resources, allowing parental burnout to decrease during the pandemic crisis. Conclusions: The findings are instructive for both theory and practice. The study successfully operationalised the BR2 model-the model obtained from the path analysis fits well, confirms the structure of parental burnout theory, and demonstrates the appropriateness of the application of BR2 theory in crisis conditions. The most effective way to help parents in a crisis situation is (in addition to psychological support) the effective provision of specialist help for children, resulting in a reduced risk of an unfavourable balance between demands and family resources. The family- or parent-oriented interventions that address professional help in problems with children can be the most effective at reducing the negative consequences of a pandemic on children and their parents. The COVID-19 pandemic has shown the importance of investing in healthcare infrastructures.

The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study)

OBJECTIVE

The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM).

DESIGN AND METHODS

Data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Pandemic group: including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9-15 months prior to visit 2. Pre-pandemic group: had ABPM at two visits, performed before the pandemic within 9-15 months interval. We determined the following hypertension phenotypes: masked hypertension, white coat hypertension, sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH). We analyzed the prevalence of phenotypes and their changes between visits.

RESULTS

Data of 1419 patients, 616 (43 %) in the pandemic group and 803 (57 %) in the pre-pandemic group, were analyzed. At baseline (visit 1), the prevalence of hypertension phenotypes did not differ between groups. In the pandemic group, the change in hypertension phenotypes between two visits was not significant (p = 0.08). In contrast, in the pre-pandemic group, the prevalence of SCH increased during follow-up (28.8 % vs 38.4 %, p < 0.01) while the prevalence of SUCH decreased (34.2 % vs 27.8 %, p < 0.01). In multivariable adjusted analysis, the only factor influencing negative changes of hypertension phenotypes was the COVID-19 pandemic period.

CONCLUSION

These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes.

Adequate antenatal care service utilizations after the onset of COVID-19 pandemic in Ethiopia: a systematic review and meta-analysis

Background

The world faces great difficulty in continuing to provide essential maternity health care after the onset of COVID-19 pandemic Many women have trouble accessing maternity healthcare due to fear of infection. A decline in the utilization of maternity health services is suggested to worsen adequate antenatal care service utilization. Thus, this study aimed to determine the pooled estimate of adequate antenatal care service utilization after the onset of COVID-19 in Ethiopia.

Methods

The searching of articles was carried out on Web of Science, Scopus, PubMed, CINHAL, Google Scholar, African journals online, and the institutional repository of Ethiopian universities. Using a Microsoft Excel standardized spreadsheet, the data were extracted. A random effect model was used to determine a pooled estimate of adequate antenatal care utilization. I 2 statistics were used to quantify the amount of heterogeneity. The evidence of publication bias was examined using Egger's regression test and a visual inspection of the funnel plot. Subgroup and sensitivity analyses were also carried out.

Results

Finally, this systematic review and meta-analysis included 11 eligible articles. The overall pooled estimate of adequate antenatal care service utilization after the onset of COVID-19 pandemic in Ethiopia was 46.28% (95% CI: 35.32%-57.26%). There is a substantial amount of heterogeneity between studies (I 2 = 99.07%, p < 0.001). Pregnant women who visited antenatal care early were 10.9 times more likely to have adequate antenatal care utilization than those without early visits (AOR = 10.93, 95% CI: 7.2-14.66).

Conclusion

In this review, the percentage of women who utilized adequate antenatal care after the onset of COVID-19 pandemic in Ethiopia was less than half. Early antenatal care visit is an important factor to achieve adequate antenatal care service utilizations.

Systematic review registration

: CRD42023495279.

Disability, poverty and health-service accessibility in the context of the COVID-19 pandemic: a population-based repeated cross-sectional study in Colombia

OBJECTIVES

In Colombia, 4.3% of the population 5 years or older lives with a disability. They face higher levels of poverty and social exclusion compared with persons without disabilities. This article aims to understand the factors associated with access to preventative and curative health services for people with disabilities in Colombia. Additionally, it explores whether access to health services for people with disabilities changed during the COVID-19 pandemic.

DESIGN

This is a population-based repeated cross-sectional study.

SETTING

This study took place in Colombia, from 2018 to 2021.

DATA SOURCES AND PARTICIPANTS

National Quality of Life Survey datasets in Colombia from 2018 to 2021, including people 5 years or older, were reviewed. People were classified into three groups: person with any disability, person with multiple disabilities and person without disabilities.

PRIMARY AND SECONDARY OUTCOME MEASURES

A multinomial regression model was used to calculate the probability of access to preventative services during the previous year in four categories: general practitioner (GP) and dentist, GP only, dentist only and no consultation. A logistic model for curative consultations with and without hospitalisation in people who reported having a health problem.

RESULTS

People with disabilities demanded more preventative health services, except for dental services, compared with people without disabilities. Similarly, they experienced more health problems and demanded more curative services than people without disabilities, except during the year 2020, when no significant differences were found between people with and without disabilities. For people with disabilities, poverty was not associated with a lower likelihood of consultation, except for preventative dental consultations, which were significantly lower for poor people with disabilities. In addition, the subsidised insurance regimen was identified as an important variable in the utilisation of healthcare in Colombia.

CONCLUSION

People with disabilities in Colombia demand more health services compared with people without disabilities. Despite being in a worse condition according to various socioeconomic indicators, few factors affect their demand for healthcare services. The COVID-19 pandemic was associated with a significant reduction in the probability of access to outpatient treatment services during 2020 for people with disabilities. Longitudinal studies and comparison with other Latin American countries are recommended.

Impact of the COVID-19 pandemic on international cutaneous squamous cell carcinoma incidence: A systematic review and meta-analysis

Background

Non-melanoma skin cancer (NMSC) is the most common cancer globally in white ethinicity populations, and cutaneous squamous cell carcinoma (cSCC) is the second most common subtype. The COVID-19 pandemic severely impacted public and private healthcare systems. Many studies have reported reduced cancer diagnoses during the pandemic. The impact of the COVID-19 pandemic on global cSCC and NMSC incidence is poorly reported.

Objectives

The aim was to conduct a systematic review and meta-analysis to assess the impact of the COVID-19 pandemic on global cSCC and NMSC incidence rates, compared with 2019 incidence rates. Two primary outcome measures were used: crude incidence rate ratios (CIRR) and age-standardised incidence rate ratios (ASIRR).

Methods

A structured search was undertaken on 23 March 2023 using grey literature and four electronic databases: MEDLINE, CINAHL, EMBASE and Web of Science. Studies published before January 2020 were excluded. A quality assessment was undertaken using A. Lomas quality assessment tool. CIRR outcomes were synthesised in a meta-analysis, while ASIRR outcomes were narratively synthesised.

Results

Fourteen cancer registries were included, capturing data from 13 countries across Europe. Variation was observed in NMSC and cSCC incidence across the cancer registries. Pooled cSCC crude incidence rates in 2020 were equal to crude incidence rates in 2019 (cSCC-CIRR 1.00 (95% confidence interval (CI) 0.94-1.06). In 2021, the pooled result indicated a non-significant 8% increase in cSCC crude incidence rates, compared with 2019 (cSCC-CIRR 1.08 (95% CI 0.98-1.19). Significant reductions were reported in NMSC incidence across all meta-analyses in 2020 and 2021 compared with 2019. Heterogeneity was observed across most pooled estimates (I 2>75%).

Conclusion

There was a lack of high quality data on cSCC incidence rates recorded during the pandemic outside of Europe. The COVID-19 pandemic resulted in no significant changes in cSCC incidence across Europe. By contrast, NMSC incidence fell across Europe following the pandemic. Significant reductions in pooled NMSC incidence rates may reflect a delay in basal cell carcinoma presentation, diagnosis and treatment. Although annual incidence rates for cSCC were not affected by the pandemic, delays in treatment may still have occurred, which may result in poorer outcomes yet to be fully understood.

The impact of the COVID-19 pandemic on incidence gap in screen-detectable cancers: a cohort study in Greater Poland, Poland

Background

The global COVID-19 pandemic has had a significant impact on healthcare systems. This study aimed to assess the incidence gap in screening-detectable cancers in the Greater Poland (Poland) in 2020.

Materials and methods

Data on breast, cervix uteri, and colorectal cancer cases diagnosed from 2010 to 2020 were obtained from the regional cancer registry. Standardized incidence ratios (SIR) and incidence rate differences (IRD) were calculated to estimate the change in incident cancer cases during the pandemic. The number of observed cases was extracted from the registry database. Simple linear regression analysis was used to predict the expected number of incident cancer cases in 2020 and the age-standardized incidence rate based on registry data from the preceding ten years (2010-2019).

Results

In 2020, the registered number of incident female breast cancer cases decreased by 12% [SIR 0.88, 95% confidence interval (CI): 0.88-0.92, observed: 1,848, expected: 2,101], resulting in an IRD of -6.3 per 100 K. The number of registered cervical cancers decreased by 15% (SIR 0.85, 95% CI: 0.73-0.98, observed: 181, expected: 213), with an IRD of -0.8 per 100 K. For colorectal cancer, there was a 16% decrease in new cases among females (SIR 0.84, 95% CI: 0.78-0.90) and a 15% decrease among males (SIR 0.85, 95% CI: 0.80-0.91), resulting in IRDs of -3.04 and -5.29 per 100K, respectively.

Conclusions

The COVID-19 pandemic led to a significant, 15% decrease in newly diagnosed screening-detectable cancer cases in 2020. Further studies are needed to investigate the impact of delayed cancer diagnoses on stage at diagnosis and survival rates.

Did Covid-19 make things worse? The pandemic as a push factor stimulating the emigration intentions of junior doctors from Poland: A mixed methods study

Covid-19 has challenged health systems around the world and increased the global competition for medical professionals. This article investigates if the pandemic and its management became an important push factor influencing the migration intentions of medical students and junior doctors and how this factor compared in importance to others. A mixed methods study-a survey and in-depth interviews-was conducted with final-year students at public medical universities in Poland, a country already suffering from a significant emigration of medical staff. The research demonstrated that the difficulties of the Polish healthcare system in dealing with Covid-19 were a factor that slightly positively influenced the emigration intentions of medical students and junior doctors. Nevertheless, the pandemic's influence was not decisive. Factors such as the socio-political situation in Poland (.440**) (including hate speech directed at doctors by politicians and patients), the participants' family situation (.397**), healthcare system organization (.376**), or the opportunity of pursuing a planned career path (.368**) proved more influential. Salary is still important but did not turn out to be among the decisive factors. This allows us to conclude that migration decisions of medical students have a very well-established basis that does not fundamentally change even under the influence of such dramatic situations as the pandemic. This conclusion has important implications for healthcare management and the ongoing discussion in migration studies on the evolution of push and pull factors in place and time.

The impact of the first and the second wave of the COVID-19 pandemic on vascular surgery practice in the leading regional center: a comparative, retrospective study

BACKGROUND

We conducted an analysis of the vascular surgery regional center reorganization in response to the first and the second wave of the coronavirus disease-2019 (COVID-19) pandemic to see what lessons we learned from the first wave.

METHODS

The study included a total of 632 patients admitted to the vascular surgery department in three periods: March-May 2020, October-December 2020, and October-December 2019 as a control period.

RESULTS

In the pandemic periods the number of admitted patients decreased in relation to the control period. There was a reduction in performed procedures. We observed an increase in the ratio of less invasive procedures. There was a significant decline in hospitalization time in comparison to the control period.

CONCLUSIONS

The reduction of scheduled admissions and procedures affected vascular centers all over the world. Minimally invasive procedures were more willingly performed to shorten the hospitalization time and reduce the patient's exposure to hospital infection. It allowed us to treat more patients during the second wave. Nevertheless, an increased number of vascular patients should be expected in the future, which will result from the failure to perform elective procedures during the pandemic.

Perceived barriers of access to health and nutrition services under drought and food insecurity emergency in north-east Uganda: a qualitative study

BACKGROUND

In the face of drought and food insecurity emergency, evidence on access to health and nutrition services is important. Karamoja is one of the regions that have experienced extreme drought and food insecurity emergency in Uganda. As a part of the drought and food insecurity emergency response, World Health Organization (WHO) with Ministry of Health (MoH) has designed and implemented a qualitative study in 15 districts that have experienced drought and food insecurity emergency in north-east Uganda. Thus, we aimed to explore the barriers of access to health and nutrition services in drought and food insecurity emergency affected districts in north-east Uganda.

METHODS

We employed a descriptive qualitative study design. We interviewed 30 patients and 20 Village Health Teams (VHT) from 15 districts. We employed an in-depth interview with semi-structured questions to collect data until information saturation reached. We used thematic data analysis approach by ATLAS.ti version 7.5.1.8 software.

RESULTS

Of the 30 interviewed subjects, 15 were female, and the median age of the subjects was 29 years with interquartile range (IQR) of 23 to 37 years. Majority (68.8%) of subjects reported that access to health and nutrition services was harder to them. Four themes: sociocultural and economic; environmental; health system, and individual related factors were identified as the barriers of access to health and nutrition services.

CONCLUSION

The present study identified several modifiable barriers that hinder access to health and nutrition services in drought and food insecurity affected districts. Comprehensive interventions aimed at addressing sociocultural, economic, environmental, health system and subject related challenges are required to improve access to health and nutrition services in drought and food insecurity affected setups.

How COVID-19 has changed the utilization of different health care services in Poland

BACKGROUND

The COVID-19 pandemic has affected health care systems in many ways, including access to and the use of non-COVID services. The aim of the study was to assess the impact of the pandemic on the utilization of different public health care services in Poland.

METHODS

The aggregated data on health care users and provided services for the years 2015/2016-2021 were used to analyse the changes in health care utilization during the pandemic and deviations from pre-pandemic utilization trends. Quantitative analysis was complemented with qualitative descriptions of the changes in principles of health care provision during the pandemic.

RESULTS

The results show a considerable drop in the provision of most health care services in 2020 that in some cases disturbed pre-pandemic utilization trends and was not made up for in 2021. The most significant decrease has been observed in the field of preventive and public health services, as well as rehabilitation. The provision of these services was put on hold during the pandemic.

CONCLUSIONS

The accumulated COVID-19-related "health debt" urgently calls for government actions to strengthen disease prevention and health promotion in Poland.

Decrease in the number of new cancer diagnoses during the first year of the COVID-19 pandemic - cohort study of 3.5 million individuals in western Poland

Introduction

The COVID-19 pandemic has considerably affected healthcare systems worldwide and is expected to influence cancer incidence, mortality, stage at diagnosis, and survival. This study aimed to assess COVID-19-related changes in cancer incidence observed in 2020 in the Greater Poland region.

Materials and methods

Data from the Greater Poland Cancer Registry on cancer patients diagnosed between 2010 and 2020 were analysed. To quantify the change in the number of incident cancer cases during the COVID-19 pandemic, we calculated the standardized incidence ratio (SIR) and the incidence rate difference (IRD) to assume the pandemic-attributable gap in cancer incidence.

Results

In 2020, in Greater Poland, the expected number of new cancer cases was 18 154 (9 226 among males and 8 927 among females), while the observed number was 14 770 (7 336 among males and 7 434 among females). The registered number of cancer cases decreased in 2020 by 20% (SIR 0·80, 95% CI 0·78 to 0·81) and 17% (SIR 0·83, 95% CI 0·81 to 0·85) in males and females, respectively. Among men, the most significant difference was reported for myeloma (SIR 0·59, 95% CI 0·45 to 0·77), among women for bone cancer (SIR 0·47, 95% CI 0·20 to 0·93). In females the observed incidence was higher than expected for cancer of an unspecified site (SIR 1·19, 95% CI 1·01 to 1·38). In our study, the decrease in new cancer cases was greater in males than in females.

Discussion

The observed incidence was affected in most cancer sites, with the most significant deviation from the expected number in the case of myeloma. An increase in the observed incidence was reported only in women diagnosed with cancer of an unspecified site, which might reflect shortages in access to oncological diagnostics.

3D Printing in the Fight Against Covid-19

Purpose

The paper describes the design concept and findings from technological and initial clinical trials conducted to develop a helmet for non-invasive oxygen therapy using positive pressure, known as hCPAP (Helmet Continuous Positive Airway Pressure).

Methods

The study utilized PET-G filament, a recommended material for medical applications, along with the FFF 3D printing technique. Additional technological investigations were performed for the production of fitting components. The authors proposed a parameter identification method for 3D printing, which reduced the time and cost of the study while ensuring high mechanical strength and quality of the manufactured elements.

Results

The proposed 3D printing technique facilitated the rapid development of an ad hoc hCPAP device, which was utilized in preclinical testing and treatment of Covid-19 patients, and yielded positive results. Based on the promising outcomes of the preliminary tests, further development of the hCPAP device's current version was pursued.

Conclusion

The proposed approach offered a crucial benefit by significantly reducing the time and costs involved in developing customized solutions to aid in the fight against the Covid-19 pandemic.

Changes in the Level of Premature Mortality in the Polish Population Due to Selected Groups of Cardiovascular Diseases before and during the Pandemic of COVID-19

BACKGROUND

In the years 2020 and 2021, the COVID-19 pandemic disrupted Poland's health care system and caused a high number of excess deaths. After nearly 30 years of continuous dynamic increase in the life expectancy of the Polish population and a decrease in premature mortality that led to a reduction in the health gap between Poland and Western European countries, regrettably, a decline in life expectancy was recorded. For males, the decline amounted to 2.3 years and, for females, to 2.1 years.

AIM

The aim of this study was to assess changes in the level of premature mortality due to selected cardiovascular diseases in Poland before and during the COVID-19 pandemic.

METHOD

Time trends of deaths of patients under the age of 65 due to ischemic heart disease, cerebrovascular disease and aortic aneurysm were analyzed by gender and age groups. The joinpoint model was used in determining time trends.

RESULTS

Premature mortality due to all of the cardiovascular diseases analyzed had been declining steadily by about 5% per year since 2008. However, at the end of the second decade of the 21st century, a significant change in the dynamics of the trend was observed, particularly with regard to deaths from ischemic heart disease, which since 2018 caused premature mortality increases of 10% per year in the female population. In the male population, an increase of nearly 20% per year has been observed since 2019. The changes also affected premature mortality due to cerebrovascular disease.

CONCLUSIONS

After nearly three decades of significant decline in premature mortality from cardiovascular diseases in Poland, there was a reversal in the trend, in particular as regards ischemic heart disease. The unfavorable changes intensified in the subsequent two years. The simultaneous increase in the number of cardiovascular incidents ending in death and the decline in access to prompt diagnosis and effective treatment may explain the unfavorable changes in the deaths caused by cardiovascular disease and the increase in premature mortality due to cardiovascular disease.

Evaluation of Outpatient Access to the Greek Health System Considering the Constraints of the COVID-19 Pandemic

Background The COVID-19 pandemic fundamentally changed the way healthcare is delivered in most healthcare systems around the world. It is now known that, in addition to the medical and economic impact of the pandemic on societies, there is another unmet medical need due to the difficulties and barriers that have existed and may still exist in the provision of health services at the primary care level in public hospitals. In Greece, there appears to have been a similar problem in citizens' access to health care in the country's public hospitals, which negatively affected the satisfaction of outpatients and significantly prevented them from receiving the medical care they needed.  Methods This study relied on two international questionnaires; the Visit Specific Satisfaction (VSQ-9), an instrument measuring patients' satisfaction with their visit to the physician, and the Patient Satisfaction Questionnaire Short-Form (PSQ-18), consisting of 18 questions measuring both satisfaction and dissatisfaction. The questionnaires were collected electronically between 01.03.22 and 20.03.22 from two hundred and three outpatient residents of the region of Eastern Macedonia and Thrace in Greece. Results The results of the study show that satisfaction of hospital outpatient department users is positively influenced by both access to medical care after the last visit (p=0.008 < 0.05) and frequency of visits (Pearson correlation coefficient=0.178, p=0.012). In addition, lower satisfaction with access to care was found among participants with the lowest income (p=0.010) and those with a chronic illness (p=0.002), which was attributed to pandemic limitations in access to health care services in public hospital outpatient departments. Regarding the overall satisfaction of participants, 40.9% were dissatisfied, and 32.5% were dissatisfied with specific hospital services. Conclusions It was found that patients were hindered from accessing medical care in the hospital due to the restrictions caused by the pandemic. This seemed to cause problems both in accessing a specialist and in making appointments. Half of the outpatients in the sample reported having difficulty communicating with the hospital to make an appointment or to access medical services in general. A relationship was also found between patient satisfaction and the quality of services provided, in terms of medical services offered, such as their availability, and patient satisfaction with the appropriate information they receive from physicians during the pandemic period. The study also found that long-term care hospitals need to improve patient satisfaction with existing medical services.

COVID-19 Vaccination among a Population Experiencing Homelessness: A Survey in Italy

The purposes of this cross-sectional study were to determine the knowledge, attitudes, and behaviors about COVID-19 and its vaccination among 313 individuals experiencing homelessness in Italy and to identify the associated factors. A total of 20.5% identified the virus as a causative agent for COVID-19 and 44.2% identified how the SARS-CoV-2 infection wastransmitted. Those living in homeless shelters were more likely to have this knowledge. Concerns about the safety of the COVID-19 vaccine werehigher in those who were younger, with secondary school as the highest level of education, who practiced Christianity, and who did not believe that COVID-19 was a severe disease. A total of 83.9% received the vaccination. Those who were older, who had correct knowledge, whoperceived to be at a higher risk of getting the disease, and who had a lower concern about the vaccine side effects were more likely to have received the vaccination. The primary reasons for accepting the COVID-19 vaccine were that it wasa preventive measure and that it wasmandatory; those unvaccinated indicated, as the main reasons, a fear of side effects and that it wasnot useful. A relationship and communication between healthcare professionals and this hard-to-reach population are needed, with the implementation of educational and information programs.

Use of the Internet for Health Purposes-A National Web-Based Cross-Sectional Survey among Adults in Poland

The Internet is one of the most popular information sources. This study aimed to assess the public attitudes towards the use of the Internet for health purposes as well as to identify factors associated with the use of the Internet for health purposes among adults in Poland. A web-based cross-sectional survey was carried out between 9 and 12 September 2022 on a nationwide random-quota sample of 1092 adults in Poland. The study questionnaire included 10 questions on Internet use for health purposes. The most common reason for the use of the Internet for health purposes was searching for information on drugs and their effects (69.9%). Almost two-thirds of participants used the Internet for searching for health information (64.9%), for doctors/medical services (63.4%), or for medical facilities (65.3%). Over half of the participants used the Internet for checking online reviews of doctors (55.2%) and 43.5% of the participants ordered drugs or dietary supplements online. Out of 9 different socioeconomic factors analyzed in this study, having higher education, being female, as well as living in cities from 100,000 to 499,999 residents were the most important factors (p < 0.05) associated with the use of the Internet for health purposes. This study confirmed a high level of adoption of medical Internet in Poland.

Feelings of Polish and Palestinian Students after Receiving Vaccinations against COVID-19

The COVID-19 pandemic has limited human freedom in many areas. Developing a COVID-19 vaccine has been a key task to contain the spread of the virus. In many countries, there is increasing concern about anti-vaccines due to complications after receiving the vaccine. The research problem concerns the opinions of Polish and Palestinian students after receiving vaccinations against COVID-19. This study involved 657 respondents (332 from Poland and 325 from Palestine) who completed the original questionnaire online. The respondents present two different cultures, embedded in different existential conditions, also in terms of health care, and especially the availability of vaccines. The obtained data indicate that almost 50% of research participants from both countries believe that vaccines are an effective antidote to the pandemic situation. Respondents in both populations believed that it was their personal choice to undergo vaccinations. The social motivation for vaccination in both groups was the desire to participate in public life, and the possibility of free travel for Poles, and the fear of infecting other people for Palestinians. The most common side effect reported after vaccination was pain at the site of the infection. Medical assistance was more often sought by respondents from Palestine. From an existential, psychosocial and health perspective, vaccines contributed to strengthening the vital forces in a large part of the population, allowed rebuilding social interactions and gave a sense of security in the daily functioning of a person.