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Al Qaf'an E, Alford S, Porteous K, Lim D. Healthcare Decision-Making in a Crisis: A Qualitative Systemic Review Protocol. Emerg Med Int 2024; 2024:2038608. [PMID: 38715979 PMCID: PMC11074907 DOI: 10.1155/2024/2038608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/16/2024] [Accepted: 03/23/2024] [Indexed: 05/12/2024] Open
Abstract
Background. Throughout history, communities have faced outbreaks of infectious diseases and other natural and man-made disasters that pose significant threats to lives, public health, and business continuity. Many of these disasters are crises that require critical decisions to be made in a short, crucial time with limited information and unforeseen circumstances amidst panic, fear, and shock. The COVID-19 pandemic is a recent example, with public leaders responding to and formulating strategies to attenuate the relentless waves of transmission and surges in resource demands. The pandemic underscored the importance of understanding how healthcare leaders make decisions in-crisis and what factors healthcare leaders prioritize in their decision-making process. Methods/Design. PubMed(NLM), Embase(Ovid), Scopus(Elsevier), Business Source(EBSCOhost), and ProQuest will be searched for primary qualitative studies published in English to explore the multi-faceted decision-making processes of healthcare leaders during a public health crisis. A meta-ethnographic approach will synthesize insights into healthcare leaders' experiences and perspectives and generate a conceptual theory of decision-making in crisis. Discussion. Understanding how healthcare leaders make critical decisions during public health crises takes advantage of the lessons learned to inform how future health crises are managed. (This systematic review is registered in PROSPERO: CRD42023475382).
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Affiliation(s)
- Ehmaidy Al Qaf'an
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Broadway, Ultimo, Australia
| | - Stewart Alford
- Kaplan Business School, Kaplan Australia, Brisbane, Australia
| | - Kimberley Porteous
- Education and Research Services (Health), UTS Library, University of Technology Sydney, Broadway, Ultimo, Australia
| | - David Lim
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Broadway, Ultimo, Australia
- Mparntwe Centre for Evidence in Health: A JBI Centre of Excellence, Alice Springs, Australia
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Adu FA, Poku CA, Adu AP, Owusu LB. The role of social support and self-management on glycemic control of type 2 diabetes mellitus with complications in Ghana: A cross-sectional study. Health Sci Rep 2024; 7:e2054. [PMID: 38650722 PMCID: PMC11033339 DOI: 10.1002/hsr2.2054] [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: 05/05/2023] [Revised: 02/08/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Diabetes mellitus (DM) can result in detrimental complications which are connected with long-term impairments and disabilities. Chronic complications are well-known consequences of type 2 diabetes mellitus (T2DM) progression, which reduce patient quality of life, place a burden on the healthcare system, and increase mortality. Measures to promote health outcomes for people with DM are scanty; the study therefore aimed at determining the effects of self-management and social support on glycemic control of T2DM with complications in Ghana. Methods A cross-sectional design using convenience sampling was conducted on 400 T2DM patients using Hensarling's Diabetes Family Support Scale and Summary of Diabetes Self‑Care Activities scale. Data analysis was conducted using descriptive, Pearson Moment Product Correlation and Binary Logistic Regression on self-management, social support, and glycemic control in T2DM patients. Results Social support among participants was high and there was a positive correlation or relationship between social support and T2DM self-management. There was a correlation between social support and self-management (r = 0.149, p < 0.05) and diet control (r = 0.221, p < 0.05). The results also showed a significant correlation between medication adherence and glycemic management (r = 0.116, p < 0.05) while female T2DM participants, individuals with at least primary education were less likely to have low self-management relative to T2DM. Conclusion Though the level of T2DM self-management was high it does not translate to good glycemic control. Focused health education programs should be incorporated into patients' care plans which will be particularly relevant for patients with T2DM and will contribute to positive physiological and psychological outcomes. Furthermore, a more robust monitoring and follow-up scheme should be scaled up or instituted for patients with T2DM.
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Affiliation(s)
- Frank Amankwah Adu
- Medical Technology in the Xiangya School of NursingCentral South UniversityChangshaChina
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Collins Atta Poku
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Amanda Parko Adu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Lydia Boampong Owusu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
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Binyaruka P, Mtenga SM, Mashasi I, Karugu CH, Mohamed SF, Asiki G, Mair FS, Gray CM. Factors associated with COVID-19 vaccine uptake among people with type 2 diabetes in Kenya and Tanzania: a mixed-methods study. BMJ Open 2023; 13:e073668. [PMID: 38149426 PMCID: PMC10711896 DOI: 10.1136/bmjopen-2023-073668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/21/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND People with type 2 diabetes (T2D) are at increased risk of poor outcomes from COVID-19. Vaccination can improve outcomes, but vaccine hesitancy remains a major challenge. We examined factors influencing COVID-19 vaccine uptake among people with T2D in two sub-Saharan Africa countries that adopted different national approaches to combat COVID-19, Kenya and Tanzania. METHODS A mixed-methods study was conducted in February-March 2022, involving a survey of 1000 adults with T2D (500 Kenya; 500 Tanzania) and 51 in-depth interviews (21 Kenya; 30 Tanzania). Determinants of COVID-19 vaccine uptake were identified using a multivariate logistic regression model, while thematic content analysis explored barriers and facilitators. RESULTS COVID-19 vaccine uptake was lower in Tanzania (26%) than in Kenya (75%), which may reflect an initial political hesitancy about vaccines in Tanzania. People with college/university education were four times more likely to be vaccinated than those with no education (Kenya AOR=4.25 (95% CI 1.00 to 18.03), Tanzania AOR=4.07 (1.03 to 16.12)); and people with health insurance were almost twice as likely to be vaccinated than those without health insurance (Kenya AOR=1.70 (1.07 to 2.70), Tanzania AOR=1.81 (1.04 to 3.13)). Vaccine uptake was higher in older people in Kenya, and among those with more comorbidities and higher socioeconomic status in Tanzania. Interviewees reported that wanting protection from severe illness promoted vaccine uptake, while conflicting information, misinformation and fear of side-effects limited uptake. CONCLUSION COVID-19 vaccine uptake among people with T2D was suboptimal, particularly in Tanzania, where initial political hesitancy had a negative impact. Policy-makers must develop strategies to reduce fear and misconceptions, especially among those who are less educated, uninsured and younger.
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Affiliation(s)
- Peter Binyaruka
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Sally M Mtenga
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Irene Mashasi
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Caroline H Karugu
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Shukri F Mohamed
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Gershim Asiki
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Frances S Mair
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cindy M Gray
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
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Josiah BO, Uzor CC, Duncan BA, Enebeli EC, Otoboyor NL. Efficacy, safety, and public attitude toward COVID-19 vaccines: A systematic review. Ann Afr Med 2023; 22:405-414. [PMID: 38358138 PMCID: PMC10775944 DOI: 10.4103/aam.aam_13_23] [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: 01/30/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 02/16/2024] Open
Abstract
Background This paper reviews some of the literature on the safety and efficacy of different COVID-19 vaccines, the attitudes, and perceptions of people towards the vaccines, and the factor underlying such perceptions and behavior. Methods Two major databases (PubMed and Epistemonikos) were checked using search expansion mechanisms and several search strings. After the title, abstract, and full-text analysis, 19 studies were selected for review. Results The seven different vaccines studied all have supporting data on their efficacy in the reduction of COVID-19 cases, prevention of hospitalization after infection, and reduction in the mortality rate of COVID-19 patients. There was high hesitancy about the COVID-19 vaccine and the perceived efficacy and safety of the vaccines are less than recorded in clinical data. Distrust of the vaccines, their manufacturers and different institutions and governments, personal beliefs and feelings, age, gender, education, and socioeconomic status were identified factors affecting behaviors towards the COVID-19 vaccines. Conclusion Several articles support the efficacy of COVID-19 vaccines, but general awareness and conception about them vary, including hesitancy, distrust, and some acceptance. Many factors affected the perception and attitude of people toward these vaccines. More clinical data on the efficacy and safety of COVID-19 vaccines should be generated to help boost confidence among users.
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Affiliation(s)
- Blessing Osagumwendia Josiah
- Department of Nursing, Turks and Caicos Islands Community College, Grand Turk, Turks and Caicos Islands
- Department of Research and Statistics, Institute of Nursing Research, Oshogbo, Nigeria
| | - Chinelo C. Uzor
- Windsor University School of Medicine, Brighton's Estate, Cayon. St. Kitts and Nevis, Leeds, United Kingdom
| | - Brontie A. Duncan
- Freelance Financial Consultant, Basseterre, St. Kitts and Nevis, Leeds, United Kingdom
| | - Emmanuel Chukwunwike Enebeli
- Department of Nursing, Turks and Caicos Islands Community College, Grand Turk, Turks and Caicos Islands
- Adult Critical Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Ndidi Louis Otoboyor
- Medical, Surgical, and Neuro Intensive Care Units, Scripps Hospital, San Diego, California, United States of America
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Ekpor E, Akyirem S. Global acceptance of COVID-19 vaccine among persons with diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2023; 201:110731. [PMID: 37236364 DOI: 10.1016/j.diabres.2023.110731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 05/28/2023]
Abstract
AIM This review aimed to estimate the level of acceptance of COVID-19 vaccine among persons with diabetes. METHODS A systematic search was conducted on PubMed, MEDLINE, Embase, and CINAHL to identify relevant studies for this review. A random-effects meta-analysis was performed to generate an overall estimate of vaccine acceptance. The I2 statistic was used to quantify the degree of variation across studies, and subgroup analysis was conducted to identify the sources of heterogeneity. The review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). RESULTS This review included 18 studies involving 11,292 diabetes patients. The pooled prevalence of COVID-19 vaccine acceptance among persons with diabetes was 76.1% (95% CI: 66.7% - 83.5%). The pooled prevalence across the continent ranged from 68.9% (95% CI: 47.8% - 84.3%) in Asia to 82.1% (95% CI: 80.2% - 83.8%) in Europe. Barriers to vaccine acceptance included misinformation, lack of information, mistrust, health concerns, and external influences. CONCLUSION The barriers to vaccine acceptance identified in this review, could inform the formulation of health policies and public health interventions that are specifically tailored to address the needs of persons with diabetes.
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Affiliation(s)
- Emmanuel Ekpor
- School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana; Christian Health Association of Ghana, Accra, Ghana.
| | - Samuel Akyirem
- Yale School of Nursing, Yale University, New Haven, Connecticut, USA
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Njoga EO, Awoyomi OJ, Onwumere-Idolor OS, Awoyomi PO, Ugochukwu ICI, Ozioko SN. Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out-COVID-19 Vaccination Acceptance Rates as Case-in-Point. Vaccines (Basel) 2022; 10:1934. [PMID: 36423029 PMCID: PMC9697713 DOI: 10.3390/vaccines10111934] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 08/29/2023] Open
Abstract
Vaccine hesitancy (VH) is the seventh among the WHO's top 10 threats to global public health, which has continued to perpetuate the transmission of vaccine preventable diseases (VPDs) in Africa. Consequently, this paper systematically reviewed COVID-19 vaccine acceptance rates (VARs)-including the vaccine uptake and vaccination intention-in Africa from 2020 to 2022, compared the rates within the five African regions and determined the context-specific causes of VH in Africa. Generally, COVID-19 VARs ranged from 21.0% to 97.9% and 8.2% to 92.0% with mean rates of 59.8 ± 3.8% and 58.0 ± 2.4% in 2021 and 2022, respectively. Southern and eastern African regions had the top two VARs of 83.5 ± 6.3% and 68.9 ± 6.6% in 2021, and 64.2 ± 4.6% and 61.2 ± 5.1% in 2022, respectively. Based on population types, healthcare workers had a marginal increase in their mean COVID-19 VARs from 55.5 ± 5.6% in 2021 to 60.8 ± 5.3% in 2022. In other populations, the mean VARs decreased from 62.7 ± 5.2% in 2021 to 54.5 ± 4% in 2022. As of 25 October 2022, Africa lags behind the world with only 24% full COVID-19 vaccinations compared to 84%, 79% and 63% reported, respectively, in the Australian continent, upper-middle-income countries and globally. Apart from the problems of confidence, complacency, convenience, communications and context, the context-specific factors driving COVID-19 VH in Africa are global COVID-19 vaccine inequality, lack of vaccine production/maintenance facilities, insecurity, high illiteracy level, endemic corruption, mistrust in some political leaders, the spreading of unconfirmed anti-vaccination rumors and political instability. With an overall mean COVID-19 acceptance rate of 58%, VH still subsists in Africa. The low VARs in Africa have detrimental global public health implications, as it could facilitate the emergence of immune invading SARS-CoV-2 variants of concern, which may spread globally. Consequently, there is a need to confront these challenges frontally and engage traditional and religious leaders in the fight against VH in Africa, to restore public trust in the safety and efficacy of vaccines generally. As the availability of COVID-19 vaccines improves, the vaccination of pets and zoo-animals from which reverse zoonotic transmission of SARS-CoV-2 have been reported is recommended, to limit the evolution and spread of new variants of concern and avert possible SARS-CoV-2 epizootic or panzootic diseases in susceptible animal species.
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Affiliation(s)
- Emmanuel O. Njoga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
| | - Olajoju J. Awoyomi
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta PMB 2240, Nigeria
| | - Onyinye S. Onwumere-Idolor
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Nigeria
| | - Priscilla O. Awoyomi
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
| | - Iniobong C. I. Ugochukwu
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Universita degli Studi di Bari, 70010 Valenzano, Italy
| | - Stella N. Ozioko
- Institute of Aquaculture, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
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Mesele H, Shiferaw M, Tunta A, Seid A, Kassahun W. Willingness to Receive COVID-19 Vaccination Among Adult Diabetes Patients in Woldia Comprehensive Specialized Hospital, North Ethiopia; A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:2451-2459. [PMID: 36081925 PMCID: PMC9447444 DOI: 10.2147/ppa.s379531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND According to recently published data, individuals infected with COVID-19 having concomitant diabetes may experience disease worsening or even death. The purpose of this study was to determine diabetes patients' willingness to get the COVID-19 vaccine as well as its magnitude and determinants. METHODS Three hundred eighty six diabetes patients who visited Woldia Comprehensive Specialized Hospital during February and March 2022 participated in this institution-based cross-sectional study. Descriptive statistics were used to demonstrate frequencies and percentages, while logistic regression was used to identify the relevant determinants of vaccination readiness. Age, gender, income, place of residence, COVID-19 exposure, length of diabetes, awareness of and attitudes toward the COVID-19 immunization were all evaluated as associated factors. RESULTS Out of 386 study participants, 268 (69.43%) were male and 146 (37.82) completed their secondary schooling. From 386 study participants 82.6% (95% CI; 78.5-86.3%) were willing to get vaccinated. The uptake of the COVID-19 vaccination among diabetes patients was independently influenced by sex (Adjusted Odd Ratio [AOR] = 6.84 (2.98, 15.68)), exposure to the illness (AOR 8.98 (3.22, 25.04)), attitude (AOR = 2.63 (1.2, 5.77)), and length of the disease (AOR = 0.62 (0.51, 0.76)). CONCLUSION Most of the study participants were willing to get the COVID-19 immunization. The relevant agency should make the immunization available in order to enhance disease control and reduce infection-related complications with special consideration of diabetes patients.
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Affiliation(s)
- Habtamu Mesele
- Woldia Comprehensive Specialized Hospital, Woldia, Ethiopia
| | - Mulu Shiferaw
- Biomedical Unit, School of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
- Correspondence: Mulu Shiferaw, Biomedical Unit, School of Nursing, College of Health Sciences, Woldia University, PO Box 400, Woldia, Ethiopia, Email
| | - Abayneh Tunta
- Biomedical Unit, School of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Addisie Seid
- Woldia Comprehensive Specialized Hospital, Woldia, Ethiopia
| | - Woldeteklehymanot Kassahun
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, Woldia, Ethiopia
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