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Chandy P, Kanthi E, Pradeep P, Sathianathan P, Jebakamal S, Narchaithi M, Anbarasi S. Lived experience of health-care providers during COVID-19: A meta-synthesis. Indian J Psychiatry 2022; 64:120-129. [PMID: 35494325 PMCID: PMC9045354 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_1403_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 11/07/2021] [Accepted: 01/27/2022] [Indexed: 11/05/2022] Open
Abstract
AIM OF THE STUDY There is currently no meta-synthesis focused on the lived experiences of health-care providers during COVID-19. This meta-synthesis adds to evidence-based literature with an in-depth exploration of how health-care providers responded to the COVID-19 crisis. MATERIALS AND METHODS The meta-synthesis approach was used for the extraction and synthesis of data. RESULTS Fifteen qualitative research articles were identified and analyzed; the majority of which were done in China 7 (48%) and Iran 6 (40%). The total sample size was 383, and the majority of the samples were nurses 282 (74%). Three overarching themes identified were "It is my duty," "I am exhausted and about to fall," and "I have overcome it." The subthemes were professional responsibility, challenges faced, the unexpected burden at work, self-coping and reflection, hospital support, government support, and social support. CONCLUSION The recommendations for the policy-makers, put forward by the current study are; designing and engineering effective personal protective equipment (lightweight protective suit with long-lasting durable diapers and face masks with a portal for drinking juice or water), rostering minimal working hours, live-in care facilities, exclusion of pregnant and sick health care providers during an epidemic assignment and frequent outbreak training sessions for all department staff.
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Affiliation(s)
- Ponnambily Chandy
- Department of Community Health Nursing, Chettinad College of Nursing, Chettinad Academy of Research and Education, Kanchipuram, India
| | - Esther Kanthi
- Department of Paediatric Nursing, College of Nursing, Christian Medical College, Vellore, India
| | - Preetha Pradeep
- Acute Care Ward, Royal Hospital for Women, New South Wales 2031, Australia
| | | | - S Jebakamal
- Department of Nursing Service, ESI Hospital, Vellore, India
| | - Meetpin Narchaithi
- Department of Medical and Surgical Nursing, Scudder College of Nursing, Ranipet, Tamil Nadu, India
| | - S Anbarasi
- Department of Paediatric Nursing, College of Nursing, Christian Medical College Vellore Chittoor Campus, Chittoor, Andhra Pradesh, India
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Atreya S, Jeba J, Pease N, Thyle A, Murray S, Barnard A, Munday D, Mathews L, Leng M, Palat G, Ganesh A, Chakraborty S, Anbarasi S, Kumar R, Muckaden M, Grant E. Primary palliative care competency framework for primary care and family physicians in India-Collaborative work by Indian Association of Palliative Care and Academy of Family Physicians of India. J Family Med Prim Care 2019; 8:2563-2567. [PMID: 31548932 PMCID: PMC6753829 DOI: 10.4103/jfmpc.jfmpc_451_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 06/19/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022] Open
Abstract
The discrepancy in the demand for palliative care and distribution of specialist palliative care services will force patients to be eventually cared for by primary care/family physicians in the community. This will necessitate primary care/family physicians to equip themselves with knowledge and skills of primary palliative care. Indian National Health Policy (2017) recommended the creation of continuing education programs as a method to empower primary care/family physicians. With this intention, a taskforce was convened for incorporating primary palliative care into family/primary care practice. The taskforce comprising of National and International faculties from Palliative Care and Family Medicine published a position paper in 2018 and subsequently brainstormed on the competency framework required for empowering primary care/family physicians. The competencies were covered under the following domains: knowledge, skills and attitude, ethical and legal aspects, communication and team work. The competency framework will be presented to the National Board of Examinations recommending to be incorporated in the DNB curriculum for Family Medicine.
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Affiliation(s)
- Shrikant Atreya
- Department of Palliative Care and Psycho-oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Jenifer Jeba
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nikki Pease
- Department of Palliative Medicine, Velindre NHS Trust, Cardiff, Wales, UK
| | - Ann Thyle
- Emmanuel Hospital Association, New Delhi, India
| | - Scott Murray
- Emeritus Professor of Primary Palliative Care, Primary Palliative Care Research Group, The University of Edinburgh, Edinburgh, Scotland
| | - Alan Barnard
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Dan Munday
- National Academy of Medical Sciences, Kathmandu, Nepal
| | - Lulu Mathews
- Institute of Palliative Medicine, Kozhikode, Kerala, India
| | - Mhoira Leng
- Makerere University, Kampala, Uganda, Africa
| | - Gayatri Palat
- MNJ Institute of Oncology and Regional Cancer Center, Hyderabad, Telangana, India
| | - Alka Ganesh
- Department of Medicine, G Kuppuswamy Memorial Hospital, Coimbatore, Tamil Nadu, India
| | - Sulagna Chakraborty
- Department of Palliative Medicine, AMRI Dhakuria, Kolkata, West Bengal, India
| | - Sahaya Anbarasi
- Department of Distance Education, Christian Medical College, Vellore, Tamil Nadu, India
| | - Raman Kumar
- Academy of Family Physicians of India, New Delhi, India
| | - Maryann Muckaden
- Department of Palliative Medicine, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Elizabeth Grant
- Global Health Academy and the Primary Palliative Care Group, The University of Edinburgh, Edinburgh, Scotland
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Velavan J, Anbarasi S, Sitther A, Arun S. Cost-effective primary health care training using a blended learning model. Med Educ 2019; 53:511. [PMID: 30856276 DOI: 10.1111/medu.13846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Jeba J, Atreya S, Chakraborty S, Pease N, Thyle A, Ganesh A, Palat G, Matthew L, Anbarasi S, Kumar R, Muckaden MA, Barnard A, Leng M, Munday D, Murray SA. Joint position statement Indian Association of Palliative Care and Academy of Family Physicians of India - The way forward for developing community-based palliative care program throughout India: Policy, education, and service delivery considerations. J Family Med Prim Care 2018; 7:291-302. [PMID: 30090767 PMCID: PMC6060921 DOI: 10.4103/jfmpc.jfmpc_99_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit. The Indian National Health Policy (NHP) 2017 and other international bodies endorse palliative care as an essential health-care service component. NHP 2017 also recommends development of distance and continuing education options for general practitioners to upgrade their skills to provide timely interventions and avoid unnecessary referrals. Methods: A taskforce was formed with Indian and International expertise in palliative care and family medicine to develop this paper including an open conference at the IAPC conference 2017, agreement of a formal liaison between IAPC and AFPI and wide consultation leading to the development of this position paper aimed at supporting integration, networking, and joint working between palliative care specialists and generalists. The WHO model of taking a public health approach to palliative care was used as a framework for potential developments; policy support, education and training, service development, and availability of appropriate medicines. Recommendations: This taskforce recommends the following (1) Palliative care should be integrated into all levels of care including primary care with clear referral pathways, networking between palliative care specialist centers and family medicine physicians and generalists in community settings, to support education and clinical services. (2) Implement the recommendations of NHP 2017 to develop services and training programs for upskilling of primary care doctors in public and private sector. (3) Include palliative care as a mandatory component in the undergraduate (MBBS) and postgraduate curriculum of family physicians. (4) Improve access to necessary medications in urban and rural areas. (5) Provide relevant in-service training and support for palliative care to all levels of service providers including primary care and community staff. (6) Generate public awareness about palliative care and empower the community to identify those with chronic disease and provide support for those choosing to die at home.
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Affiliation(s)
- Jenifer Jeba
- Department of Medical Oncology, Christian Medical College Hospital, Vellore, India
| | - Shrikant Atreya
- Department of Palliative Care and Psycho-oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Sulagna Chakraborty
- Department of Palliative Medicine, AMRI Dhakuria, Kolkata, West Bengal, India
| | - Nikki Pease
- Palliative Medicine, Velindre NHS Trust, Cardiff, Wales, UK
| | - Ann Thyle
- Emmanuel Hospital Association, New Delhi, India
| | - Alka Ganesh
- Deptartment of Medicine, G Kuppuswamy Memorial Hospital, Coimbatore, Tamil Nadu, India
| | - Gayatri Palat
- MNJ Institute of Oncology and Regional Cancer Center, Hyderabad, Telangana, India
| | - Lulu Matthew
- Institute of Palliative Medicine, Kozhikode, Kerala, India
| | - Sahaya Anbarasi
- Department of Distance Education, Christian Medical College Hospital, Vellore, India
| | - Raman Kumar
- Academy of Family Physicians of India, Mumbai, Maharashtra, India
| | - Mary Ann Muckaden
- Department of Palliative Medicine, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Alan Barnard
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Dan Munday
- National Academy of Medical Sciences, Kathmandu, Nepal
| | - Scott A Murray
- St Columba's Hospice Chair of Primary Palliative Care, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland
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Velavan J, Anbarasi S, Bhandary S, Vyas R. Demographic profiling of students: an advocacy tool for family medicine. Med Educ 2015; 49:539-540. [PMID: 25924160 DOI: 10.1111/medu.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Raji JB, Velavan J, Anbarasi S, Grant L. Can credit systems help in family medicine training in developing countries? An innovative concept. J Family Med Prim Care 2014; 3:183-7. [PMID: 25374849 PMCID: PMC4209667 DOI: 10.4103/2249-4863.141596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
There is irrefutable evidence that health systems perform best when supported by a Family Physician network. Training a critical mass of highly skilled Family Physicians can help developing countries to reach their Millennium Development Goals and deliver comprehensive patient-centered health care to their population. The challenge in developing countries is the need to rapidly train these Family Physicians in large numbers, while also ensuring the quality of the learning, and assuring the quality of training. The experience of Christian Medical College (CMC), Vellore, India and other global examples confirm the fact that training large numbers is possible through well-designed blended learning programs. The question then arises as to how these programs can be standardized. Globally, the concept of the “credit system” has become the watch-word for many training programs seeking standardization. This article explores the possibility of introducing incremental academic certifications using credit systems as a method to standardize these blended learning programs, gives a glimpse at the innovation that CMC, Vellore is piloting in this regard partnering with the University of Edinburgh and analyses the possible benefits and pitfalls of such an approach.
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Affiliation(s)
- J Beulah Raji
- Department of Distance Education, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jachin Velavan
- Department of Distance Education, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sahaya Anbarasi
- Department of Distance Education, Christian Medical College, Vellore, Tamil Nadu, India
| | - Liz Grant
- Department of General Practice, Global Health Academy, University of Edinburgh, Edinburgh, Scotland, UK
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Gnananayagam EJ, Solomon R, Chandran A, Anbarasi S, Sen S, Moses PD. Long segment Hirschsprung's disease in the Waardenburg-Shah syndrome. Pediatr Surg Int 2003; 19:501-3. [PMID: 12811477 DOI: 10.1007/s00383-002-0944-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2002] [Indexed: 11/25/2022]
Abstract
Presentation with signs of bowel obstruction in an infant with Waardenburg syndrome should raise the suspicion of aganglionosis. We report such a case of long segment Hirschsprung's disease associated with Waardenburg syndrome. Long term care of such children is fraught with high morbidity and mortality.
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Affiliation(s)
- E J Gnananayagam
- Department of Child Health, Christian Medical College Hospital, 632004 Vellore, Tamil Nadu, India
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