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AIMS AND OBJECTIVES: This study aimed (a) to identify the communication issues and problems faced by individuals with hearing impairment (HI)/deafness during the COVID-19 pandemic and (b) to describe strategies to overcome the issues/problems and/or prevent their negative impact. BACKGROUND: Individuals with mild or severe HI face everyday communication problems, which have been worsened during the COVID-19 pandemic. However, no studies have summarised the available evidence to better understand the communication challenges faced by them and strategies allowing better interactions. The long duration of the outbreak-more than 2 years, with policies that have just been lifted in some countries-and the possible return of restrictions in the next Winter suggest the need to summarise evidence in the field. DESIGN AND METHODS: A rapid review is reported here in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Medline, CINAHL and Scopus databases were searched, including (a) primary or secondary studies published from January 2020 to 12 January 2022, (b) involving individuals with HI/deafness, (c) during the COVID-19 pandemic and (d) written in English. Data were extracted and summarised by using a content analysis approach. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. RESULTS: Fourteen studies were included as follows: three non-systematic reviews, seven cross-sectional, three quasi- experimental and one qualitative study, performed mainly in the US and the UK. Face mask covering use; physical and social distancing; and information, education, rehabilitation, and healthcare accessibility have emerged as the main challenges triggering consequences such as social isolation, loneliness, poor knowledge regarding the prevention and mental health issues. Strategies mitigating these challenges are as follows: (a) adopting transparent face masks, (b) using basic skills while interacting (e.g. maintaining eye contact), (c) improving the availability of sign language interpreters, (d) allowing the presence of family members and (e) teaching basics of sign language to healthcare professionals. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: Individuals with HI/deafness live with several challenges, suggesting that their vulnerability has increased tremendously during the COVID-19 pandemic. The effectiveness of strategies to overcome these difficulties should be scrutinised by conducting more research. Moreover, there should be increased awareness among all citizens by equipping them with simple strategies to communicate effectively with individuals with HI, an approach that may increase inclusiveness and prevent further negative consequences and burden.
ABSTRACT
In the last two years, all hospitals have adopted restricted visitation policies due to the coronavirus disease 2019. The objective of this study was to assess the consequences of hospital visitation restrictions on the most common outcome measures on adult patients who underwent surgery. A retrospective study design was conducted according to the STrengthening the Reporting of OBservational studies in Epidemiology statements in 2021. Forty patients exposed to a no-visitors policy and forty unexposed patients (1:1) were enrolled. Patients who were not allowed to receive family visits were more likely to report disorientation/agitation episodes (n = 25, 62.5% vs. n = 12, 30.0%; p < 0.01), spend more sleepless nights (n = 10, 25.0% vs. n = 1, 2.5%; p < 0.01), be restrained (n = 8, 20.0% vs. n = 1, 2.5%; p = 0.02), incur device-removal incidents (n = 14, 35.0% vs. n = 5, 12.5%; p = 0.01) compared to unexposed patients. Conversely, pain episodes were significantly more frequent in the unexposed group (n = 7.1, SD = 7.9 vs. n = 2.4, SD = 2.8; p < 0.01), and there was lower clinical deterioration risk (NEWS of 0-4 average 19.5, SD = 12.2 evaluations vs. 12.3, SD = 8.6; p < 0.01) compared to exposed patients. According to the results, family visiting restrictions should be measured against their possible advantages in order to prevent negative outcomes for surgical patients and to improve the quality of care.
ABSTRACT
BACKGROUND: Nursing education has been disrupted by the onset of the COronaVIrus Disease 19 (COVID-19) pandemic, potentially impacting learning experiences and perceived competencies at the time of graduation. However, the learning experiences of students since the onset of COVID-19, their perceived competences achieved and the employment status one month after graduation, have not been traced to date. METHODS: A cross sectional online survey measured the individual profile, the learning experience in the last academic year and the perceived competences of the first COVID-19 new nursing graduates in two Italian universities. Details relating to employment status and place of employment (Covid-19 versus non-COVID-19 units) one month after graduation were also collected and the data compared with those reported by a similar cohort of new graduates pre-pandemic in 2018-2019. All those who graduated in November 2020 and attended their third year after the onset of the COVID-19 pandemic were eligible. The online survey included individual, nursing programme and first working experience variables alongside the Nurse Competence Scale (NCS). Descriptive and inferential statistical analyses were performed. RESULTS: A total of 323 new graduates participated. In their last academic year, they experienced a single, long clinical placement in non-COVID-19 units. One month after graduation, 54.5% (n = 176) were working in COVID-19 units, 22.9% (n = 74) in non-COVID-19 units and 22.6 (n = 73) were unemployed. There was no statistical difference among groups regarding individual variables and the competences perceived. Fewer new graduates working in COVID-19 units experienced a transition programme compared to those working in non-COVID-19 units (p = 0.053). At the NCS, the first COVID-19 new graduate generation perceived significantly lower competences than the pre-COVID-19 generation in the 'Helping role' factor and a significant higher in 'Ensuring quality' and 'Therapeutic interventions' factors. CONCLUSIONS: The majority of the first COVID-19 new graduate generation had been employed in COVID-19 units without clinical experience and transition programmes, imposing an ethical debate regarding (a) the role of education in graduating nurses in challenging times with limited clinical placements; and (b) that of nurse managers and directors in ensuring safe transitions for new graduates. Despite the profound clinical placement revision, the first COVID-19 new graduate generation reported competences similar to those of the pre-COVID-19 generation, suggesting that the pandemic may have helped them to optimise the clinical learning process.
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OBJECTIVE: To summarize the experience of individuals placed in quarantine during an outbreak. DESIGN: A meta-summary and a meta-synthesis based upon a systematic review of qualitative studies. SAMPLE: The Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Scopus databases were all searched up to April 2020. MEASUREMENTS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed; then, the methodological quality of the studies included was assessed with the Critical Appraisal Screening Programme tool for qualitative studies. RESULTS: Five studies have been included documenting the experience of 125 adult individuals. A total of 16 codes emerged: in the meta-summary, the most and least frequent codes were "Thinking about quarantine" (80%) and "Emotional roller coaster," "Being alert for any symptom," "Trusting or not?," "Knowing who brought the infection," and "Living in a surreal world" (20%). The codes which emerged were categorized into three main themes which summarized the whole experience of being placed in quarantine: (a) "Being swamped with a thousand emotions"; (b) "Being restrained"; and (c) "Needing to be considered." CONCLUSIONS: The experience of quarantine for people is a long journey which can feel chaotic due to uncertainty about the consequences on health, work, and the future. The findings of this study can help nurses in caring for quarantined individuals by enabling them to understand people's need for educational and emotional support. Ensuring the supply of consistent information is also important to increase people's compliance.