Protection Motivation Theory and Intentions to Receive the COVID-19 Vaccine.

Background. Declared a "public health threat of international concern" by the World Health Organization, the COVID-19 virus has caused the deaths of over half a million individuals in the United States in just the first 23 months after detection. The vaccine has recently been introduced to reduce this public health threat. However, due, in part, to the rapidity with which the vaccine was developed, many individuals display vaccine hesitancy. Purpose. The current study examined the utility of the Protection Motivation Theory of Health (PMT) in predicting intentions to receive the COVID-19 vaccine. Method. One hundred twenty-nine unvaccinated respondents (drawn from an initial sample of 255 participants) completed a survey assessing the components of the PMT and intentions to receive the vaccine. Respondents could also provide an open-ended response regarding any concerns they had with the vaccine. Conclusions. The PMT accounted for 76% of the variance in vaccine intentions. Vulnerability, outcome efficaciousness, and maladaptive response rewards each accounted for unique variance. Open-ended responses reflecting concerns with the vaccine fell into 8 categories, with the most common being concern with the long-term side effects of the vaccine. These results suggest that public health campaigns promoting the vaccine should focus on vulnerability to COVID-19, protective functions of the vaccine, and overcoming what people perceive as benefits of not receiving the vaccine.

Climate toxicity: An increasingly relevant clinical issue in Cancer Care.

In recent years the terms time and financial toxicities have entered the vocabulary of cancer care. We would like to introduce another toxicity: climate toxicity. Climate toxicity is a double-edge sword in cancer care. Increasing cancer risk by exposure to carcinogens, and consequently increasing treatment requirements leads to ever growing damage to our environment. This article assesses the impact of climate change on patients, the climate toxicity caused by both healthcare workers and healthcare facilities, and suggests actions that may be taken mitigate them.

Impact of the COVID-19 pandemic on cancer care in Ireland - Perspectives from a COVID-19 and Cancer Working Group.

Upon the COVID-19 pandemic onset in Ireland, cancer service disruptions occurred due to prioritisation of COVID-19 related care, redeployment of staff, initial pausing of screening, diagnostic, medical and surgical oncology procedures, staff shortages due to COVID-19 infection and impacts on the physical and mental health of cancer healthcare workers. This was coupled with reluctance among people with symptoms suspicious for cancer to attend for clinical evaluation, due to concerns of contracting the virus. This was further compounded by a cyber-attack on national health service IT systems on May 14th 2021. The Irish Cancer Society, a national cancer charity with a role in advocacy, research and patient supports, convened a multi-disciplinary stakeholder group (COVID-19 and Cancer Working Group) to reflect on and understand the impact of the pandemic on cancer patients and services in Ireland, and discuss potential mitigation strategies. Perspectives on experiences were gathered across domains including timeliness of data acquisition and its conversion into intelligence, and the resourcing of cancer care to address cancer service impacts. The group highlighted aspects for future research to understand the long-term pandemic impact on cancer outcomes, while also highlighting potential strategies to support cancer services, build resilience and address delayed diagnosis. Additional measures include the need for cancer workforce recruitment and retention, increased mental health supports for both patients and oncology professionals, improvements to public health messaging, a near real-time multimodal national cancer database, and robust digital and physical infrastructure to mitigate impacts of the current pandemic and future challenges to cancer care systems.

The impact of the COVID-19 pandemic on non-national doctors in Ireland.

BACKGROUND: International doctors make up nearly half of the physicians working in Ireland and are an integral part of the health service. The COVID-19 pandemic declared in March 2020 led to a global healthcare emergency. Resulting national lockdowns precluded travel at a time of need for family support. AIM: We aimed to measure the professional, psychosocial, and financial impact of the COVID-19 pandemic on non-EEA doctors working in Ireland. METHODS: An 88-item online survey of demographics, well-being, and financial resilience was circulated nationally between November 2021 and January 2022. The results were analysed using RStudio and Microsoft Excel 365. RESULTS: One hundred thirty-eight responses were received. Sixty-two percent of responders reported wishing to stay in Ireland long-term and 44% had applied for citizenship. Despite 80% of responders working in their desired speciality, only 36% were on a specialist training scheme. Forty-seven percent felt their career was affected by the COVID-19 pandemic. Seventy-three percent of respondents reported missing significant events in their home country. Over 50% reported significant mental health issues personally or in their families; however, only a minority sought professional help. Financial issues were a source of anxiety for 15% of respondents. Financial resilience was poor, 20% of respondents cited a 1-month financial reserve, 10% had a personal pension, and 9% had made a will. CONCLUSIONS: The COVID-19 pandemic has had a multifactorial negative impact on non-national doctors working in Ireland. More must be done to offer multidimensional support to this cohort who are a crucial part of the underserviced Irish healthcare system.

Protection motivation unmasked: Applying protection motivation theory to skepticism toward COVID-19 mask and vaccine mandates.

Variants of COVID-19 have sparked controversy regarding mask and/or vaccine mandates in some sectors of the country. Many people hold polarized opinions about such mandates, and it is uncertain what predicts attitudes towards these protective behavior mandates. Through a snow-ball sampling procedure of respondents on social media platforms, this study examined skepticism of 774 respondents toward these mandates as a function of the Protection Motivation Theory (PMT) of health. Hierarchical linear regressions examined Protection Motivation (PM) as a predictor of mask and vaccine mandate skepticism independently and with political party affiliation as a control. PM alone accounted for 76% of the variance in mask mandate skepticism, p < 0.001 and 65% in vaccine mandate skepticism, p < 0.001. When political affiliation was entered (accounting for 28% of the variance in mask mandate skepticism, p < 0.001, and 26% in vaccine mandate skepticism, p < 0.001), PM still accounted for significant percentages of variance in both mask (50%) and vaccine (43%) mandate skepticism, ps < 0.001. Across regressions, perceived severity, outcome efficaciousness, and self-efficacy each directly accounted for unique variance in mask and vaccine mandate skepticism, ps < 0.001; only perceived vulnerability failed to account for unique variance in the regressions, ps > 0.05. Specifically, the more severe participants perceived COVID-19 to be and the greater the perceived efficacy of masks and vaccines preventing the spread of COVID-19, the lower participants' skepticism toward mask and vaccine mandates. Similarly, the higher participants' self-efficacy in wearing masks or receiving the vaccine, the lower their skepticism toward mask and vaccine mandates.

Rapid and Laboratory SARS-CoV-2 Antibody Testing in High-Risk Hospital Associated Cohorts of Unknown COVID-19 Exposure, a Validation and Epidemiological Study After the First Wave of the Pandemic.

Objective: We aimed to use SARS-CoV-2 antibody tests to assess the asymptomatic seroprevalence of individuals in high-risk hospital cohorts who's previous COVID-19 exposure is unknown; staff, and patients requiring haemodialysis or chemotherapy after the first wave. Methods: In a single Center, study participants had five SARS-CoV-2 antibody tests done simultaneously; one rapid diagnostic test (RDT) (Superbio Colloidal Gold IgM/IgG), and four laboratory tests (Roche Elecsys® Anti-SARS-CoV-2 IgG [RE], Abbott Architect i2000SR IgG [AAr], Abbott Alinity IgG [AAl], and Abbott Architect IgM CMIA). To determine seroprevalence, only positive test results on laboratory assay were considered true positives. Results: There were 157 participants, of whom 103 (65.6%) were female with a median age of 50 years (range 19-90). The IgG component of the RDT showed a high number of false positives (n = 18), was inferior to the laboratory assays (p < 0.001 RDT vs. AAl/AAr, p < 0.001 RDT vs. RE), and had reduced specificity (85.5% vs. AAl/AAr, 87.2% vs. RE). Sero-concordance was 97.5% between IgG laboratory assays (RE vs. AAl/AAr). Specificity of the IgM component of the RDT compared to Abbott IgM CMIA was 95.4%. Ten participants had positivity in at least one laboratory assay, seven (9.9%) of which were seen in HCWs. Two (4.1%) hematology/oncology (H/O) patients and a single (2.7%) haemodialysis (HD) were asymptomatically seropositive. Asymptomatic seroprevalence of HCWs compared to patients was not significant (p = 0.105). Conclusion: HCWs (9.9%) had higher, although non-significant asymptomatic seroprevalence of SARS-CoV-2 antibodies compared to high-risk patients (H/O 4.1%, HD 2.7%). An IgM/IgG rapid diagnostic test was inferior to laboratory assays. Sero-concordance of 97.5% was found between IgG laboratory assays, RE vs. AAl/AAr.

Finding the silver lining in the COVID-19 crisis.

Research has confirmed there is a silver lining to many aversive experiences and that negative occurrences can be an opportunity for post-traumatic growth (PTG). To investigate benefit-finding in the COVID-19 crisis, 179 MTurk workers were surveyed. Participants reported dips in satisfaction with work, leisure, fitness, mental health, and finances in the midst of the pandemic, relative to 6 months prior and in the future. Benefit-finding in COVID-19 was significantly related to PTG, coping, gratitude, and mental health. The most common benefits of the crisis included more time with family and friends, slower pace of life, and improvements in physical health.

Virtual oncology clinics during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has resulted in radical changes in the delivery of healthcare worldwide. Our oncology service (at an Irish national cancer centre) rapidly transitioned to the use of telemedicine or virtual clinics (VC) to minimise potential risk of exposure to COVID-19 amongst an immunosuppressed, high-risk population. Our study aimed to evaluate the use of VC in this setting. METHODS: An 18-point questionnaire was designed to investigate the patient experience of VC during the COVID-19 pandemic in Ireland and compliance with guidelines developed in Ireland to conduct VC and the role of VC in the future. Questionnaires were distributed following the receipt of verbal consent from patients during the VC. Descriptive statistics were utilised for data analysis using SPSS®. RESULTS: One hundred and four patients returned completed surveys (n = 104/164, 63% response rate). Overall satisfaction levels were high with most patients (n = 58/100, 58%; no answer provided (NAP), n = 4) equally satisfied or nearly equally satisfied with VC in comparison to a usual clinic encounter. The majority of patients felt that there should be a role for VC in the future (n = 84/102, 82%; NAP, n = 2). The majority of patients (n = 61/99, 61%; NAP, n = 5) were very relieved to avoid a hospital visit due to perceived risk of potential exposure to COVID-19. CONCLUSION: The majority of oncology patients were satisfied with a VC encounter. VC may have a role in the future of medical care in Ireland post the COVID-19 pandemic.