ABSTRACT
Research Framework: The pandemic has disrupted the daily lives of families for over a year. In addition to the fears and uncertainties associated with COVID-19, the pandemic has required the redefinition of many daily routines, including leisure activities, access to services, work, schooling and interpersonal relationships. Children, who are unlikely to have COVID-19, have nonetheless experienced the impact of social and health measures put in place to address it. Objectives: Using a child-based approach, this article seeks to understand how the COVID-19 pandemic and the resulting social and health measures have affected the lives of families, particularly the grandparents/grandchildren relationship. Methodology: This study uses a longitudinal qualitative design with three measurement times according to the various key moments of the pandemic. A total of 154 children and adolescents were interviewed three times in semi-structured interviews via Zoom. Results: The results highlights the ways in which grandchildren and grandparents adapted to maintain their relationship during the pandemic. From this study, we find that grandchildren are concerned about their grandparents' health, but still want face-to-face contact with them, despite the risks. Conclusions: The relationship between grandchildren and their grandparents is an emotional and lasting one that endures and adapts in times of crisis. Contribution: This article gives an account of the importance of grandparents in the lives of their grandchildren, particularly in times of crisis. It also provides a better understand of how families have adapted during the pandemic. © 2022 Centre - Urbanisation Culture Societe de l'INRS. All rights reserved.
ABSTRACT
BACKGROUND: Individuals experiencing chronic illnesses face many physical, emotional, and social strains as a result of their illnesses, all the while trying to navigate unfamiliar territory in the healthcare system. Navigation is a strategy that can help people facing complex care needs and barriers to care in finding and accessing needed supports in the health care system. Navigators provide a patient-centred service, guiding individuals through their care plans and overcoming barriers to care. Navigation supports for individuals experiencing complex care needs have shown significant promise and have been gaining traction across Canada. METHODS: The Canadian Healthcare Navigation Conference was the first event of its kind in Canada to bring together navigation researchers, service providers, students, decision makers, and individuals with lived experience to share lessons learned, promising practices, and research findings. This event was co-hosted by the Family Navigation Project at Sunnybrook Health Sciences Centre and NaviCare/SoinsNavi at the University of New Brunswick, and took place virtually on April 15-16, 2021. RESULTS: This event spanned two days, which both began with a keynote address, one from a researcher and medical professional in navigation, and another from an individual with lived experience involved in advocacy in Canadian healthcare. Concurrent oral presentations by a variety of presenters were held following each keynote presentation. A poster session was held at the end of the first day, and a panel presentation rounded out the second day. Concurrent and poster presentations covered a range of topics pertaining to approaches to navigation, navigator roles, evaluation and quality improvement, lived experience in navigation, and navigation in the context of the COVID-19 pandemic. The panel presentation focused on identifying how the navigation field has progressed in Canada and identifying crucial next steps in navigation. These next steps were determined to be: 1) agreement on navigation-related definitions, 2) regulation and training, 3) equity, diversity, inclusion, and accessibility, 4) integrating lived experience, and 5) regional coordination. CONCLUSION: This conference was an important first step to creating a shared national conversation about navigation services so that we can continue to develop, implement, and share best evidence and practices in the field.
ABSTRACT
Background: Studies suggest that patients with cancer are more likely to experience severe outcomes fromCOVID-19. Therefore, cancer centers have undertaken efforts to care for patients with cancer in COVID-free zones.Nevertheless, nosocomial transmission of COVID-19 in patients with cancer likely occurs, but the frequency andrelevance of these events remain unknown. The goal of this study was to determine the incidence and impact ofhospital-acquired COVID-19 in this population and identify prognostic factors for COVID-19 severity in patients withcancer. Methods: Patients with cancer and a laboratory-confirmed or presumed diagnosis of COVID-19 were prospectivelyidentified using provincial registries and hospital databases between March 3rd and May 23rd, 2020, in theprovinces of Quebec and British Columbia. Patients' baseline characteristics including age, sex, comorbidities, cancer type, and type of anticancer treatment were collected. The primary outcome was incidence of hospital-acquired infection defined by diagnosis of SARS-CoV-2 5 days after hospital admission for COVID-unrelated cause. Co-primary outcomes were death or composite outcomes of severe illness from COVID-19 such as hospitalization, supplemental oxygen, intensive-care unit (ICU) admission, and/or mechanical ventilation. Results: A total of 253 patients (N=250 adult and N=3 pediatric) with COVID-19 and cancer were identified, and themajority were residents of Quebec (N=236). Ninety patients (35.6%) received active anticancer treatment in the last3 months prior to COVID-19 diagnosis. During a median follow-up of 23 days, 209 (82.6%) required hospitalization,38 (15%) required admission to ICU, and 71 (28%) died. Forty-seven (19%) had a diagnosis of hospital-acquiredCOVID-19. Median overall survival was shorter in those with hospital-acquired infection, compared to acontemporary community-acquired population (27 days vs. 71 days, HR 2.2, 95% CI 1.2-4.0, p=0.002). Multivariateanalysis demonstrated that hospital-acquired COVID-19, age, ECOG status, and advanced stage of cancer wereindependently associated with death. Conclusion: Our study demonstrates a high rate of nosocomial transmission of COVID-19, associated withincreased mortality in both univariate and multivariate analysis in the cancer population, reinforcing the importanceof treating patients with cancer in COVID-free zones. We also validated that age, poor ECOG, and advanced cancer were negative prognostic factors for COVID-19 in patients with cancer.