ABSTRACT
Objective: To analyze comparatively the topics of quality of life (QL), and well-being (WB) in a population of German and Portuguese adults during the pandemics, in order to obtain a deeper understanding of the psychological vulnerability to crisis across countries and cultures. Method(s): The defined dimensions of "trait anxiety", "feeling of threat", "difficulty to relax", "empathy & pro-social attitude", "health care", "sleep quality" and "optimism" were measured as predictors of QL and WB. A sample of 470 adults divided in three age groups - young adults (18-34 years), middle-aged adults (34-54 years) and old adults (55 years and older) - completed a self-report questionnaire assessing socio-demographic data, as well as quality of life and well-being during the pandemics period, through the above mentioned dimensions. Result(s): Portuguese participants expressed higher empathy & pro-social attitude and health care, but in Germany participants reported higher quality of sleep. Young adults in both countries gave similar responses: a) they rated their quality of life lower than middle-age adults (mean difference=-4.83, SE=1.63, p < 0.01) and old adults (mean difference=-8.61, SE=2.04, p < 0.01), b) they showed also lower optimism than middle-age (mean difference=-1.02, SE = 0.35, p < 0.02) and old adults (mean difference=-1.51, SE = 0.34, p < 0.01), and c) they showed lower well-being than middle-age (mean difference=- 2.37, SE = 0.81, p < 0.02). Conclusion(s): Young adults rated their quality of life, optimism, and well-being during pandemics lower than middle-age and old adults, and experienced higher levels of trait anxiety and difficulty to relax. It seems that young adults show a lower psychological adjustment than other age groups during COVID-19 crisis. It is concluded that quality of life, optimism, and well-being during the pandemics are affected differently according to country and group of age, suggesting individual differences in psychological vulnerability across cultures and ages, and consequently the need of specific interventions to cope with the pandemic's crisis.
ABSTRACT
Purpose/Objectives: The COVID-19 pandemic magnified the longstanding health disparities and unique health needs of adolescents from racially and ethnically diverse backgrounds. With the rapid expansion of telehealth nationally, it is essential that health systems consider how telehealth could influence health equity and be leveraged to meet the needs of diverse populations. We launched a quality improvement (QI) initiative at a large safety-net hospital to assess adolescent and parent perspectives on the use of telehealth, specifically exploring barriers and facilitators to implementation, and then develop recommendations for adapting telehealth practices to optimize care and promote equity for diverse populations of adolescents. Design/Methods: From January-May 2021, we conducted surveys with adolescents ages 12-21 who had a telehealth visit at a county safety-net hospital during the COVID-19 pandemic (n=70) and their parents (n=41). We purposively sampled for adolescents from populations known to be underutilizing telehealth within our system;in our final sample, 39% were Latinx and 33% were Black, with 30% of Black adolescents identifying as Somali. The electronic surveys, which were delivered in English, Spanish or Somali, included questions about respondents': experiences and satisfaction with telehealth;barriers and facilitators to telehealth;experiences of racism and discrimination in healthcare;indicators of high-quality adolescent care and demographics. We analyzed data using descriptive statistics for quantitative variables, and content analysis for qualitative (open-ended) responses. We then hosted four listening sessions with adolescents (n=9) and parents (n=4) to collectively review findings and develop recommendations to optimize care for diverse adolescents and their families. Results: Participants were generally satisfied with telehealth and rated visits highly on quality of care (Figure 1). Commonly reported barriers to telehealth included: difficulty connecting to the visit, a lack of private space, feeling the provider may not be able to evaluate them fully during the visit, and not being able to get labs or imaging. Seven percent of adolescents and 15% of parents reported experiencing discrimination in healthcare, with over one-third (36%) of these experiences occurring during telehealth visits. Nearly half of adolescents (44%) expressed concern that something private from the visit might be shared with their parents, and 10% of adolescents did not have a private space to talk to their providers. Drawing on findings from surveys and listening sessions, we developed recommendations for clinicians and health systems (Table 1) and disseminated them across our hospital system. Conclusion/Discussion: Our QI initiative engaged a diverse population of adolescents and parents in developing recommendations for clinician- and systems-level changes for improving equity in the delivery and, ultimately, access to telehealth care. Our findings have implications, not only for our large safety-net county medical center, but also for other clinics serving racially and ethnically diverse young people. (Table Presented).
ABSTRACT
The World Health Organization has declared that the COVID-19 pandemic is a health emergency and recommended social distancing as a measure to contain the spread of the disease. This directive invokes the fundamental human right to housing while, contradictorily, exposing the restrictions to exercising this right in self-built territories. In order to better understand this relationship, this article recalls the pathways of the Special Zone of Social Interest (Zona Especial de Interesse Social: ZEIS) in Salvador, a municipality which, alongside the municipalities of Recife and Belo Horizonte, was a precursor for the instrument's design. It also examines ZEIS implementation within the context of the political and health crisis, and the dismantling of urban policy in Brazil, corresponding to the expansion of property borders into these areas. Given the urgency triggered by the pandemic, it aims to analyse the values and meanings attributed to the ZEIS, the instrument's legal affirmation and support processes, and the attributes that could interfere with its scope of implementation. This is a qualitative study, backed by documentary research and bibliographic review and supported by geo-processing techniques. The results provide evidence of the validity and importance of the instrument in disputes for the symbolic and material strengthening of territories, at a point that acknowledges the instrument's emancipatory hermeneutics, constructed through the praxis of social agents in the territories and in the state sphere.