ABSTRACT
Background In March 2020, care within hospices had to be dramatically altered to comply with COVID-19 government guidance. Some services at Dorothy House Hospice were rapidly suspended, others adapted due to safety restrictions. Frequently, the human touch, typically enshrined in hospice care, was replaced with virtual/remote connections including video (Zoom) and telephone calls. Aim To identify and understand the impact of communication changes on patients', clients' and families' experiences of Dorothy House Hospice in the context of COVID-19 and explore their future communication preferences. Method In July 2020 a postal survey was sent to all who had used Dorothy House Hospice services since March 2020. Using closed questions plus free text comments, the survey asked about people's experiences of services since March 2020 including levels of satisfaction with communication, difficulties encountered and preferences for future communication types. Data were analysed using frequency counts, with exemplar quotations extracted. Results Responses were received from 218 participants comprising: patients (62%), family/carers/friends (28%) and bereaved people (10%). 189 (87%) of respondents reported receiving the right amount of information despite service changes, and 185 (85%) were happy with the format of contact received. 172 (62%) respondents did not want to receive video calls in future, however, 71% (n=10) of respondents aged 18-44 were happy with this method, compared with 12% (n=18) aged 65+. Respondents reported minor technical difficulties with Zoom and regret at restrictions on face-toface interactions. Concerns surrounding privacy during remote consultations at home, and hearing difficulties, were occasionally raised. Conclusion The majority of responses were overwhelmingly positive;patients, clients and families were reassured and appreciative that they were still able to access Dorothy House Hospice services, albeit sometimes in alternative formats. Steps to improve online access and technical support/education are needed to support older service users to access services with confidence.
ABSTRACT
Background/aims: The COVID-19 pandemic has brought conversations about death and dying to the fore. Prior studies indicate that holding conversations about the future and end of life planning is beneficial but can be very difficult. Therefore, it is important to identify how the pandemic may have affected the conversations people have had, or would want to have, and the potential role of public engagement in that context. The study had two aims: 1) to understand the publics' experiences of participating in conversations about death and dying, and the impact of COVID-19 on those conversations, and 2) to examine the role of public engagement and citizen science in end of life care, death and dying. Methods: A scoping review of the health and social sciences literature was conducted to identify relevant citizen science and public engagement projects. Individual semi-structured interviews (n=12) were conducted with public volunteers between June and August 2021 and analysed using thematic coding. Results: The qualitative interview data generated nine main themes which included the triggers, barriers, and benefits to conversations about death and dying;and the influence of personal factors, such as age. Moreover, the impact of COVID-19 in prompting thinking and conversations about death and dying was clear. The predominance of social dialogue around COVID-19 was reported as beneficial in encouraging useful conversations, however sadness was apparent at those conversations that had not been possible in the pandemic. The scoping review identified 33 articles and numerous public engagement projects, but found no evidence of a citizen science project entirely focused on death or dying. Conclusions: The role of the COVID-19 pandemic in thinking about death and dying was clearly evidenced. Numerous examples of public engagement activities were also identified. However, both the interview and scoping study data highlight the sensitivity of the subjects, and opportunities and constraints in discussing death and dying openly.
ABSTRACT
This article focuses on global poliovirus containment certification, advisory group decisions, and evolving use of live poliovirus vaccines. In 2018, a resolution of the 71st World Health Assembly urged Member States to accelerate containment of poliovirus. Since then, progress has been made globally, despite challenges and delays. The COVID-19 pandemic has disrupted some poliovirus containment activities, as it has for all global programmes, including planned GAPIII certification audits, a vital component. WHO Member States that have proposed PV2 PEFs are urged to reassess whether retention of materials is necessary. Once WPV3 was declared eradicated in 2019, WPV3 and cVDPV3 materials became subject to the same containment requirements as PV2. As there are no immediate plans to remove the type 3 vaccine strain from use, OPV3 is not currently subject to containment requirements. cVDPV2 outbreaks continue to complicate global polio outbreak responses and poliovirus containment. Inventories of cVDPV2 materials and destruction or transfer to a PEF should be documented once a cVDPV2 outbreak is closed. In addition, all OPV2 materials, including retained stool specimens and vials of mOPV2, tOPV and nOPV2, should be tracked from the point of release to use or destruction. Even with current disruptions in other aspects of poliovirus containment, all WHO Member States with PEFs should adhere to World Health Assembly resolutions, including officially establishing legally empowered NACs and submission of PEF certificates of participation.