ABSTRACT
PURPOSE: This study aims to explore the associations among psychological distress, perceived social support, and family satisfaction among family members of non-COVID-19 intensive care unit (ICU) patients during the COVID-19 pandemic. DESIGN: A cross-sectional study. METHODS: Family members of patients with at least 48 h in the ICU and without a COVID-19 diagnosis were screened between January and March 2021. For enrolled ICU family members, five questionnaires for perceived stress (Perceived Stress Scale), anxiety symptoms (General Anxiety Disorder-7), depressive symptoms (Patient Health Questionnaire-9), perceived social support (Medical Outcomes Study Social Support Survey), and family satisfaction (Family Satisfaction with Care in the Intensive Care Unit-24) were administered by phone either in English or Spanish language. Sociodemographic and patient clinical data were also collected. Data were analyzed using descriptive statistics, Pearson's correlations, Mann-Whitney U, and Fisher's exact tests. FINDINGS: Of 87 eligible ICU family members, 63 were enrolled (72.4%); 27% of the sample presented with clinically significant symptoms of anxiety, 25.4% with depression, and 76.2% had a high perception of social support. ICU family members with low/fair perceived social support reported statistically significantly higher perceived stress and lower family satisfaction. Perceived stress was negatively correlated with family satisfaction. Clinically significant symptoms of anxiety and depression were not statistically associated with family satisfaction or perceived social support. CONCLUSIONS: While ICU admission-related stress may undermine family satisfaction, perceived social support may be positively associated with the way that ICU family members of non-COVID-19 patients evaluate the quality of care in the ICU. Knowing the factors that influence family satisfaction in the ICU may assist stakeholders and policy developers to improve family-centered care in the hospital setting. CLINICAL RELEVANCE: Early screening for psychological distress and social support levels during admission should be included in updates of visiting and communication policies in the ICU. Prompt identification of family members at risk of a poor ICU experience may enhance efforts to support them, particularly in acute care settings where differentiated approaches to COVID-19 and non-COVID-19 ICU family members are established.
ABSTRACT
The aim of this study was to investigate the COVID-19 vaccination acceptance rate and its determinants among healthcare workers in a multicenter study. This was a cross-sectional multi-center survey conducted from February 5 to April 29, 2021. The questionnaire consisted of 26 items in 6 subscales. The English version of the questionnaire was translated into seven languages and distributed through Google Forms using snowball sampling; a colleague in each country was responsible for the forward and backward translation, and also the distribution of the questionnaire. A forward stepwise logistic regression was utilized to explore the variables and questionnaire factors tied to the intention to COVID-19 vaccination. 4630 participants from 91 countries completed the questionnaire. According to the United Nations Development Program 2020, 43.6 % of participants were from low Human Development Index (HDI) regions, 48.3 % high and very high, and 8.1 % from medium. The overall vaccination hesitancy rate was 37 %. Three out of six factors of the questionnaire were significantly related to intention to the vaccination. While 'Perceived benefits of the COVID-19 vaccination' (OR: 3.82, p-value<0.001) and 'Prosocial norms' (OR: 5.18, p-value<0.001) were associated with vaccination acceptance, 'The vaccine safety/cost concerns' with OR: 3.52, p-value<0.001 was tied to vaccination hesitancy. Medical doctors and pharmacists were more willing to take the vaccine in comparison to others. Importantly, HDI with OR: 12.28, 95 % CI: 6.10-24.72 was a strong positive determinant of COVID-19 vaccination acceptance. This study highlighted the vaccination hesitancy rate of 37 % in our sample among HCWs. Increasing awareness regarding vaccination benefits, confronting the misinformation, and strengthening the prosocial norms would be the primary domains for maximizing the vaccination coverage. The study also showed that the HDI is strongly associated with the vaccination acceptance/hesitancy, in a way that those living in low HDI contexts are more hesitant to receive the vaccine.