ABSTRACT
Objectives: Across many Asian countries, family caregivers provide a wide range of patient care activities while staying in the patient's room. This unique care arrangement has been reported as a factor contributing to the spread of outbreaks including Middle East respiratory syndrome and coronavirus disease 2019 (COVID-19) in many Asian countries. We sought to understand the context in which direct patient care activities are provided by family caregivers and/or private caregivers in hospitals across Bangladesh, Indonesia, and South Korea from the infection prevention and control (IPC) perspective. Methods: We used a multimethod design with both quantitative and qualitative approaches. In total, 432 patients were surveyed from 5 tertiary-care hospitals across 3 selected countries, and 64 participants from 2 groups were interviewed: group A comprised patients, family caregivers and private caregivers and group B comprised healthcare workers. Survey data were analyzed descriptively, and the interview data were analyzed using thematic analysis. Results: The study findings highlight the different landscapes of care provision in the selected countries. Both the interviews and surveys highlighted 2 aspects of family caregiving. (1) Family caregivers inhabit in the patient zone for long periods, resulting in overcrowding, and (2) they provide a wide ranges of physically associated care activities, including those associated with the risk of healthcare-associated infections (HAIs). Despite the high number of family caregivers and their in-depth involvement in direct patient care, education and support provided to family caregivers around IPC/HAI were insufficient and varied. Also, challenges related to maintaining adequate hygiene in the environment for minimum IPC were reported. Conclusions: This study has elucidated the current landscape of family involvement in inpatient care provision and acknowledges their contribution to high risks of HAI, as well as their current lack of IPC knowledge and practice. These findings reveal that future updates in IPC strategy should acknowledge this arrangement with family caregivers and should address this role with IPC measures.
ABSTRACT
Background: Poor compliance with infection prevention and control (IPC) measures has been a longstanding issue globally. To date, healthcare workers (HCWs) have been the primary target for policy and strategy revisions. Recent studies exploring the contributing factors to the spread of COVID-19 across countries in Asia have suggested that the scope of focus should be extended to family carers who provide patient care activities. This study aimed to explore factors affecting patients' and their family carers' IPC compliance in hospitals in Bangladesh, Indonesia, and South Korea. Method: A qualitative study incorporating 57 semi-structured interviews was conducted in five tertiary-level hospitals across the three focus countries between July 2019 and February 2020. Interviews were undertaken with: (1) patients, family carers and private carers; and (2) healthcare workers, including nurses, doctors, and hospital managers. Drawing upon the principles of grounded theory, data were inductively analyzed using thematic analysis. Results: A total of three main themes and eight subthemes are identified. Key themes focused on the assumptions made by healthcare workers regarding the family/private carers' level of understanding about IPC and training received; uncertainty and miscommunication regarding the roles of family/private carers; variations in carer knowledge toward IPC and healthcare-associated infections, and the impact of cultural values and social norms. Conclusion: This exploratory study offers novel findings regarding the factors influencing IPC compliance among patients and their family/private carers across various cultural settings, irrespective of resource availability. The role of cultural values and social norms and their impact on IPC compliance must be acknowledged when updating or revising IPC policies and guidelines.
Subject(s)
COVID-19 , Caregivers , Humans , Indonesia , Bangladesh , Republic of KoreaABSTRACT
PURPOSE: This study aimed to assess the incidence of axillary lymphadenopathy on ultrasound after COVID-19 vaccination and to investigate the factors affecting lymphadenopathy. METHODS: We evaluated patients who had received a COVID-19 vaccination within 12 weeks before an ultrasound examination between August and October 2021. The incidence of vaccine-related ipsilateral axillary lymphadenopathy was evaluated using ultrasound. Age, sex, presence of axillary symptoms, injection site, vaccine type, interval from vaccination, and dose were compared between the groups with and without axillary lymphadenopathy. RESULTS: We included 413 patients, 202 (49%) of whom showed axillary lymphadenopathy on ultrasound after COVID-19 vaccination. Age, interval from vaccine, vaccine brand, vaccine type, dose, and symptom were significantly different between the lymphadenopathy and non-lymphadenopathy groups (p < 0.001), while the injection site and sex were not. Receiving an mRNA vaccine was the most important factor for axillary lymphadenopathy (p < 0.001), followed by intervals of 1-14 (p < 0.001) and 15-28 days (p < 0.001), younger age (p = 0.006), and first dose (p = 0.045). CONCLUSION: COVID-19 vaccine-related axillary lymphadenopathy on ultrasound is common. mRNA type, an interval of 4 weeks, younger age, and first dose were the important factors. Breast clinicians should be well aware of these side effects when performing imaging examinations and provide accurate information to patients.
ABSTRACT
We present the computed tomography, ultrasonographic findings of a case of contralateral supraclavicular lymphadenopathy that occurred after AstraZeneca COVID-19 vaccination. Contralateral supraclavicular lymphadenopathy is very rare, but may be expected as an adverse reaction after COVID-19 vaccination. Radiologists as well as referring clinicians should be aware of this self-limiting process and its imaging features.
ABSTRACT
PURPOSE: To evaluate the results of operating an in-hospital coronavirus disease 2019 screening station on an outpatient basis and to identify the effectiveness and necessity of such a screening station. PATIENTS AND METHODS: This cross-sectional study included 1345 individuals who were tested for COVID-19 using real-time reverse transcription polymerase chain reaction (RT-PCR) at an in-hospital screening station on an outpatient basis. The subjects were healthcare workers (HCWs) with suspected COVID-19 symptoms or exposure to patients with confirmed COVID-19, caregivers at the hospital for complete enumeration, and patients who were scheduled to be admitted to a nonrestricted area in the hospital or to visit for outpatient treatment, but had suspected COVID-19 symptoms. The subjects were divided and compared as follows: HCW versus non-HCW groups and RT-PCR positive versus negative groups. RESULTS: A total of 140 had symptoms, 291 wanted to be tested, and 664 were asymptomatic but were screened. Seven subjects had positive results for COVID-19. Compared with the non-HCWs, the HCWs were younger and had a lower rate of underlying medical conditions. In addition, there were more women, individuals with exposure to confirmed cases, and individuals with symptoms or those who just wanted to be tested. The frequency of all symptoms was high among the HCWs. The results of the logistic regression analysis showed that the HCWs were significantly associated with the presence of symptoms, having an odds ratio of 23.317 (confidence interval, 15.142-35.907L; P < 0.001). The positive group had a high rate of exposure to patients with confirmed COVID-19 and had more subjects with symptoms or those who wanted to be tested. CONCLUSION: In-hospital screening stations are a relatively safe way to protect and support HCWs and to reduce and manage the spread of infection within the hospital effectively during an outbreak in the community.