ABSTRACT
Background: The COVID-19 Pandemic had a significant negative impact on the mental health of healthcare workers (HCWs). Evidence-based interventions that could be used to mitigate this impact are lacking in the literature. This review aims to evaluate psychological interventions used for employees following previous disasters and assess the transferability of these interventions to a healthcare setting during the COVID-19 pandemic. Methods: Intervention information from a previously published systematic review of the literature published up to 2015 was extracted, and an additional search of studies published from 2015–2020 was conducted. Studies were assessed for transferability using a checklist derived from the PIET-T process model. Results: Interventions from eighteen studies were assessed for transferability (including three studies identified in an updated literature search). Interventions established as most transferable included resilience training, meditation/mindfulness interventions, and cognitive behavioural therapy. Psychological debriefing was transferable but as it is contrary to current recommendations is not deemed appropriate for adoption. Conclusions: Several existing interventions have the potential to be utilised within the COVID-19 context/ pandemic. More research needs to be undertaken in this area to assess these interventions upon transfer. © Journal of Public Health and Emergency. All rights reserved.
ABSTRACT
Since the emergence of the COVID-19 pandemic, there has been increased interest in identifying ways of protecting the mental well-being of healthcare workers (HCWs). Much of this has been directed towards promoting and enhancing the resilience of those deemed as frontline workers. Based on a review of the extant literature, this paper seeks to problematise aspects of how 'frontline work' and 'resilience' are currently conceptualised. Firstly, frontline work is arbitrarily defined and often narrowly focused on acute, hospital-based settings, leading to the needs of HCWs in other sectors of the healthcare system being overlooked. Secondly, dominant narratives are often underpinned by a reductionist understanding of the concept of resilience, whereby solutions are built around addressing the perceived deficiencies of (frontline) HCWs rather than the structural antecedents of distress. The paper concludes by considering what interventions are appropriate to minimise the risk of burnout across all sectors of the healthcare system in a post-pandemic environment.
ABSTRACT
Introduction: Coronavirus Disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a worldwide pandemic. It is primarily a pulmonary disease which can lead to respiratory distress syndrome;some go on to develop ventilator dependent chronic respiratory failure. In these patients, enteral feeding is critical and initially provided by nasogastric (NG) or orogastric (OG) tubes. However, feeding tubes are associated with local complications such as nasopharyngeal/oropharyngeal erosions and esophageal/gastric cardia ulceration. Percutaneous endoscopic gastrostomy (PEG) tube placement facilitates longer-term enteral access. Minimal data exists on the safety and efficacy of PEG tube placement in patients with SARS-CoV-2 infection. Methods: A retrospective chart review was performed to collect data for patients who underwent PEG tube placement between January 2020 to January 2021 at Houston Methodist Hospital. Inclusion criteria included patients who had endoscopic PEG tube placement during this time interval. Exclusion criteria included patients who underwent PEG placement via interventional radiology or surgically. Approval for study was obtained from the Institutional Review Board at Houston Methodist Hospital. Success was defined as PEG placement and use to provide enteral nutrition with no complications over a 4-week period after placement. Results: 36 patients with (mean age 63.6 years;38.8% females) and 104 patients without COVID-19 infection (mean age 64.9 years, 44.2% females) were included in the study. 25 patients were excluded who had missing data, had PEG-J tube placed, or had it placed by interventional radiology initially and exchanged endoscopically during the study period. Table 1 summarizes the main demographic and clinical characteristics of participants. COVID-19 patients were more likely to be obese, be on anticoagulants and have a tracheostomy in place. 11.1% of the patients with COVID-19 developed PEG-related complications compared to 16.3% patients without COVID-19 χ2 with Yate's correction (1, N=140) = 0.23, p=0.65. The success rates of PEG placement in patients with and without COVID -19 were similar at 97.2% and 90.3%, respectively,, χ2(1, N=140) =1.7, p=0.18. Conclusion: This is, to our knowledge, the first study to assess the safety and efficacy of PEG tube placement in patients with SARSCoV- 2 infection. The study demonstrates that despite high BMI and rate of anticoagulant therapy, PEG placement was universally successful, and complication rates no different from those of age- and gender-matched non-COVID-19 patients. PEG tube placement offers a safe and effective means of providing longer term access for enteral nutrition in COVID- 19 patients. (Table Presented)
ABSTRACT
Background: Traditional health care delivery has been forced to transform to online or telehealth forums due to COVID-19. Patrons receiving psychological therapies had routines disrupted. In Western Australia, interstate and international borders have remained closed, and social and physical distancing restrictions have begun ease within the state. However, the uncertainty of the COVID-19 pandemic remains ever present. As routine in-person appointments recommenced, encouraging a sense of community and addressing physical health through a free exercise programme were hypothesised to be beneficial. Methods: A complimentary, bodyweight exercise programme was offered alongside psychological treatments in a community-based Psychological Services Centre. The Psychological Services Centre already provides group programmes to tackle common issues like sleep and stress for patrons to access. The inclusion of free classes targeting physical activity was hypothesised to be a wellattended component;however, recruitment appeared to be negatively affected by the global COVID-19 pandemic. Results: To overcome these challenges, the recruitment approach was modified. The psychological services centre structurally changed the forms patrons complete as a new client, adding a box indicating whether they would like to be contacted directly regarding relevant research opportunities. This initiative gathered over 70 patrons of which a total of three participants responded to the direct email. Conclusion: Flexibility in delivery (e.g. time variants, online vs in-person) and providing take-home materials (e.g. programme reminders) are essential for ensuring participant involvement. While requiring more creativity on behalf of the researchers, the additional modes of delivery will undoubtedly be advantageous for the participants.
ABSTRACT
Aims To explore the feasibility and identify the perceived barriers and enablers of developing an ECHO programme for CAMHs in Ireland. Methods The study adopted a qualitative research design incorporating a CAMHS:ECHO seminar and workshops with (N=29) healthcare professionals working in primary care/ mental health services. Participant consent was received, and thematic analysis conducted on rapporteur notes. Results Clinicians reported a high-level of interest in the project. Perceived opportunities included potential reduction in CAMHS waiting lists, opportunity for shared care of ADHD, improved time management, clinical skills, and access to advice on referrals. Perceived challenges included the issue of clinical governance, increased GP workload and the issue of incentives. Conclusion Barriers to successful rollout of an ECHO model in CAMHS were outweighed by perceived benefits and enablers identified by participants. Given the increased use and acceptability of telepsychiatry during COVID-19, coupled with the positive support offered by attendees, consideration should be given to more formally piloting CAMHS:ECHO.