Impact of diabetes on emergency care of acute myocardial infarction patients during the coronavirus disease 2019 pandemic: a nationwide population-based study.

Background: Although acute myocardial infarction (AMI) requires timely intervention, limited nationwide data is available regarding the association between disruption of emergency services and outcomes of patients with AMI during the coronavirus disease 2019 (COVID-19) pandemic. Moreover, whether diabetes mellitus (DM) adversely affects disease severity in these patients has not yet been investigated. Methods: This nationwide population-based study analyzed 45,648 patients with AMI, using data from the national registry of emergency departments (ED) in Korea. Frequency of ED visits and disease severity were compared between the COVID-19 outbreak period (year 2020) and the control period (the previous year 2019). Results: The number of ED visits by patients with AMI decreased during the first, second, and third waves of the outbreak period compared to the corresponding time period in the control period (all p-values < 0.05). A longer duration from symptom onset to ED visit (p = 0.001) and ED stay (p = 0.001) and higher rates of resuscitation, ventilation care, and extracorporeal membrane oxygen insertion were observed during the outbreak period than during the control period (all p-values < 0.05). These findings were exacerbated in patients with comorbid DM; Compared to patients without DM, patients with DM demonstrated delayed ED visits, longer ED stays, more intensive care unit admissions (p < 0.001), longer hospitalizations (p < 0.001), and higher rates of resuscitation, intubation, and hemodialysis (all p-values < 0.05) during the outbreak period. While in-hospital mortality was similar in AMI patients with and without comorbid DM during the two periods (4.3 vs. 4.4%; p = 0.671), patients with DM who had other comorbidities such as chronic kidney disease or heart failure or were aged ≥ 80 years had higher in-hospital mortality compared with those without any of the comorbidities (3.1 vs. 6.0%; p < 0.001). Conclusion: During the pandemic, the number of patients with AMI presenting to the ED decreased compared with that of the previous year, while the disease severity increased, particularly in patients with comorbid DM.

Emergency nurses' communication experiences with patients and their families during the COVID-19 pandemic: A qualitative study.

BACKGROUND: In the emergency department, essential information is verified primarily through communication with patients and families. Thus, an in-depth understanding of emergency nurses' communication experiences with patients is required to facilitate the provision of effective therapeutic care. OBJECTIVE: To analyze emergency nurses' communication experiences with patients and their families. METHODS: A qualitative descriptive design was used. Interviews were conducted with 15 nurses between 2021 and 2022. Thematic analysis was carried out. This study was conducted in accordance with the consolidated criteria for reporting qualitative studies (COREQ). RESULTS: Three themes were identified: transformation of communication approaches due to COVID-19, obstacles in therapeutic communication, and continuous endeavors for improved communication. CONCLUSION: Emergency nurses experienced various barriers in communication with patients and their families, which were exacerbated by COVID-19. Nevertheless, nurses attempted to enhance their communication skills. Organizational support is pertinent to establish effective communication strategies.

Critical role of information and communication technology in nursing during the COVID-19 pandemic: A qualitative study.

AIM: To examine the need for information and communication technology (ICT)-based nursing care in improving patient management during the pandemic. BACKGROUND: Maintaining traditional approaches to nursing in the ongoing coronavirus disease (COVID-19) pandemic predisposes health care systems to a risk of diminished quality of care. Using ICT (real-time videoconferencing, mobile robots and artificial intelligence) could reduce burnout and infection risks by minimizing face-to-face contact. METHOD: Qualitative descriptive design with content analysis. RESULTS: Overall, 24 participants (14 nurses, six medical/nursing informatics experts and four technology experts) were interviewed. Three main themes were extracted: emerging challenges for nurses due to COVID-19, impact of new technology on patient and nurse experiences and concerns with implementation of technology. CONCLUSION: A significant portion of nurses' work was unrelated to professional nursing, causing burnout. ICT could help reduce nurses' burden by facilitating environmental management and non-contact communication and providing emotional support for patients. IMPLICATIONS FOR NURSING MANAGEMENT: Establishing an ICT-based nursing care system that considers the physical environment and communication infrastructure of health care institutions, user's digital health literacy and user safety to effectively manage non-nursing care-related activities and undertake tasks that can be delegated may improve the quality of care for quarantined patients and reduce risk of cross-infection.

Frontline nurses' caring experiences in COVID-19 units: A qualitative study.

AIM: Exploring nurses' caring and communication experiences in COVID-19 units. BACKGROUND: Frontline nurses play a critical role in providing 24-h bedside nursing care to COVID-19 patients. An in-depth understanding of frontline nurses' lived experiences is necessary to establish appropriate nursing strategies during crises, such as the COVID-19 pandemic. METHODS: Qualitative descriptive design with content analysis. RESULTS: Fifteen nurses were interviewed, and three themes were identified: central role of therapeutic communication, compassion that deepens naturally and expansion of professionalism in nursing. CONCLUSION: The nurses proactively provided care for COVID-19 patients, and they acknowledged and accepted their roles in protecting the lives and ensuring the health of their patients daily. The nurses' experiences in COVID-19 units served as an opportunity for ruminating and rediscovering the meaning of nursing. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital policymakers and nurse managers should strive to resolve the communication-related challenges faced by nurses. Standardizing and implementing effective communication strategies should be considered in nursing management.

Life-Changing Experiences of Mothers with School-Age Children during the COVID-19 Pandemic: Focusing on Their Health Risk Perceptions and Health-Related Behaviors.

This study aimed to explore health risk perceptions, changes in health-related behaviors, and life experiences of mothers with school-age children during the early coronavirus disease (COVID-19) pandemic. Data were collected between 16 July and 10 September 2020, by individual interviews and analyzed through qualitative content analysis. After the twelve participants' experiences were analyzed, four themes and ten sub-themes were derived. The four themes were: "Struggling to identify the substance of COVID-19," "Taking the initiative to protect the health of the family," "Frustrated by the brutal reality of no end in sight," and "Trying to adjust wisely to an inevitable new lifestyle." The findings suggest that while the world remains in an ongoing battle with COVID-19, national health institutions should prepare a health education system for specific infection prevention methods that can be practiced by individuals in daily life.