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In 2020–2021, in the context of the COVID-19 pandemic, the postgraduate medical education system went to forced measures to preserve the life and health of students and teaching staff in the form of a temporary transition to distance learning. During the training on the "Emergencies” module by interns of various specialties, we conducted an anonymous testing of 342 young colleagues with subsequent certain conclusions. A remote andra gogical process is acceptable and useful only as a component of the dual form of higher medical education. The remote form of training in large classrooms has many disadvantages, so it is advisable to conduct classes in small groups. This type of training requires careful study, optimization and adaptation to modern conditions. © 2022. The Authors.
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Purpose This study compares doctor staffing level and the scale of medical education in China with those of other countries and proposes policy recommendations for future adjustments to the scale of China's medical education. Design/Approach/Methods This study employs a literature review and descriptive analysis. Findings China had 1.98 medical doctors per 1,000 people in 2018, ranking 85th out of the 193 member-states of the World Health Organization (WHO). In 2017, China had 1.99 practicing doctors per 1,000 people, only ranking above Turkey (1.88) in Organisation for Economic Co-operation and Development (OECD) countries. China had only 10.28 medical graduates per 100,000 people—placing in the bottom third of OECD countries. China's provision of 1.4 medical schools per 10 million people was also significantly lower than the global average (3.9). However, the average number of students enrolled in medical schools (509) in China was significantly higher than the global average (160). Originality/Value Although the scale of admission in undergraduate medical education must be expanded in China, this needs to be achieved while controlling the average number of medical students per school and reducing enrollment in low-quality medical schools. Furthermore, it is necessary to establish new medical schools while improving the operating level of existing ones.
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Introduction/Objective The study estimates the associations between the key pandemic indicators and the allocation of COVID-19-related bonus and welfare payments to Russian healthcare workers. Methods The study uses regression analysis. Results The study examines two consecutive types of COVID-19-related bonus payments: (1) incentive payments (in 2020) and (2) welfare payments (in 2020–2022). Concerning incentive payments (type 1), the study supports hypotheses regarding the association between the number of persons infected with COVID-19 in a relevant region and the actual/estimated amount of budget transfers to a relevant region for bonus payments to medical workers (a) for special working conditions and additional workload and (b) for performing particularly important work. As for welfare payments (type 2), the study supports hypotheses regarding the association between (1) COVID-19 cases, (2) COVID-19 recoveries, and (3) the fiscal year-end closeout and the amount of welfare payments. Conclusion The main channel for financing payments to medical workers is a special welfare payment through the system of the Social Insurance Fund of the Russian Federation. This source exceeds the estimated total transfers and subsidies for similar purposes in 2020. The study tests hypotheses regarding the association between the key pandemic indicators and the size of various types of budget transfers for bonus and welfare payments to medical workers. © 2023, Serbia Medical Society. All rights reserved.
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Since the Great Influenza Pandemic of 1918, a pandemic of such magnitude as the COVID-19 pandemic was yet to be confronted. While the pandemic led to unforeseen challenges globally as well as at the country level, it also brought forth certain perennial issues. This editorial is an attempt to revisit some of the major challenges faced by healthcare professionals in India during the pandemic. Timely interventions by the government of India dealt with several challenges confronted by the healthcare sector. However, issues about working hours, mental health, safety, and security of healthcare professionals also need to be looked into in the future.
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Despite the United States' unique delivery of healthcare and status as a place of discovery and cutting-edge science, overall life expectancy is actually lower than that of other countries with similar per capita income. In comparison, developing countries around the world are utilizing innovative tactics to provide care to large amounts of people in a cost-effective way. The coronavirus disease of 2019 (COVID-19) pandemic, if anything, has proven the interconnectedness of the world, showing how certain health diseases can directly affect those in other countries, bringing the need to understand global health to the forefront of medicine. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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Background: Concern about vaccine hesitancy is growing worldwide. Vaccine hesitancy can have effects for both the individual and the community, especially in the context of severe acute respiratory syndrome coronavirus 2 disease (COVID-19) pandemic. Methods: A 16-item questionnaire was administered to 385 healthcare workers to find out the reasons for COVID-19 vaccine hesitancy. Results: Their mean age was 36.6 +or- 9.6 years. 'Fear of getting side effects' (61.8%) was the most common reason for vaccine hesitancy, followed by reasons such as 'to wait and observe for some more time' (60.3%), 'doubts on safety and efficacy of vaccine' (49.4%), 'The intensity of COVID-19 has come down' (36.6%), 'self-perception of having good immunity' (33.8%), 'need to apply for leave' (30.3%) and 'Fear of death' (29.0%). 'To wait and observe for some more time' was the major reason for hesitancy amongst men. Security guards were more hesitant to take the vaccine, because of side effects, whereas doctors and sanitary workers wanted to wait and observe for some more time. Conclusions: Factors identified in the present study need to be addressed for overcoming vaccine hesitancy.
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BACKGROUND: Doctors at primary health care are prone to have work stress and it can affect their performance. Employee engagement may have close relationship with the doctor's performance during the COVID-19 pandemic. AIM: This study aims to determine the relationship between work stress and the doctor's performance at primary health care using employee engagement mediation and COVID-19 pandemic moderation. METHOD(S): This research is a descriptive study using a quantitative approach which was conducted on 354 doctors at Malang primary health care. The questionnaire was analyzed using partial least square. RESULT(S): The work stress had a significant positive effect on the doctor's performances (beta = 0.257, t-stat = 3.324). Work stress has a significant positive effect on employee engagement (beta = 0.726, t-stat = 22,967). Employee engagement does not significantly affect the doctor's performance (beta = 0.044, t-stat 0.105). Employee engagement does not mediate the work stress effect on doctor's performance (beta = 0.032, t-stat = 0.105). The COVID-19 pandemic did not moderate the work stress effect on doctors' performance (beta = -0.222, t-stat = 0.981). CONCLUSION(S): Primary health care leaders still need to pay attention to factors that can reduce the doctor's performance and employee engagement, include factors that can increase the work stress during the COVID-19 Pandemic.Copyright © 2023 Fida Rahmayanti, Noermijati Noermijati, Armanu Armanu, Fatchur Rohman.
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Introduction: Rise of major Healthcare associated infections (HAIs) can be mitigated by inculcating good infection control practices which can only be possible by proper and timely educational training of healthcare workers. Aim: To reinforce infection prevention and control knowledge and practices of nursing staff through proper training program- To conduct the training in multiple sessions, to assess the immediate outcome of training program by conducting Pre and Post test (in written format only) Materials and Methods: This study was done in a tertiary care hospital in Davangere, Karnataka over a period of 2 years. Healthcare workers including 144 nurses and 12 doctors underwent training in four sessions where knowledge on how to identify, audit and conduct surveillance of major healthcare associated infections, management of needlestick injuries were imparted through interactive lectures and video demonstrations followed by hands on hand hygiene, proper use and disposal of personal protective equipments. Pre and Post test were given to know their basal knowledge and effect of our training intervention. Data was collected, analyzed and tabulated. Results: Out of four sessions covering a total of 144 nurses, 84 were trained before the onset of COVID-19 and remaining 60 were trained in the latter half of 2021, when the lockdown was relaxed in our region. The mean total Knowledge score in pre test and post test was 5.93 +or- 1.336 and 7.95 +or- 1.040. The mean difference was -2.021 and it was statistically significant by paired test. (p - 0.001). The mean total practice pretest and post test score was 3.57 +or- 1.48 and 4.56 +or- 1.114. Paired t test showed significant mean difference between the pretest and post test score. (p - 0.001). Conclusion: Our training intervention was effective in increasing their awareness on proper infection prevention and control practices. Repeated training and retraining of healthcare care workers have to be carried out to prevent and control healthcare associated infections.
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The spread of COVID-19 across the world, triggered multiple stresses among doctors working tirelessly round the clock to attend sick patients. Doctors had to cope with new environment thereby developing anxiety and fear. The current paper identifies and explores the stress intensity developed among doctors with the aid of multi-criteria decision analysis in doctors working in private and government hospitals of India during COVID-19. After identification of numerous stresses through questionnaire, weights are assigned to common most stress factors by employing AHP method. Furthermore, comparative analysis and prioritization of stress factors is performed with the aid of TOPSIS. The current combined system is a quantitative analysis furnished to establish the feasibility of the methods in weighing and MCDM in stress assessment. This study identifies and predicts the foremost stress factor which needs to be addressed by hospital management to keep doctors with a stable and fresh mindset. This research further establishes a proper MCDM technique which need to be applied in all hospital to regulate and distribute doctors work load without overloading them. Psychological stress is the foremost type of stress reported by multiple doctors. Results showed that lack of balance among personal and professional life followed by lack of communication is highly related problem in doctors in such adverse events.
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Introduction: The world, particularly India, is in the midst of one of the worst pandemics ever. The second wave of the COVID-19 pandemic has hit the country like a tsunami, taking a toll on life. A robust health-care industry with competent, productive, and positive manpower is needed like never before. The productivity of doctors is directly related to the fulfillment they experience in their jobs. Aims and Objectives: The study will try to explore the satisfaction level of doctors working in Haryana. It will also delve into major determinants of satisfaction and dissatisfaction. Materials and Methods: The cross-sectional survey-based analysis was conducted in FMHS SGTU on doctors employed in Haryana. The prevalidated questionnaire was administered via Google Forms. Results: A total of 515 filled pro forma were obtained. 71.6% of doctors were found to be satisfied in their chosen profession. Discussion: The discontentment among doctors is now globally acknowledged. It stems from a wide array of issues such as the growing incidents of workplace violence, lack of security measures, deteriorating doctor-patient relationship, erratic work hours, monumental workload in stressful environment, inadequate infrastructure, and pitiful pay. Conclusion: There is marked diminution in doctors' morale who regret being in this profession more and more. However, with the joint efforts of society and competent authorities, this grim situation can be rectified. Steps should be taken to build a strong doctor-patient relationship based on trust and boost infrastructure so that medical profession can be made alluring in the 21(st) century.
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Research has explored how the COVID-19 pandemic triggered a wave of conspiratorial thinking and online hate speech, but little is empirically known about how different phases of the pandemic are associated with hate speech against adversaries identified by online conspiracy communities. This study addresses this gap by combining observational methods with exploratory automated text analysis of content from an Italian-themed conspiracy channel on Telegram during the first year of the pandemic. We found that, before the first lockdown in early 2020, the primary target of hate was China, which was blamed for a new bioweapon. Yet over the course of 2020 and particularly after the beginning of the second lockdown, the primary targets became journalists and healthcare workers, who were blamed for exaggerating the threat of COVID-19. This study advances our understanding of the association between hate speech and a complex and protracted event like the COVID-19 pandemic, and it suggests that country-specific responses to the virus (e.g., lockdowns and re-openings) are associated with online hate speech against different adversaries depending on the social and political context.
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Objectives: We determined the prevalence of psychological distress, and the associations between sociodemographic factors, anxiety, depression, COVID-19-related experiences, and psychological distress, among nurses and doctors in Nigeria. Methods: The study was a cross-sectional descriptive study, conducted over a month (1st of July-31st of July 2021) among 434 Health Care Workers (HCWs) [225 (51.8%) nurses and 209 (48.2%) doctors] from two tertiary health facilities in southwestern Nigeria. Binary logistic regression was carried out to determine the factors associated with psychological distress (dependent variable), while the independent variables were anxiety, depression, and COVID-19 experience-related factors. Results: The prevalence of moderate and severe psychological distress was 49.1% and 5.8%, respectively. Individuals who had the first degree had significantly lower odds (AOR: 0.43; p = 0.037) of experiencing psychological distress while being a nurse (AOR: 2.03; p = 0.014), higher levels of anxiety (1.28; p < 0.001), and depression (AOR: 1.17; p = 0.005) were associated with significantly higher odds of experiencing moderate to severe levels of psychological distress. Conclusion: There is a high level of psychological distress experienced by these health workers. Hence, they will benefit from strategies to reduce their distress.
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COVID-19 , Psychological Distress , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Nigeria/epidemiology , Depression/epidemiology , Pandemics , Anxiety/epidemiology , Health PersonnelABSTRACT
Affected by the COVID-19 pandemic in 2020, rural medical and health safety has attracted much attention. As an important supplier of rural primary medical and health services, rural doctors play an important role in the prevention and control of the pandemic. However, the rural primary medical and health service system is facing problems in the construction of rural doctors' team, such as "no recruitment, no retention". This article proposes a two-dimensional analytical framework of "goal deviation" and "tool deviation", analyzes the causes of the development dilemma of rural doctors and further investigates the mechanism for establishing an effective country doctor system. The study finds that the goal deviation between the policy goal of "prevention and treatment synchronization" and the social process of "prevention in the first place" is the root cause of the development dilemma of rural doctors, whereas the tool deviation resulted from the divergence between policy tools(recruitment requirements of rural doctors, salary system and promotion system) and the social process is the surface cause of their development dilemma. Therefore, the establishment of longterm development mechanism of rural doctors should start from the following four aspects: First, making the policy goals adapt to the social process of rural doctors' function transformation, improving the "hierarchical diagnosis and treatment" system framework, and clarifying the functional division of rural primary medical and health service providers;Second, providing flexible recruitment requirements, so that rural doctors can be recruited;Third, improving the incentive mechanism, appropriately increasing their salary and subsidies, clarifying the subordinate relationship, and opening up the promotion channels for rural doctors, so that they can stay;Fourth, building a strong county medical and health community.
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Global health crises impose considerable strain in health care systems worldwide that create mental health challenges among medical practitioners. Greater challenges are experienced by doctors practicing in rural areas of developing countries such as the Philippines that have weak healthcare infrastructures and meager resources for health services. Thus, this study sought to explore doctors' experiences of working in rural areas during the COVID-19 pandemic and to identify contextual factors contributing to their mental health. Interpretative phenomenological analysis was used in gathering and analyzing data from semistructured interviews with 12 doctors who worked in rural areas in Eastern Visayas, a region that has very few doctors and that experienced a rise in COVID-19 cases at the time of the study. The findings revealed challenges to doctors' mental health that include fear of exposure, burnout, scarcity of supplies, and patient-related challenges that reflected contextual realities in the area. The results also described coping strategies utilized by the rural doctors, e.g., communing with nature, diskarte (resourcefulness), social support from family and coworkers, and bayanihan (observed in this study as mutual support among doctors in the rural community to achieve collective goals). The findings highlight policy implications and other forms of support that will sustain rural doctors' mental health amid a pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement The sustainable development goals highlight the importance of promoting good health and well-being (SDG3). The wellness of healthcare workers is critical, especially amid a global pandemic, as they fulfill their duty of caring for others in the front line despite threats of exposure to the disease (Khoo et al., 2021;Luan et al., 2020). These challenges are exacerbated in rural areas where there are few doctors serving the entire community (Muzyamba et al., 2021), and there was lack of supplies, medicines, and equipment needed to provide proper healthcare even prior to the pandemic (Mohammadiaghdam et al., 2020;Vashist, 2017). Using the lens of interpretative phenomenological analysis, this study gathered insights from the experiences of doctors working with rural communities in the Philippines amid the COVID-19 pandemic. The findings will hopefully orient policies and efforts to sustain and enhance the mental health and overall wellness of rural doctors practicing underserved communities amid a global health crisis. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Objective-To assess final estimates of physician experiences related to COVID-19 and to compare preliminary estimates used in NCHS early-release dashboards with final estimates in this report. Methods-Physicians interviewed in periods 3 and 4 (December 15, 2020, through May 5, 2021) of the 2020 National Ambulatory Medical Care Survey (NAMCS) were asked a series of questions about experiences related to COVID-19 (n = 422). This report presents final nationally representative estimates for selected measures of COVID-19-related experiences among physicians in the United States and compares preliminary and final estimates for these measures. Results-Between September 2020 and May 2021, 31.1% of office-based physicians in the United States experienced shortages of personal protective equipment, and 38.4% of physicians had to turn away COVID-19 patients or refer them elsewhere for care. The percentage of physicians using telemedicine for patient care increased from 43.1% before the pandemic to 88.4% after the start of the pandemic. No statistically significant differences were seen between preliminary and final estimates for the measures assessed in this report. Conclusions-By making changes to NAMCS partway through the survey year, the National Center for Health Statistics was able to produce nationally representative estimates of physician experiences related to an emerging health threat, the COVID-19 pandemic. Additionally, the similarity between preliminary and final estimates for measures of interest provides evidence of the value of developing preliminary earlyrelease estimates.
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In Das Kapital, Marx cited the Public Health Report of Dr. Simon, the promoter of the British public health reform? and developed Marx's "industrial pathology", which not only directly demonstrated the oppression and exploitation of capitalism on the working class, but also indirectly raised expectations and construction of doctors' professional ethics and social values. Marx believed that the doctors should have professional, fair and resolute ethic, and only by placing their value in the working people and putting the health and interests of the people first, can they better save the dying, heal the wounded, and play a greater role of value and advantage. Reviewing the professional ethics and social values of doctors from the perspective of Marx's "industrial pathology" not only enlightens people on how to better respond to the COVID-19, but also has important reference significance for the construction of contemporary medical ethics. © 2023, Editorial department of Chinese Medical Ethics. All rights reserved.
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Chinese village doctors, the "gatekeepers" of rural residents' health, shoulder heavy responsibility of providing basic public health services (BPHS) for rural residents. The health-care reform on BPHS launched in 2009 has much influenced village doctors as well as the delivery of health service. This chapter has depicted the challenges and struggles facing Chinese village doctors in the BPHS. COVID-19 is the specific setting for a better understanding of a more real situation. The findings suggest that the diverse roles that the village doctors display as well as the multiple challenges faced by village doctors in the setting of China's prevention and control against COVID-19, however, make the supply of rural medical services uncertain and unsustainable, which would undermine China's reform of primary medical and health care system. © 2023 Nova Science Publishers, Inc.
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We developed a pandemic telephone outreach protocol to identify risk for social isolation, health destabilization, medication issues, inadequate services and supports, and caregiver stress among older adults at high risk of destabilization. Screening, conducted between April 1, 2020, and May 8, 2020, was targeted to those who had previously been screened as frail or who were identified as vulnerable by their family physician. This study describes the implementation and results of this risk screening protocol and describes patient, caregiver, and health professional perceptions of this outreach initiative. Mixed methods included satisfaction surveys and interviews completed by patients/caregivers (N = 300 and N = 26, respectively) and health professionals (N = 18 and N = 9, respectively). A medical record audit collected information on patient characteristics and screening outcomes. A total of 335 patients were screened in the early weeks of the pandemic, of whom 23% were identified with at least one risk factor, most commonly related to the potential for health destabilization and medication risk. Follow-up referrals were made most frequently to physicians, a pharmacist, and a social worker. The outreach calls were very well received by patients and caregivers who described feeling cared for and valued at a time when they were socially isolated and lonely. The outreach calls provided access to trusted COVID-19 information and reassurance that health care was still available. The majority of health professionals (>86%) were "very" or "extremely" satisfied with the ease of completing the screening via telephone and value for time spent;for 79% the protocol was "very" or "extremely" feasible to implement. Health professional interviews revealed that patients were unaware they could access care during the pandemic lockdown but were reassured that care was available, potential crises were averted, and they supported future implementation. Risk screening provides a significant opportunity to provide information, support, and mitigate potential risks and is an important and feasible component of pandemic planning in primary care.
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No abstract available.