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BACKGROUND: Long-term oxygen therapy (LTOT) can increase survival time and relieve symptom burden in patients with COPD and chronic hypoxemia. The Department of Respiratory Medicine at Odense University Hospital invites patients with LTOT and COPD to the out-patient clinic for treatment evaluation every 6 months to regulate or terminate treatment and support patients' treatment adherence. The out-patient clinic, however, experiences many absences or cancellations from patients. For that reason, patients were offered virtual consultation as an alternative to physical attendance. This study was initiated to uncover reasons for absences and the patients' experiences of virtual consultation to promote a more patient-centered clinical practice for patients with COPD and LTOT. METHODS: A qualitative study encompassing semi-structured interviews with 20 subjects was conducted in the winter of 2021. The subjects had tried or been given the opportunity of virtual consultation. Data were analyzed inspired by Kvale and Brinkmann focusing on the subject's perspectives on virtual consultation. RESULTS: The analysis resulted in 3 main themes: limitations and vulnerabilities, independence and quality of life, and personal strategies. Subjects expressed that everyday life with LTOT and COPD was characterized by limited resources in terms of energy, oxygen, and time. LTOT was perceived as a necessary means to maintain a sense of independence and quality of life. However, LTOT also meant additional limitations due to cumbersome equipment and feelings of isolation. Most subjects considered the virtual consultation to be oxygen-, energy-, and time-preserving, as it meant avoiding stressful transportation and handling of oxygen cylinders, COVID-19 exposure, waiting time, and not having to involve others for help. CONCLUSIONS: The subjects' perspective showed that follow-up on LTOT as a virtual consultation was considered a valuable offer. The chosen method was found to be relevant in uncovering subjects' attitudes toward clinical practice procedures.
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Advance care plans (ACPs) increase patient-centered care, reduce caregiver burden and healthcare costs. However, only about 25% of Canadians over 50 years of age have completed an ACP. An anonymous, cross-sectional survey was distributed to those ≥70 years attending a primary care clinic-based COVID-19 vaccination event in Regina, SK in April 2021. The survey included questions about demographics, attitudes, engagement in ACPs according to the Stage of Change model, and patient-reported influence of COVID-19 on ACP thoughts or actions. One hundred thirty-four surveys were completed (96% response rate). Twenty-seven percent of respondents were at the precontemplation stage, 21% at contemplation stage, 16% at planning stage, 26% at action stage, and 10% at maintenance stage. Thirty-three percent of respondents had thought more about ACPs during the pandemic, but few updated or created plans. Most respondents felt comfortable talking with their physician and partners. There is a need for physicians to initiate ACP conversations with patients.
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Residents of care homes across the globe are affected by the spread of SARS-CoV-2 as they have been identified as a high-risk group and because they experienced strict social isolation regulations during the first wave of the pandemic. Social isolation of older people with poor physical and mental health is strongly associated with mental health problems and decreased life expectancy. Other research has shown that older people managed to adapt to the changes brought about by the pandemic and have linked this to the concept of resilience. The aim of this research project was to investigate how this applied to residents in care home settings during the first phases of the contact ban in Germany from sociology, developmental psychology and environmental gerontology perspectives, and to gain in-depth understanding of residents' experiences. This paper draws on structured interview data collected from residents in two care homes during early June 2020 in Frankfurt am Main, Germany. The findings show that their experiences were shaped by three factors: care home settings and the approach of staff to handling the contact ban;biographical sense of resilience;and a hierarchy of life issues. The findings highlight the importance of locally specific response mechanisms in care homes, agency and belonging of residents despite health-related limitations and the importance of a critical (gendered) lens on understanding their experiences.
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Population around the world had huge concern toward COVID19 disease that affect directly or indirectly on all populations' lives. It caused by novel virus called sever acute respiratory syndrome coronavirus-2 (SARS-CoV-2), therefore;The Iraqi Ministry of Health (MOH) and numerous scientific agencies had advised to promote population for receiving Covid 19 vaccines as Largest astride of an attempt to reduce the serious challenges burden of Covidi 9 in global. Aims of Study are: 1-To evaluate prevalence of the willingness to accept different types of COVID19 vaccines in middle and south of Iraq. 2-Compare the vaccinated and unvaccinated of the southern Iraqi population and detection some factor behind acceptance of COVID19 vaccines. Method: Based Cross-Sectional Observational Study utilized validated questionnaire.it conducted from 5 February to 5 April 2022 and distribute in two ways,online and manually, depending on the different living locations of the participants. Results: The total number of participants' responses was 767. It is obtained from the distribution of surveys in different ways. 104 of participants were excluded due to not giving complete answers to the survey questionnaire. On the other hand, 42 of the participants were excluded due to not living in the middle and south of Iraq. 621 participants from the total participant response were enrolled in the study analysis. Half of participants were 50.08% female and other half were 49.92% male with 52.33% of the participants were married. About two-third of the participants accepted to receive covid19 vaccines (75.68%), while 24.31 % of the participants were unvaccinated(14.65% of them hesitant and 9.66% rejecters). Most of participants were from Basra city (79.87%) and more than half of them were vaccinated and other were unvaccinated (71.98% versus 28.02%) (P value=0.000). Two-third of the participants had graduated degree bachelor and more (75.8%) and the percent of vaccinated group of them were significantly higher than unvaccinated (80.9% versus 19.1%) (P value = 0.000). Less than half of the participants were the healthcare providers (35.91%) and the percent of vaccinated group of them were significantly higher than unvaccinated (82.96% versus 17.04%) (P value=0.002). A small percent of the participants had a chronic disease (15.46%) and 79.17% of them accepted to receive covid19 vaccines which was higher than unvaccinated (20.83%, where 9.3% hesitant and 11.45% rejecters). More than half of participants had sign and symptoms of Covid19 infection (61.84%) and 78.39% of them were vaccinated which was significantly higher than unvaccinated (21.61%) (P value=0.046) and only 41.22% of them were diagnosed by doctor. More than half of the participants had one of the family members and/or friends died from corona virus (66.51%) and 79.18% of them were vaccinated which was significantly higher than unvaccinated (20.82%) (P value=0.004). Conclusion From above results, the percent of covid 19 vaccines acceptance was higher than hesitancy and rejection. The higher rate of covid 19 vaccines acceptance could be related to many factors that might affect on the success of vaccinated programs, including: level of education, place of living, had sign and symptoms of Covid19 infection have family members and/or friends died from covid19 and are members of the health care providers. Knownledgment The study was supported by clinical trial
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In this regular feature, aesthetic nurse Claudia McGloin presents a brief synopsis of a range of recently published articles on medical aesthetics. Research roundup aims to provide an overview, rather than a detailed summary and critique, of the papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided at the end of each study summary
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Background: Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2, is a global pandemic resulting in the deaths of more than 3 million people across the world. It has been reported to be more fatal in individuals with chronic diseases than in healthy adults without a diagnosis of hypertension, diabetes, cardiovascular disorders, or respiratory system diseases. Aim: To determine the experiences and attitudes of individuals with comorbidities in relation to the coronavirus disease 2019 pandemic. Methods: This quali tativ e-phe nomen ologi cal study was conducted with individuals with chronic diseases among the family members of students attending the Healthcare Services Department of Eldivan Vocational School of Health. The sample of the study consisted of 17 individuals with chronic diseases. Data were collected through online interviews conducted between June and July 2020. The obtained data were analyzed using content analysis, and themes were created. Results: The mean age of the participants was 67.17 years;47% were men, and 53% were women. From the data obtained through the interviews, 2 main themes emerged in relation to the pandemic experiences of the participants: negative emotions and positive responses. The theme of negative emotions related to the pandemic was further divided into the following sub-themes: fear of death, fear of being in social environments, lack of information about the pandemic, and external pressures. The theme of positive responses had 2 subthemes: trust in government and spirituality, and individual measures. Conclusion: Individuals with chronic diseases have experienced many positive and negative emotions during the pandemic period. It is recommended to establish emergency information and advice lines for these individuals, provide them with training on health communication and health literacy, and raise their awareness of similar pandemics through practices such as public service announcements.
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Background/Aims: A climate of trust in maternity may improve the experiences of staff and women accessing maternity services. The aim of this study was to explore how a climate of trust was promoted through creation of a regular virtual maternity multidisciplinary forum, known as a maternal medicine huddle, during the COVID-19 pandemic and what influence this had on the organisational culture of a local maternity system and the experiences of women receiving maternity care. Methods: Through a critical feminist methodology, six participants were interviewed using a semi-structured interview schedule. Interviews were conducted through Miscrosoft Teams, with the six participants representing each of the six trusts in a selected local maternity and neonatal system. Results: Developing trust for teamwork is valued, while at the same time interprofessional and interorganisation challenges are highlighted that can impact workplace culture. Conclusions: The huddles have built a climate of trust, working to deliver safe, equitable care for those using maternity services and a supportive learning environment for those providing it.
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Background/Aims: Remote service delivery became a key method of providing therapy for psychological oncology services during the COVID-19 pandemic and beyond. This study aimed to understand the experiences and preferences of both patients and therapists who undertook remote psychological therapy in a cancer support service, with a view to informing ongoing service provision. Methods: A total of 99 out of 152 invited patients completed an online mixed-methods (quantitative and qualitative) audit survey. All patient participants had accessed therapy with the psycho-oncology support team at Guy's Cancer Centre in London. Of the 12 therapists and four trainee therapists working in this service, 11 and two from each group (respectively) completed a corresponding survey about their experiences as therapists. For quantitative data, descriptive statistics were collated. Results: Patients rated their experience of remote therapy as positive, reporting that they felt respected, understood and confident during therapy, and acknowledged the associated advantages of increased accessibility and infection control. Despite this, 87% of patients and 100% of therapists expressed a preference to access or deliver therapy in person, with patients identifying human connection and relationship building as key reasons for choosing in-person delivery. Therapists valued the relational aspects of in-person psychological support and reported that remote delivery had negatively affected the quality of therapy delivered. Conclusions: Understanding the needs and preferences of patients and therapists is important in informing ongoing psychological service delivery. The results highlight the importance of retaining provision for in-person service delivery and offering choice to patients in how they access psychological support, in line with personalised care recommendations made by the NHS Long Term Plan.
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By June 2021, children and young people had experienced two periods of lockdown and home learning in Northern Ireland. The detrimental impact of these periods of indefinite confinement is wider reaching than reported educational stagnation, with the fundamental rights of childhood: play;rest;and leisure;all adversely implicated. Autistic children's experiences of Covid‐19 have been largely absent from current crisis and recovery discourse. This is the first published study to directly and specifically involve autistic children both as research advisors and as research participants in a rights‐based participatory study relating to the pandemic. Drawing on concepts of ableist childism and epistemic injustice, this article presents, through Photovoice, the emotional, social and educational experiences of post‐ primary aged autistic young people in Northern Ireland during the first 2020 lockdown of the Covid‐19 pandemic. The project was grounded in a child rights‐based approach and was guided by a group of four autistic young advisors aged 11–15. The paper concludes by arguing that government responses to the pandemic, as experienced by autistic young people, act as forms of oppression that prioritises and further embeds normative non‐autistic structures and responses under the guise of public health necessity.
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Background/Aims: The COVID-19 pandemic led to many services being conducted remotely, including ear, nose and throat services. Although much in-person activity has now resumed, some services are still being provided remotely. This pilot study explored patients' satisfaction with the virtual multidisciplinary team balance clinics established at the authors' practice, looking at the feasibility of continuing this model of service delivery in the future. Methods: Self-administered questionnaires were posted to the 56 patients who had received a virtual consultation with the service between March and September 2020, of which 22 were returned. The questionnaire presented respondents with 14 items, with which they rated their agreement on a 6-point Likert scale. Correlations between the final item (which measured overall satisfaction) and the other items were analysed using Spearman's rho. Results: Overall, respondents were satisfied with the virtual consultations. Respondents either agreed or strongly agreed with 13 of the 14 items;the only exception was 'I obtained better access to healthcare services by use of telemedicine'. Most respondents were happy with the quality of communication and valued the time saved on travel, although one pointed out that this may not be an appropriate mode of service delivery for patients who are deaf. Conclusions: Virtual clinics can be an acceptable adjunct to traditional clinical consultations in an ear, nose and throat outpatient department for balance disorders and should be continued in future.
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Objectives: To evaluate the usability and effectiveness of a digital application for wound care from a clinician-and-patient user perspective. Methods: A quasi-experimental design was conducted in four settings in an Australian health service from July to December 2019 to October 2020. Owing to the coronavirus disease pandemic, the study paused in March 2020 but then restarted immediately after 3 weeks. Data were collected from patients in the standard group (n = 166, 243 wounds), and intervention group (n = 124, 184 wounds). Clinicians participated in a survey (n = 10) and focus group interviews (n = 13) and patients were interviewed (n = 4). Wound documentation data were analysed descriptively. Interviews were thematically analysed. Results: Positive evaluations identified improvements such as instantaneous objective wound assessment, shared wound plans, increased patient adherence and enhanced efficiency in providing virtual care. Compared to the standard group, wound documentation in the intervention group improved significantly (more than two items documented 24% versus 70%, p < .001). During the intervention, 101 out of 132 wounds improved (mean wound size reduction = 53.99 %). The travel-related fuel cost saved for a patient living in a rural area was on average $72.90. Conclusions: The digital application provided real-time wound data with an interface for communication between the patient and clinician and clinicians in a hospital, community, and outpatient setting in a variety of settings. The use of the application facilitated remote patient monitoring, and reduced patient travel time, while maintaining optimal wound care.
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Background/Aims: The COVID-19 pandemic led to many services being conducted remotely, including ear, nose and throat services. Although much in-person activity has now resumed, some services are still being provided remotely. This pilot study explored patients' satisfaction with the virtual multidisciplinary team balance clinics established at the authors' practice, looking at the feasibility of continuing this model of service delivery in the future. Methods: Self-administered questionnaires were posted to the 56 patients who had received a virtual consultation with the service between March and September 2020, of which 22 were returned. The questionnaire presented respondents with 14 items, with which they rated their agreement on a 6-point Likert scale. Correlations between the final item (which measured overall satisfaction) and the other items were analysed using Spearman's rho. Results: Overall, respondents were satisfied with the virtual consultations. Respondents either agreed or strongly agreed with 13 of the 14 items;the only exception was 'I obtained better access to healthcare services by use of telemedicine'. Most respondents were happy with the quality of communication and valued the time saved on travel, although one pointed out that this may not be an appropriate mode of service delivery for patients who are deaf. Conclusions: Virtual clinics can be an acceptable adjunct to traditional clinical consultations in an ear, nose and throat outpatient department for balance disorders and should be continued in future.
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The COVID-19 pandemic has brought many challenges, including doctor-patient relationships (DPRs). This study aims to investigate the change in patients' attitudes towards doctors during the pandemic. We collected 24,000 reviews in Beijing, China from an online health platform, with half of the data from 2019 and another half from 2020. These data were compared using sentiment and word frequency analyses. Results show that the number of negative reviews has reduced significantly, and the salient topics of negative reviews have shifted from doctor-related to administration-related. These findings suggest that the DPRs have improved but there is room for managerial improvements in the health sector. © 2022 ACM.
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Document the experiences of people with chronic spinal cord injury (SCI) during the COVID-19 pandemic. A cross-sectional survey. An academic medical center. A convenience sample of 35 participants from a local SCI Model Systems Center who completed a survey online or by phone between September 2021 and March 2022. Not applicable. A scale "COVID-19: Impact of the pandemic and HRoL in cancer patients and survivors" obtained from NIH PhenX Toolkit was adapted for SCI population that measures personal COVID-19 exposures and experiences, including COVID-19 specific emotional and physical reactions, health care disruption and concerns, disruption to daily activities and social interactions, financial hardship, perceived benefits, functional social support, and perceived stress management. This sample had a mean age of 51.8 years, a mean duration of injury of 22.2 years, and 55.9 % had paraplegia with American Spinal Injury Association Impairment Scale A, B, or C. 17.1% of participants had COVID-19 infection. Forty percent of participants were fully vaccinated which is lower than that of general population in the state (53.5%). More than half of participants were concerned about family members or close friends getting or dying from COVID-19, had feelings of sadness or depression, and experienced disruptions in day to day social interactions with family and/or friends. The majority reported perceived benefits, had functional social supports, and had ability to manage stress. Participants reported varying COVID-19 related impacts, including employment (eg, 8.5% lost job), health care disruption (eg, 37.1% general care disruption), and financial hardship (eg, 34.3% financial difficulties). These results provide important markers for developing interventions for SCI population in future crises. No disclosure.
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BACKGROUND: Understanding public and patient attitudes to clinical research is paramount to successful recruitment. The COVID-19 pandemic has led to additional hurdles in achieving this. Our aim is to understand the current factors and attitudes towards clinical trial participation in order to assist in recruitment to clinical trials. METHODS: We conducted face-to-face interviews with patients in the outpatient department at a tertiary eye hospital facilitated by a 32-item questionnaire developed by the research team. Patient characteristics were correlated with their responses, in addition to qualitative thematic text analysis. RESULTS: A total of 53 patients were interviewed. Forty per cent indicated that they would be willing to participate in clinical research in the current climate. General motivating factors for involvement in research included personal gain, altruism and contribution to innovation. Factors limiting participation included concerns regarding own safety, inconvenience, accessibility and lack of benefit. 22.6% of participants felt that the COVID-19 pandemic has changed their outlook on research. These were categorised into positive (increased awareness of the importance and need for research, altruism) and negative (increased anxiety, need to minimise exposure to the hospital environment) influences. CONCLUSIONS: Factors influencing patients' decisions to participate in trials are similar to those observed prior to COVID-19 but with an increased focus on the environment the research is conducted in. The COVID-19 pandemic has had positive and negative impacts on patient attitudes towards research. Trial design, with a particular focus on setting and safety measures, in reassuring patients is increasingly important.
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COVID-19 , Ophthalmology , Patient Participation , Patient Selection , Clinical Trials as Topic , Humans , Outpatients , Pandemics , Surveys and QuestionnairesABSTRACT
As well as being a basic diagnostic tool, our hands as midwives give us the opportunity to provide a tender touch, which research tells us can boost the immune system, reduce pain and trigger the release of endorphins and oxytocin.1 Touch is a powerful yet sometimes underestimated sense;as babies it is our first sensation and as we grow, a universal language. Touch fosters compassion and empathy2 by activating the vagus nerve3 and can help with reconciliation.4 In addition, touch indicates trust, and calms the cardiovascular system.
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I used to love my job, but recently I have had to brace myself before starting a shift, as I wonder 'how much abuse am I going to suffer today?'.
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AUTH Why you should read this article: • To learn about the experience of two trusts that set up a home denosumab self-administration service for patients during the coronavirus disease 2019 (COVID-19) pandemic • To recognise the need for a robust, comprehensive and consistent training process for patients to self-administer denosumab at home safely • To identify the benefits for patients and their families of a home denosumab self-administration service In October 2012 the National Institute for Health and Care Excellence approved the use of subcutaneous denosumab for the management of bone metastases from solid tumours. For patients receiving intravenous chemotherapy, denosumab can be administered in parallel with this, obviating the need for additional hospital visits. However, patients receiving oral chemotherapy or denosumab alone often must attend hospital solely for a subcutaneous injection of the latter. This article describes the experience of two NHS trusts in setting up a home self-administration service for denosumab during the coronavirus disease 2019 (COVID-19) pandemic. The service development project took place during 2020-2021. The article explores the barriers to and facilitators of this project and reports the results of a patient feedback survey which showed that all respondents wished to continue self-administration of denosumab at home.