Tahap Tekanan Emosi dan Sokongan Sosial dalam kalangan Ibu Bapa Semasa Pandemik COVID-19

Abstrak: Masyarakat terpaksa menghadapi perubahan norma kehidupan lebih-lebih lagi dari segi sosial sejak kerajaan melaksanakan Perintah Kawalan Pergerakan (PKP) sepanjang tempoh pandemik bagi mengekang penularan wabak COVID-19. Oleh itu, objektif kajian ini dilakukan untuk mengenal pasti tekanan emosi dan sokongan sosial kesan daripada perubahan norma kehidupan masyarakat semasa pandemik COVID-19 lebihlebih lagi dalam kalangan ibu bapa. Dalam kajian ini, kaedah reka bentuk kuantitatif digunakan dengan menggunakan teknik keratan lintang. Seramai 89 orang responden dalam kalangan ibu bapa mahasiswa Program Kerja Sosial, Fakulti Sains Sosial Kemanusiaan (FSSK), Universiti Kebangsaan Malaysia (UKM) telah menjawab soal selidik yang terbahagi kepada tiga bahagian iaitu demografi, tahap tekanan dan sokongan sosial. Hasil kajian menunjukkan bahawa ibu bapa menghadapi tahap tekanan yang sederhana secara keseluruhannya. Ibu bapa juga menerima sokongan sosial dari pasangan, keluarga dan rakan-rakan. Hasil kajian turut mendapati, terdapatnya hubungan yang signifikan antara tahap tekanan emosi dan sokongan sosial. Oleh yang demikian, pengkaji menyimpulkan bahawa sokongan sosial yang tinggi dari keluarga membantu mengekalkan tahap tekanan pada tahap sederhana dalam kalangan ibu bapa semasa tempoh pandemik COVID-19.Alternate :The community has had to face a change in the norms of life especially from a social point of view since the government implemented the Movement Control Order (MCO) throughout the pandemic period to curb the spread of the COVID-19 epidemic. Therefore, the objective of this study was to identify the emotional stress and social support of the impact of changes in the norms of community life during the COVID-19 pandemic, especially among parents. In this study, a quantitative design method was used using a crosssectional technique. A total of 89 respondents among the parents of students of the Social Work Program, Faculty of Social Sciences and Humanities (FSSK), Universiti Kebangsaan Malaysia (UKM) have answered the questionnaire which is divided into three parts, namely demographics, stress level and social support. The results of the study showed that parents face a moderate level of stress overall. Parents also received social support from partners, family, and friends. The results of the study also found that there was a significant relationship between emotional stress level with social support. Therefore, the researcher concluded that high social support from the family helps keep the stress level at a moderate level among parents during the period of the COVID-19 pandemic.

A Double Jeopardy: COVID-19 impacts on the travel behavior and community living of people with disabilities.

The COVID-19 pandemic response has had a significant impact on the general population's ability to participate in their communities. Individuals with disabilities, an already socially disadvantaged population, are more vulnerable to and have likely been disproportionately impacted by COVID-19 response conditions. Yet, the extent to which daily community living activities of people with disabilities have been impacted is unknown. Thus, this study assesses their travel behavior and community living during the COVID-19 pandemic conditions compared with those of the general population during the same period. A web survey was conducted using Qualtrics's online panel data (respondents included 232 people with disabilities and 161 people without disabilities). Regression models found that people with disabilities reduced their daily travel to a greater extent but at varying degrees, depending on the destination types and travel modes. Reductions in taxi rides (including ride-hailing services) were most significant among people with cognitive and sensory (vision and hearing) disabilities. By place type, cognitive disability was associated with a trip reduction for multiple destination types-grocery, restaurants, outdoor recreation, indoor recreation, and healthcare providers. Findings from this study could contribute to decision- and policy-making in planning, transportation, and community services during the remainder of the COVID-19 pandemic, in future major public health crises, as well as post-COVID, because the adjustments in travel behavior and community living might be longer-term.

Innovative technology-enhanced social work service during COVID-19: How 'Garden on the Balcony' promoted resilience, community bonds and a green lifestyle

The ongoing COVID-19 pandemic has motivated social workers to reckon with and transform traditions in service delivery. The development, application, and evaluation of technology-enhanced practices have become more vital than ever. Garden on the Balcony (GOB) was an innovative internet-based social work service designed to respond rapidly to the COVID-19 outbreak in Beijing. This paper introduces the underlying perspectives and design of GOB and reports participants' reflections on the program to understand its mechanisms and implications. Interview data from GOB participants were collected 4 months after the program ended. Thematic analysis generated three major themes, suggesting that GOB had (a) promoted individual resilience and family cohesion;(b) built online and offline community bonds;and (c) cultivated a green lifestyle and spiritual reflection on life. This study demonstrates a practical example of the effective use of technology-enhanced practice.

Digital Practices by Citizens During the COVID-19 Pandemic: Findings From an International Multisite Study.

BACKGROUND: The COVID-19 pandemic brought digital practices and engagement to the forefront of society, which were based on behavioral changes associated with adhering to different government mandates. Further behavioral changes included transitioning from working in the office to working from home, with the use of various social media and communication platforms to maintain a level of social connectedness, especially given that many people who were living in different types of communities, such as rural, urban, and city spaces, were socially isolated from friends, family members, and community groups. Although there is a growing body of research exploring how technology is being used by people, there is limited information and insight about the digital practices employed across different age cohorts living in different physical spaces and residing in different countries. OBJECTIVE: This paper presents the findings from an international multisite study exploring the impact of social media and the internet on the health and well-being of individuals in different countries during the COVID-19 pandemic. METHODS: Data were collected via a series of online surveys deployed between April 4, 2020, and September 30, 2021. The age of respondents varied from 18 years to over 60 years across the 3 regions of Europe, Asia, and North America. On exploring the associations of technology use, social connectedness, and sociodemographic factors with loneliness and well-being through bivariate and multivariate analyses, significant differences were observed. RESULTS: The levels of loneliness were higher among respondents who used social media messengers or many social media apps than among those who did not use social media messengers or used ≤1 social media app. Additionally, the levels of loneliness were higher among respondents who were not members of an online community support group than among those who were members of an online community support group. Psychological well-being was significantly lower and loneliness was significantly higher among people living in small towns and rural areas than among those living in suburban and urban communities. Younger respondents (18-29 years old), single adults, unemployed individuals, and those with lower levels of education were more likely to experience loneliness. CONCLUSIONS: From an international and interdisciplinary perspective, policymakers and stakeholders should extend and explore interventions targeting loneliness experienced by single young adults and further examine how this may vary across geographies. The study findings have implications across the fields of gerontechnology, health sciences, social sciences, media communication, computers, and information technology. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3389/fsoc.2020.574811.

Public Health Safety in Community Living Circles Based on a Behavioral Motivation Perspective: Theoretical Framework and Evaluation System.

Public health problems, such as the spread of COVID-19 and chronic diseases, are mainly caused by the daily life activities of community residents. Therefore, there is a need to build a healthy and safe community living circle through the evaluation of health behaviors in daily life. This paper proposes a theoretical framework and evaluation system for public health safety in community living circles, from a behavioral motivation perspective. Firstly, based on the behavioral motivation theory, a theoretical framework for the study of public health safety in community living circles is constructed from the perspective of the "project-activity-health" coupling relationship network, regarding community residents' daily life activities. Then, a public health safety evaluation system for community living circles is proposed based on this framework, which includes the following: (1) identifying the scope of community living circles based on Spatio-temporal Activities Analysis; (2) Based on the theory of protection motivation, a health behavior evaluation model based on the three elements of "spatial and temporal geographical environment-daily life activities-public health safety" is established; (3) Based on the hierarchy of public health problems, a public health safety evaluation model of the community living circle is established. The behavioral motivation-based evaluation system explores a new approach and research paradigm for community-scale public health safety theory; this will help to achieve the goal of "healthy communities" when further empirical evidence is available.

Outbreak and Management of COVID-19 and Infection Prevention Control Practices at a Community Living Center in Veterans Administration Hospital, North Texas

Background. The increase in SARS-CoV-2 cases due to the omicron wave led to significant utilization of healthcare resources and reduced acute care hospital beds at the Veterans Administration Hospital, North Texas Health Care System (VANTHCS). As a result, veterans with non-severe disease were managed at a VANTHCS community living center (CLC) during a COVID-19 outbreak. Methods. Veterans residing at the CLC with laboratory-confirmed cases of SARS-CoV-2 (the virus that causes COVID-19) by polymerase chain reaction diagnosed from January 1 to February 15, 2022, were included in the descriptive analysis. We described resident characteristics and outcomes and infection control practices (IPC) implemented to control the outbreak. Resident data was ascertained from the COVID-19 facility dashboard and medical record system. Results. From January 1-February 15, 2022, 33 adults residing at the CLC were diagnosed COVID-19. Most infections (93.9%) occurred between January 12-24 (figure 1). The median age was 76 years [interquartile range, 71-80 years] and 30 (90.9%) were men and 25 (75.8%) were white and 5 (15.2%) African American (table 1). Among the total cases, 9 (27.3%) resided in the dementia unit. Nineteen of 33 (57.6%) were asymptomatic. Overall, 28 (84.8%) were documented to be fully vaccinated against SARS-CoV-2 and 24 (72.7%) were boosted. Obesity, ischemic heart disease, chronic obstructive pulmonary disease, and stroke were the most common comorbidities. Residents were cohorted based on COVID-19 results. A multidisciplinary team was convened, and staff were fit tested for appropriate personal protective equipment (PPE) and received refresher training on hand hygiene, donning and doffing of PPE. Most residents were determined to have mild or moderate COVID-19 and managed at the CLC while 7 (21.2%) were hospitalized in the acute care hospital. For management of COVID-19, 11 (33.3%) received dexamethasone and 25 (75.8%) received remdesivir. Overall, 32 (97%) residents survived while one hospice resident was transferred to acute care and died;only 1 resident required ICU admission. Epidemic curve of laboratory-confirmed coronavirus disease 2019 (COVID-19) disease at a Community Living Center, Veterans Administration Hospital, North Texas Health Care System, January-February 2022. Table 1 Epidemiological Characteristics, and Outcomes of Laboratory-confirmed COVID-19 cases (N=33) Abbreviation: BMI, body mass index;COPD, Chronic Obstructive Pulmonary Disease;ESRD, end stage renal disease 1Other comorbidity (asthma n=1 and chronic liver disease n=2) Conclusion. It is feasible to administer COVID-19therapies to high-risk residents with mild-moderate disease in a CLC with a multidisciplinary team and IPC strategies.

The Impact of the COVID-19 Pandemic on the Prevalence of Multidrug-resistant Organisms in Veterans Affairs Nursing Homes

Background. Multidrug-resistant organisms (MDRO) in long-term care facilities are prevalent and pose a major health concern for their residents. During the COVID-19 pandemic, infection control measures were justifiably heightened in every aspect of health care, including nursing homes. There are reports depicting decreasing prevalence of MDRO in hospital settings during the pandemic. We compared the prevalence of MDRO in our facility's nursing homes in the two-year period before vs. the two years of the pandemic. Methods. Northport Veterans Affairs Medical Center provides long-term nursing home care structured as community living centers including mental health and hospice care;a 139 total bed capacity. A retrospective review of culture data collected by infection control preventionists comparing the prevalence of MDROs between 1 March 2018 to 28 February 2022 was performed. Data included: Nasopharyngeal MRSA swabs, urine, wound, blood, sputum cultures, C. difficile toxin and PCR assays. MDRO included ESBL E. coli, K. pneumoniae, P. mirabilis, MDR Pseudomonas spp (resistance to 2/3 antibiotics: cefepime/piperacillin-tazobactam/ciprofloxacin), carbapenem-resistant Pseudomonas spp, and vancomycin-resistant Enterococcus spp. Results. There were 75209 bed days of care from 1 March 2018 to 28 February 2020 vs. 77531 from 1 March 2020 to 28 February 2022. The MRSA rate per 1000 patient days decreased from 4.98 pre-COVID to 2.70 during-COVID, P < 0.001. Similarly, there was a decrease in C. difficile 0.69 vs. 0.13, P< 0.001, ESBL E. coli 0.53 vs. 0.51, P< 0.001 and S. maltophilia (no cases during COVID). There was an increase in ESBL K. pneumoniae 0.51 vs. 0.63, P< 0.001, MDR Pseudomonas 0.05 vs. 0.49, P< 0.001, carbapenem-resistant Pseudomonas 0.026 vs. 0.077, P< 0.001 and VRE 0.22 vs. 0.31, P< 0.001. There were no Candida auris or Acinetobacter spp detected in the study period. MDRO occurrences before and during COVID-19 pandemic Conclusion. While increased awareness and implementation of infection control measures during the years of the COVID-19 pandemic led to decrease in certain infections in our nursing homes, like C. difficile, a surprising uptick in ESBL K. pneumoniae and MDR Pseudomonas was noted. This is a concerning trend that merits further study to identify molecular factors and increase stewardship efforts in diligent use of carbapenems.

Using Mnemonics, Remote Coaching, and the Range-Bound Changing Criterion Design to Teach College Students with IDD to Make Employment Decisions

Adults with intellectual and developmental disability (IDD) increasingly are accessing inclusive college programs to gain academic and employment preparation for future community living. Decision-making and self-determination are two inter-related skills taught in these programs. In this study, we investigated an intervention that combined remote audio coaching (RAC) and a mnemonic strategy to teach employment decision- making skills to three college students with IDD. We evaluated the intervention using the range-bound changing criterion design to assess students' stepwise progress. All students substantially increased their employment decision-making skills, generalized those skills to a novel job coach who was not part of the intervention, and maintained the skills after the intervention was removed. We discuss implications of the procedures and results of this decision-making intervention, as well as the goodness-of-fit of the experimental design for evaluating controlled, gradual skill increases.

COVID-19 Health and Rehabilitation Implications among Multiply Marginalized People of Color with Disabilities: A Scoping Review

The purpose of this scoping review was to examine the literature about Coro- navirus disease 2019 (COVID-19) and health and rehabilitation implications for persons of color, including those with multiple marginalized statuses (i.e., racial/ethnic minority and disability), and map out research gaps. Several themes emerged from this review that included disproportionate burdens of infections, hospitalizations and deaths;structural racism as a driver of inequity;diminished employment opportunities, and limited data on race and disability. The findings revealed the existence of serious evidence gaps relating to multiply marginalized people of color with disabilities within the COVID-19 context. A clear need exists for more research on COVID-19 outcomes disaggregated by disability and race so that the field has a fuller understanding of the impact of the pandemic on people of color with disabilities. Additionally, minority serving institutions (e.g., HBCUs and TCUs), as experts in addressing marginalized communities' needs, should play a leadership role in equity research. © 2022 National Rehabilitation Association. All rights reserved.

COVID-19 and Persons With Intellectual and Developmental Disabilities: Implications for Future Policy, Practice, and Research.

The COVID-19 pandemic has been hard for everyone. For the estimated seven and a half million people in the United States who live with intellectual disability (Residential Information Systems Project, 2020), it has been very hard. Lives have been disrupted by lost jobs, lack of access to friends/family, and challenges finding enough staff to provide supports and needed healthcare. Studies have shown that people with IDD are at a much greater risk of getting COVID-19 and dying from it (Cuypers et al., 2020; Gleason et al., 2021; Kaye, 2021; Landes, Turk, & Ervin, 2020; Nygren & Lulinski, 2020). Without question, people with intellectual and developmental disabilities (IDD) struggled as the COVID-19 pandemic began and as it has continued. Too many were isolated from friends and family for far too long. Too many were lonely and bored. Too many have not received the support they have needed during the pandemic. Far too many were denied treatment and far too many have died. As a nation we must reflect on what has happened and listen to people with IDD and their families about their experiences. This commentary reflects on the implications of COVID-19 for research, policy, and practice through the lens of people with IDD.

Factors associated with hospital admission and severe outcomes for older patients with COVID-19.

BACKGROUND: Morbidity and death due to coronavirus disease 2019 (COVID-19) experienced by older adults in nursing homes have been well described, but COVID-19's impact on community-living older adults is less studied. Similarly, the previous ambulatory care experience of such patients has rarely been considered in studies of COVID-19 risks and outcomes. METHODS: To investigate the relationship of advanced age (65+), on risk factors associated with COVID-19 outcomes in community-living elders, we identified an electronic health records cohort of older patients aged 65+ with laboratory-confirmed COVID-19 with and without an ambulatory care visit in the past 24 months (n = 47,219) in the New York City (NYC) academic medical institutions and the NYC public hospital system from January 2020 to February 2021. The main outcomes are COVID-19 hospitalization; severe outcomes/Intensive care unit (ICU), intubation, dialysis, stroke, in-hospital death), and in-hospital death. The exposures include demographic characteristics, and those with ambulatory records, comorbidities, frailty, and laboratory results. RESULTS: The 31,770 patients with an ambulatory history had a median age of 74 years; were 47.4% male, 24.3% non-Hispanic white, 23.3% non-Hispanic black, and 18.4% Hispanic. With increasing age, the odds ratios and attributable fractions of sex, race-ethnicity, comorbidities, and biomarkers decreased except for dementia and frailty (Hospital Frailty Risk Score). Patients without ambulatory care histories, compared to those with, had significantly higher adjusted rates of COVID-19 hospitalization and severe outcomes, with strongest effect in the oldest group. CONCLUSIONS: In this cohort of community-dwelling older adults, we provided evidence of age-specific risk factors for COVID-19 hospitalization and severe outcomes. Future research should explore the impact of frailty and dementia in severe COVID-19 outcomes in community-living older adults, and the role of engagement in ambulatory care in mitigating severe disease.

Building the bridge from hospital to home: Phase II in the development of a pilot program to support patients with spinal cord injury/disorder (SCI/D) transition back into the community

Background: This project is the second phase of a clinical quality improvement (QI) project, which aims to develop a pilot program to provide transitional services to persons with spinal cord injury (SCI). Transitional services refer to those provided during the acute period post-discharge from inpatient rehabilitation, as persons with SCI reintegrate to community living. The first phase of the QI project is documented elsewhere. Objectives: To contribute to the holistic understanding of the barriers and facilitators that influence the transition process, and ways of supporting persons with spinal cord injury (SCI) through the transition. Methods: This project includes analysis of surveys that were distributed under the previous phase of the QI project as well as development, administration, and analysis of second round surveys. This project also includes an environmental scan and researching evaluation methods for similar projects in the published literature. Provision of services during the COVID-19 pandemic was researched. Results: There are a variety of transitional models of care from outpatient clinics to in-home and communitybased services. Survey respondents described challenges during their transition experience with emergent challenges noted by those who discharged during the COVID-19 pandemic. Community services in Calgary were described to identify gaps in support for persons with SCI during the transition. Conclusions: The transition from hospital to home must be bolstered, and context-relevant rehabilitation is needed. Future programs must be developed to weather uncertain circumstances, such as a global pandemic or inclement weather, to ensure continuous support for persons with SCI.

Impact of fever thresholds in detection of COVID-19 in Department of Veterans Affairs Community Living Center residents.

BACKGROUND: Among nursing home residents, for whom age and frailty can blunt febrile responses to illness, the temperature used to define fever can influence the clinical recognition of COVID-19 symptoms. To assess the potential for differences in the definition of fever to characterize nursing home residents with COVID-19 infections as symptomatic, pre-symptomatic, or asymptomatic, we conducted a retrospective study on a national cohort of Department of Veterans Affairs (VA) Community Living Center (CLC) residents tested for SARS-CoV-2. METHODS: Residents with positive SARS-CoV-2 tests were classified as asymptomatic if they did not experience any symptoms, and as symptomatic or pre-symptomatic if the experienced a fever (>100.4°F) before or following a positive SARS-CoV-2 test, respectively. All-cause 30-day mortality was assessed as was the influence of a lower temperature threshold (>99.0°F) on classification of residents with positive SARS-CoV-2 tests. RESULTS: From March 2020 through November 2020, VA CLCs tested 11,908 residents for SARS-CoV-2 using RT-PCR, with a positivity of rate of 13% (1557). Among residents with positive tests and using >100.4°F, 321 (21%) were symptomatic, 425 (27%) were pre-symptomatic, and 811 (52%) were asymptomatic. All-cause 30-day mortality among residents with symptomatic and pre-symptomatic COVID-19 infections was 24% and 26%, respectively, while those with an asymptomatic infection had mortality rates similar to residents with negative SAR-CoV-2 tests (10% and 5%, respectively). Using >99.0°F would have increased the number of residents categorized as symptomatic at the time of testing from 321 to 773. CONCLUSIONS: All-cause 30-day mortality was similar among VA CLC residents with symptomatic or pre-symptomatic COVID-19 infection, and lower than rates reported in non-VA nursing homes. A lower temperature threshold would increase the number of residents recognized as having symptomatic infection, potentially leading to earlier detection and more rapid implementation of therapeutic interventions and infection prevention and control measures.