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Introduction: Adopting diabetes self-care behaviors to control blood glucose is essential, but adherence to them has been challenged due to restrictions related to Covid-19. These restrictions have negatively impacted the psychosocial condition of individuals with diabetes, which could lead to poor self-care. Accordingly, this study aimed to explore the experiences of individuals with type 2 diabetes regarding self-care behaviors and diabetes management during the COVID-19 pandemic. Material(s) and Method(s): This qualitative study was conducted using conventional content analysis, the data of which were collected through interviews with people over 18 years of age with type 2 diabetes who were selected from the Endocrinology Clinic of Erfan Hospital in Tehran. Using telephone and WhatsApp, semi-structured interviews were conducted with 20 participants (15 women). Content analysis was done using the constant comparative method, and the open and axial coding method was applied. The data were manually coded, and the main themes and categories emerged from data. Result(s): Two main themes emerged from the data: 1) challenges and limitations toward diabetes self-care and 2) facilitators of efficient self-care. Challenges and limitations included 4 sub-themes: Inevitable lifestyle changes, psychosocial problems, limited/lack of access to health care services and medication, and adverse physical effects. Facilitators had 2 sub-themes: improved individual capability and maintaining social interaction. Conclusion(s): Our findings indicated that inevitable lifestyle changes, limited access to health care, and adverse psychosocial consequences were the most critical challenges for diabetes management during the COVID-19 pandemic. Improving stress management skills and effective coping strategies can facilitate the adoption of self-care behaviors.Copyright © 2022, Research Institute for Endocrine Sciences. All rights reserved.
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Background/Purpose: Adolescent and young adult (AYA) cancer survivors experience acute and long-term challenges, including disruptions to developmental milestones, altered relationships, and difficulty managing follow-up care. The COVID-19 pandemic likely exacerbated these challenges, but, to date, we know little about young survivors' day-to-day lives during this time. Here, we qualitatively assessed AYA cancer survivors' pandemic-related experiences. Method(s): Thirty-five AYA cancer survivors (85% female, Mage = 32.7 years, 71% White, September 2020-March 2021) wrote factual details about their day-to-day lives (e.g., "what is a typical day like?") as part of a larger randomized controlled trial. Participants were, on average, 5.9 years post-diagnosis;the majority were diagnosed with lymphoma (25.7%) or thyroid cancer (17.1%). Data were analyzed using constant comparative method. Result(s): Five themes emerged: (1) job changes (e.g., inability to work due to immunosuppression, fear career would become less viable);(2) limited interactions/relational depth (e.g., feeling "left out" due to immunosuppression, inability to date, risky family behaviors limit meaningful connection);(3) varying reactions to virtual communication (e.g., gratitude for online schooling, exercise, and social media, withdrawing from friendships due to "zoom burn out," not attending therapy due to lack of engagement);(4) difficulty engaging in health-promoting behaviors and attending/interacting in medical appointments (e.g., problems maintaining nutrition and exercise routines, postponing surveillance appointments, missing family member presence in medical appointments), and (5) disruptions/ delays to post-treatment milestones/plans (e.g., delaying vocational changes, wedding and family planning, and celebratory travel). Notably, no themes associated with positive adjustment emerged. Conclusions and Implications: Goals within multiple domains were obstructed and unmet needs were identified, namely, assistance navigating isolation, relationship disruptions, career/financial barriers, and access to medical care. Results are limited due to the methodology, as this was not a structured interview. Nonetheless, individual counsel with AYA cancer survivors is recommended to provide resources and address pandemic-induced barriers to health and well-being.
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This paper offers the 6 A's model of social worker associations and COVID-19, which includes (i) 'Apprehend', (ii) 'act', (iii) 'advocate', (iv) 'alliance', (v) 'an emphasis on solidarity and resilience' and (vi) 'a future prospect'. The model is based on the findings of qualitative analysis of social worker associations' reports on COVID-19. It also offers insights that can be utilised in similar crises in the future.
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This paper reports on the lessons learnt from the COVID-19-induced emergency remote (online) teaching and learning of a one-year teacher education course. The final-year course, within a four-year Bachelor of Education programme, aimed at developing pre-service teachers' knowledge of the nature and process of learning and how to guide and support learning in diverse school contexts. The course was planned before the COVID-19 pandemic, and teaching and learning would have taken place on campus, with limited online activities. The ensuing lockdown in South Africa resulted in university teaching and learning moving abruptly online. We investigated lessons learnt from the transition to emergency remote (online) teaching. Data were generated by conducting semi-structured interviews with 20 student teachers about their experiences of the course. The data were analysed using the constant comparative method. Analysing the data highlighted the benefits of remote (online) teaching that should be considered when using a blended approach to harness online teaching affordances. As we advance, we will implement a fully blended approach, harnessing the affordances of both online and contact-based teaching and learning. Practitioner Notes 1. Students in higher education benefit from explicit communication and continuous support from lecturers. 2. Small-group practice and reflection sessions are beneficial to students' learning (online or during contact sessions). 3. Students in higher education benefit when course content is structured in a consistent, routinized and accessible way. 4. Teacher education students should be prepared to adapt to teaching in different contexts (contact, blended or remote). 5. Higher education courses should combine the best affordance of online and contact teaching. © 2023, University of Wollongong. All rights reserved.
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Introduction: Globally, disparities exist in healthcare quality, accessibility and regulation (Das, & Gertler, 2007). Consequently, few countries have governing bodies overlooking healthcare-professional (HCP) practice (Epstein, & Bing, 2011). Research has suggested that HCP regulation depended on nations' human development index (HDI), gross domestic product (GDP), and safety (Ozturk, & Topcu, 2014). IPC enables partnership working between HCPs to ensure patient-centred care (Gregory, & Austin, 2016). This study thematically analysed pharmacy professional standards' documents of various countries and investigated whether nations' developmental parameters influenced pharmacy regulation. Objectives * To compare global pharmacy professional standards on IPC. * To synthesise a thematic framework to evaluate literature on IPC. * To iInvestigate the relationship between HDI, GDP, global peace index (GPI), and pharmacy regulation. Method(s): A group (N = 8) of countries were studied based on 2018 HDI classification;(N = 4) 'very high' (Australia, Hong Kong, Canada, United Kingdom) and (N = 4) 'low' (Solomon Islands, Haiti, Yemen, South Sudan). Pharmacy professional standards' documents were screened to extract IPC-related themes via a constant comparative method. This facilitated thematic framework synthesis;'pharmacists' attitudes' and 'patient outcomes' were measures of IPC. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), (N = 17) peer-reviewed journal articles from 2010-2019 studying pharmacists in sample countries were selected. Key terms searched on Medline/PubMed databases were: 'IPC', 'pharmacist' and 'professional standards'. Literature was then reviewed with reference to the thematic framework and development metrics (HDI/GDP/GPI). This study did not require ethics approval. Result(s): Of the countries (N = 8) studied, only HDI-classified 'very high' had professional standards' documents, frequently incorporating IPC. Key themes were: 'shared decision-making', 'continuity-of-care', and 'effective communication'. Seven studies referred to these themes and confirmed IPC benefits: fewer medication-related errors4. The number of IPC standards and HDI-rank for 'very high' countries, except Hong Kong, were positively correlated, suggesting possible economic impact on pharmacy sector progress. Two studies found cultural influences on Hong Kong pharmacists' attitudes as contributory to a hierarchical than IPC-approach to healthcare provision5. HDI and GPI had a strong negative correlation (r = -0.83), potentially explaining low pharmacist density and GDP healthcare expenditure in HDI-classified low. Conclusion(s): Results denote that IPC improved patient safety (Gregory, & Austin, 2016). Global differences existed in pharmacists' attitudes and IPC training. These correlated with growing gaps in HDI and GPI between HDI-classified 'very high' and 'low' countries. Qualitative analysis highlighted the need for elaboration of 'continuity-of-care' and inclusion of 'understanding roles/responsibilities of team members' in the United Kingdom's professional standards set by the General Pharmaceutical Council. Future work could study 2021/inequality-adjusted HDI data, 'high'/'medium' HDI countries to improve validity alongside COVID19 impact on GDP and pharmacy practice.
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The aims of the study are to characterize the role of various types of community dining centers located in the Argentinian province of Mendoza in feeding vulnerable children during the pandemic and to compare initiatives coming from social movements that facilitate the state's food assistance to the ones managed by self-directed neighborhood associations and those of governmental spaces. The methodology is qualitative and exploratory. Semi-structured interviews were conducted with 16 informants from neighborhoods located in Gran Mendoza and Gran San Rafael with food insecurity between April and August 2021. A constant comparative method was used to analyze the information. Result(s): There were differences in the predictability of resources to provide food between community dining centers which related to their connections with direct food assistance policies implemented before and during the pandemic. Shared characteristics included women being in charge and the deployment of combined strategies of obtaining resources to deal with higher food demand. The food offered was similar and subject to the availability of supplies and diners' preferences. Conclusion(s): Community initiatives contributed to sustaining the nutrition of children and teenagers from families working in the informal economy that utilized them due to isolation-related salary cuts. No relevant differences were found between menus offered in dining centers managed by social movements and the self-managed, neighborhood-based ones. The management experiences of neighborhood associations, the support of neighbors, and previously built relationships of trust with donors and external organizations were key to upholding the delivery of rations and care of isolated people. Copyright © 2022, Sociedad Chilena de Nutricion Bromatologia y Toxilogica. All rights reserved.
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INTRODUCTION: Clinician burnout is far-reaching and impact individuals, healthcare systems, and patient care, and has been declared an area of major priority by leading critical care societies. The unprecedented demands of the COVID-19 pandemic have exacerbated mental health issues, including anxiety and post-traumatic stress disorder for intensive care unit (ICU) staff who were already at increased risk, leading to subsequent increased burnout. Therefore, we explored the secondary role that post-ICU clinics may play in reducing the symptoms of ICU staff burnout. METHOD(S): We performed a qualitative secondary analysis of semi-structured interviews with multidisciplinary post-ICU clinician members of the Critical and Acute Illness Recovery Organization (CAIRO) between February and March 2021. The original study examined how clinicians perceived the COVID-19 pandemic changed post-ICU care delivery. Data were analyzed post-hoc through a constant comparative method. RESULT(S): Twenty-nine multidisciplinary clinicians from 15 international sites (Canada, the United States, the United Kingdom) participated in the study. The sample was largely female (72.4%) working in academic clinical settings (69.0%). Median length of time in clinician role was 16 years (IQR 7, 21), and median length of time working with a post-ICU program was 3 years (IQR 1, 4). We identified two overlapping mechanisms by which participants perceived reduced symptoms of ICU staff burnout: 1) staff exposure to and expression of humanizing behaviors and 2) visualizing and communicating treatment successes. Practical examples included sharing videos, photographs, and written stories of survivors with the ICU team;directly staffing post-ICU clinics;and in-person contact between ICU staff and survivors and families after ICU discharge. CONCLUSION(S): Multidisciplinary clinicians in post- ICU clinics commonly perceived that a bidirectional compassionate relationship and authentic interaction and communication with ICU survivors reduced the symptoms of burnout. Interprofessional teams in the ICU and healthcare administration should consider how programs that facilitate interaction with critical illness survivors may reduce the symptoms of burnout in ICU staff.
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BACKGROUND: The COVID-19 pandemic magnified the digital health divide among marginalized populations when health systems scaled back inperson visits as a public health precaution. We conducted this qualitative study during the pandemic to solicit patient and provider perceptions of use of digital health programs (patient portals, telemedicine, remote hypertension/diabetes monitoring) and to inform strategies to surmount barriers to accessing remote care. METHODS: We conducted semi-structured interviews with 40 patients and 29 primary care providers (PCPs) from northern and southeastern Louisiana who were recruited within an integrated delivery health system and an FQHC between May and July 2021. We used constant comparative method of grounded theory to identify themes. Commonalities/differences in perspectives between patients and PCPs were analyzed. RESULTS:Most patients recruited to the study self-identified as Black (68%), female (73%), mean age 51, lived in an urban area (77%), and had Medicaid (58%). Most PCPs were White (79%), male (52%), mean age 39, and reported Medicaid as the predominant insurer (59%). Most patients reported using smartphones for accessing the internet for health and non-health activities. Some participants used apps to track their health but noted internet/data/storage limits. PCPs noted increased uptake of misinformation on the internet prompting them to proactively recommend websites and apps. Most patients had used a patient portal and reported convenience of messaging their PCP, getting refills, scheduling appointments, and reviewing test results. PCPs noted a concurrent increase in their in-basket workload with a particular concern for frequent messaging like cellphone texting. Most patients had telemedicine video visits using their smartphones - some of which converted to audio when technology problems arose. Patients and PCPs noted telemedicine is appropriate for routine follow-up but preferred in-person visits. PCPs noted additional workflow disruption when moving from in-person to video visits in the same clinic session. Few patients were enrolled in a digital health program for remote monitoring;however, patients and PCPs agreed these programs provide valuable adjuncts to chronic care. PCPs reported patient limitations in accessing such programs due to the need for smartphones/internet/WiFi and select insurance coverage which can lead to further disparities in access to care. CONCLUSIONS: Health policies that support broadband/internet/ smartphone service as a standard utility and insurance coverage for digital health programming are paramount for surmounting major patient barriers. Clinical practice procedures which optimize technical support for patients and providers are also needed. RESULTS: Of the 236 women in the study, there was a mean age of 66.5 years ± 7.1;67 self-identified as Black, 93 as White, 49 as Hispanic and 16 as Other. Median CA anxiety score was 3 while DM anxiety score was 2.5 (p<0.001). For the anxiety groups, 67 (28%) were in the high CA/high DM group, 52 (22%) in the high CA/low DM group, 15 (6%) in the low CA/high DM group, and 94 (39%) in the low CA/low DM group. Participants in the high CA/low DMand low CA/low DMgroups were more likely to adhere to a healthy diet (73% and 71% compared with 51% for high CA/high DM and 53% for low CA/high DM, p= 0.02). They also had an increased likelihood of consuming at least 5 servings of fruits and veggies daily (69% and 57% vs. 45% for high CA/high DM and 40% for low CA/high DM, p= 0.03) and adhering to oral DM medications (62% and 75% vs. 52% for high CA/high DM and 20% for low CA/high DM, p= 0.05). CONCLUSIONS: Older breast cancer survivors with DM have different levels of anxiety about CA versus DM and those with high DM anxiety are less likely to adhere to DMSMBs. Our findings suggest that increased anxiety might hinder one's ability to achieve disease control, making anxiety management vital to supporting patient adherence and health.
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Introduction: During the COVID-19 pandemic, low-wage workers faced high exposure risk as they continued to work in essential public-facing jobs such as grocery store clerks and gas station attendants. In a context where these types of jobs were usually precarious and had no paid sick leave, we explored how low-wage workers navigated decision-making around when to take sick leave. Material: From September 2021 to April 2022, in-depth, semi-structured interviews were conducted in Ontario and Quebec (Canada) with 72 low-wage and public-facing workers, managers of these kinds of workers, and key informants with insight into legal and policy issues related to low-wage workers. Methods: Interviews were transcribed verbatim and coded in NVivo. Analysis followed constant comparative methods as well as situational analysis. Results: Public-facing, low-wage workers and managers described psychosocial pressures of COVID-19-related customer aggression. In a context of economic insecurity, participants described a focus on “pleasing the customer”, “not rocking the boat” and a reluctance to take sick leave when experiencing COVID-19 symptoms for fear of loss of income and loss of future work shifts. Conclusions: Workers who worked while ill weighed risks of COVID-19 against risks of loss of income (need for food, paying the rent) and decided that working while ill was least problematic. This is a problem for society as poor worker protections put the public at risk.
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Objective: Pandemic-related changes produced a major shift for parental roles, responsibilities, and expectations. Our objective was to identify parenting challenges experienced by low-income postpartum mothers during a global pandemic lockdown. Study Design: In this qualitative investigation, we conducted semi-structured interviews with 40 postpartum individuals who gave birth in a single center in Chicago in the first three months of the COVID-19 pandemic (January-March 2020). Interviews addressed issues related to maternal health and well-being, including parental stress, limited access to essential goods, and COVID-related barriers to providing for children. All interviews were conducted via phone, transcribed, and analyzed using the constant comparative method. Results: Of the 40 participants, 50% (n=20) identified as non-Hispanic Black and 38% (n=15) as Hispanic;75% (n=30) were parents of multiple children. The primary parenting-related themes included challenges of parenting multiple children, barriers to self-care, and novel barriers to providing for children (Table). Subthemes within challenges of parenting multiple children include new role as an educator, struggle with entertaining, and time allocation. The barriers to self-care subthemes included lack of free time, changes in self-care and coping strategies, and effects on maternal mental health. The novel barriers to providing for children subthemes included lack of communal support, financial stress, and difficulty obtaining essential needs. Conclusion: Obstetric providers are often a first-line point of contact for postpartum individuals and may benefit from understanding how psychosocial stressors experienced during the pandemic may negatively affect maternal health. Our findings suggest new psychosocial burdens were introduced by the pandemic that challenged individual health and wellbeing during the postpartum period. Findings can inform interventions, which may include enhanced support from the clinical team or connections to community resources, to alleviate postpartum challenges for mothers and their families. [Formula presented]