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Objective: Healthcare professionals were the workers most affected by Covid-19, espe-cially during the first waves of the pandemic. Thus, the aim of this study is to evaluate the perceived risk of exposure to Covid-19, the information received and the work participation between nurses, physicians and nursing assistants. Method(s): A cross-sectional study was conducted using an epidemiological survey among nurses, physicians and nursing assistants in a university hospital. Aspect and content validation, cognitive pretest, and piloting of the epidemiological survey was carried out with thirty subjects. A descriptive analysis was per-formed using mean and standard deviation (SD) for quantitative variables and absolute (n) and relative (%) frequencies for qualitative variables. The chi-square test and the ANOVA test were applied to assess the association of the responses with the variables: sex, type of worker, area of work and activity in Covid-19 Units. Result(s): Nurses, physicians and nursing assistants worked mainly in assistance areas and high risk of exposure units. Nursing assistants and nurses had a higher perception of risk. Nurses were less involved in the organiza-tion, but felt more supported by their colleagues. However, physicians felt more supported by their superiors and better care when they had a health problem. Conclusion(s): Nursing assistants and nurses presented higher risk perception, nurses were less involved in the organization of health care, while physicians felt more supported by their superiors.Copyright © 2023, Fundacion Index. All rights reserved.
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During the coronavirus pandemic, it was clearly seen how vulnerable society is with its entire health and sanitary security system, how vulnerable medicine is to a biological attack (whether it was natural or manufactured in a laboratory) and how chaotically society reacts as a whole, when faced with an unknown danger.It was quickly seen that medical science and technology have its limits and risks, that they do not always serve the cause of the suffering man, that biotechnology and genetic manipulation pose a major danger to humanity and that, for the simple reason that it is the product of human reason, always doubtful and hesitant. It has gone so far as to the principles of medical ethics were breached, whether we are talking about non-maleficence or beneficence, decision-making autonomy or nondiscriminatory attitude toward access to resources, with serious damage to the individual -medical system relationship.
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Legal protection for doctor's work safety during the Covid 19 pandemic has not received optimal preventive action from the government with the data showing that the death of health workers in Indonesia accounts for the highest in Asia. This study aims to discuss the concept of legal protection for doctors' work safety in handling Covid-19 cases on the basis of Saddu al-Dzari'ah. The main data source for this study's juridical-normative methodology consisted of secondary data from written legal materials quantitatively examined to provide analytical descriptive data. Results showed that legal protection for the safety of doctors in dealing with Covid-19 cases cannot be as required and correctly implemented in the legislation;in reality the rights of doctors are still neglected and not fulfilled. The government's failure to take preventive measures to offer legal protection for doctors means that mafsadat (injury) in managing C-19 cases persists, which is also evidenced by the number of doctors who died from C-19. Our findings suggest the importance of having the concept of legal protection for doctors in handling Covid-19 cases based on Saddu al-Dzari'ah so that doctors get comprehensive protection. © 2022, University of Muhammadiyah Malang. All rights reserved.
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Introduction: Families of patients admitted to the Intensive Care Unit (ICU) experience significant emotional distress.1 Visiting restrictions mandated during the COVID-19 pandemic presented new barriers to family communication, including a shift from regular bedside nursing updates and in-person family meetings to scheduled, clinician-led telephone calls and video calls.2 This resulted in loss of non-verbal clues and feedback during family discussions, difficulties establishing rapport with families and risked inconsistent messages and moral injury to staff.3 Objectives: We aimed to design a system where all ICU family discussions were documented in one place in a standardised format, thereby clarifying information given to families to date and helping staff give families a consistent message. In addition, we aimed to provide practical advice for the staff making family update telephone calls and strategies for managing difficult telephone conversations. Method(s): We designed and implemented an ICU family communication booklet: this was colour-coded blue;separate to other ICU documentation within the patient notes;and included communication aids and schematics to help staff optimise and structure a telephone update. Using Quality Improvement methodology, we completed four Plan-Do-Study-Act (PDSA) cycles and gathered qualitative and quantitative feedback: this occurred prior to the project and at one,12,18 and 21 months post introduction. We implemented suggested changes at each stage. We designed staff surveys with questions in a 5-point Likert scale format plus opportunity for free comments. Twenty-one months post implementation, we designed and delivered an MDT awareness campaign using the 'tea-trolley training' method,4 departmental induction sessions for new ICU doctors and nurses and a 'Message of the Week' initiative. An updated version of the booklet was introduced in February 2022 (Figure 1). Result(s): Staff survey results are shown in Table 1. Forty-six staff participated in tea trolley training, feedback form return rate 100%. Following feedback, the family communication booklet was updated to include the following: a prompt to set up a password;a new communication checklist at the front, including documentation of next of kin contact details, a prompt to confirm details for video calls, confirm primary contact and whether the next of kin would like updates during the night;consent (if the patient is awake) for video calls while sedated;information regarding patient property;prompt to give families our designated ICU email address to allow relatives to send in photographs to display next to patients' beds;prompts to encourage MDT documentation and patient diary entry. Conclusion(s): During unprecedented visiting restrictions in the COVID-19 pandemic, we implemented an ICU family communication booklet which has been so successful that we plan to use it indefinitely. We plan to further develop this tool by encouraging MDT involvement, seek further staff feedback in six months' time, incorporate this structure into our electronic patient information system when introduced and collect feedback from patients and their next of kin at our ICU follow up clinic. This communication booklet would potentially be reproducible and transferable to other ICUs and could be used as part of a national ICU family communication initiative.
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Background: Work stress among healthcare staff has been identified as an extensive problem already before the pandemic. To be able to treat the surge of COVID-19 patients in need of intensive care COVID-19 ICUs were swiftly set up and staffed. The aim of this study was to investigate what staff perceived as most stressful. Material(s) and Method(s): During spring 2020 up to 270 COVID-19 patients were simultaneously treated in ICU's in the greater Stockholm and Sormland regions, upholding 100 ICU beds pre-pandemic.1 Staff reactions to work in a COVID-19 ICU was collected in a survey. Nine causes for stress were scored on a five graded likert like scale from does not agree to fully agrees. 612 nurses and physicians, both regular ICU staff and newcomers, working in ICU's in 2 larger and 3 smaller hospitals responded, (response rate approx. 35%). Data was analyzed using structural equation modeling to calculate loading of each factor. Result(s): The highest scoring cause of stress was "making a mistake". "Getting infected" got the lowest score among the 9 predefined causes. Conclusion(s): Clinicians working in COVID-19 ICUs were generally confident not to get infected at work. Commitment to maintain patient safety and frustration not to live up to standards of care in this strained situation was reflected in "making a mistake" and "relatives cannot visit" scoring as the number one and three out of the nine causes of stress. Increased knowledge about work-related stressors is crucial, in order to prevent detrimental impacts of such stressors.
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Wellbeing, defined as ‘a state of positive feelings and meeting full potential in the world' and burnout (the opposite of wellbeing) are increasingly being recognized as important factors in healthcare workforces. Junior doctors are subject to a high rate of burnout and as a result the numbers leaving the NHS continue to rise. The cause of this is multifactorial and reflects societal and political changes as well as demand on an already strained service. Key components include the lingering effects of the COVID-19 pandemic, the financial turmoil of the cost-of-living crisis, the loss of team and social structure at work, and uncertainty around the future of the NHS. Addressing the contributory factors is an important challenge for coming years to maintain a healthy, motivated, and effective medical workforce.
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BACKGROUND: Under the background that the concept of a community with shared future for mankind has been advocated, the doctor-patient relationship has rapidly sublimated into a community with shared future for doctor-patient. The purpose of this study was to analyze the changes and relationships of anxiety, perceived a community with shared future for doctor-patient (PCSF), health self-consciousness (HSC) and benefit finding (BF) in the outbreak stage of COVID-19 and in the stable stage of COVID-19. METHODS: The questionnaire consisted of a self-designed health self-consciousness scale, perceived a community with shared future for doctor-patient scale, revised 7-item generalized anxiety disorder scale and benefit finding scale. Questionnaires were administered in the outbreak stage of COVID-19 and in the stable stage of COVID-19 to address public anxiety, BF, and trust between medical staff and patients. RESULTS: Risk perception will increase anxiety in public, and the public who trust medical staff and the ability of the government to prevent and control the epidemic will have a higher PCSF. Compared with those in the outbreak stage of COVID-19, PCSF, HSC and BF all decreased in the stable stage of COVID-19. HSC partly plays a mediating role in the process of the influence of PCSF and BF (95% CI = [0.3785, 0.5007], [0.2357, 0.3695], P < .001). The R-value of the model in the outbreak stage of COVID-19 and in the stable stage of COVID-19 were 0.555 and 0.429, and the value of R2 was 0.308 and 0.184 respectively (P < .001). In the stable stage of COVID-19, the coefficient of anxiety â PCSF is negative. The B values of anxiety and PCSF are positive, and the moderating effect is negative (P = .038). Anxiety has a negative moderating effect between PCSF and HSC, indicating that anxiety will weaken the positive impact of PCSF on HSC. It means that there exists a substitution relationship between anxiety and PCSF. CONCLUSIONS: The common goal of medical staff and patients is health, and health is the premise of the meaning of life. Vigorously advocating for PCSF can not only promote a harmonious doctor-patient relationship, but also establish a good HSC and improve the understanding of the meaning of life in the public. Furthermore, if the common concept of a community with a shared future for doctor-patient is integrated into the values of life, it may be more stable and long-term to maintain a good doctor-patient relationship. In addition, we should guard against the influence of high-level anxiety on the path of meaning perception.
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COVID-19 , Humans , COVID-19/epidemiology , Physician-Patient Relations , Anxiety/epidemiology , Anxiety Disorders , Surveys and QuestionnairesABSTRACT
Introduction: This article focuses on doctors' responsibility for the Indonesian vaccination program as the Indonesian Government program in the health sector. Since the WHO declared Covid-19 a pandemic, Indonesian citizens must get a vaccine for antibodies. However, the Covid-19 vaccine as an emergency use vaccine has a Post-Immunisation Adverse Event. The problem of this research is to what extend the doctor's responsibility both in civil law and criminal law for detriment due to covid-19 vaccine especially in the Indonesian legal system. Methods: This study uses normative legal research with a statutory and conceptual approach. Sources of legal materials are obtained from primary legal materials, such as statutory regulations and secondary legal materials, namely books and scientific journals. Results: Doctors in Covid-19 vaccination program must comply with professional standard operating procedures and ethics in. Violation of this standard will be subject to legal and ethical sanctions. A legal sanction includes civil and criminal punishment after being analysed by the disciplinary and ethics committee. Doctors are also responsible for nurses' and midwives' errors in vaccine injection as a form of delegation authority. Conclusions: Based on Indonesian regulations, vaccine practitioner is doctors, nurses and midwives. Both nurses and midwives must be under a doctor's supervision. In practice, improving antibodies through the vaccine has adverse. Consequently, governments and vaccine practitioners are potentially responsible in front of the law, both civil and criminal law when certain criteria are meet. © 2023 UPM Press. All rights reserved.
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BACKGROUND: The COVID-19 pandemic greatly affected doctors' increasing workload, especially in Primary Health Care Facilities. If this is not addressed immediately, it will affect the performance or quality of a doctor's service. AIM: This research objective is to identify the role of Primary Healthcare Facility doctors' workload in moderating the impact of the COVID-19 Pandemic on their performance. METHOD(S): The explanatory-descriptive research was conducted using a quantitative approach. The research respondents were 103 general practitioners who worked at a Primary Healthcare Facility in Malang City (35.0% male and 65.0% female, the most extensive age range was 26-35 years (74.8%), with a working period of 1-5 years. 57 (55.3%) The research instrument was a questionnaire declared valid and reliable, distributed online, and analyzed using Partial Least Square. RESULT(S): The findings demonstrated that the COVID-19 pandemic significantly positively affected the performance of Primary Healthcare Facility doctors (beta = 0.455, t stat = 11.390). The pandemic also significantly impacted workload (beta = 0.283, t stat = 4.347). Workload impacted performance significantly and positively (beta = 0.224, t stat 4.157). Workload mediates the COVID-19 Pandemic influence on doctors' performance (beta = 0.063, t stat = 3.005). CONCLUSION(S): Doctors at Primary Health Care have not all experienced a decline in performance despite the increased workload due to the COVID-19 Pandemic. It forces doctors to juggle between completing their tasks, fighting against disease, and improving their performance.Copyright © 2023.
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Balint group helps health professionals to get emotional support and different perspectives of feedback, inspire reflection, and alleviate job burnout. During the outbreak of COVID-19, it was difficult for medical staff to carry out the traditional form of in person Balint group. Referring to the work of international pilot online Balint group, leaders of Balint group all over China have accumulated some experience and encountered new problems by using the internet to carry out discussion. In order to assist and standardize the work of online Balint group and enrich the ways of expanding Balint work, the Working Committee on Doctor-patient Relationship, Chinese Psychiatrist Association, Chinese Medical Doctor Association organized experts to have two rounds of discussion, and developed the consensus on: Principles and forms of online Balint group, the way of using web platforms for demonstration and learning, matters needing attention, the future development, and so on.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.
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Background: Telemedicine system enables doctors and patients to communicate while staying afar which can be helpful for areas with lesser health facilities and at times of natural or health disasters. In developing countries like Bangladesh, telemedicine service offers the potential for wider health access and equity if effectively implemented. Therefore, the response and acceptance of care receivers who are the main beneficiaries of the service should be explored. As Dhaka University Telemedicine Programme (DUTP) is a non-profit University project-induced successful telemedicine service in Bangladesh, our study was conducted on the DUTP hotline-based telemedicine programme aimed to explore patients' prior knowledge and response (experience, satisfaction and acceptance) about the service. Method(s): The cross-sectional study was conducted by interviewing 200 participants over the phone with a structured questionnaire to analyze their knowledge and response. Participants were selected by randomization from the patient pool of hotline-based DUTP telemedicine service. The data was analyzed using SPSSv20. Results and discussion: Among the participants, 41% of total participants knew about telemedicine services before COVID-19. Average patient satisfaction was well above moderate level (p-value< 0.01;mean 3.88). 16.5% respondents mentioned about having any problem while availing the service where 'treatment or service related problem' was the most common. Significant association was found between people's 'occupation' and 'knowledge before COVID-19' (p = 0.002) indicating to the probable role of profession or occupation in molding people's health-service related knowledge. Patient-doctor communication ['perception about doctor's adequate evaluation (Q3)' and 'understanding doctor's advice properly (Q4)'] was found to be significantly associated with 'age' and 'location (division)' while most respondents (around 90%) perceived the communication as effective. 'Age' had also an association with 'treatment or service related problem'. 80.5% were willing to take the service in the future even by paying fees. All participants appreciated telemedicine service in general when they were asked about its possible inclusion in mainstream primary healthcare. Conclusion(s): The overall response of patients toward DUTP hotline-based telemedicine, in general, came out to be positive. Concerned authorities and policymakers may exploit this accepting attitude of people toward developing effective telemedicine services in order to ensure wider health and well-being of population.Copyright © 2023 The Authors
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Objective: Although these days the priority is to fight the Covid-19 pandemic, the importance of human papillomavirus (HPV) infection is not to be neglected. Mechanism: Cervical cancer is caused mainly by a chronic infection with one or more of the high-risk subtypes of HPV -most commonly a sexually transmitted disease acquired early in life. Most HPV infections go away on their own, but some can lead to a precancerous state that, if left untreated, can undergo complete neoplastic transformation. Findings in Brief: There is a hope that in the future the combination of screening tests with vaccinations against oncogenic strains of HPV will allow reductions in the percentage of those contracting cervical cancer. Conclusion(s): The importance of educational activities should be emphasized in developmental gynecology in the context of oncological prevention. The roles of both doctors and nurses are important here. During the Covid-19 Pandemic, these kinds of activities are not to be abandoned. In addition, efforts should be made to develop more practical and workable HPV and cervical screening strategies for use during a pandemic.Copyright © 2022 The Author(s). Published by IMR Press.
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Introduction: National Service Evaluations of COVID-19 ARDS care in the US and UK showed significant variability in clinical practice, and adherence to existing guidelines. To better understand the basis for this, we explored factors influencing decision-making around mechanical ventilation in COVID-19. Method(s): We conducted interprofessional focus groups identifying factors that influenced decision-making through thematic analysis. From this, we developed a questionnaire to validate these themes with a larger sample of critical care professionals across the UK. Kruskal- Wallis or Mann-Whitney U tests were used for data analysis. Result(s): There were 179 complete responses from doctors, nurses and physios. In their usual practice, 66% of clinicians reported adherence to national ARDS guidelines. However, 80% thought COVID-19 ARDS presented differently to their previous clinical knowledge/experience of ARDS and 72% thought deviating from usual practice was necessary. Doctors were more likely to think deviation was necessary (p < 0.001) but there was no difference across level of ICU experience (p = 0.845). Clinicians reported their ventilatory decision-making was most influenced by disease factors, followed by team then contextual and least by environmental factors (p < 0.001). Disease factor was seen as most important across profession and experience level. During COVID-19, 68% of clinicians reported not being confident in their ventilatory decision-making;however, clinicians who felt COVID-19 ARDS presentation fitted with their previous clinical knowledge/experience of ARDS reported greater confidence (p < 0.001). Confidence was not affected by experience (p = 0.522) or profession (p = 0.294) (Fig. 1). Conclusion(s): Clinicians were influenced by the uncertain understanding of COVID-19 ARDS, especially when they considered previous experiences to be less relevant. In the event of another novel disease, developing a consistent, understandable clinical models of disease should be prioritised to optimise decision making.
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Diagnosing the patients remotely, controlling the medical equipment, and monitoring the quarantined patients are some of the necessary and frequent activities in COVID-19. Internet of Medical Things (IoMT) makes this works easy and feasible. Sharing information from patients and sensors associated with the patients to doctors is always an integral part of IoMT. Unauthorized access to such information may invite adversaries to disturb patients financially and mentally; furthermore, leaks in its confidentiality will lead to dangerous health concerns for patients. While ensuring authentication and confidentiality, We must focus on the constraints of IoMT, such as low energy consumption, deficient memory, and the dynamic nature of devices. Numerous protocols have been proposed for authentication in healthcare systems such as IoMT and telemedicine. However, many of these protocols were neither computationally efficient nor provided confidentiality, anonymity, and resistance against several attacks. In the proposed protocol, we have considered the most common scenario of IoMT and tried to overcome the limitations of existing works. Describing the system module and security analysis proves it is a panacea for COVID-19 and future pandemics.
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Introduction. The Seasonal Continuity of Care (CAS) is a service of the Bergamo Health Protection Agency that provides medical and healthcare services, gua-ranteeing outpatient or home care to Italian and foreign tourists and seasonal workers during the months of July and August. The Covid-19 pandemic and the shortage of doctors made it impossible to provide the service in 2021 as in previous summer seasons. Aims. To activate a CAS service with the involvement of nurses. Methods. A "Hub -Spoke" network model was activated;nurses in the Spoke sites, with the patient in attendance, through teleconsul-tation by video call, made remote contact with a doctor in the Hub. Results. In the 3 Spoke CASs, from 2 to 22 August 2021, 274 services (of which 14.3% were telecon-sultations between the nurse at the Spoke CAS site and the doctor at the Hub site) and 162 repeat prescription re-quests were made. Teleconsultation was mainly performed for patients with acute pathology (71.8%), mainly for arth-ralgia and fever. In the majority of cases, it was sufficient to answer to the needs of the patient (87.2%);a small num-ber of cases were referred to a doctor's appointment (10.3%) or to Emergency Department (2.6%). Conclusions. Nurse triage reduced the time of medical visits, allowing more patients to be taken care of. The need for digital in-frastructure, training and integration with district servi-ces emerged.
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In this article, we analyze the image of healthcare and health professionals in the Russian television media agenda before and during the COVID-19 pan-demic and determine the frequency and content of health-related news reports on federal and regional evening newscasts for 2019-2021 (by the example of two news programs-Vremya, Channel One, and Vesti. Don, channel Russia-1). Content analysis of news reports was conducted by the Southern Federal University research team (Rostov-on-Don, Russia) in the course of the RFBR-supported research project on social well-being of the medical community in a complex epidemiological situation. Altogether, we have analyzed 1096 evening Vremya newscasts and 784 Vesti. Don newscasts. The sample set included 244 Vremya news items (about 19% of the total number), and 152 Vesti. Don news items (about 17%, respectively). The sampling was random mechanical (with a certain preset interval). The coded categories and units of analysis were registered as cards, one card per each news item. As the categories for analysis, we have selected topic, genre, nature, locality, length, central figure in a news piece, and presence of a challenge or a problem situation. Unit of count-news piece. On both federal and regional television in general, there was a significant increase in the number of news stories on healthcare from 2019 to 2021. In 2020 and 2021, the thematic angle has changed radically towards the news on the pandemic of a 2019 coronavirus disease and vaccination against it. It should be noted that the main heroes of health-related news reports were and still are neither doctors, nor patients, but representatives of the authorities and Rospotrebnadzor;the share of reports about ordinary doctors was decreasing;with the launch of COVID-19 vaccination, the number of news items featuring mid-level health professionals went up;on the other hand, as COVID-19 was spreading, scientists and inventors appeared in health-related news less frequently, especially in regional news;the pandemic has significantly shifted the focus from child patients to adults, and especially to the elderly. Keywords: medicine, healthcare, healthcare worker, doctor, nursing staff, media agenda, media, COVID-19 pandemic, coronavirus, content analysis, television, news story, in-depth interview
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Cardiovascular diseases were the leading cause of death in the world prior to the COVID-19 pandemic. A wide range of risk factors may precipitate a cardiovascular disease and therefore multiple aspects of the patient's history may lend a hand in the diagnosis of the specific stage of cardiovascular disease that is presented by the patient. This article will give a general review of the knowledge and skillsets needed by a clinician to distinguish and at the same time correlate the different presenting symptoms and the potential cardiac issue associated with them. History taking is a very essential and critical clinical skill that is of paramount assistance in diagnosing and treating the patient with the right management therapies to find a cure for the disease. Basic approaches in the evaluation of the physical condition and cardiac assessment are important skills in healthcare that help decrease mortality in everyday life and therefore are needed to be learned efficiently. Lifestyle changes and modern standard of living especially in a developing country like India contribute majorly to the evolution of this disease in the population as well as the eating habits and addictions which play a vital role in the progression of the disease. The aim of this article is also to give an outline of various risk factors and recent etiological agents by analyzing the epidemiological variation and patterns that can be ruled out or considered associated with the cardiovascular related-symptomatology and relevant history of the patient to confirm a diagnosis by investigations which will direct the clinician towards specific treatments and recovery of the patient. A special topic of understanding would be the COVID-19-associated cardiovascular complications which have been recently discovered and studied as a result of the pandemic.
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There are a lot of questions regarding the differentiation and diagnosis of ophthalmic diseases by a doctor of first contact. The article in the form of questions and answers presents a multidisciplinary discussion of a pediatrician and an ophthalmologist in relation to anatomical and physiological approaches to the formation of diagnoses, those conditions that are accompanied by the symptom of "red eye". The authors discuss algorithms for diagnosis, and modern approaches to the treatment of red eye syndrome. Clinical criteria for acute conjunctivitis of various etiology are presented. Considered modern approaches to the diagnosis and treatment of eye lesions using local antibacterial agents in various forms of releases, different combinations of active substances, including the drugs Floxanext, Tobrotsim-Next-Sombi and Tobrotsim-Next.Copyright © 2021, Professionalnye Izdaniya. All rights reserved.