Comparing Responses to COVID-19 Across Institutions: Conceptualization of an Emergency Response Maturity Model.

The impact of Covid-19 on hospitals was profound, with many lower-resourced hospitals' information technology resources inadequate to efficiently meet the new needs. We interviewed 52 personnel at all levels in two New York City hospitals to understand their issues in emergency response. The large differences in IT resources show the need for a schema to classify hospital IT readiness for emergency response. Here we propose a set of concepts and model, inspired by the Health Information Management Systems Society (HIMSS) maturity model. The schema is designed to permit evaluation of hospital IT emergency readiness, permitting remediation of IT resources where necessary.

Paradoxical experiences of healthcare workers during COVID-19: a qualitative analysis of anonymous, web-based, audio narratives.

PURPOSE: To gain a deeper understanding of healthcare workers experiences during COVID-19 using an anonymous, web-based, audio narrative platform. METHODS: Data were collected from healthcare workers in the midwestern United States using a web-enabled audio diary approach. Participant recordings were analysed using a narrative coding and conceptualization process derived from grounded theory coding techniques. RESULTS: Fifteen healthcare workers, in direct patient care or non-patient care roles, submitted 18 audio narratives. Two paradoxical themes emerged: 1) A paradox of distress and meaningfulness, where a harsh work environment resulted in psychological distress while simultaneously resulting in new rewarding experiences, sense of purpose and positive outlooks. 2) A paradox of social isolation and connection, where despite extreme isolation, healthcare workers formed intense and meaningful interpersonal connections with patients and colleagues in new ways. CONCLUSIONS: A web-enabled audio diary approach provided an opportunity for healthcare workers to reflect deeper on their experiences without investigator influence, which led to some unique findings. Paradoxically, amid social isolation and extreme distress, a sense of value, meaning and rewarding human connections emerged. These findings suggest that interventions addressing healthcare worker burnout and distress might be enhanced by leveraging naturally occurring positive experiences as much as mitigating negative ones.

Conceptualization and Validation of the Occupation Insecurity Scale (OCIS): Measuring Employees' Occupation Insecurity Due to Automation.

Increased use and implementation of automation, accelerated by the COVID-19 pandemic, gives rise to a new phenomenon: occupation insecurity. In this paper, we conceptualize and define occupation insecurity, as well as develop an Occupation Insecurity Scale (OCIS) to measure it. From focus groups, subject-matter expert interviews, and a quantitative pilot study, two dimensions emerged: global occupation insecurity, which refers to employees' fear that their occupations might disappear, and content occupation insecurity, which addresses employees' concern that (the tasks of) their occupations might significantly change due to automation. In a survey-study sampling 1373 UK employees, psychometric properties of OCIS were examined in terms of reliability, construct validity, measurement invariance (across gender, age, and occupational position), convergent and divergent validity (with job and career insecurity), external discriminant validity (with organizational future time perspective), external validity (by comparing theoretically secure vs. insecure groups), and external and incremental validity (by examining burnout and work engagement as potential outcomes of occupation insecurity). Overall, OCIS shows good results in terms of reliability and validity. Therefore, OCIS offers an avenue to measure and address occupation insecurity before it can impact employee wellbeing and organizational performance.

'I went there in an effort to help the child, but you can see there is corruption in the world': Adults' conceptualisations and enactments of child protection in schools in a challenging context.

Schools have the potential to be sites of support for vulnerable children, but can also be sites of violence perpetration. In this qualitative study we explore how adult school stakeholders in and around two public Catholic primary schools in Zimbabwe conceptualise and enact child protection. We analysed our findings in light of the protracted economic crisis in Zimbabwe; the current policy context for child protection; and the Covid-19 pandemic. We conducted semi-structured interviews with 18 adult education stakeholders in and around one rural and one urban school in the Harare Archdiocese, from October 2020 to January 2021. This comprised 12 school-level stakeholders, including teachers (N = 4), parents (N = 4), school priests (N = 2), and headteachers (N = 2), who were the main focus of this study, and a further 6 high-level education actors. We employed thematic analysis. Adults in this study placed considerable responsibility on children to protect themselves, with often unreasonably high expectations of children's capacity to prevent abuse. At times they also blamed and stigmatised children, which was gendered, and particularly emerged around adolescent sexuality. Our findings suggest that this was linked to social norms around discipline, protection and gender, but in particular, the way these emerged in relation to the challenges of the context. Policy and interventions to promote child protection in schools in Zimbabwe should incorporate both an attention to the challenges teachers face in contexts of adversity, as well as address a tendency for adult school stakeholders to hold children responsible for their own protection.

Nurse well-being: A concept analysis.

BACKGROUND: An understanding of nurse well-being remains elusive, particularly in the current toxic health care environment. Therefore, a conceptual definition of nurse well-being is needed. PURPOSE: The purpose of this paper is to report results of a concept analysis of nurse well-being. METHODS: Rodgers' Evolutionary Method of concept analysis was used to examine the attributes, antecedents, consequences, and related concepts of nurse well-being. FINDINGS: Findings revealed varying levels of nurse well-being: individual, organizational and community. Individual attributes included happiness, satisfaction, optimism, compassion, gratitude, forgiveness, and sound body/spirit. Organizational/community attributes included teamwork, sense of mission, pride in work, and social integration. Antecedents reflected commonalities with Maslow's hierarchy of needs, ranging from basic human needs to self-actualization. Consequences included resilience, collegial relationships, continued growth and development, empowerment, purposeful work, and physical/mental health. DISCUSSION: Standardized definitions of individual and organizational/community nurse well-being should guide future research and policy development. Organizations must build capacity for nurses' well-being and explore its connection to patient safety and quality outcomes.

Videoconference anxiety: Conceptualization, scale development, and preliminary validation.

As a result of the COVID-19 pandemic, activities involving a large part of life have started to be carried out via videoconferencing. Videoconferencing can be disadvantageous for individuals with social anxiety due to increased social presence, decreased mutual understanding, and awkward communication. The authors aimed to develop a scale to explore the difficulties experienced by individuals with social anxiety during videoconferencing. A total of 598 children and adolescents participated in the study. The data were collected with the Sociodemographic Information Form, the Videoconference Anxiety Scale, and the Liebowitz Social Anxiety Scale. According to exploratory factor analysis, the scale consisted of 25 items and a single factor. Factor loads were between 0.62 and 0.81; the single factor explained 52.95% of the variance. This study shows that the Videoconference Anxiety Scale is a valid and reliable instrument for Turkish children.

Applying ICD-11 criteria of Gaming Disorder to identify problematic video streaming in adolescents: Conceptualization of a new clinical phenomenon.

Background and aims: Internet video streaming (VS) has become a popular leisure activity among the majority of adolescents, especially under the COVID-19 pandemic. Research on binge watching patterns in adults suggests an addictive potential of VS. To date, no unified conceptualization on problematic VS and no standardized assessment tools for adolescents exist even though they might be especially vulnerable. Methods: STREDIS-A is based on the ICD-11 criteria of gaming disorder. It was validated in a representative sample of 959 dyads of 10- to 17-year old adolescents with frequent VS and a respective parent using standardized questionnaires on Internet addiction, depressive and anxiety symptoms, insomnia, loneliness, and academic performance in an online survey. Item structure was investigated by factorial analyses. Cutoffs were estimated and latent profile analysis was performed. Results: The two-factorial structure of STREDIS-A describes cognitive-behavioral symptoms and negative consequences of VS. Internal consistency and criterion validity were good to excellent. It could excellently discriminate between affected and non-affected adolescents. Discussion and conclusions: The present study makes a significant contribution to the conceptualization of a new phenomenon. It provides the very first tool to assess streaming disorder in adolescents for clinical and research settings. Clinical validation is highly warranted.

Stakeholders' Perception of the Palestinian Health Workforce Accreditation and Regulation System: A Focus on Conceptualization, Influencing Factors and Barriers, and the Way Forward.

The Health Workforce Accreditation and Regulation (HWAR) is a key function of the health system and is the subject of increasing global attention. This study provides an assessment of the factors affecting the Palestinian HWAR system, identifies existing gaps and offers actionable improvement solutions. Data were collected during October and November 2019 in twenty-two semi-structured in-depth interviews conducted with experts, academics, leaders, and policymakers purposely selected from government, academia, and non-governmental organizations. The overall perceptions towards HWAR were inconsistent. The absence of a consolidated HWAR system has led to a lack of communication between actors. Environmental factors also affect HWAR in Palestine. The study highlighted the consensus on addressing further development of HWAR and the subsequent advantages of this enhancement. The current HWAR practices were found to be based on personal initiatives rather than on a systematic evidence-based approach. The need to strengthen law enforcement was raised by numerous participants. Additional challenges were identified, including the lack of knowledge exchange and salary adjustments. HWAR in Palestine needs to be strengthened on the national, institutional, and individual levels through clear and standardized operating processes. All relevant stakeholders should work together through an integrated national accreditation and regulation system.

Understanding Migrant Farmworkers' Health and Well-Being during the Global COVID-19 Pandemic in Canada: Toward a Transnational Conceptualization of Employment Strain.

During the COVID-19 pandemic, Canada imposed certain international travel bans and work-from-home orders, yet migrant farmworkers, declared essential to national food security, were exempt from such measures. In this context, farm worksites proved to be particularly prone to COVID-19 outbreaks. To apprehend this trend, we engaged an expanded and transnational employment strain framework that identified the employment demands and resources understood from a transnational perspective, as well as the immigration, labour, and public health policies and practices contributing to and/or buffering employment demands during and after the COVID-19 pandemic. We applied mixed methods to analyze administrative data, immigration, labour, and public health policy, as well as qualitative interviews with thirty migrant farmworkers employed in Ontario and Quebec. We concluded that the deleterious outcomes of the pandemic for this group were rooted in the deplorable pre-pandemic conditions they endured. Consequently, the band-aid solutions adopted by federal and provincial governments to address these conditions before and during the pandemic were limited in their efficacy because they failed to account for the transnational employment strains among precarious status workers labouring on temporary employer-tied work permits. Such findings underscore the need for transformative policies to better support health equity among migrant farmworkers in Canada.

A concept analysis of clinical judgment in undergraduate nursing students.

AIM: To offer a clear understanding of the definition, attributes, antecedents, and consequences of undergraduate nursing students' clinical judgment in the nursing education context. BACKGROUND: Clinical judgment is a concept with broad uses among healthcare professionals. Its definitions and attributes vary across contexts. There is no established understanding of clinical judgment in nursing students. DESIGN: This concept analysis was performed using the eight steps of Walker and Avant's framework. DATA SOURCES: A literature search was conducted using search engines and included peer-reviewed articles related to clinical judgment in nursing students. RESULTS: Clinical judgment in nursing students was defined as the cognitive process exhibited via a nursing action by observation, patient assessment, interpreting, and prioritizing data that lead to responding using the appropriate nursing practice with the patient. Reflection was used to evaluate nursing students' clinical judgment to revise nursing practice. Antecedents included nursing education curriculum, student's knowledge, previous clinical experience, critical thinking, and clinical reasoning. The consequences of clinical judgment were clinical judgment ability, safe nursing practice, nursing care quality, and patient safety. CONCLUSIONS: This concept analysis gives clear insights into the definition, attributes, antecedents, and consequences of undergraduate nursing student's clinical judgment.

Trauma-Informed Education in Nursing: A Concept Analysis.

BACKGROUND: Trauma-informed education provides a framework for a collaborative, relational trauma awareness model when working with nursing students. This concept analysis provides clarification, explicates the conceptual meaning of trauma-informed education, and lays a foundation for nurse educators navigating the challenge of meeting student needs during and after the coronavirus disease 2019 (COVID-19) pandemic. METHOD: Using Walker and Avant's concept analysis method, exhaustive multi-disciplinary and ancestry searches conducted in PubMed, CINAHL, ERIC, and PsychINFO identified 31 relevant article that were evaluated for relevance to the concept analysis as it relates to the context of nursing education. RESULTS: This analysis proposes a new definition of trauma-informed education to support future practice and research endeavors, providing a framework for transforming the nurse educator-student dyadic relationship. CONCLUSION: Trauma-informed education can provide a collaborative relational model with students based on trauma awareness as affecting one's being and self. [J Nurs Educ. 2022;61(6):296-302.].

Long COVID and episodic disability: advancing the conceptualisation, measurement and knowledge of episodic disability among people living with Long COVID - protocol for a mixed-methods study.

INTRODUCTION: As the prevalence of Long COVID increases, there is a critical need for a comprehensive assessment of disability. Our aims are to: (1) characterise disability experiences among people living with Long COVID in Canada, UK, USA and Ireland; and (2) develop a patient-reported outcome measure to assess the presence, severity and episodic nature of disability with Long COVID. METHODS AND ANALYSIS: In phase 1, we will conduct semistructured interviews with adults living with Long COVID to explore experiences of disability (dimensions, uncertainty, trajectories, influencing contextual factors) and establish an episodic disability (ED) framework in the context of Long COVID (n~10 each country). Using the conceptual framework, we will establish the Long COVID Episodic Disability Questionnaire (EDQ). In phase 2, we will examine the validity (construct, structural) and reliability (internal consistency, test-retest) of the EDQ for use in Long COVID. We will electronically administer the EDQ and four health status criterion measures with adults living with Long COVID, and readminister the EDQ 1 week later (n~170 each country). We will use Rasch analysis to refine the EDQ, and confirm structural and cross-cultural validity. We will calculate Cronbach's alphas (internal consistency reliability), and intraclass correlation coefficients (test-retest reliability), and examine correlations for hypotheses theorising relationships between EDQ and criterion measure scores (construct validity). Using phase 2 data, we will characterise the profile of disability using structural equation modelling techniques to examine relationships between dimensions of disability and the influence of intrinsic and extrinsic contextual factors. This research involves an academic-clinical-community partnership building on foundational work in ED measurement, Long COVID and rehabilitation. ETHICS AND DISSEMINATION: This study was approved by the University of Toronto Research Ethics Board. Knowledge translation will occur with community collaborators in the form of presentations and publications in open access peer-reviewed journals and presentations.

Household emergency preparedness: A multidisciplinary concept analysis.

BACKGROUND: Household emergency preparedness, at the individual and family micro-level, is often identified as below national disaster preparedness standards. AIMS: Conceptual clarity of household emergency preparedness is foundational for disaster preparedness research, theory construction, and instrument use. MATERIALS & METHODS: Adhering to Walker and Avant's (2019) concept analysis method, the purpose of this paper is to outline the concept of household emergency preparedness by identifying the uses of the concept, the defining attributes, antecedents, consequences, and empirical referents. Literature sources were identified using the Cumulative Index for Nursing and Allied Health (CINAHL), ProQuest Central, PsycInfo, PubMed, and government websites. CONCLUSION: Concept clarification is critical for future selection of research designs involving multidisciplinary community-based interventions for household emergency preparedness, as well as to understand how preparedness efforts at the individual and family micro-level may influence larger disaster preparedness system outcomes.

Bodily, emotional, and public sphere at the time of COVID-19. An investigation on concrete and abstract concepts.

The outbreak of Covid-19 pandemics has dramatically affected people's lives. Among newly established practices, it has likely enriched our conceptual representations with new components. We tested this by asking Italian participants during the first lockdown to rate a set of diverse words on several crucial dimensions. We found concepts are organized along a main axis opposing internal and external grounding, with fine-grained distinctions within the two categories underlining the role of emotions. We also show through a comparison with existing data that Covid-19 impacted the organization of conceptual representations. For instance, subclasses of abstract concepts that are usually distinct converge into a unitary group, characterized by emotions and internal grounding. Additionally, we found institutional and Covid-19 related concepts, for which participants felt more the need for others to understand the meaning, clustered together. Our results show that the spread of Covid-19 has simultaneously changed our lives and shaped our conceptual representations.

Scoping review protocol to understand the conceptualisation, implementation and practices of health promotion within the context of primary healthcare in Africa.

INTRODUCTION: The ongoing COVID-19 pandemic has highlighted the importance of health promotion in empowering and sustaining communities, as well as the need to build resilient health systems and work collectively with other sectors to protect and promote health. The WHO has mainstreamed health promotion in the Global health agenda. However, the definition and practices of health promotion in Africa are not well understood and documented, with often, an interchangeable use of the concept of health promotion and health prevention. This scoping review is to explore how health promotion is defined and practised in Africa and identify gaps in its implementation within the framework of the Ottawa Charter. METHODS AND ANALYSIS: The scoping review will employ the approach described by Arksey and O'Malley in 2005. The approach consists of five stages: (1) formulating the research questions, (2) identifying relevant studies, (3) selecting eligible studies, (4) charting the data and (5) collating, summarising and reporting the results. This protocol employed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The review will apply the PRISMA extension for scoping reviews to present the results. The scoping review will adapt the five principles set forth in the Ottawa Charter to categorise the outcomes and uses its strategies to define the interventions. Data bases searched are Ovid Medline, Embase, Cochrane Library, CINAHL, SCOPUS, CABI, JBI Evidence Synthesis and grey literature. The database last searched was January 2021. ETHICS AND DISSEMINATION: This review does not require ethics approval. Our dissemination strategy includes peer review publication, policy brief, presentation at conferences and relevant stakeholders.

Conceptualizing Vulnerability for Health Effects of the COVID-19 Pandemic and the Associated Measures in Utrecht and Zeist: A Concept Map.

The COVID-19 pandemic and the associated measures have impacted the health of many. Not all population groups are equally vulnerable to such health effects, possibly increasing health inequalities. We performed a group concept mapping procedure to define a common, context-specific understanding of what makes people vulnerable to health effects of the pandemic and the measures. We organized a two-step, blended brainstorming session with locally involved community members, using the brainstorm focus prompt 'What I think makes people vulnerable for the COVID-19 pandemic and the measures is…'. We asked participants to generate as many statements as possible. Participants then individually structured (sorted and ranked) these statements. The structuring data was analysed using the groupwisdomTM software and then interpreted by the researchers to generate the concept map. Ninety-eight statements were generated by 19 participants. Sixteen participants completed both structuring tasks. The final concept map consisted of 12 clusters of vulnerability factors, indicating a broad conceptualization of vulnerability during the pandemic. It is being used as a basis for future research and local supportive interventions. Concept mapping is an effective method to arrive at a vulnerability assessment in a community in a short time and, moreover, a method that promotes community engagement.

Conceptualization and implementation of an interdisciplinary clinic for children with drug-resistant epilepsy during the COVID-19 pandemic.

OBJECTIVE: To describe the rapid conceptualization and implementation of an interdisciplinary epilepsy clinic for children with drug-resistant epilepsy (DRE) at Arkansas Children's Hospital (ACH) during the COVID 19 pandemic. METHODS: Focusing on care design and care coordination for children with DRE, multiple stakeholder groups decided to implement a clinic after the systematic rating of constructs present in a theoretical meta-analytic framework. Based on the projected success, the new interdisciplinary clinic (composed of an epileptologist, a neurosurgeon, and a neuropsychologist and coordinated by a full-time nurse) was established. Clinic operations were further refined through discussions with patients, families, and care providers. We collected data retrospectively (August 2020 to June 2021) to determine referral patterns, clinic scheduling metrics, patient characteristics, clinical recommendations, and epilepsy quality metrics. RESULTS: Of the 32 Consolidated Framework for Implementation Research constructs assessed, 24 were positively rated to predict a high probability of successful implementation of the clinic. For approximately 100 patient visits, appearance and usage rates were >75%, yielding a clinic utilization rate of approximately 60%. Among 76 unique patients (average age of 12 years, 60% focal epilepsy), 39 patients (51.3%) were deemed eligible for epilepsy surgery evaluation. The majority of the patients (53.9%) were advised for additional diagnostic testing, and 31.6% of patients were scheduled for vagus nerve stimulation. More patients (33%) had changes in their existing anti-seizure medication (ASM) regimen rather than an addition of a new ASM (7.9%). Standardized epilepsy quality measures showed >80% to 90% adherence in 3 (reproductive counseling, depression and anxiety screening, documentation of seizure frequency) out of 4 metrics. SIGNIFICANCE: This is the first study to show that an interdisciplinary clinic can be a valuable attribute of care models in high-need children with DRE by enabling comprehensive one-stop service for diagnostic evaluation, surgical consideration, and brief assessment of psychiatric comorbidities without compromising consensus-based best practices.

Reflective practice in nursing: A concept analysis.

PURPOSE: This paper aims to clarify the concept of reflective practice in nursing by using Rodgers' evolutionary method of concept analysis. DATA SOURCES: Literature and references on the concept of reflective practice were obtained from two databases: Scopus and Nursing and Allied health database. Peer-reviewed articles published in English language between 2011-2021 that included the terms 'reflection' and/or 'reflective practice' in the title were selected. Seminal pieces of work were also considered in this analysis. A total of 23 works were included. Most of the selected works addressed the concept of reflective practice in nursing education or nursing practice. DATA SYNTHESIS: The data analysis integrated the stages identified in Rodgers' method of concept analysis to analyze the concept of reflective practice. Analysis of selected works provided an understanding of common surrogates, antecedents, attributes, and consequences of the concept of reflective practice. CONCLUSIONS: Reflective practice is a cognitive skill that demands conscious effort to look at a situation with an awareness of own beliefs, values, and practice enabling nurses to learn from experiences, incorporate that learning in improving patient care outcomes. It also leads to knowledge development in nursing. Considering the current circumstances of the COVID-19 pandemic, this paper identifies the need for nurses to go beyond reflection-on-action and also include reflection-in-action and reflection-for-action as part of their practice. IMPLICATIONS FOR NURSING PRACTICE: This analysis identifies the need for future nursing researchers to develop reflective models or strategies that promote reflection among nurses and nursing students before, during, and after the clinical experiences.

Differences and similarities in the conceptualization of COVID-19 and other diseases in the first Italian lockdown.

Several studies have highlighted the flexible character of our conceptual system. However, less is known about the construction of meaning and the impact of novel concepts on the structuring of our conceptual space. We addressed these questions by collecting free listing data from Italian participants on a newly-and yet nowadays critical-introduced concept, i.e., COVID-19, during the first Italian lockdown. We also collected data for other five illness-related concepts. Our results show that COVID-19's representation is mostly couched in the emotional sphere, predominantly evoking fear-linked to both possible health-related concerns and social-emotional ones. In contrast with initial public debates we found that participants did not assimilate COVID-19 neither completely to severe illnesses (e.g., tumor) nor completely to mild illnesses (e.g., flu). Moreover, we also found that COVID-19 has shaped conceptual relations of other concepts in the illness domain, making certain features and associations more salient (e.g., flu-fear; disease-mask). Overall, our results show for the first time how a novel, real concept molds existing conceptual relations, testifying the malleability of our conceptual system.

Design in biology and rational design in vaccinology: A conceptual analysis.

This review discusses the philosophical foundations of what used to be called "the scientific method" and is nowadays often known as the scientific attitude. It used to be believed that scientific theories and methods aimed at the truth especially in the case of physics, chemistry and astronomy because these sciences were able to develop numerous scientific laws that made it possible to understand and predict many physical phenomena. The situation is different in the case of the biological sciences which deal with highly complex living organisms made up of huge numbers of constituents that undergo continuous dynamic processes; this leads to novel emergent properties in organisms that cannot be predicted because they are not present in the constituents before they have interacted with each other. This is one of the reasons why there are no universal scientific laws in biology. Furthermore, all scientific theories can only achieve a restricted level of predictive success because they remain valid only under the limited range of conditions that were used for establishing the theory' in the first place. Many theories that used to be accepted were subsequently shown to be false, demonstrating that scientific theories always remain tentative and can never be proven beyond and doubt. It is ironical that as scientists have finally accepted that approximate truths are perfectly adequate and that absolute truth is an illusion, a new irrational sociological phenomenon called Post-Truth conveyed by social media, the Internet and fake news has developed in the Western world that is convincing millions of people that truth simply does not exist. Misleading information is circulated with the intention to deceive and science denialism is promoted by denying the remarkable achievements of science and technology during the last centuries. Although the concept of intentional design is widely used to describe the methods that biologists use to make discoveries and inventions, it will be argued that the term is not appropriate for explaining the appearance of life on our planet nor for describing the scientific creativity of scientific investigators. The term rational for describing the development of new vaccines is also unjustified. Because the analysis of the COVID-19 pandemic requires contributions from biomedical and psycho-socioeconomic sciences, one scientific method alone would be insufficient for combatting the pandemic.