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2.
Sci Rep ; 11(1): 23711, 2021 12 09.
Article in English | MEDLINE | ID: covidwho-1565733

ABSTRACT

Since the beginning of the COVID-19 pandemic, evidence shows the negative psychological impact of lockdown measures in the general population. It is also important to identify predictors of psychological distress in vulnerable people, particularly patients with history of depressive episodes (the most prevalent psychiatric disorder), in order to adapt mental health strategies for future lockdown measures. This study aim was to (1) compare in 69 healthy controls (HC) and 346 patients with a major depressive episode in the two previous years (PP) self-reported psychological symptoms (depression, anxiety, insomnia, suicidal ideation, traumatic stress, anger) and living conditions during the first national French lockdown, and (2) identify predictors of significant psychological distress in PP. The levels of psychological symptoms were very low in HC compared with PP, independently of the living conditions. Half of PP had no psychiatric contact during the lockdown. Loneliness and boredom were independent predictors of depression, anxiety and insomnia, whereas daily physical activity was a protective factor. Virtual contacts protected against suicidal ideation. Our results highlight the need of specific strategies to target loneliness and boredom and to improve care access, including telepsychiatry. Longitudinal studies must investigate the COVID-19 pandemic psychological impact in clinical samples.


Subject(s)
COVID-19 , Depressive Disorder, Major/psychology , Mood Disorders/psychology , Patients/psychology , Quarantine/psychology , Adaptation, Psychological , Adolescent , Adult , Aged , Anger , Anxiety/psychology , Boredom , Female , France , Health Services Accessibility , Humans , Loneliness/psychology , Male , Mental Health/statistics & numerical data , Middle Aged , Patients/statistics & numerical data , Psychological Distress , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/psychology , Social Conditions/statistics & numerical data , Social Determinants of Health , Stress Disorders, Traumatic/psychology , Suicidal Ideation , Telemedicine , Young Adult
3.
Int J Environ Res Public Health ; 17(22)2020 11 19.
Article in English | MEDLINE | ID: covidwho-1456323

ABSTRACT

Skill mix refers to the number and educational experience of nurses working in clinical settings. Authors have used several measures to determine the skill mix, which includes nurse-to-patient ratio and the proportion of baccalaureate-prepared nurses. Observational studies have tested the association between nursing skill mix and patient outcomes (mortality). To date, this body of research has not been subject to systematic review or meta-analysis. The aim of this study is to systematically review and meta-analyse observational and experimental research that tests the association between nursing skill mix and patient mortality in medical and surgical settings. We will search four key electronic databases-MEDLINE [OVID], EMBASE [OVID], CINAHL [EBSCOhost], and ProQuest Central (five databases)-from inception. Title, abstract, and full-text screening will be undertaken independently by at least two researchers using COVIDENCE review management software. We will include studies where the authors report an association between nursing skill mix and outcomes in adult medical and surgical inpatients. Extracted data from included studies will consist measures of nursing skill mix and inpatient mortality outcomes. A meta-analysis will be undertaken if there are at least two studies with similar designs, exposures, and outcomes. The findings will inform future research and workforce planning in health systems internationally.


Subject(s)
Nursing Staff, Hospital , Patients , Adult , Databases, Factual , General Surgery/statistics & numerical data , Humans , Nursing Staff, Hospital/standards , Nursing Staff, Hospital/statistics & numerical data , Patients/statistics & numerical data , Personnel Staffing and Scheduling/statistics & numerical data , Workforce/statistics & numerical data
4.
Am J Med Sci ; 363(1): 18-24, 2022 01.
Article in English | MEDLINE | ID: covidwho-1446372

ABSTRACT

BACKGROUND: Following the high morbidity and mortality due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infections in New Orleans, Louisiana, we sought to assess progress toward herd immunity. METHODS: Ochsner Health employees and patients who volunteered for Abbott SARS-CoV-2 immunoglobulin G (IgG) antibody test between March 1 and May 1, 2020 were included. We estimated IgG prevalence and used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for variables associated with IgG test status. RESULTS: Of the 13,343 participants with IgG test results, 78.6% were women, 70.6% were non-Hispanic White, 21.1% non-Hispanic Black, 2.9% Hispanic Americans and 5.4% belonged to other races. Overall, 7.99% (95% CI: 7.53-8.45%) of the participants tested IgG positive. In age-, sex- and body mass index (BMI)-adjusted analyses, non-Hispanic Blacks were 2.7-times more likely to test positive than non-Hispanic Whites (OR=2.72; 95% CI: 2.33-3.19). Corresponding ORs (95% CIs) were 1.29 (0.84-1.99) for Hispanic Americans and 1.22 (0.85-1.75) for Other race/ethnicities. Compared to participants in administrative occupations, physician assistants (OR=7.14; 95% CI: 1.72-29.6) and therapists (OR=4.74; 95% CI: 1.49-15.03) were significantly more likely to have IgG antibodies while the association among nurses was not significant (OR=2.35; 95% CI: 0.96-5.77). Relative to 1.40, the test threshold for positivity, our measurements indicate a strong immune response (5.38±1.69), especially among those with a higher BMI. CONCLUSIONS: SARS-COV-2 IgG antibodies were prevalent only in 8% of the participants. IgG prevalence was highest among non-Hispanic Blacks and participants with higher BMI but was lower among older participants.


Subject(s)
Antibodies, Viral , COVID-19 , Immunoglobulin G , SARS-CoV-2 , Antibodies, Viral/blood , COVID-19/blood , COVID-19/epidemiology , COVID-19/immunology , COVID-19 Serological Testing , Female , Health Personnel/statistics & numerical data , Humans , Immunoglobulin G/immunology , Male , New Orleans/epidemiology , Patients/statistics & numerical data , Prevalence , SARS-CoV-2/immunology
6.
Psychiatr Q ; 92(4): 1785-1796, 2021 12.
Article in English | MEDLINE | ID: covidwho-1378979

ABSTRACT

The need for consultation-liaison psychiatry on COVID-19 wards has substantially increased since the start of the pandemic. In this cross-sectional study, we aimed to summarize the characteristics of patients admitted to the post-COVID-19 ward of the American University of Beirut Medical Center who received a psychiatric consultation. We collected relevant sociodemographic and medical data, information about past psychiatric history, psychiatry consultation details, hospital course, and disposition outcome. We also conducted chi-square and binary logistic regression analyses to assess the association between the different variables and disposition outcome. A total of 52 patients (mean age 57.33 years; equal gender distribution) were seen by the psychiatry consult-liaison team. Most had medical comorbidities and 21.2% required intubation. The most prevalent psychiatric diagnoses were delirium (30.8%), major depressive episode (15.4%), and other anxiety disorder (15.4%). Pharmacological management was implemented in 90.4% of cases and mainly included second-generation antipsychotics (36.5%). Non-pharmacological interventions consisted of those related to delirium and therapy for anxiety. Only intubation was significantly associated with disposition outcome (p = 0.004). This study highlights the various psychiatric themes emerging during the acute and post-acute periods of hospitalization for COVID-19. Hospitalized individuals recovering from the infection should be diligently screened and referred to the psychiatry consultation-liaison team to ensure the implementation of appropriate interventions.


Subject(s)
COVID-19 , Mental Disorders , Mental Health Services , Patients , Referral and Consultation , Adult , Aged , COVID-19/epidemiology , COVID-19/therapy , Cross-Sectional Studies , Female , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Middle Aged , Patients/psychology , Patients/statistics & numerical data , Referral and Consultation/statistics & numerical data
7.
Nurs Outlook ; 69(1): 13-21, 2021.
Article in English | MEDLINE | ID: covidwho-1368740

ABSTRACT

BACKGROUND: The rapidly evolving COVID-19 pandemic has become a global health crisis. Several factors influencing risk perception have been identified, including knowledge of the disease, information sources, and emotional states. Prior studies on COVID-19-related risk perception primarily focused on the general public, with little data available on COVID-19 patients. PURPOSE: To investigate COVID-19 patients' risk perception, knowledge of the disease, information sources, and emotional states in the epicenter, Wuhan, during the COVID-19 outbreak in China. METHODS: Data were collected online using self-administered electronic questionnaire developed with reference to previous relevant studies and publications by the World Health Organization. FINDINGS: A higher level of perceived risk was found in relation to COVID-19 as compared to other potential health threats. Knowledge gaps existed regarding transmission and prevention of COVID-19. Additionally, risk perception was negatively related to knowledge and positively related to depressive states. Moreover, social media was a primary source for COVID-19 information, whereas the most trusted sources were health professionals. DISCUSSION: Realistic perception of risk should be encouraged considering both physical and mental health while developing relevant strategies. Furthermore, risk communication needs to be specifically tailored for various target groups, such as the elderly and mentally vulnerable individuals, with the adoption of popular media platforms.


Subject(s)
COVID-19/therapy , Health Knowledge, Attitudes, Practice , Patients/psychology , Adult , Aged , COVID-19/epidemiology , China/epidemiology , Consumer Health Information/statistics & numerical data , Emotions , Female , Humans , Male , Middle Aged , Patients/statistics & numerical data , Risk Assessment , Surveys and Questionnaires , Young Adult
8.
J Prim Care Community Health ; 11: 2150132720954687, 2020.
Article in English | MEDLINE | ID: covidwho-1318263

ABSTRACT

BACKGROUND: COVID-19 is a highly infectious disease which usually presents with respiratory symptoms. This virus is disseminated through respiratory droplets, and, therefore, individuals residing in close quarters are at a higher risk for the acquisition of infection. The prison population is at a significantly increased risk for infection. METHODS: Prisoners from the Montford Correctional facility in Lubbock, Texas, hospitalized in the medical intensive care unit at University Medical Center between March 1, 2020 and May 15, 2020 were compared to community-based patients hospitalized in the same medical intensive care unit. Clinical information, laboratory results, radiographic results, management requirements, and outcomes were compared. RESULTS: A total of 15 community-based patients with a mean age of 67.4 ± 15.5 years were compared to 5 prisoners with a mean age of 56.0 ± 9.0 years. All prisoners were men; 10 community-based patients were men. Prisoners presented with fever, dyspnea, and GI symptoms. The mean number of comorbidities in prisoners was 2.4 compared to 1.8 in community-based patients. Prisoners had significantly lower heart rates and respiratory rates at presentation than community-based patients. The mean length of stay in prisoners was 12.6 ± 8.9 days; the mean length of stay in community-based patients was 8.6 ± 6.5. The case fatality rate was 60% in both groups. CONCLUSIONS: Prisoners were younger than community-based patients but required longer lengths of stay and had the same mortality rate. This study provides a basis for comparisons with future studies which could involve new treatment options currently under study.


Subject(s)
Coronavirus Infections/therapy , Critical Care/statistics & numerical data , Pandemics , Patients/statistics & numerical data , Pneumonia, Viral/therapy , Prisoners/statistics & numerical data , Academic Medical Centers , Age Distribution , Aged , Aged, 80 and over , COVID-19 , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/mortality , Female , Hospitalization , Humans , Intensive Care Units , Length of Stay/statistics & numerical data , Male , Middle Aged , Pneumonia, Viral/epidemiology , Pneumonia, Viral/mortality , Retrospective Studies , Texas/epidemiology , Treatment Outcome
9.
Psychiatr Q ; 92(4): 1531-1539, 2021 12.
Article in English | MEDLINE | ID: covidwho-1252185

ABSTRACT

We investigated the effects of lockdown, as implemented by retirement homes to cope with the spread of Covid-19, on hallucinatory experiences in patients with Alzheimer's disease (AD). The study included 47 patients with AD living in retirement homes and who were already experiencing hallucinations prior to the lockdown. We invited caregivers to rate hallucinatory experiences in these patients during the lockdown, and compared this rating with that provided by the same caregivers prior to the lockdown. Results demonstrated increased hallucinatory experiences in patients with AD during the lockdown, compared with before the lockdown. The decrease in social and physical activities during the lockdown, and especially, the physical separation of residents from family members, might have led to decreased sensory stimulation and increased loneliness, and consequently, to the hallucinatory experiences in patients with AD living in retirement homes during the lockdown. While the restrictive measures were necessary to cope with the spread of Covid-19, these measures have increased hallucinations in patients with AD living in retirement homes, at least in those who were already experiencing hallucinations prior to the lockdown.


Subject(s)
Alzheimer Disease , COVID-19 , Communicable Disease Control , Hallucinations , Patients , Aged , Alzheimer Disease/epidemiology , Alzheimer Disease/therapy , COVID-19/epidemiology , COVID-19/prevention & control , Female , Hallucinations/epidemiology , Homes for the Aged/organization & administration , Humans , Male , Patients/psychology , Patients/statistics & numerical data
10.
Biomed Res Int ; 2021: 6610045, 2021.
Article in English | MEDLINE | ID: covidwho-1247435

ABSTRACT

BACKGROUND: This study is aimed at confirming the effectiveness of nonpharmaceutical interventions during the COVID-19 outbreak in Hubei, China. METHODS: The data are all from the epidemic information released by the National Health Commission of the People's Republic of China and the Health Commission of Hubei Province. We used the multivariable linear regression by the SPSS 19.0 software: the cumulative number of confirmed cases, the cumulative number of cured cases, and the number of daily severe cases were taken as dependent variables, and the six policies, including the Joint Prevention and Control Mechanism of the State Council, lockdown Wuhan city, the first-level response to public health emergencies, the expansion of medical insurance coverage to suspected patients, mobile cabin hospitals, and counterpart assistance in Hubei province, were gradually entered into multiple linear regression models as independent variables. RESULTS: The factors influencing the cumulative number of diagnosed cases ranged from large to small: mobile cabin hospitals and the expansion of medical insurance coverage to suspected patients. The factors influencing the cumulative number of cured cases ranged from large to small: counterpart support medical teams in Hubei province and mobile cabin hospitals. The factors influencing the number of daily severe cases ranged from large to small: mobile cabin hospitals and the expansion of medical insurance coverage to suspected patients. CONCLUSION: The mobile cabin hospital is a major reason for the successfully defeating COVID-19 in China. As COVID-19 pandemic spreads globally, the mobile cabin hospital is a successful experience in formulating policies to defeat COVID-19 for other countries in the outbreak phase.


Subject(s)
Ambulances/statistics & numerical data , COVID-19/therapy , Communicable Disease Control/methods , Pandemics/prevention & control , Public Health/methods , China/epidemiology , Disease Outbreaks/statistics & numerical data , Humans , Insurance, Major Medical/standards , Linear Models , Patients/statistics & numerical data , Policy , Software , Telemedicine/methods
11.
Am Soc Clin Oncol Educ Book ; 41: 413-422, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1234573

ABSTRACT

Effective delivery of cancer care via telehealth requires a planned care system that accounts for myriad patient, provider, and practice/cancer center resources before, during, and after the care episode. Telehealth is broadly defined as a method to have virtual, bidirectional communication between patients and providers. Telehealth can include methods such as audio-only, video-consultation, and tele-monitoring, which can occur in a synchronous, asynchronous, or blended format. The purpose of this review is to present common foundational principles for providing clinical cancer care via telehealth, followed by an overview of three distinct examples of comprehensive telehealth programs that have been developed to meet the needs of patients and families across the cancer trajectory, including survivorship, rehabilitation, and palliative care phases. The programs described are exemplars that were developed and implemented prior to the coronavirus pandemic, so they reflect many years of planning and evidence. Lessons learned include the need for ongoing patient support, clinician training, and cancer health system/practice programmatic considerations such as billing, scheduling, reimbursement, software, and hardware/platform security. Although the COVID-19 pandemic produced an explosive shift in regulations and implementation, sustainability of these changes may not be long-term. Nevertheless, a permanent shift in cancer care to include telehealth is likely here to stay.


Subject(s)
Family/psychology , Neoplasms/epidemiology , Patients/statistics & numerical data , Telemedicine/methods , Humans
12.
JAMA Netw Open ; 4(5): e2110314, 2021 05 03.
Article in English | MEDLINE | ID: covidwho-1230184

ABSTRACT

Importance: After the emergence of COVID-19, studies reported a decrease in hospitalizations of patients with ischemic stroke (IS), but there are little to no data regarding hospitalizations for the remainder of 2020, including outcome data from a large cohort of patients with IS and comorbid COVID-19. Objective: To assess hospital discharge rates, demographic factors, and outcomes of hospitalization associated with the COVID-19 pandemic among US patients with IS before vs during the COVID-19 pandemic. Design, Setting, and Participants: This retrospective cohort study used data from the Vizient Clinical Data Base on 324 013 patients with IS at 478 nonfederal hospitals in 43 US states between January 1, 2019, and December 31, 2020. Patients were eligible if they were admitted to the hospital on a nonelective basis and were not receiving hospice care at the time of admission. A total of 41 166 discharged between January and March 2020 were excluded from the analysis because they had unreliable data on COVID-19 status, leaving 282 847 patients for the study. Exposure: Ischemic stroke and laboratory-confirmed COVID-19. Main Outcomes and Measures: Monthly counts of discharges among patients with IS in 2020. Demographic characteristics and outcomes, including in-hospital death, among patients with IS who were discharged in 2019 (control group) were compared with those of patients with IS with or without comorbid COVID-19 (COVID-19 and non-COVID-19 groups, respectively) who were discharged between April and December 2020. Results: Of the 282 847 patients included in the study, 165 912 (50.7% male; 63.4% White; 26.3% aged ≥80 years) were allocated to the control group; 111 418 of 116 935 patients (95.3%; 51.9% male; 62.8% White; 24.6% aged ≥80 years) were allocated to the non-COVID-19 group and 5517 of 116 935 patients (4.7%; 58.0% male; 42.5% White; 21.3% aged ≥80 years) to the COVID-19 group. A mean (SD) of 13 846 (553) discharges per month among patients with IS was reported in 2019. Discharges began decreasing in February 2020, reaching a low of 10 846 patients in April 2020 before returning to a prepandemic level of 13 639 patients by July 2020. A mean (SD) of 13 492 (554) discharges per month was recorded for the remainder of 2020. Black and Hispanic patients accounted for 21.4% and 7.0% of IS discharges in 2019, respectively, but accounted for 27.5% and 16.0% of those discharged with IS and comorbid COVID-19 in 2020. Compared with patients in the control and non-COVID-19 groups, those in the COVID-19 group were less likely to smoke (16.0% vs 17.2% vs 6.4%, respectively) and to have hypertension (73.0% vs 73.1% vs 68.2%) or dyslipidemia (61.2% vs 63.2% vs 56.6%) but were more likely to have diabetes (39.8% vs 40.5% vs 53.0%), obesity (16.2% vs 18.4% vs 24.5%), acute coronary syndrome (8.0% vs 9.2% vs 15.8%), or pulmonary embolus (1.9% vs 2.4% vs 6.8%) and to require intubation (11.3% vs 12.3% vs 37.6%). After adjusting for baseline factors, patients with IS and COVID-19 were more likely to die in the hospital than were patients with IS in 2019 (adjusted odds ratio, 5.17; 95% CI, 4.83-5.53; National Institutes of Health Stroke Scale adjusted odds ratio, 3.57; 95% CI, 3.15-4.05). Conclusions and Relevance: In this cohort study, after the emergence of COVID-19, hospital discharges of patients with IS decreased in the US but returned to prepandemic levels by July 2020. Among patients with IS between April and December 2020, comorbid COVID-19 was relatively common, particularly among Black and Hispanic populations, and morbidity was high.


Subject(s)
COVID-19/complications , Hospitalization/statistics & numerical data , Ischemic Stroke/complications , Outcome Assessment, Health Care/standards , Patients/classification , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/epidemiology , Cohort Studies , Female , Hospital Mortality/trends , Hospitalization/trends , Humans , Ischemic Stroke/epidemiology , Male , Middle Aged , Outcome Assessment, Health Care/methods , Outcome Assessment, Health Care/statistics & numerical data , Pandemics/prevention & control , Pandemics/statistics & numerical data , Patients/statistics & numerical data , /statistics & numerical data , Retrospective Studies , Risk Factors , United States/epidemiology
13.
Psychiatr Q ; 92(4): 1439-1457, 2021 12.
Article in English | MEDLINE | ID: covidwho-1202805

ABSTRACT

The study was designed to investigate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on mental health and perceived psychosocial support for elderly psychiatric patients in a longitudinal design. n = 32 patients with affective or anxiety disorders aged ≥60 years were included. Telephone interviews were conducted in April/May 2020 (T1) and August 2020 (T2). The psychosocial impact (PSI) of the pandemic and psychopathology were measured. Changes between T1 and T2 were examined. Patients' psychosocial support system six months before the pandemic and at T1/T2 was assessed. We found a significant positive correlation between general PSI and depression as well as severity of illness. General PSI differed significantly depending on social contact. Neither general PSI nor psychopathology changed significantly between T1 and T2. At T1, patients' psychosocial support systems were reduced as compared to six months before. Patients reported an increase in psychosocial support between T1 and T2 and high demand for additional support (sports, arts/occupational therapy, physiotherapy, psychotherapy). Elderly psychiatric patients show a negative PSI of the pandemic. They are likely to suffer from an impaired psychosocial situation, emphasizing the importance of developing concepts for sufficient psychosocial support during a pandemic.


Subject(s)
Anxiety Disorders , COVID-19 , Mood Disorders , Pandemics , Patients , Aged , Aged, 80 and over , Anxiety Disorders/psychology , Anxiety Disorders/therapy , COVID-19/epidemiology , COVID-19/psychology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Mood Disorders/psychology , Mood Disorders/therapy , Patients/psychology , Patients/statistics & numerical data
14.
Value Health Reg Issues ; 24: 240-246, 2021 May.
Article in English | MEDLINE | ID: covidwho-1199117

ABSTRACT

OBJECTIVES: Vaccines are recognized as the most effective strategy for long-term prevention of coronavirus disease 2019 (COVID-19) because they can reduce morbidity and mortality. The purpose of the present study was to evaluate willingness to pay (WTP) for a future COVID-19 vaccination among young adults in Southern Vietnam. METHODS: A cross-sectional, descriptive, and analytic study was undertaken with data collected from a community-based survey in southern Vietnam for 2 weeks in May 2020. The contingent valuation method was used to estimate WTP for COVID-19 vaccine. The average amount that respondents were willing to pay for the vaccine was US$ 85.9 2 ± 69.01. RESULTS: We also found the differences in WTP according to sex, living area, monthly income, and the level of self-rated risk of COVID-19. CONCLUSION: Our findings possibly contribute to the implementation of a pricing policy when the COVID-19 vaccine is introduced in Vietnam.


Subject(s)
COVID-19 Vaccines/economics , Health Expenditures/standards , Immunization/economics , Patients/psychology , Adolescent , Adult , COVID-19 Vaccines/therapeutic use , Cross-Sectional Studies , Female , Health Care Costs/standards , Health Care Costs/statistics & numerical data , Health Expenditures/statistics & numerical data , Humans , Immunization/methods , Male , Middle Aged , Patients/statistics & numerical data , Vietnam
15.
JCO Clin Cancer Inform ; 5: 394-400, 2021 04.
Article in English | MEDLINE | ID: covidwho-1171727

ABSTRACT

PURPOSE: COVID-19 has infected more than 94 million people worldwide and caused more than 2 million deaths. Patients with cancer are at significantly increased risk compared with the general population. Telemedicine represents a common strategy to prevent viral spread. We sought to evaluate patient with cancer and physician perceptions of telemedicine during the COVID-19 pandemic. METHODS: A 16-question survey was e-mailed to 1,843 active e-mails of patients presenting to one of the six cancer clinics at a comprehensive cancer care center from January 1, 2020, to June 1, 2020. A six-question survey was e-mailed to attending physicians of those clinics. Specialties included Medical Oncology, Hematology-Oncology, Surgical Oncology, Urological Oncology, and Gynecologic Oncology. RESULTS: Three hundred seventy-four patients (20.3%) and 14 physicians (66.7%) responded. Most (68.2%) currently prefer in-person visits, and 80.4% prefer in-person visits following pandemic resolution. More than half (52.2%) of patients preferring virtual visits do so because of convenience. Most (63.1%) patients with cancer are comfortable with a complete physical examination. Surgical patients are more likely to prefer a complete examination (P = .0476). Physicians prefer in-person visits (64.2%) and believe that virtual visits maybe or probably do not provide comparable care (64.2%). 71.4% believe that virtual visits help prevent the spread of infectious disease. CONCLUSION: Given preferences for in-person visits, cancer care teams should be prepared to continue providing in-person visits for many of their patients. The discrepancy between patient and provider concern for spread of infectious disease represents an area where patients may benefit from increased education. Providers should feel comfortable performing physical examinations at their own discretion.


Subject(s)
Attitude , COVID-19/prevention & control , Medical Oncology/methods , Neoplasms/therapy , Telemedicine/methods , Aged , COVID-19/epidemiology , COVID-19/virology , Humans , Internet , Middle Aged , Neoplasms/diagnosis , Pandemics , Patients/psychology , Patients/statistics & numerical data , Physicians/psychology , Physicians/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , SARS-CoV-2/physiology , Surveys and Questionnaires
17.
Support Care Cancer ; 29(9): 5463-5473, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1126558

ABSTRACT

PURPOSE: This study aimed to explore the psychosocial impacts of the coronavirus disease (COVID-19) pandemic on cancer patients, survivors, and carers in Australia. METHODS: Using real-time insights from two Cancer Council NSW services-131120 Information and Support Line and Online Community (CCOC) forums-we assessed service demand trends, distress levels (using the distress thermometer), and content from 131120 calls and online posts between 01 December 2019 and 31 May 2020. Emergent themes were identified through an inductive conventional content analysis with 131120 call notes, followed by a deductive directed content analysis on CCOC posts. RESULTS: In total, 688 COVID-19-related 131120 calls (n = 496) and online posts (n = 192) were analysed. Service demand peaked in March 2020 and self-reported distress peaked in May 2020 at an average of 8/10 [Mean = 7.5; SD = 0.9]. Five themes emerged from the qualitative analysis: psychological distress and fear of virus susceptibility, practical issues, cancer service disruptions, information needs, and carer Issues. CONCLUSIONS: The psychosocial impacts of COVID-19 on people affected by cancer are multifaceted and likely to have long-lasting consequences. Our findings drove the development of six recommendations across three domains of support, information, and access. Cancer patients, survivors, and carers already face stressful challenges dealing with a cancer diagnosis or survivorship. The added complexity of restrictions and uncertainty associated with the pandemic may compound this. It is important that healthcare providers are equipped to provide patient-centred care during and after this crisis. Our recommendations provide points of consideration to ensure care is tailored and patient oriented.


Subject(s)
COVID-19/psychology , Cancer Survivors/psychology , Caregivers/psychology , Neoplasms/therapy , Patients/psychology , Adult , Aged , Australia/epidemiology , COVID-19/epidemiology , Cancer Survivors/statistics & numerical data , Caregivers/statistics & numerical data , Female , Humans , Male , Middle Aged , Patients/statistics & numerical data , Social Support
18.
Eur J Clin Microbiol Infect Dis ; 40(9): 2023-2028, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1122785

ABSTRACT

During an epidemic period, we compared patients hospitalized for initial suspicion of COVID-19 but for whom an alternative diagnosis was finally retained (n = 152) with those who had COVID-19 (n = 222). Most common diagnoses were another infectious disease and heart failure. COVID-19-negative patients were more often active smokers had less often cough, fever, and digestive symptoms, as compared to the 222 COVID-19-positive patients. They had higher median neutrophil and lymphocyte counts and lower CRP level. In multivariate analysis, no current smoking, neurocognitive disorder, myalgia, and fibrinogen ≥4g/L were independently associated with a final diagnosis of COVID-19.


Subject(s)
COVID-19/diagnosis , Adult , Aged , COVID-19/therapy , COVID-19/virology , Hospitalization , Humans , Male , Patients/statistics & numerical data , Retrospective Studies , SARS-CoV-2/physiology
19.
J Am Geriatr Soc ; 69(4): 868-873, 2021 04.
Article in English | MEDLINE | ID: covidwho-1096867

ABSTRACT

BACKGROUND: Residents of nursing homes and long-term care facilities are at increased risk for severe coronavirus disease-19 (COVID-19) but may not be able to access monoclonal antibody therapies offered at outpatient infusion centers due to frailty and logistical issues. We describe a mobile monoclonal antibody infusion program for patients with COVID-19 in skilled nursing facilities and provide descriptive data on its outcomes. DESIGN: Retrospective cohort study. SETTING: Collaboration between Mayo Clinic and skilled nursing facilities in Southeast Minnesota was developed to administer anti-spike monoclonal antibodies under the FDA Emergency Use Authorization. PARTICIPANTS: Seventy five residents of skilled nursing facilities at high risk of COVID-19 complications. EXPOSURE: Emergency use treatment with bamlanivimab and casirivimab-imdevimab. MEASUREMENTS: Hospitalization and medically attended visits. RESULTS: The mobile infusion unit, staffed by Mayo Clinic Infusion Therapy registered nurses and supported by the skilled nursing facility staff, infused anti-spike monoclonal antibodies to 45 of 75 patients (average age, 77.8 years) in December 2020. The infusions occurred at an average of 4.3 days after COVID-19 diagnosis. Fourteen days after infusion, there were no deaths, two emergency department visits, and three hospitalizations, for a combined event rate of 11.1%. There was one reported adverse event. CONCLUSION: The implementation of a mobile infusion unit embedded in a collaborative process resulted in rapid infusion of monoclonal antibodies to high-risk COVID-19 patients in skilled nursing facilities, who would otherwise be unable to access the novel therapies. The therapies were well tolerated and appear beneficial. Further study is warranted to explore the scalability and efficacy of this program.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/drug therapy , Mobile Health Units , Skilled Nursing Facilities , Aged , Drug Combinations , Female , Humans , Male , Minnesota , Patients/statistics & numerical data , Referral and Consultation , Retrospective Studies
20.
Clin Psychol Psychother ; 28(4): 988-1000, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1030671

ABSTRACT

OBJECTIVE: First, to investigate how psychotherapists and patients experience the change from in-person to remote psychotherapy or vice versa during COVID-19 regarding the therapeutic interventions used. Second, to explore the influence of therapeutic orientations on therapeutic interventions in in-person versus remote psychotherapy. METHOD: Psychotherapists (N = 217) from Austria were recruited, who in turn recruited their patients (N = 133). The therapeutic orientation of the therapists was psychodynamic (22.6%), humanistic (46.1%), systemic (20.7%) or behavioural (10.6%). All the data were collected remotely via online surveys. Therapists and patients completed two versions of the 'Multitheoretical List of Therapeutic Interventions' (MULTI-30) (version 1: in-person; version 2: remote) to investigate differences between in-person and remote psychotherapy in the following therapeutic interventions: psychodynamic, common factors, person-centred, process-experiential, interpersonal, cognitive, behavioural and dialectical-behavioural. RESULTS: Therapists rated all examined therapeutic interventions as more typical for in-person than for remote psychotherapy. For patients, three therapeutic interventions (psychodynamic, process-experiential, cognitive interventions) were more typical for in-person than for remote psychotherapy after correcting for multiple testing. For two therapeutic interventions (behavioural, dialectical-behavioural), differences between the four therapeutic orientations were more consistent for in-person than for remote psychotherapy. CONCLUSIONS: Therapeutic interventions differed between in-person and remote psychotherapy and differences between therapeutic orientations in behavioural-oriented interventions become indistinct in remote psychotherapy.


Subject(s)
Office Visits , Psychotherapy , Remote Consultation , Adult , Austria/epidemiology , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Patients/psychology , Patients/statistics & numerical data , Psychotherapists/psychology , Psychotherapists/statistics & numerical data , Psychotherapy/methods , Surveys and Questionnaires
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