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Background: The COVID-19 Pandemic had a significant negative impact on the mental health of healthcare workers (HCWs). Evidence-based interventions that could be used to mitigate this impact are lacking in the literature. This review aims to evaluate psychological interventions used for employees following previous disasters and assess the transferability of these interventions to a healthcare setting during the COVID-19 pandemic. Methods: Intervention information from a previously published systematic review of the literature published up to 2015 was extracted, and an additional search of studies published from 2015–2020 was conducted. Studies were assessed for transferability using a checklist derived from the PIET-T process model. Results: Interventions from eighteen studies were assessed for transferability (including three studies identified in an updated literature search). Interventions established as most transferable included resilience training, meditation/mindfulness interventions, and cognitive behavioural therapy. Psychological debriefing was transferable but as it is contrary to current recommendations is not deemed appropriate for adoption. Conclusions: Several existing interventions have the potential to be utilised within the COVID-19 context/ pandemic. More research needs to be undertaken in this area to assess these interventions upon transfer. © Journal of Public Health and Emergency. All rights reserved.
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Background Stroke is one of the leading causes of disability in adulthood. Cooperatively organised stroke care requires a high degree of interprofessional competence of junior professionals. Objectives The project aim was to develop interprofessional competences for stroke care, to identify gaps in care as well as approaches to innovation during the pandemic through joint research. The focus was on person-centred care, communication and collaboration, roles and responsibilities, including stroke-navigators. German Bachelor students of occupational therapy, physiotherapy and speech therapy of the 7th semester (n = 22) were accompanied online in 60 teaching units in 2020/2021. The seminars consisted of (a) theoretical introduction to interprofessional stroke care (b) case-based collaboration with problem-based learning (c) applied health services research. The evaluation was based on a central questionnaire and written reflections from all students. Results The following themes were identified and investigated in 5 interprofessional groups: (1) Impact of the Covid-19 pandemic on the acute care and rehabilitation of stroke patients, (2) International comparison of interprofessional stroke care based on guidelines to improve current practice, (3) Interprofessional diagnostics in stroke care, (4) Interprofessional patient-centered goal setting in outpatient stroke care, (5) Agreements of actors involved in stroke treatment to best serve the needs of the patient. The response rate to the centralised evaluation was low (14%). The project was rated good to very good in terms of planning and presentation, relevance, and interaction with students. Conclusions The students reported central aspects for interprofessional learning: The reflections predominantly described growth in professional competences, in skills for cooperation and problem solving, which can be transferred to professional life. The main point of criticism was the necessity of digital teaching in the pandemic. Key messages • Empowering interprofessional cooperation through a joint project of different Bachelor programmes helps to strengthen the students’ professional identity and shared responsibility for stroke care. • Online teaching can be a valuable facilitator of learning, but should not completely replace face-to-face teaching for stroke care.
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Introduction Public trust in the health system is essential to control the Covid-19 pandemic. It can influence the extent to which interventions to combat a pandemic are accepted by citizens. The objective of this review was to map the evidence of measurements of the concept of public trust in the health system with a focus on health system institutions. Methods We performed a systematic literature search in the databases Web of Science and Embase in March 2020. Quantitative studies measuring trust on a system level with regard to healthcare were eligible if they addressed the general public and were published in English or German. We excluded studies that measured trust on an interpersonal level, in a single health profession, or a single treatment. We extracted data to map the characteristics of measurements. Results Of initially 7137 identified articles, 87 studies were included in the mapping. In 58 (67%) of the studies, trust was the outcome variable. Most studies (69%) measured the level of trust with single items, 27 studies (31%) used scales or indices to measure the concept of trust. Of these, 12 studies measured healthcare system trust, 7 trust in government and political institutions, 4 trust in healthcare organisations, 3 trust in health insurances, and 1 trust in health data management institutions. Most common domains of trust in the healthcare system refer to policies, quality of services, communication and provision of information, relationships with providers and their expertise, and quality of cooperation between providers. Theoretical dimensions of the concept of trust include fidelity, competency, trustworthiness, integrity and global trust. Conclusions Few quantitative studies examine dimensions of public trust on a health system level. Future country-specific research on the concept of public trust may support the understanding of context-specific determinants for the tailoring of interventions to promote trust in health systems. Key messages Public trust is an important aspect for controlling a pandemic, as it is a precondition for accepting interventions, such as vaccination programmes. Country-specific research may promote the understanding of public trust and the tailoring of interventions to increase health system trust.
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Background The outbreak of SARS in 2002 lead to a public health ethics discourse. The crisis management of that time was ethically analysed and lessons to be learned discussed. Scholarship and WHO, among others, developed an ethics of pandemic preparedness. The current “corona crisis” also faces us with ethical challenges. This presentation is comparing the two crises from an ethical point of view and a focus on Europe. Methods An ethics framework for pandemic preparedness (Schröder et al. 2006 and Schröder-Bäck 2014) is used to make a synopsis of ethical issues. Ethical aspects of 2002 and 2020 that were discussed in the literature and in the media are compared. For 2020, the focus is on interventions in Italy, Germany, Switzerland, and the Netherlands. Results Topics that emerged from the 2002 crisis were, among others, revolving around aspects of stigmatisation and fair distribution of scarce resources (esp. vaccines, antivirals). Currently, most urgent and ethically challenging aspects relate to social distancing vs. autonomy: Isolation and quarantine are handled differently across Europe and the EU. Questions of transferability of such interventions prevail. Contexts vary vertically over time (2002 vs. 2020) and horizontally (e.g. between Italy and Germany at the same time). Furthermore, trust in authorities, media and health information is a key issue. Conclusions Ethical aspects are key for good pandemic preparedness and management. The context of the crises between 2002 and 2020 has slightly changed, also based on “lessons learned” from 2002. This has implications on ethical issues that are being discussed. New lessons will have to be learned from the 2020 crisis. Key messages Pandemic preparedness and outbreak management entail many ethical tensions that need to be addressed. Currently, questions of trust and transferability are key to the crisis management, further ethical issues could still emerge.