ABSTRACT
Introduction The last months of 2019 saw the emergence of a novel coronavirus, SARS-COV-2, capable of causing widespread disease in humans. The rapid spread of this new disease culminated in one of the biggest pandemics in known history. The far-reaching social, economical, and health effects of this pandemic are still unfolding on a global scale. Given the interconnectedness of social, environmental, and biological factors in manifesting psychiatric illnesses, it is fair to assume that the profound effects of this pandemic would likely increase the strain on mental healthcare systems. The objective of this study was to assess the mental health burden amongst healthcare workers at Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH & RC) at the start of the COVID-19 pandemic and to identify any differences in the mental health scores of anxiety, depression, and sleep disturbance for professionals directly involved in the care of COVID-19 patients as compared to those who were not. Material and methods This was an observational cross-sectional clinical study that used self-reported questionnaires after approval from the hospital's ethical board. The sample size was calculated based on a study published previously by Huang using a 23.04% incidence of anxiety in medical staff. Depression was quantified using the Patient Health Questionnaire-9 score (PHQ-9), anxiety by the Beck Anxiety Inventory, and sleep quality using the Pittsburgh Sleep Quality Index checklist (PSQI). A total of 221 healthcare workers who completed the questionnaires were included in the study and the results were analyzed using SPSS Statistics v. 23 (IBM Corp., Armonk, NY). Levene's test was used to assess the equality of variances, and an independent sample t-test and chi-square test were applied for the comparison of means. A one-way ANOVA test was used to compare means across more than two groups. Results Of the 221 healthcare workers recruited in the study, 57% were males, and 43% were females. Among the sample, 43% of participants were doctors, 27.1% were nurses, and others were technicians and medical assistants. It was observed that 50% of males and 36% of female healthcare workers experienced moderate to severe depression at the onset of the pandemic. Furthermore, 35% of males and 25% of females suffered from moderate to severe anxiety, and more than 80% of our study population reported poor quality of sleep. Conclusion The present study reported a high prevalence of anxiety levels, depressive symptoms, and poor sleep quality among the healthcare professionals working in SKMCH & RC Lahore during the COVID-19 pandemic irrespective of direct contact with COVID-19 patients in a healthcare setting.
ABSTRACT
Introduction Over the years, the process of obtaining informed consent has evolved and now places an emphasis on the concept that patients should play a major role in medical decision making. Failure to adequately involve patients in making decisions regarding their health can lead to medicolegal consequences. Therefore, taking informed consent is a fundamental component of anaesthesia training. Simulation, for training, is an excellent tool that is being utilised widely in the training of medical professionals. The use of simulated training for teaching the process of informed consent is an innovative initiative that can provide improved results. Material and methods After approval from the institutional review board, a prospective clinical study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from August 2019 to September 2020. Sixteen anaesthesia trainees were randomly selected for the study. The study was divided into pre-interventional, interventional and post interventional phases. For data collection, a predesigned checklist was used. Data collected was analysed using SPSS version 23 (IBM Inc., Armonk, New York). The McNemar test was deployed to assess the difference between the baseline assessment and post-simulated training assessment; p-value < 0.05 was taken to be significant. Results Of the 16 participants, the majority were males (n= 13). A positive impact was observed in terms of improvement of the outcome of the following study components i.e., description of benefits of the procedure (p=0.01), disclosure of associated minor risks (p=0.005), disclosure of major risks (p=0.01), discussion of alternatives (p=0.001), teach back (p=0.001), documentation of patients' verbal agreement (p=0.01), and communication skills involving utilising the process of connecting, introduction, communication, permission, response, and exit (p = 0.01). Conclusion Simulated training had a positive impact in improving outcomes in the following study components: description of benefits of the procedure, disclosure of associated risks, discussion of alternatives, teach back, documentation of patients' verbal agreement, and utilisation of the process of connecting, introduction, communication, permission, responding, and exiting.
