The Effect of the COVID-19 Pandemic on Grief Experiences of Bereaved Relatives: An Overview Review.

The COVID-19 pandemic has disrupted grief experiences of bereaved relatives and altered accustomed ways of coping with loss. To understand how bereaved relatives experienced grief during COVID-19, a review, using the overview method, was conducted. An overview of empirical data about this subject has been lacking and therefore, PubMed and CINAHL databases were searched for empirical studies published from January 1, 2020 until December 31, 2021. 28 articles were included in the review. Thematic analysis showed different emotional responses, changes in grief, the effect of absence during final moments, a lack of involvement in the caring process, the impact on communities and social support systems and the alteration of funerals among bereaved relatives. During COVID-19, death is characterized by poor bereavement outcomes and health implications, but bereaved also show signs of resilience and coping. Directions for future research about cultural and societal differences in grief and support methods are suggested.

Translation and cross-cultural adaptation of the risk assessment instrument TilThermometer for a Swedish version - patient handling in the healthcare sector.

BACKGROUND: Work-related musculoskeletal disorders are common in the healthcare sector due to exposure of physical demanding work tasks. Risk assessment is necessary to prevent injuries and promote a safety culture. The TilThermometer has proved to be useful in the Netherlands for assessing healthcare workers' physical exposure to patient handling. The aim of this study was to translate the risk assessment instrument TilThermometer from Dutch to Swedish, perform cross-cultural adaptation, and evaluate its linguistic validity to a Swedish healthcare context. METHODS: Translation and validation process was performed according to following eight steps: 1) Translation (two translators), 2) Synthesis, 3) Back-translation (two back-translators), 4) Synthesis, 5) Linguistic review (one bilingual reviewer), 6) fifteen experts in a panel review according to Delphi-method, 7) Semi-structured interviewing eleven informants, analyzed using qualitative content analysis and step 8) discussion and input from creators of the instrument. RESULTS: A new Swedish version, the TilThermometer, was provided through the translation process (steps 1-5). The linguistic validity and usefulness were confirmed thru step 6 and 7. Consensus was reached in the expert review after two rounds, comments were analyzed and grouped into five groups. The qualitative content analyses of the interviews emerged in to three categories: 1) "User-friendly and understandable instrument", 2) "Further development", and 3) "Important part of the systematic work-environment management". CONCLUSION: In this study, the cross-cultural adaption and translation performed of the Swedish version of TilThermometer assured linguistic validity. This is this first phase before further testing the psychometrics aspects, inter-rater reliability and feasibility of TilThermometer. In the second phase TilThermometer will be implemented and evaluated together with other measures in the Swedish healthcare sector.

The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes.

OBJECTIVES: Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic devices on mechanical load during patient handling activities. METHODS: For each patient, based on national guidelines, it was recorded which specific ergonomic devices were required during distinct patient handling activities, defined by transferring a patient, providing personal care, repositioning patients in the bed, and putting on and taking off anti-embolism stockings. During real-time observations over ~60 h among 186 nurses on 735 separate patient handling activities in 17 nursing homes, it was established whether ergonomic devices were actually used. Mechanical load was assessed through observations of frequency and duration of a flexed or rotated trunk >30° and frequency of pushing, pulling, lifting or carrying requiring forces <100 N, between 100 and 230 N, and >230 N from start to end of each separate patient handling activity. The number of patients and nurses per ward and the ratio of nurses per patient were used as ward characteristics with potential influence on mechanical load. A mixed-effect model for repeated measurements was used to determine the influence of ergonomic devices and ward characteristics on mechanical load. RESULTS: Use of ergonomic devices was required according to national guidelines in 520 of 735 (71%) separate patient handling activities, and actual use was observed in 357 of 520 (69%) patient handling activities. A favourable ratio of nurses per patient was associated with a decreased duration of time spent in awkward back postures during handling anti-embolism stocking (43%), patient transfers (33%), and personal care of patients (24%) and also frequency of manually lifting patients (33%). Use of lifting devices was associated with a lower frequency of forces exerted (64%), adjustable bed and shower chairs with a shorter duration of awkward back postures (38%), and an anti-embolism stockings slide with a lower frequency of forces exerted (95%). CONCLUSIONS: In wards in nursing homes with a higher number of staff less awkward back postures as well as forceful lifting were observed during patient handling activities. The use of ergonomic devices was high and associated with less forceful movements and awkward back postures. Both aspects will most likely contribute to the prevention of low back pain among nurses.

Special approaches for safe handling of disabled children in The Netherlands.

This article illustrates the manner in which care providers and lawmakers in The Netherlands are addressing safe patient handling of disabled children. Standardization of ergonomic practices for safe patient handling of children requires tailored solutions at both the ward and the individual patient level. Elements such as physical contact versus device-assisted transfer, healing environment, and nonverbal (or haptonomic) communication should all be taken into accountfor a program to be successful. Experience from The Netherlands has shown that consideration of these factors, national guidelines, and the presence of ergocoaches can all help to ensure the success of ergonomic interventions, thereby reducing the possibility of direct caregiver injuries.

Prolonged standing in the OR: a Dutch research study.

Prolonged standing is considered to be an occupational risk factor for musculoskeletal disorders. This cross-sectional, multicenter study examined whether Dutch perioperative personnel exceeded ergonomic guidelines for standing in the workplace (ie, not more than one hour of continuous standing and not more than four hours of standing in total per day). Perioperative personnel in 16 hospitals recorded their standing times on a daily basis. The average standing time in the OR was 2.5 hours per work day; however, participants exceeded the ergonomic guidelines on two out of three work days.A reduction in the source of the strain is considered to be the most effective way to prevent occupational health problems. Taking "microbreaks" to relax or move and job duty rotation could help reduce excessive physical stress.

Work-related musculoskeletal disorders of perioperative personnel in the Netherlands.

Approximately one-third of all cases of sick leave for health care workers are related to musculoskeletal disorders (MSDs) originating in the neck, shoulders, and back. A cross-sectional multicenter survey based on the Nordic Questionnaire for Analysis of Musculoskeletal Symptoms investigated the nature and scope of MSDs among Dutch OR personnel. The three-month prevalence rates for MSDs in OR personnel were found to be high compared to MSDs in the general population and comparable to rates in other strenuous professions in health care, industry, and construction. The causes of MSDs that participants mentioned were summarized into four main categories: prolonged standing, awkward postures, lifting and pushing; and climactic conditions.

Safe patient handling program in critical care using peer leaders: lessons learned in the Netherlands.

Occupational back pain remains a serious problem for nurses. In Dutch health care, ergonomic changes are stimulated through convenants. For acute and critical care, a covenant was drawn up and guidelines for nursing practice developed and implemented. Because of the diverse and rapidly changing nature of ergonomic problems, the process has to be specific. A strong emphasis thus was placed on self-management and empowerment of nurses. One or two nurses were appointed per ward as peer leaders, called ergocoaches. They received additional training and were given responsibility for safe work practices. This article reports on progress made to date, viewed as work in progress.