ABSTRACT
Health systems could play an important role in efforts to build vaccine confidence in communities that have been hardest hit by Covid-19. Boston Medical Center (BMC) health system, New England's largest safety-net hospital, along with its community partners, implemented a Covid Response Program aimed at building vaccine confidence. The program was supported by a multifaceted and multilingual communications campaign including: 1) traditional and social media channels with trusted messengers, 2) consistent and accessible core messaging, 3) transparent dialogue, and 4) partnership with state and local health government officials. Between December 2020 and June 2022, BMC disseminated 650 social media posts leading to 12 million impressions and more than 1.8 million post engagements. The campaign included a TikTok video later featured during the presidential inauguration, resulting in more than 3.7 million views. BMC's HealthCity digital publication released 20 articles gaining more than 73,000 views while the FAQ/vaccine scheduling site, translated into seven languages, reached 844,000 page visits. At six months into the vaccination program, 70% of BMC primary care patients 18 years or older had received at least one shot and 60% were fully vaccinated, having received either two mRNA doses or one adenovirus vaccine. The proportions rose to 82% with one dose and 75% fully vaccinated at 12 months. By 24 months into the program, 83% of BMC primary care patients had received at least one shot and 77% were fully vaccinated; however, notable differences existed by race/ethnicity. Seventy six percent of Black patients and 75% of Latino patients were fully vaccinated, compared with 85% of Asian and 81% White patients. Key lessons learned include the importance of a multilingual, multimedia campaign and the need for bidirectional communication that could quickly shift to address evolving issues.
ABSTRACT
Applying the theory of Nursing as Caring can help the nurse provide care that is perceived as caring by moderately to severely injured trauma patients. The Caring Behaviors Inventory was administered in a 1-to-1 interview format to hospitalized trauma patients in a level 2 trauma center. Nurses were positively perceived in their caring behaviors with some variation based on gender and ethnicity. The modified Caring Behaviors Inventory is quick to use and is reliable and valid.
Subject(s)
Emergency Nursing , Empathy , Inpatients/psychology , Nurse-Patient Relations , Wounds and Injuries/nursing , Wounds and Injuries/psychology , Adult , Attitude , Female , Humans , Male , Nursing Staff/psychology , Patient Satisfaction , Trauma CentersABSTRACT
This qualitative study explored family members' perceptions of nurses' caring behaviors. Semistructured interviews were conducted with 10 family members of moderately to severely injured trauma patients cared for at a level II trauma center. The dominant behavior identified as being caring was explaining what was going on and interpreting medical jargon. Appearing hurried and abrupt was noted as behavior that was not caring. In a highly stressful situation such as trauma, the interpersonal relationship the nurse develops with the family influences the perception of the care received.
Subject(s)
Attitude to Health , Family/psychology , Multiple Trauma/nursing , Nurse's Role , Nursing Staff, Hospital/psychology , Professional-Family Relations , Adolescent , Adult , Aged , Attitude of Health Personnel , Clinical Competence , Empathy , Female , Health Knowledge, Attitudes, Practice , Helping Behavior , Humans , Kinesics , Male , Middle Aged , Multiple Trauma/etiology , Nurse's Role/psychology , Nursing Methodology Research , Nursing Staff, Hospital/education , Qualitative Research , Surveys and Questionnaires , Trauma Centers , Young AdultABSTRACT
Articular cartilage swells when its collagen network is degraded, both in osteoarthritis (OA) and following mechanical trauma. However, most of the experimental evidence actually shows that it is small excised samples of cartilage that swell, implying that the cartilage was not greatly swollen in-situ before it was excised. We hypothesise that degraded cartilage can be prevented from swelling in-situ by restraint from adjacent normal cartilage and subchondral bone. Four adjacent osteochondral specimens, 20 x 20 mm, were obtained from regions of the humeral heads of each of 11 skeletally-mature cows. The central region of each specimen was injured by compressive loading using a 9 mm-diameter flat metal indenter, and cartilage surface damage was confirmed using Indian ink. Damaged cartilage was allowed to swell in physiological saline for 1 h under one of four conditions of restraint: (A) normal in-situ restraint from subchondral bone and surrounding cartilage, (B) restraint from bone only, (C) restraint from cartilage only, (D) no restraint (excised specimen). Cartilage hydration was assessed by freeze-drying to constant weight. Proteoglycan loss from damaged cartilage was quantified by analyzing the GAG content of the surrounding bath using the DMB assay. Hydration of damaged cartilage after swelling depended on restraint (p < 0.001), averaging: (A) 76.8%, (B) 78.2%, (C) 78.0%, (D) 81.3%. GAG loss following cartilage surface damage was insufficient to explain observed differences in hydration. The 6% increase in hydration between (A) and (D) can be attributed to swelling which is prohibited when the cartilage remains in-situ. Swelling of degraded cartilage can be largely prevented if it remains in-situ, supported by adjacent healthy bone and cartilage. Adverse physico-chemical consequences of cartilage degradation and swelling may become apparent only when this support is diminished, either because the affected region is large, or following deterioration of adjacent bone or cartilage.
