Care Of COVID-19 Patients Research Articles

The devastating trio of sarcopenia, frailty, and COVID-19 - A systematic review and meta-analysis.

Background & aimsSarcopenia, frailty, and COVID-19 appear to be intertwined. Preventive and intervention measures are required to break this link and mitigate the consequences of rising morbidity and mortality among older adults. This study aimed to identify and synthesize important factors related to the interaction of the devastating trio and their impact on the health and mortality of older adults.MethodsData were gathered via searches of PubMed, Cochrane Library, Google Scholar, and Elsevier Mendeley Website. Study selection and data extraction were conducted by the two authors independently. The primary outcome was mortality, secondary outcomes included hospitalization and risk of development of severe disease among older Covid-19 patients. The study results are presented as adjusted odds and hazard ratios with 95% CI.ResultsA total of 1725 studies were identified through our electronic databases searches. After screening and assessing for eligibility, 39 studies were included in this review, a total of 51,796 patients were included in the systematic review. Our results indicated that frail patients recorded a higher mean age compared to non-frail patients (p < 0.00001), and COVID-19 frail patients had significantly increased mortality rate compared to non-frail patients, the log adjusted OR was 2.10 (1.63, 2.71); I2 = 78%; p < 0.00001.ConclusionAge and frailty are important risk factors for mortality among older adults COVID-19 patients. COVID-19 patients with sarcopenia had a higher risk of developing severe conditions, including hospitalization and ICU admission. Findings that support the use of frailty and sarcopenia indicators to help in the decision-making process for medical care in older adults COVID-19 patients.

Environmental detection of SARS-CoV-2 in hospital rooms in different wards of a university hospital

BackgroundTransmission of SARS-CoV-2 can occur through direct, indirect, or close contact with infected people. However, the extent of environmental contamination is unknown. The nature of the relation between patients’ symptoms and SARS-CoV-2 environmental shedding remains unclear. The aim of this study was to assess the relationship between patient covid-19 status and environmental contamination.MethodsBetween May to November 2020, environmental swabs were taken before and after room disinfection at day 7 after symptom onset in a cohort of patients clinically or biologically diagnosed positive for Covid-19. Twelve surfaces per room were collected in 13 rooms. Sample analysis was performed by RT-PCR for SARS-CoV-2 detection (SARS-CoV-2 R-Gene® (Biomérieux)). Clinical data (day of illness, symptoms, RT-PCR results) was collected from the clinical software.ResultsFive medical units were included in the study. Of 156 samples collected in 13 rooms, 5 rooms (38.5%) presented 11 SARS-CoV-2 positive samples. These positive samples were detected on 8 different surfaces. There was no association between detection of SARS-CoV-2 and patient’s age (p= 1) or patient’s symptoms (p= 0.3).ConclusionViral shedding during Covid-19 appears unrelated to the presence of symptoms, patient’s age, and low value cycle threshold of patient’s test. This study supports the evidence for the environmental shedding of SARS-CoV-2 until at least 7 days after patient’s symptoms onset. It emphasizes the need for strict compliance with contact precaution, hand hygiene, the correct use of personal protective equipment and a room disinfection for the routine care of Covid-19 patients.

Moral Distress among Frontline Physicians and Nurses in the Early Phase of COVID-19 Pandemic in Italy.

During the COVID-19 health emergency, healthcare professionals faced several ethical demanding job stressors, becoming at particular risk of moral distress. To date, only a few scales have been developed to evaluate moral distress among frontline professionals working in contact with COVID-19 patients. Moreover, although many healthcare professionals from various disciplines were converted to COVID-19 patient care, no study has yet analyzed whether the resulting change in duties might represent a risk factor for moral distress. Thus, this study aimed to investigate how and when the change in duties during the emergency would be related to healthcare professionals’ psycho-physical malaise. To this aim, a first Italian adaptation of the Stress of Conscience Questionnaire (SCQ) was provided. In total, 272 Italian healthcare professionals participated in this cross-sectional study. Healthcare professionals who had to perform tasks outside their usual clinical duties were more likely to experience moral distress and then psycho-physical malaise. This was particularly likely for those who were extremely concerned about becoming infected with the virus. The results also indicated that the Italian adaptation of the SCQ had a one-factor solution composed of six items. This study provides the first Italian adaptation of SCQ and practical suggestions on how supporting professionals’ well-being during emergencies.

Impact of the COVID-19 pandemic on emergency hospital cancer admissions in a UK region

BackgroundThe pandemic disrupted society and health services through lockdowns and resource reallocation to care for COVID-19 patients. Reductions in numbers of cancer patients having surgery, being diagnosed pathologically or via 2-week wait, and screening programs pauses have been described. The effect on emergency presentation, which represents an acute episode with poor outcomes, has not been investigated. This study explored the pandemic’s impact on emergency hospital admissions for cancer patients in a UK region.MethodsHospital discharge data for cancer patients in Northern Ireland, which included route to admission, were analysed for the pandemic era in 2020 compared to averages for March to December 2017–2019, focusing on volume and route of emergency admissions by demography and tumour site.FindingsCompared with the pre-pandemic era, the number of cancer emergency admissions fell by 12·3% in 2020. Emergency admissions for cancer were significantly reduced when COVID-19 levels were highest (− 18·5% in April and − 16.8% in October). Females (− 15·8%), urban residents (− 13·2%), and age groups 0 to 49 and 65–74 years old (− 17%) experienced the largest decreases as did those with haematological (− 14·7%), brain and CNS (− 27·9%), and lung cancers(− 14·3%). Significant reductions in referrals from outpatient departments (− 51%) and primary care (− 43%) (p < 0·001) were counterbalanced by admissions from other routes including confirmed or suspected COVID-19 infection (increase 83·6%).InterpretationReductions in emergency admissions, and pathologically diagnosed cancers, as reported by the Northern Ireland Cancer Registry (NICR), indicate undiagnosed patients in the community which has implications for future workloads and survival. Data suggest undiagnosed cases may be higher for haematological, brain and CNS, and lung cancers and among females. Efforts should be made to encourage people with symptoms to present for diagnosis or reassurance.FundingThe NICR is funded by the Public Health Agency of Northern Ireland. This work was supported by Macmillan Cancer Support and uses data collected by health services as part of their care and support functions.

Rules of engagement: The role of mistreatment from patients in the nurse, physician and advanced practice provider experience

The objective of this study is to examine the incidence of reported stress due to mistreatment by patients toward clinicians and the role of mistreatment from patients along with organizational factors in clinician distress. A survey of clinicians was conducted at a large academic medical center, resulting in a final analytic sample of 1,682 physicians, nurses, advanced practice providers and clinical support staff. Nurses reported the greatest incidence of mistreatment by patients as a major stressor (18.69%), followed by Advanced Practice Providers (11.26%), Clinical Support Staff (10.36%), and Physicians (7.69%). Logistic regression analysis was conducted to determine the relationship of individual- and organization-level characteristics with the odds of reporting mistreatment from patients as a major stressor. Overall findings indicate that nurses and those who work in the ER and ambulatory or outpatient clinics were more likely to be stressed from mistreatment by patients than other clinicians. Stress due to mistreatment by patients was also associated with higher Well-Being Index (WBI) distress scores, rapid changes in workflows or policies, ongoing care of COVID-19 patients, under-staffing, and low perceived organizational support. Gender or sexual minorities (not identifying as male or female) and younger (18-34 years of age) healthcare workers were also more likely to experience stress from mistreatment by patients. Individual resilience was not statistically significantly associated with reported stress from mistreatment by patients. Organizations must examine expectations for patient and visitor behavior in tandem with service standards for clinicians toward patients. Experience Framework This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens.

Emotional Experiences of COVID-19 Patients in China: A Qualitative Study.

This study explored the emotional experiences of COVID-19 patients in China. Thirty-four patients diagnosed with COVID-19 participated in semi-structured telephone interviews. We used qualitative methods to investigate the distribution patterns and characteristics of patients’ emotional experiences. The results indicated that emotional experiences showed different characteristics at different stages during isolation and treatment. COVID-19 patients’ emotional discourse encompassed eight main themes, namely, feelings of shock at the diagnosis, yearning for future life, attachment to one’s family, depression during the treatment, self-restriction due to probable contagiousness, powerlessness about the disease, open-mindedness about death, and faith in the joint efforts to fight COVID-19. These themes related to experiences concerning infection, isolation, outlook on life and death, stigma, and macro-identity. The findings suggest that the unexpected experience of COVID-19 infection exacerbated patients’ negative emotions. COVID-19 patients’ emotional stress stemmed from isolated environments, physiological effects of the disease, panic about the unknown, and realistic economic pressure. The government, medical staff, family members of patients, and the media should therefore work together to ensure proper emotional care for COVID-19 patients.

Nurses' Ethical Challenges During Caring for COVID-19 Patients: Literature Study

The COVID-19 pandemic has had many impacts on health services. As the most health workers who stand on the front lines, nurses have faced many ethical challenges when treating patients with COVID-19. The ethical challenge of nurses is basically due to the gap between nursing practice and nursing goals. This study aims to identify empirical evidence related to nurses' ethical challenges when caring for COVID-19 patients. This research method uses a literature study analyzing articles from four reputable databases such as Pubmed, Proquest, CINAHL, Science Direct, and one search engine Google Scholar with publication years between 2020 - 2021. The keywords used are 'COVID-19', 'critical care nursing', 'caring', 'ethical challenges', 'ethical issues', and 'ethical dilemmas' with the help of boolean operators 'OR' and 'AND', articles were selected in stages using PRISMA. From the results of 854 articles, only 7 articles were identified that met the inclusion and exclusion criteria. The Article review result found three themes related to the ethical challenges that occurred, namely the ethical challenges in the nursing care process, ethical challenges in nursing professionals, and ethical challenges in health interprofessional relationships. Ethical challenges cause nurses' discomfort at work, and can even cause job stress. Regarding these results, nurses need to get support to overcome ethical dilemmas that occur through the provision of resources according to needs, preparation of SOPs regarding the roles and duties of nurses, as well as increasing knowledge related to the care of COVID-19 patients.

Nurse's experience in giving nursing care to Covid-19 patients.

ObjectiveThe objective was to describe Nurse's experience in giving nursing care to covid-19 patients.MethodPhenomenology design was used in this study. Participants in this study were nurses who provided nursing care for COVID-19 patients. Participant data were obtained from the nursing office and contacted via cell phone to become participants. After data saturation the researcher found six nurses as participants. In-depth interviews were conducted from July to August 2020 to explore the experiences of nurses giving nursing care to Covid-19 patients. Data was analyzed using the Colaizzi method.ResultWe found five themes of nurses giving nursing care to Covid-19 patients. The themes include the Motivation of nurses to provide nursing care during the COVID-19 pandemic, the nurse emotional response, the patient emotional response, the problems faced by COVID-19 nurses, and the expectations of the nurses.ConclusionNurses need support while giving nursing care to Covid-19 patients to break Covid-19 transmission.

Network Analysis of Comorbid Anxiety and Insomnia Among Clinicians with Depressive Symptoms During the Late Stage of the COVID-19 Pandemic: A Cross-Sectional Study.

BackgroundA high proportion of clinicians experienced common anxiety, insomnia and depression during the COVID-19 pandemic. This study examined the item-level association of comorbid anxiety and insomnia symptoms among clinicians who suffered from depressive symptoms during the late stage of the COVID-19 pandemic using network analysis (NA).MethodsClinicians with depressive symptoms (with a Patients Health Questionnaire (PHQ-9) total score of 5 and above) were included in this study. Anxiety and insomnia symptoms were measured using the Generalized Anxiety Disorder Scale - 7-item (GAD-7) and Insomnia Severity Index (ISI), respectively. Network analysis was conducted to investigate the network structure, central symptoms, bridge symptoms, and network stability of these disturbances. Expected influence (EI) was used to measure the centrality of index.ResultsAltogether, 1729 clinicians were included in this study. The mean age was 37.1 [standard deviation (SD)=8.04 years], while the mean PHQ-9 total score was 8.42 (SD=3.33), mean GAD-7 total score was 6.45 (SD=3.13) and mean ISI total score was 8.23 (SD=5.26). Of these clinicians, the prevalence of comorbid anxiety symptoms (GAD-7≥5) was 76.8% (95% CI 74.82–78.80%), while the prevalence of comorbid insomnia symptoms (ISI≥8) was 43.8% (95% CI: 41.50–46.18%). NA revealed that nodes ISI7 (“Interference with daytime functioning”) (EI=1.18), ISI4 (“Sleep dissatisfaction”) (EI=1.08) and ISI5 (“Noticeability of sleep problem by others”) (EI=1.07) were the most central (influential) symptoms in the network model of comorbid anxiety and insomnia symptoms in clinicians. Bridge symptoms included nodes PHQ3 (“Sleep”) (bridge EI=0.55) and PHQ4 (“Fatigue”) (bridge EI=0.49). Gender did not significantly influence the network structure, but “having the experience of caring for COVID-19 patients” significantly influenced the network structure.ConclusionCentral symptoms and key bridge symptoms identified in this NA should be targeted in the treatment and preventive measures for clinicians suffering from comorbid anxiety, insomnia and depressive symptoms during the late stage of the COVID-19 pandemic.

The evolution of nutrition intervention during the COVID-19 pandemic.

COVID-19 has challenged health professionals in widely divergent areas, including innovation of practice, communication, multidisciplinary activities, broader use of technology, and adaptability. The role of the dietitian and other health professionals in dealing with the evolving crisis might be considered essential in treating patients. Given the limited access to various food options, nutrition screening and assessment deserves a high priority to complete a comprehensive nutrition evaluation, identify nutrition risks, prioritize care, and provide early nutrition intervention and support to all patients with or who have had, COVID-19 and are experiencing ongoing symptoms. Such an intervention would benefit the patients and the health system by reducing the length of hospital stay, ameliorating further complications, limiting hospital readmission, enhancing recovery, and assisting in the management of comorbidities and their metabolic alterations. This brief overview outlines the essential role of nutrition intervention and support as part of an integrated, multidisciplinary treatment program for the care of COVID-19 patients during the pandemic. Restrictive movements have changed consultative approaches, and the importance of Telenutrition for the effective communication of health status and recommendations.

The Need for Speed: A Qualitative Study on Nurse Recruitment and Management Amidst the COVID-19 Pandemic in Indonesia.

IntroductionNursing workforce is a pivotal element in tackling the COVID-19 pandemic. However, this has not been comprehensively discussed, particularly in Indonesia. This study aimed to explore stakeholders’ perspectives on Indonesian nursing workforce recruitment and management during the COVID-19 pandemic.MethodsThis study employed a qualitative design with an exploratory descriptive approach. Stakeholders who recruited and managed nursing resources in Indonesia were involved. In-depth interviews and focus group discussions with stakeholders representing eight different institutions were undertaken. Data were analysed using thematic analysis. Eight key stakeholders were interviewed.ResultsThree themes emerged, namely uncertain recruitment system, nursing labour market situation, and workforce management dynamics. COVID-19 caused reduced workforce capacity and increased demands for health professionals, especially nurses.ConclusionUncertainty and volatility happened at the recruitment and management of nursing human resources during the pandemic. Stakeholders were not convinced of overall quality of local nurses recruited to care for COVID-19 patients given workforce was dominated by new graduates and nurses without specialistic qualifications. Employers gave new staff more training to ease their deployment to COVID-19 units to make up for the nurses’ lack of expertise and experience.

Juggling act: COVID-19’s impact on the quality of life of Gynecologic Oncologists (053)

Objectives: To assess the impact of the COVID-19 pandemic on Gynecologic Oncologists’ professional quality of life.Methods: Society of Gynecologic Oncology (SGO) members classified as full member Gynecologic Oncologists were surveyed via an anonymous RedCAP online survey regarding their professional quality of life. The survey was composed of a brief questionnaire to assess basic demographics and the impact the COVID-19 pandemic has had on their personal and professional lives. This was followed by the ProQOL survey, a validated scale to assess the professional quality of life. Descriptive statistics were calculated. Associations between sociodemographic variables and professional quality of life were analyzed utilizing logistic regression.Results: Of the 1,241 invited members, 151 (12%) completed the survey. The median age was 46 years old. Most participants were female (60%), White (78%), and were in academic practice (56%). Few (3%) reported being cross deployed to care for COVID-19 patients. Most (64%) reported a stable patient volume during the COVID-19 pandemic. Some experienced either a decrease (19%) or an increase (17%) in patient volume. The majority (60%) reported having children under the age of 18 or having children older than 18 that required care/supervision. Half (51%) of that group reported being the primary care organizer for their children. A third (34%) of those with children reported changing childcare plans due to COVID-19. The respondents who had their childcare altered by COVID-19 were 5.3 times as likely to have moderate or high burnout scores compared to those who did not have childcare impacted by the pandemic (OR: 5.3, p=0.003). Logistic regression demonstrated that among respondents with children who required childcare, females were 3.4 times as likely to have moderate or high burnout compared to their counterparts (p=0.05).Conclusions: The majority of Gynecologic Oncologists did not experience significant changes to their work type or workload as a result of the COVID-19 pandemic. However, there was a significant impact on the personal lives of those with children. Gynecologic Oncologists who had their childcare plans altered due to COVID-19 experienced significant levels of moderate to high burnout compared to those who did not have these personal stressors at home.

ANALISIS PEMBIAYAAN PERAWATAN PASIEN COVID-19 OLEH PEMERINTAH PUSAT DI INDONESIA

In late 2019 and early 2020 the world was shocked by the emergence of a disease caused by a virus. Virus is widely reported to have emerged from a Huanan Seafood Wholesale Market in Wuhan City, the Capital of Hubei Province, Central China. After COVID-19 has been designated as a pandemic outbreak in the World, the country is present as a guarantor of community needs in handling COVID-19 cases. Thus, this paper specifically discusses the financing of suspect patient care and positive confirmed patients for COVID-19 in Indonesia which is financed by the state through the state through Ministry of Republic of Indonesia. The purpose of writing this journal is to find out the policies and sources of funding for handling COVID-19 in Indonesia by the Central Government and the flow of services and referral for COVID-19 patients. The method used in this paper is literature review. The literature review is done by reading and analyzing and analyzing various literatures, both in the form of documents, journal data publications from The Finance Ministry and from the official website that releases information relevant to research. Data analysis is performed by reducing, classifying, interpreting, and drawing conclusions. Based on data distribution of cases up to April 5, 2020 the number of positive cases was 2,273 with mortality rates ranging from 8.7%, spread in 32 provinces out of a total of 34 provinces in Indonesia. Policies and anticipatory measures have been taken by the government, both at the central government, provincial, district and city governments in the effort to overcome this COVID-19 pandemic. The main step that has been taken by the government is the issuance of Government Regulation in Lieu of Perppu Law Number 1 Year 2020 concerning State policy and financial stability for handling the COVID-19 pandemic 19. Some problems handling COVID-19 patients at COVID-19 referral hospitals are the lack of availability of facilities and infrastructure such as the COVID-19 patient's special room, personal protective equipment for health workers, lack of human resources such as doctors, nurses who can work directly in serving and treating COVID-19 patients. The government through the Ministry of Health on 24 April 2020 has issued a circular number HK.02.01/Menkes/295/2020 regarding claims for reimbursing COVID-19 care costs by hospitals. Followed from the official website of the government namely indonesia.go.id, the claim refers to the applicable provisions in the decision of the minister of health number HK.01.07/MENKES/238/2020 about the technical guidelines for claiming reimbursement of certain infectious disease patient care costs for hospitals which organizes COVID-19 services. COVID-19 patient care costs in Indonesia are charged to the budget of the National Disaster Management Agency (BNPB) so that if there are patients who have already paid, the hospital must return the fee. Government Policy and Financing Sources for Handling COVID-19 in Indonesia by the Central Government and the Flow of Claims for Suspended Patient Care and positive COVID-19 confirmation.

A machine learning model on Real World Data for predicting progression to Acute Respiratory Distress Syndrome (ARDS) among COVID-19 patients.

IntroductionIdentifying COVID-19 patients that are most likely to progress to a severe infection is crucial for optimizing care management and increasing the likelihood of survival. This study presents a machine learning model that predicts severe cases of COVID-19, defined as the presence of Acute Respiratory Distress Syndrome (ARDS) and highlights the different risk factors that play a significant role in disease progression.MethodsA cohort composed of 289,351 patients diagnosed with COVID-19 in April 2020 was created using US administrative claims data from Oct 2015 to Jul 2020. For each patient, information about 817 diagnoses, were collected from the medical history ahead of COVID-19 infection. The primary outcome of the study was the presence of ARDS in the 4 months following COVID-19 infection. The study cohort was randomly split into training set used for model development, test set for model evaluation and validation set for real-world performance estimation.ResultsWe analyzed three machine learning classifiers to predict the presence of ARDS. Among the algorithms considered, a Gradient Boosting Decision Tree had the highest performance with an AUC of 0.695 (95% CI, 0.679–0.709) and an AUPRC of 0.0730 (95% CI, 0.0676 – 0.0823), showing a 40% performance increase in performance against a baseline classifier. A panel of five clinicians was also used to compare the predictive ability of the model to that of clinical experts. The comparison indicated that our model is on par or outperforms predictions made by the clinicians, both in terms of precision and recall.ConclusionThis study presents a machine learning model that uses patient claims history to predict ARDS. The risk factors used by the model to perform its predictions have been extensively linked to the severity of the COVID-19 in the specialized literature. The most contributing diagnosis can be easily retrieved in the patient clinical history and can be used for an early screening of infected patients. Overall, the proposed model could be a promising tool to deploy in a healthcare setting to facilitate and optimize the care of COVID-19 patients.

A Close Shave: Balancing Religious Tolerance and Patient Care in the Age of COVID-19.

In this essay we discuss an ethical dilemma that recently arose in our institution, involving healthcare workers who lamented the requirement to shave their facial hair as a condition to care for COVID-19 patients. The essay represents a genuine attempt to grapple with the dilemma sensibly and vigorously. We first provide a brief introduction, focusing on the tension between religious tolerance and the institutional obligation to optimize patient care and public health in the age of COVID-19. We then discuss the complex relationship between facial hair and cultural as well as religious factors throughout history. Next, we make a case, based on several principles in Islam jurisprudence, that Muslim healthcare professionals in our institution should be expected to shave their facial hair so they could care for COVID patients. We end with considering two alternative solutions that were offered in the literature.

The changing landscape of pharmaceutical alternatives to the unregulated drug supply during COVID-19

BackgroundThe dual COVID-19 and overdose emergencies amplified strain on healthcare systems tasked with responding to both. One downstream consequence of the pandemic in the USA and Canada was a surge in drug overdoses resulting from public health-restricted access to services and an increasingly toxic unregulated drug supply. This study aimed to describe changes implemented by programs prescribing pharmaceutical alternatives to the drug supply during the early stages of the COVID-19 pandemic.MethodsAn environmental scan used surveys and qualitative interviews with service providers across Canada to examine pharmaceutical alternative prescribing practices and programs before and during the pandemic. This study summarized the nature, frequency, and reasons for pandemic-driven service delivery changes using directed content analysis, counts, and thematic analysis.ResultsEighty-two of the 103 participating sites reported 1193 unique changes in physical space (368), client protocols (347), program operations (342), ancillary services (127), and staffing (90). Four qualitative themes describing the reasons for these changes emerged, namely (1) decreasing risk of COVID-19 infection; (2) decreasing risk of overdose; (3) prioritizing acute care of COVID-19 patients; and (4) improving client access to treatment.ConclusionsWhile most changes were aimed at decreasing risk of COVID-19 infection, some were found to be at odds with the measures needed to combat the overdose crisis; others met dual objectives of decreased risk of both overdose and infection. Further research should examine which changes should be kept or reversed once COVID-19-related public health measures are lifted.

The lived experience of nursing students caring for COVID-19 patients

Background and objective: As the wave of COVID-19 pandemic hit the world, schools and students were affected in many ways. Schools had to migrate courses to an online or hybrid platform while students had to adapt their learning to take care of COVID-19 patients in the clinical setting. Caring for COVID-19 patients in the hospital setting provided the students with big challenges, and it became essential for faculty members to understand the students’ feelings and obstacles as the semester continued.Methods: Utilizing a phenomenological framework, a qualitative descriptive study was performed to determine the lived experience of student nurses caring for COVID-19 patients.Results: Four main themes emerged from the study, which included 1) Importance of a support system, 2) Moral distress, 3) Enhancement of clinical skills, and 4) Significance of therapeutic communication.Conclusions: Based on the themes, four recommendations were identified to help students and faculty, which included 1) The value of simulation, 2) Development of a support system, 3) Collaborative preceptorship, and 4) Preparation for a new era.

Burnout Among Medical Staff 1 Year After the Beginning of the Major Public Health Emergency in Wuhan, China.

ObjectivesWuhan is the city where coronavirus disease (COVID-19) was first reported and developed into a pandemic. However, the impact of the prolonged COVID-19 pandemic on medical staff burnout remains limited. We aimed to identify the prevalence and major determinants of burnout among medical staff 1 year after the beginning of the COVID-19 pandemic in Wuhan, China.Materials and MethodsA total of 1,602 medical staff from three hospitals in Wuhan, China, were included from November 1–28, 2021. Chi-square tests were conducted to compare the prevalence of burnout across groups based on sociodemographic and professional characteristics. A multivariate analysis was performed using a forward stepwise logistic regression model.ResultsApproximately 37.39% of the medical staff experienced burnout 1 year after COVID-19 pandemic. Emotional exhaustion (EE) was the most common symptom of burnout, with 1,422 (88.76%) participants reporting a severe EE. Burnout was associated with insufficient social support and “neutral” or “dissatisfied” patient-physician relationships. Respondents who participated in the care of COVID-19 patients had a higher risk of burnout symptoms than those who did not participate. In particular, mental resilience was negatively associated with burnout among the medical staff.ConclusionNearly two-fifths of the participants had symptoms of burnout, with reduced personal accomplishment being the predominant symptom 1 year after COVID-19. Healthcare organizations should regularly measure and monitor burnout among the medical staff. In addition, creating positive work environments and improving the mental resilience of medical staff may be effective ways to reduce burnout.

Influences of COVID-19 pandemic on hospital-at-home functions in Finland – a questionnaire survey

Objective To investigate functions of Finnish hospital-at-home (HAH) during the first year of COVID19-pandemic 2020 compared with the previous year 2019. Design Retrospective questionnaire survey. Setting Finnish HAHs from Northern, Eastern, Southern, Western and Central parts of Finland participated in a questionnaire web-based questionnaire survey. The numbers of patients, activities and staff in 2019 and 2020, participation in the care of COVID19 patients, availability of protective clothing, attitudes of patients towards home care and development of new practices in the corona era were asked using both predefined and free questions. Subjects questionnaire was sent to the nurses and physicians in charge of the HAHs (N = 13), 77% responded. The HAHs provided services to a total of 1,196,783 inhabitants in their municipalities. Results There were no significant changes in the numbers of patients, staff or activities between the years 2019 and 2020. Although nurses did viral tests, COVID19 patients were cared only in 40% of HAHs. Protective clothing was well available. New instructions for infection management were created. Conclusions The COVID-19 pandemic did not largely influence the functions of the examined Finnish HAHs in 2020. Most activities and patients’ characteristics remained unchanged from 2019. The role of HAHs should be further developed in Scandinavian countries, particularly during pandemics. Key Points Hospital-at-home (HAH) is a cost-effective model to provide hospital-like services. Data about the role of HAHs during COVID19 pandemics is lacking in the Nordic countries. This study shows that, the large Finnish municipal HAHs have been not influenced by pandemics.

Problems Facing Healthcare Providers When Caring for COVID-19 Patients: An Integrative Review.

The COVID-19 outbreak is a world health problem that affects millions of people. The pandemic is also causing burdens and challenges to health-care providers. Therefore, this study aimed to examine and help understand health-care providers’ problems when caring for COVID-19 patients. An integrative review following Whittemore and Kanfl’s approach was used along with a systematic search for emerging online databases and grey literature conducted from January to August 2021. The quality of papers was analyzed and a report was presented following PRISMA guidelines. A total of 18 articles that were predominantly descriptive with five themes, including mental health problems in the early stage of COVID-19 outbreak, working stress, physical and psychological impacts of disease, and the lack of support were analyzed. The results showed the pandemic’s significant psychological impact on health-care providers directly caring for COVID-19 patients. Emotional, facilities and family support are needed to maintain the health-care providers’ well-being.