Recommendations For Health Care Providers Research Articles

Advancements and challenges in digital health implementation in India: A comprehensive literature review

Digital health has emerged as a promising solution to address healthcare challenges in India, offering innovative tools and technologies to improve access, delivery, and outcomes. This comprehensive literature review provides a detailed analysis of the current state of digital health implementation in India, exploring advancements, challenges, policy initiatives, and future prospects. Drawing upon a wide range of academic literature, government reports, and industry publications, this paper examines key themes such as telemedicine, mobile health (mHealth), electronic health records (EHRs), health information exchanges (HIEs), government initiatives, challenges, and future directions in digital health. By synthesizing existing research, this paper aims to provide insights into the opportunities and barriers associated with digital health in India and offers recommendations for policymakers, healthcare providers, and stakeholders to leverage digital technologies effectively to improve healthcare delivery in the country.

The performance of artificial intelligence large language model-linked chatbots in surgical decision-making for gastroesophageal reflux disease.

Large language model (LLM)-linked chatbots may be an efficient source of clinical recommendations for healthcare providers and patients. This study evaluated the performance of LLM-linked chatbots in providing recommendations for the surgical management of gastroesophageal reflux disease (GERD). Nine patient cases were created based on key questions addressed by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guidelines for the surgical treatment of GERD. ChatGPT-3.5, ChatGPT-4, Copilot, Google Bard, and Perplexity AI were queried on November 16th, 2023, for recommendations regarding the surgical management of GERD. Accurate chatbot performance was defined as the number of responses aligning with SAGES guideline recommendations. Outcomes were reported with counts and percentages. Surgeons were given accurate recommendations for the surgical management of GERD in an adult patient for 5/7 (71.4%) KQs by ChatGPT-4, 3/7 (42.9%) KQs by Copilot, 6/7 (85.7%) KQs by Google Bard, and 3/7 (42.9%) KQs by Perplexity according to the SAGES guidelines. Patients were given accurate recommendations for 3/5 (60.0%) KQs by ChatGPT-4, 2/5 (40.0%) KQs by Copilot, 4/5 (80.0%) KQs by Google Bard, and 1/5 (20.0%) KQs by Perplexity, respectively. In a pediatric patient, surgeons were given accurate recommendations for 2/3 (66.7%) KQs by ChatGPT-4, 3/3 (100.0%) KQs by Copilot, 3/3 (100.0%) KQs by Google Bard, and 2/3 (66.7%) KQs by Perplexity. Patients were given appropriate guidance for 2/2 (100.0%) KQs by ChatGPT-4, 2/2 (100.0%) KQs by Copilot, 1/2 (50.0%) KQs by Google Bard, and 1/2 (50.0%) KQs by Perplexity. Gastrointestinal surgeons, gastroenterologists, and patients should recognize both the promise and pitfalls of LLM's when utilized for advice on surgical management of GERD. Additional training of LLM's using evidence-based health information is needed.

Characteristics of Rodeo Injuries and Suggestions for Injury Prevention: A Systematic Review.

Rodeo is a globally popular sport, with its athletes prone to various types of injuries. There is no systematic review discussing rodeo injuries across all age groups. To (1) review the published literature on incidence, types of injuries, and factors leading to injuries in rodeo athletes; (2) provide prevention recommendations for health care providers; and (3) identify gaps in the research. Systematic review; Level of evidence, 4. A comprehensive search of available literature was electronically performed through MEDLINE, Embase, and SPORTDiscus databases using the key terms "rodeo" and "injury" or "trauma" between 1995 and 2021. A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, which identified 116 eligible studies. Outcome data included frequency of injuries, risk factors for injury, and types of injury. A total of 23 studies met the inclusion criteria (N = 2105 athletes), of which 13 were retrospective studies. In the included studies, the injury rate per competition exposure (CE) ranged from 4.2 to 19.1 injuries per 1000 CE. Sprains and strains accounted for the highest percentage of injury types, ranging from 15% to 34%. The knee was the most common location of injury, making up 11.1% to 17% of injuries. Concussions occurred in up to 15.3% of injuries for all events and up to 77% of injuries in roughstock events. Of all rodeo events reported, bull riding caused the highest percentage of injuries, making up 19.4% to 58.4% of injuries, and bareback had the second highest at 15.3% to 28.8% of injuries. There was a high prevalence of various injury types and mechanisms in rodeo. Improved injury surveillance and the introduction of a comprehensive standardized injury reporting system would be helpful in the future prevention, diagnosis, and treatment of rodeo injuries.

E-cigarettes and Youth: The Known, the Unknown, and Implications for Stakeholders.

Despite the decline in the prevalence of e-cigarette use among youth during the coronavirus disease 2019 pandemic, more than 2.5 million of US high and middle schoolers are still using e-cigarettes. Furthermore, those who use e-cigarettes are starting at a younger age and are using them more intensely, reflecting, at least in part, a high addiction liability of modern e-cigarettes. Beyond addiction, accumulating evidence suggests that, in the short-term, e-cigarettes are associated with cardiovascular and pulmonary effects, whereas the long-term effects of e-cigarette use are yet to be established. The aim of this review is to synthesize current knowledge on e-cigarette use among youth, including established and potential risks and efforts to date to curb youth exposure to e-cigarettes. In addition, we provide recommendations for health care providers, researchers, and other stakeholders to address this significant public health issue.

Digital Healthcare Tools in Nigeria: Strengthening Public Health and Pandemic Preparedness - Insights from the COVID-19 Crisis

This review explores the transformative impact of digital healthcare tools in Nigeria's healthcare system, with a particular emphasis on lessons learned from the COVID-19 pandemic. Nigeria, a country grappling with healthcare disparities and limited access, has seen digital healthcare tools play a crucial role in enhancing public health and pandemic preparedness. The review begins by setting the stage for the relevance of digital healthcare tools in Nigeria, acknowledging the country's complex healthcare challenges. It outlines its objectives and research approach, ensuring transparency and precision in source selection, including Nigerian databases. The examination of digital healthcare tools in Nigeria highlights their potential to address healthcare access issues. The review also delves into the regulatory framework governing telemedicine in Nigeria, recognizing the need for a delicate balance between regulation and innovation, given the nation's unique infrastructure challenges. This provides insights into the factors influencing telemedicine adoption among both healthcare providers and patients in Nigeria. While acknowledging challenges like infrastructure limitations and regulatory complexities, the review also identifies opportunities, such as improved healthcare accessibility and cost-efficiency, brought about by digital healthcare tools in Nigeria. Concrete examples of successful digital healthcare initiatives within Nigeria are presented, offering actionable insights and a roadmap for future endeavors. The review concludes by emphasizing the essential role of digital healthcare tools in addressing Nigeria's healthcare challenges and providing tailored recommendations for policymakers, healthcare providers, and researchers. Ultimately, this comprehensive exploration goes beyond current achievements and challenges, envisioning a future where digital healthcare tools revolutionize Nigeria's healthcare landscape, identifying promising research avenues, and anticipating innovations that can shape the nation's healthcare for the better.

An Observational Study On Cervical Cancer In Sri Lanka And Its Prevention And Management

Background: Cervical cancer is a major health concern worldwide, with significant prevalence in Sri Lanka. Despite being preventable through early detection and vaccination, the disease continues to cause high morbidity and mortality among Sri Lankan women, primarily due to late diagnosis and inadequate access to treatment and preventive measures. Methods and Materials: This observational study employs a cross-sectional design to collect data from a representative sample of Sri Lankan women, using structured questionnaires and interviews. The study aims to determine the prevalence of cervical cancer, identify risk factors, assess awareness and preventive practices, and explore challenges in treatment and prevention. Statistical analysis will be performed on the collected data to achieve these objectives. Results: The study is expected to provide detailed insights into the prevalence and risk factors of cervical cancer in Sri Lanka, along with the current state of awareness and preventive measures among women. It will also highlight the barriers to effective treatment and prevention, guiding future strategies. Conclusion: The findings of this study will significantly contribute to understanding the impact of cervical cancer in Sri Lanka, offering evidence-based recommendations for healthcare providers, policymakers, and the community to improve cervical cancer prevention and management strategies, with the ultimate goal of reducing the incidence and mortality rates of the disease in the country.

Exploring fathers’ experiences of caring for a child with complex care needs through ethnography and arts-based methodologies

BackgroundAlthough the number of children living with complex care needs (CCN) is increasing worldwide, there is limited data on the experience of fathers caring for children with CCN. This paper reports on findings specific to fathers’ experiences of caring for their child with CCN and highlights recommendations provided for parents of children with CCN, service providers, and policymakers. The findings emerged from a larger study designed to examine how Canadian families of children with CCN participate in society.MethodsWe used the qualitative research approach of ethnography and arts-based methodologies (ecomaps and photovoice) as well as purposive and snowball sampling techniques. Four parents were engaged as advisors and twenty-nine fathers participated in interviews (all were married or in a relationship; age range of 28 to 55 years). In line with an ethnographic approach, data analysis involved several iterative steps including comparing data from the first, second, and third set of interviews and refining themes.ResultsOne overarching theme, striving to be there for the child with CCN, was identified. Five supporting themes further exemplified how fathers strived to be there for their child: 1) contributing to the parental team through various roles; 2) building accessibility through adaptation; 3) engaging in activities with the child; 4) expressing admiration and pride in their children; and 5) meaning making. Recommendations for parents included making and nurturing connections and asking for help while recommendations for healthcare and social service providers included communicating authentically with families and listening to parents. Fathers also indicated that leadership and funding for programs of families of children with CCN should be priorities for policymakers.ConclusionsIn addition to documenting fathers’ active involvement in their child’s care and development, our findings provide new insights into how fathers make participation in everyday life accessible and inclusive for their children. Study findings also point to 1) priority areas for policymakers (e.g., accessible physical environments); 2) factors that are critical for fostering collaborative care teams with fathers; and 3) the need for complex care teams in the adult health care system. Implications for those providing psychosocial support for these families are noted as well as knowledge gaps worthy of future exploration such as the role of diversity or intersectionality in fathering children with CCN.

How to Respond to Racist Patients: Recommendations from a Literature Review

amed. Investigation of published recommendations for handling these situations can give victims, peers, and institutions the tools necessary to prepare, protect, and support providers through these challenging encounters. Methods: This paper is a literature review. For inclusion in this review, studies must have met the criteria of providing recommendations for healthcare providers or institutions on how to deal with racist patients. Excluded articles did not include recommendations on how to handle such situations or did not otherwise meet inclusion criteria. PubMed Medline was searched in January 2022 using a combination of the following keywords and associated MeSH terms: “Racism” AND “Physician-Patient relations”. The resulted articles then underwent forward and backward citation searching. A total of 44 articles were included after evaluation of 272 articles via this process. Results: For the affected individual, recommended responses include addressing the comment firmly and directly in real time, setting boundaries and behavior expectation, reporting the incident to supervisors and to the hospital, and seeking support from peers and/or professionals. At the peer level, core practices are supporting the victim, addressing the patient if necessary, debriefing with the victim and team, and checking-in with the victim in the following days. At the institution level, core practices are enacting reporting system and tracking incidents, developing specific policies and procedures about biased patients, and training staff with focused antibias and antidiscrimination sessions. Discussion: There are steps to be taken at every level to create a supportive and inclusive practice that protects providers against racist patients. One limitation of this study was that it was not a systematic review so there may be other recommendations published that are not reflected here.

Third Report of the Japan Diabetes Society/Japanese Cancer Association Joint Committee on Diabetes and Cancer: Summary of the results of a questionnaire survey of oncologists and diabetologists-Secondary publication.

The Japan Diabetes Society and the Japan Cancer Association launched a joint committee and published their "First Joint Committee Report on Diabetes and Cancer" in 2013, compiling recommendations for physicians and health-care providers as well as for the general population. In 2016, the "Second Joint Committee Report on Diabetes and Cancer" summarized the current evidence on glycemic control and cancer risk in patients with diabetes. The current "Third Joint Committee Report on Diabetes and Cancer", for which the joint committee also enlisted the assistance of the Japanese Society of Clinical Oncology and the Japanese Society of Medical Oncology, reports on the results from the questionnaire survey, "Diabetes Management in Patients Receiving Cancer Therapy," which targeted oncologists responsible for cancer management and diabetologists in charge of glycemic control in cancer patients. The results of the current survey indicated that there is a general consensus among oncologists and diabetologists with regard to the need for guidelines on glycemic control goals, the relevance of glycemic control, and glycemic control during cancer therapy in cancer patients.

Exploring the Role of Nurses in Advance Care Planning Within Long-Term Care Homes: A Qualitative Study.

Residents in long-term care homes (LTCHs) are often diagnosed with chronic, life-limiting illnesses, and it is now a common site to provide high levels of care and eventual death. There is an urgent need to address communication gaps and uncertainties surrounding resident's end of life preferences. Nurses are well situated to be key facilitators of necessary advance care planning (ACP), ensuring residents have discussions with family, substitute decision-makers and healthcare providers regarding future health and personal care preferences. However, LTCHs present unique challenges for nurses due to not only complex comorbidities but also staffing dynamics. This study explored the experiences and perceptions of Registered Nurses (RNs) and Registered Practical Nurse (RPNs) in LTCHs regarding their role in engaging residents and families in ACP discussions. Qualitative interpretive descriptive methodology was used. Data were collected from two LTCHs in Southern Ontario with a sample of 15 nurses (7 RNs and 8 RPNs). Analysis involved review of semistructured interviews, field notes, and utilizing constant comparison within an inductive approach. Power and authority dynamics in LTCH's was an overarching theme in the data, with four subthemes: (1) Nurses lacking clarity about ACP, (2) nurses' uncertainty regarding their role in ACP, (3) nurses feeling uncomfortable engaging in ACP discussions, and (4) nurses struggling to support families in ACP discussions. Recommendations for nurses, healthcare providers, LTCH administrators, and policy makers include: (1) development of policies which support, from a systemic level, nurses to feel safe while engaging in ACP; (2) reassessing LTCH's hierarchical structure, and clarifying RN, RPN, and interdisciplinary team members roles in ACP; (3) developing culture change that allows a team and person-centered approach to ACP; and (4) providing ongoing education and mentorship for nurses to manage family dynamics and expand their understanding of ACP beyond a biomedical lens.

ENGAGING PEOPLE WITH DEMENTIA AND THEIR FAMILY IN ADVANCE CARE PLANNING: A 33 COUNTRY DELPHI STUDY

Abstract Reaching a consensus about a definitional framework of advance care planning in dementia was a main goal of an international Delphi study conducted by the European Association for Palliative Care. Four rounds with a panel of 107 experts from 33 countries were conducted between September 2021 and June 2022. The framework comprised a definition and three issues that are of particular importance in the case of dementia, which were capacity, family, and engagement and communication. Focusing on the latter, we provide recommendations that achieved a consensus in the Delphi study. We also interviewed persons with dementia and provide their recommendations for health care providers directly offered by them which the panel found eye-opening. The framework fits dementia and is unique in that it focuses on a communication process that continues independent of the level of capacity, beyond a focus on documenting specific current or end-of-life treatment preferences. It evolved in consensus with experts from western and non-western countries and it should promote inclusiveness of persons with dementia and their family caregivers. The more inclusive conceptualization of what advance care planning in dementia is, provides a much-needed basis for research and policy initiatives on advance care planning in dementia. Further, the work also highlights ambiguity such as about when family caregivers can act as proxies and when not, and the methods may be used as a template for developing frameworks on advance care planning with other specific conditions.

My Wellbeing Journal: Development of a communication and goal-setting tool to improve care for older adults with chronic conditions and multimorbidity.

Chronic conditions and multimorbidity, the presence of two or more chronic conditions, are increasingly common in older adults. Effective management of chronic conditions and multimorbidity in older adults requires a collaborative and person-centred approach that considers the individual's goals, preferences and priorities. However, ensuring high-quality personalised care for older adults with multimorbidity can be challenging due to the complexity of their care needs, limited time and a lack of patient preparation to discuss their personal goals and preferences with their healthcare team. To codesign a communication and goal-setting tool, My Wellbeing Journal, to support personalised care planning for older adults with chronic conditions and multimorbidity. We drew on an experience-based codesign approach to develop My Wellbeing Journal. This article reports on the final end-user feedback, which was collected via an online survey with older adults and their carers. Older adults with chronic conditions, multimorbidity and informal carers living in Australia. Personalised care planning was considered in the context of primary care. A total of 88 participants completed the online survey. The survey focused on participants' feedback on the tool in terms of effectiveness, efficiency, satisfaction and errors encountered. This feedback resulted in modifications to My Wellbeing Journal, which can be used during clinical encounters to facilitate communication, goal setting and progress tracking. Clinicians and carers can use the tool to guide discussions with older adults about their care planning and help them set realistic goals that are meaningful to them. The findings of this study could be used to inform the development of recommendations for healthcare providers to implement person-centred, goal-oriented care for older adults with chronic conditions and multimorbidity. Older adults living with chronic conditions and multimorbidity and their carers have contributed to the development of a tool that has the potential to significantly enhance the experience of personalised care planning. Their direct involvement as collaborators has ensured that the tool is optimised to meet the standards of effectiveness and usability.

Conversations on Cannabis and Mental Health: Recommendations for Health and Social Care Providers from Indigenous 2SLGTBQQIA+ People in Canada

With the recent legalization of cannabis in Canada, there is an urgent need for information about its effects on Indigenous populations due to the impact of cannabis on the mental health of Indigenous Peoples in Canada being largely unknown. Using the guiding principles of Etuaptmumk (Two-Eyed Seeing), Sharing Circles were held to hear the needs and experiences of Indigenous People in relation to their mental health and cannabis use. From these engagements and using gender-based and distinctions-based analysis, four recommendations were developed for academic institutions, medical regulatory authorities and health and social care providers (HSCPs) to consider when caring for Indigenous People living with mental health issues. The findings point to the disconnection between recent research on medical cannabis and its availability to Indigenous People through accessible mediums, HSCPs, and the lack of cultural safety in health and social services. The four recommendations provided are helpful to both educate frontline HSCPs about the needs and experiences of Indigenous People and improve access to current information and best practices for Indigenous People who use cannabis for mental health from the regulatory and representation perspective.

Integrating Information Technology in Healthcare: Recent Developments, Challenges, and Future Prospects for Urban and Regional Health

The use of technology in healthcare has become increasingly popular in recent years, with the potential to improve how healthcare is delivered, patient outcomes, and cost-effectiveness. This review paper provides an overview of how technology has been used in healthcare, particularly in cities and for personalized medicine. The paper discusses different ways technology is being used in healthcare, such as electronic health records, telemedicine, remote monitoring, medical imaging, wearable devices, and artificial intelligence. It also looks at the challenges and problems that come with using technology in healthcare, such as keeping patient data private and secure, making sure different technology systems can work together, and ensuring patients are comfortable using technology. In addition, the paper explores the potential of technology in healthcare, including improving how easily patients can get care, the quality of care they receive, and the cost of care. It also talks about how technology can help personalize care to individual patients. Finally, the paper summarizes the main points, makes recommendations for healthcare providers and policymakers, and suggests directions for future research. Overall, this review shows how technology can be used to improve healthcare, while also acknowledging the challenges that come with using technology in this way.

Making needle procedures comfortable for autistic children: Caregiver perspectives

BackgroundAutistic children are at greater risk for having difficulty undergoing needle procedures and poor management of their needle pain and fear. While there are general clinical practice guidelines (CPGs) available for managing pediatric needle pain and fear, it is unclear whether these strategies are appropriate for autistic children and their caregivers. MethodThe objective of this study was to explore caregiver perspectives on what is needed for needle procedures to be comfortable and CPGs to be appropriate for them and their autistic child. Twenty Canadian caregivers of autistic children were interviewed, including open-ended questions and ratings of how helpful CPG strategies would be for autistic children. ResultsUsing reflexive thematic analysis, four themes were identified: 1) autistic children’s sense of autonomy is important; 2) external factors impact autistic children’s comfort (e.g., environment, familiarity, healthcare providers); 3) caregivers play a key role by preparing themselves and others before needle procedures and 4) it is essential to tailor CPG strategies to children’s needs. ConclusionsFindings indicate that a child and family-centered approach is imperative to making needle procedures comfortable for autistic children. Practical recommendations for healthcare providers and caregivers are provided.

From Awareness to Action: A Review of Efforts to Reduce Disparities in Breast Cancer Screening.

Breast cancer is a significant public health concern, and addressing disparities in breast cancer screening is crucial for improving early detection and reducing mortality rates. This review article examines efforts to bridge the gap between awareness and action in reducing disparities in breast cancer screening. A systematic approach was employed to gather relevant literature using various databases. The selected studies encompassed a range of interventions, including policy changes, community-based programs, culturally competent interventions, technological advancements, and patient navigation. The review highlights the importance of policies and legislation in improving access to screening services and the impact of community-based initiatives in addressing disparities. Culturally competent interventions, tailored messaging, and language support were found to be effective in improving screening rates among diverse populations. Technological advancements, such as telemedicine and mobile health applications, were identified as promising approaches to increase access to screening services. Patient navigation programs effectively addressed barriers to screening and improved screening rates. The review also discusses evaluating efforts, limitations, and the need for continuous improvement. Future directions and recommendations include addressing gaps in the existing literature, proposing research directions, and providing recommendations for policymakers, healthcare providers, and researchers. By implementing these recommendations and working collaboratively, we can strive for equitable access to breast cancer screening for all populations, ultimately leading to improved outcomes and reduced disparities.

Antithrombotic Treatment in Patients With Hemophilia: an EHA-ISTH-EAHAD-ESO Clinical Practice Guidance.

Cardiovascular disease is an emerging medical issue in patients with hemophilia (PWH) and its prevalence is increasing up to 15% in PWH in the United States. Atrial fibrillation, acute and chronic coronary syndromes, venous thromboembolism, and cerebral thrombosis are frequent thrombotic or prothrombotic situations, which require a careful approach to fine-tune the delicate balance between thrombosis and hemostasis in PWH when using both procoagulant and anticoagulant treatments. Generally, PWH could be considered as being naturally anticoagulated when clotting factors are <20 IU/dL, but specific recommendations in patients with very low levels according to the different clinical situations are lacking and mainly based on the anecdotal series. For PWH with baseline clotting factor levels >20 IU/dL in need for any form of antithrombotic therapy, usually treatment without additional clotting factor prophylaxis could be used, but careful monitoring for bleeding is recommended. For antiplatelet treatment, this threshold could be lower with single-antiplatelet agent, but again factor level should be at least 20 IU/dL for dual antiplatelet treatment. In this complex growing scenario, the European Hematology Association in collaboration with the International Society on Thrombosis and Haemostasis, the European Association for Hemophilia and Allied Disorders, the European Stroke Organization, and a representative of the European Society of Cardiology Working Group on Thrombosis has produced this current guidance document to provide clinical practice recommendations for health care providers who care for PWH.

The Development of Recommendations for Healthcare Providers to Support Patients Experiencing Medication Self-Management Problems.

Medication self-management problems such as the inability to correctly obtain, understand, organize, administer or monitor medication can result in negative patient outcomes. However, supportive tools for healthcare providers to assist patients with medication self-management problems are lacking. This study aimed to develop recommendations for healthcare providers to support patients with polypharmacy who experience medication self-management problems. A three-phase study was conducted starting with (1) the mapping of medication self-management problems, followed by (2) a scoping review providing a list of relevant interventions and actions for each respective problem and (3) a three-round modified e-Delphi study with experts to reach consensus on the relevance and clarity of the recommended interventions and actions. The cut-off for consensus on the relevance and clarity of the recommendations was set at 80% expert agreement. Experts could propose additional recommendations based on their professional experience and expertise. The experts (n = 23) involved were healthcare professionals (i.e., nurses, pharmacists, and physicians) with specific expertise in medication management of patients with polypharmacy. Simultaneous with the second e-Delphi round, a panel of patients with polypharmacy (n = 8) evaluated the usefulness of recommendations. Results obtained from the patient panel were fed back to the panel of healthcare providers in the third e-Delphi round. Descriptive statistics were used for data analysis. Twenty medication self-management problems were identified. Based on the scoping review, a list of 66 recommendations for healthcare providers to support patients with the identified medication self-management problems was composed. At the end of the three-round e-Delphi study, the expert panel reached consensus on the relevance and clarity of 67 recommendations, clustered according to the six phases of the medication self-management model by Bailey et al. In conclusion, this study resulted in a guidance document including recommendations that can serve as a resource for healthcare providers to support patients with polypharmacy in case of medication self-management problems. Future research should focus on the evaluation of the feasibility and user-friendliness of the guide with recommendations in clinical practice.

A Cross-Sectional Assessment of Parental Concerns in the Pediatric Surgery Department during the COVID-19 Pandemic.

The COVID-19 pandemic has impacted various aspects of healthcare, including pediatric surgery. This study aimed to assess parental concerns and stress levels in pediatric surgery during the COVID-19 pandemic, identify factors associated with increased parental anxiety or concern, and provide recommendations for healthcare providers. A cross-sectional study was conducted in a tertiary pediatric hospital in Timisoara, Romania, involving 174 parents of pediatric patients requiring elective or emergency surgery, with a mean age of 37.6 (25-47) years, out of which 89.1% of respondents were women. Parental concerns were assessed using the Parental Concerns Questionnaire (PCQ), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS-10). Parents of children undergoing emergency surgery (n = 108) reported higher levels on the practical impact domain of the PCQ scale (3.4 vs. 2.2, p < 0.001), emotional impact (2.7 vs. 2.2, p = 0.002), and total PCQ score (9.5 vs. 7.7, p < 0.001) compared to parents of children undergoing elective surgery (n = 66). Parents in the emergent surgery group also reported higher anxiety scores on the HADS questionnaire (7.9 vs. 6.5, p = 0.009) and higher perceived stress and total score on the PSS-10 survey (7.8 vs. 5.6, p = 0.046) (10.5 vs. 9.1, p = 0.047), respectively. A significantly higher proportion of parents in the emergent surgery group were concerned about restricted visitation policies (p = 0.013) and reported delaying or considering delaying their child's surgery due to the pandemic (p = 0.036). The results demonstrate heightened concerns, anxiety, and stress among parents of children undergoing emergency surgery during the COVID-19 pandemic. Healthcare providers should address parental concerns, provide clear communication, and ensure adequate support for families. Recommendations include enhancing information about COVID-19 precautions, reassuring parents about personal protective equipment availability, and facilitating family support within visitation restrictions.

PO-01-053 LESSONS LEARNED FROM PATIENT ENGAGEMENT: EVALUATION OF A CO-LED IMPLANTABLE CARDIOVERTER DEFIBRILLATOR PATIENT EDUCATION PROGRAM

The implantable cardioverter defibrillator (ICD) is an effective treatment modality but potential risks and complications can negatively impact psychological well-being in areas such as: shock-related anxiety, depression and reduced quality of life (QOL). Ensuring patients receive timely and comprehensive education contributes to informed decision-making, improved device acceptance and ability to live well with an ICD. Incorporating patient engagement in education programs can be an effective strategy to provide peer support and real-world experiences. Development of a co-led educational program provided by expert clinicians and patient partners living with an ICD is an effective strategy and patient-centred approach to care. To evaluate a collaborate delivery model of education co-led by clinicians and patient partners to provide information, support treatment decision and facilitate living well with an ICD. Patient partners with previously implanted ICDs were recruited through a provincial network matching volunteers with healthcare providers to engage in quality care processes. Device clinicians and patient partners implemented a 1-hour, monthly education session for potential and newly implanted recipients. Curriculum was informed through current literature reporting ICD patients’ educational needs. Format transitioned from in-person to virtual at the onset of the pandemic. Participants’ experiences were evaluated using site-developed questionnaires measuring ICD curriculum knowledge and satisfaction with program delivery. Between January 2019 and December 2021, 126 participants (median age: 62 years; women: 30%) attended. Four key components were identified in the program delivery: 1) referral to program, 2) contact and coordination, 3) education session and 4) follow-up. In-person participants (n=62, 49.2%) reported the session as helpful (n=56, 94%). Virtual participants 64 (50.8%) completed an electronic survey (n=27, 45%); reporting the co-led design as very helpful (n=22, 82%) or somewhat helpful (n=5, 18%). Pivoting to a virtual format expanded access to participants living in rural areas and facilitated opportunity for family and caregivers to attend. Patient engagement is an innovative approach for clinicians to incorporate into the education provided to ICD patients. Results of this project provide practice-ready recommendations for healthcare providers to design similar programs addressing the needs of patients considering or living with an ICD.