Healthcare Support Workers Research Articles

Building resilience for healthcare professionals working in an Italian red zone during the COVID-19 outbreak: A pilot study.

The COVID‐19 pandemic has placed considerable strain on healthcare workers showing high rates of stress and psychological health problems. Interventions are urgently needed to help healthcare workers perform under conditions of great risk and uncertainty. In particular, healthcare leadership is known to be critical to supporting healthcare workers to deal with an uncertain and distressing healthcare environment. This pilot study evaluated the impact of the R2 resilience program tailored for healthcare leaders working in a highly affected COVID‐19 area in Italy. Through two group cohorts, 21 healthcare leaders completed the intervention, with 17 participants providing pre‐ and post‐intervention assessment data. Sixty‐two staff members who benefitted from their coordinators' resilience‐focused leadership were also included in the study. Findings show that participation in R2 was associated with reduction in levels of perceived stress and burnout symptoms, and increases in rugged qualities, self‐efficacy and in social‐ecological resilience. Significant changes in rugged qualities, self‐efficacy and perceived stress were also detected in staff members. High rates of participants' program satisfaction have been detected. R2 is a promising intervention for healthcare professionals working in emergency settings designed to enhance the rugged qualities and resources required to deal with heightened exposure to stress.

PENGARUH FAKTOR EKSTERNAL TERHADAP AKTIFITAS FISIK PASIEN HIPERTENSI

AbstractPatients with hypertension were mostly found to have low levels of healthy lifestyle compliance. Patients with hypertension are required to get health counseling in order to adhere to a healthy lifestyle in order to control blood pressure and prevent complications. The purpose of this study was to analyze the influence of external factors (affordability of health services, support of health workers and family support) on the physical activity of hypertensive patients. The design of the research is descriptive correlational with a cross sectional approach. The large sample sampled 145 hypertensive patients. Data collection is done using questionnaires. Data analysis using bivariate tests obtained results of health service affordability (p=0.009), health care worker support (p=0.021) and family support (p=0.012) to the physical activity of hypertensive patients. The results of this study can help the puskesmas in identifying lifestyle compliance of hypertensive patients and help patients in understanding treatment regimens to improve lifestyle compliance.

Implications of latest Care Quality Commission inspection procedures for support staff

The article focuses on Camilla Cavendish, a well-known journalist and former head of the Downing Street policy unit under prime minister David Cameron (and later baroness) published an independent review into healthcare assistants and support workers in the NHS and social care settings.

Culturally-tailored Peer Support for Doctors and Nurses of Indian Origin

The mental health and well-being needs of healthcare workers have risen sharply, fuelled by the current COVID-19 pandemic. Migrant healthcare workers are affected not only by events in the country where they work but also by events in countries where their family and friends reside. Despite, increase in psychological distress, migrant HCWs don’t use the existing resources to support their needs.
 
 This paper summarises discussions from the workshop focusing on reasons/barriers in uptake of mental health and well-being resources in the UK, the scope of peer support initiatives and its boundaries in supporting colleagues in the UK and India. Finally, it makes recommendations on the governance structure and checklist when organising peer support for healthcare workers.

Factors influencing initiation of health behaviour conversations with patients: Cross‐sectional study of nurses, midwives, and healthcare support workers in Wales

AimTo identify factors influencing healthcare professionals’ engagement in health behaviour conversations with patients.DesignCross‐sectional survey.MethodsBetween April and June 2019, an online survey of 1338 nurses, midwives and healthcare support workers was conducted. The survey assessed whether staff felt comfortable initiating health behaviour conversations with patients about five behaviours (reducing alcohol intake; stop smoking; being more active; reducing their weight; and improving their diet) and barriers to conversation initiation. Health professionals’ own health‐related behaviours, self‐rated health and mental wellbeing, and socio‐demographic characteristics were recorded. Logistic regression models were built to assess factors associated with feeling comfortable initiating health behaviour conversations for each topic.ResultLess than 50% of respondents reported feeling comfortable initiating health behaviour conversations with patients. Female staff, young professionals (18 to 29 years), those in lower staff grades and those with poorer health and low mental wellbeing were less likely to report feeling comfortable having health behaviour conversations across all topics. Those who did not adhere to physical activity and dietary guidelines were less likely to initiate a conversation about being more active and having a healthy diet, respectively. Not having time to discuss the topic, suitable space to hold a conversation, and feeling worried about offending/upsetting patients were the main barriers reported.ConclusionAround 6 in 10 members of the nursing, midwifery and healthcare support workforce in Wales potentially do not feel comfortable to initiate a health behaviour conversation with patients about health and wellbeing. Feeling less comfortable to initiate a conversation was associated with staff demographics and organizational factors.ImpactWe identified those less likely to initiate health behaviour conversations as well as personal and organizational barriers to initiation. This will help to target and tailor interventions to ensure staff are equipped and enabled to hold health behaviour conversations with patients.

Advancing Mental Health and Psychological Support for Health Care Workers Using Digital Technologies and Platforms.

BackgroundThe COVID-19 pandemic is a global public health crisis that has not only endangered the lives of patients but also resulted in increased psychological issues among medical professionals, especially frontline health care workers. As the crisis caused by the pandemic shifts from acute to protracted, attention should be paid to the devastating impacts on health care workers’ mental health and social well-being. Digital technologies are being harnessed to support the responses to the pandemic, which provide opportunities to advance mental health and psychological support for health care workers.ObjectiveThe aim of this study is to develop a framework to describe and organize the psychological and mental health issues that health care workers are facing during the COVID-19 pandemic. Based on the framework, this study also proposes interventions from digital health perspectives that health care workers can leverage during and after the pandemic.MethodsThe psychological problems and mental health issues that health care workers have encountered during the COVID-19 pandemic were reviewed and analyzed based on the proposed MEET (Mental Health, Environment, Event, and Technology) framework, which also demonstrated the interactions among mental health, digital interventions, and social support.ResultsHealth care workers are facing increased risk of experiencing mental health issues due to the COVID-19 pandemic, including burnout, fear, worry, distress, pressure, anxiety, and depression. These negative emotional stressors may cause psychological problems for health care workers and affect their physical and mental health. Digital technologies and platforms are playing pivotal roles in mitigating psychological issues and providing effective support. The proposed framework enabled a better understanding of how to mitigate the psychological effects during the pandemic, recover from associated experiences, and provide comprehensive institutional and societal infrastructures for the well-being of health care workers.ConclusionsThe COVID-19 pandemic presents unprecedented challenges due to its prolonged uncertainty, immediate threat to patient safety, and evolving professional demands. It is urgent to protect the mental health and strengthen the psychological resilience of health care workers. Given that the pandemic is expected to exist for a long time, caring for mental health has become a “new normal” that needs a strengthened multisector collaboration to facilitate support and reduce health disparities. The proposed MEET framework could provide structured guidelines for further studies on how technology interacts with mental and psychological health for different populations.

The regulation of healthcare professions and support workers in international context

BackgroundThe objective of this paper is to outline and compare the regulation of paid healthcare professions and associated support workers in international context, bringing out the lessons to be learned as appropriate. Modern neo-liberal societies have sought to enhance healthcare through greater professional regulation, albeit in different ways and at variable pace. This general trend is illustrated with reference to medicine in the UK. However, although such reforms have helpfully cascaded to other health professions, government policy in high-income countries has not yet adequately regulated the interrelated group of non-professionalised health support workers who form the largest and least recognised part of the workforce. Nonetheless, in low- and middle-income (LMIC) countries—aside from the greater need for regulation of health professions—there is even more of an imperative to regulate the disparate, largely invisible support workforce.MethodsWith reference to existing studies of the medical and wider health professions in the UK and selected other higher income societies, the importance of health professional regulation to the public is underlined in the Global North. The larger gap in the regulation of support workers in modern neo-liberal countries is also emphasised on a similar basis, with an increasingly ageing population and advances in healthcare. It is argued from the very limited patchwork of secondary literature, though, that policy-makers may want to focus even more on enhancing regulation of both the professional and non-professional workforce in LMIC societies centred mainly in the Global South, drawing on lessons from the Global North.Results/conclusionsEfforts to reform health professional regulatory approaches in more economically developed countries, while needing refinement, are likely to have had a positive effect. However, even in these societies there are still substantial shortfalls in the regulation of health support workers. There are even larger gaps in LMICs where there are fewer health professional staff and a greater dependence on support workers. With higher rates of morbidity and mortality, there is much more scope here for reforming health regulation in the public interest to extend standards and mitigate risk, following the pattern for healthcare professions in the Global North.

Are the staff in Heddfan Psychiatric Unit, Wrexham Maelor Hospital, are adhering to the personal protective equipment (PPE) guidance as per Public Health Education, England? a QIP

AimsThe aim of this audit is to assess whether healthcare staff are correctly donning and doffing PPE when entering and leaving the wards (changed to donning and doffing PPE when within 2 metres vicinity of a patient).MethodConsultants/ Junior doctors/ Ward managers/ Staff nurses/ student nurses/ Health care support workers/ Occupational therapist/ Psychologists/ Student nurses/ Housekeeping staff, were all included in this Audit. None of the staff was aware of this Audit and this was an entirely random observation. We used a standard proforma in order to audit. Followed by the Audit, we trained the staff in the unit and then re-audited.Result98% of them wore mask whilst in the ward and 94% of them washed their hands after doffing. 36% did not wear them appropriately and about 10-14% did not wear PPE at all. A mere 7 out of 50 alone used hand gel. Overall the donning and doffing of PPE was not being followed and adhered to according to the standards from PHE as per the first Audit. In particular, during donning only 1/3rd of them donned the PPE as per guidance. Likewise, the doffing technique was also poor, with only half of them removing the apron and mask correctly. Unfortunately, only 7 of the 50 people were observed to have used hand gel in between the doffing. This could be potentially increasing the risk of the spread of the coronavirus.We had trained almost 150 staff members in the Heddfan unit with regard to PPE/ donning and doffing.Handwashing prior to donning was achieved by all the staff. All the staff, that is 100 % of them adhered to the donning technique in line with the guidance in comparison to just 64% during the first Audit. Whilst hardly just 1/2 to 2/3rd of the staff followed the doffing technique adequately, the second audit showed that only 2 of the 50 staff did not follow the guidance. A meagre/ handful of them followed the utilisation of hand gel in between the tasks of doffing during the first Audit. Almost 90% of them followed the technique properly during the second Audit. Thus showing that the PPE training was successful.ConclusionFollowing the PPE training that was provided to them there was a good response from the staff and this went on to show how effectively we have managed the prevention/ contamination of virus in our unit.

A proactive, team-based, psychological solution to burnout

A proactive, team-based, psychological solution to burnout

The psychological impact of COVID-19 on health care workers working in a unique environment under the umbrella of Qatar Red Crescent Society

Objectivesto determine the levels of depression, anxiety, and stress among healthcare workers (HCWs) working in a unique male-dominated environment under the umbrella of Qatar Red Crescent, and to explore the associated factors during COVID-19 pandemic in Qatar. Methodsa cross-sectional study utilizing a web-based survey was conducted in the period between 15 November 2020 and 22 December 2020. Depression, anxiety, and stress were determined using the 9-items patient health questionnaire (PHQ-9), the 7-item generalized anxiety disorder (GAD-7) scale, and the 22- item impact of event scale revised (IES-R), respectively. We conducted multivariable logistic regression analysis to determine the predictors of mental health outcomes among HCWs. Resultsthe proportions of the participants reporting symptoms of depression, anxiety, and stress were 12.4 (95%CI: 9.3–16.1), 14.2 (95%CI: 10.9–18.1), and 18.5% (95%CI: 14.8–22.7) respectively. Arabs had significantly more severe anxiety levels than non-Arabs (p = 0.031), HCWs with high COVID-19 risk perception experienced more severe mental health outcomes (p < 0.001). The multivariable logistic regression showed that high risk perception was independently associated with depression (adjusted OR 4.62, 95%CI: 2.00–10.68), anxiety (adjusted OR 4.90, 95%CI: 2.24–10.68), and stress (adjusted OR 3.067, 95%CI: 1.62–5.79) with p < 0.001. Compared to nurses, technicians and paramedics were more likely to report anxiety symptoms with (adjusted OR 2.97, 95%CI: 1.23–7.17, p = 0.015), and (adjusted OR 5.48, 95%CI: 1.86–16.12, p = 0.002) respectively. Having a relative or a friend died of COVID-19 infection was significantly associated with depression symptoms (adjusted OR 2.54, 95%CI: 1.21–5.36, p = 0.014). Not living with family was significantly associated with the presence of different mental health outcomes. Conclusionrelatively lower rates of mental health outcomes in this study compared to others could have several explanations related to the unique characteristics of our target population and their working environment. Ensuring proper mental health support for HCWs is highly recommended.

Prevalence of mental health symptoms and its effect on insomnia among healthcare workers who attended hospitals during COVID-19 pandemic: A survey in Dhaka city

BackgroundDuring the COVID-19 pandemic, the high workload, risk of infection, and safety issues for family members may pose a threat to the mental health of healthcare workers (HCWs) working in hospital settings. The study aimed to find out the prevalence of anxiety, depression, and insomnia symptoms were among HCWs, as well as the factors related to these mental health issues. MethodsWe conducted an online survey of HCWs employed in Dhaka city from June 6 to July 6, 2020. Symptoms of anxiety, depression, and insomnia were measured using the Generalized Anxiety Disorder, the depression module of the Patient Health Questionnaire, and the Insomnia Severity Index, respectively. The related factors of anxiety, depression, and insomnia symptoms were identified using three regression models. ResultsThis research included responses from 294 HCWs (mean ± standard deviation age: 28.86 ± 5.5 years; 43.5% were female). Anxiety, depression, and insomnia symptoms were found in 20.7%, 26.5%, and 44.2% of HCWs, respectively. The variable financial difficulties was commonly found as an associated factor for anxiety, depression, and insomnia symptoms. Female HCWs were more prone to mental health symptoms and insomnia compared to male HCWs (Adjusted odds ratio- AOR = 2.20, 95% CI = 1.27–3.79). The depression symptoms among HCWs were found to be a factor for insomnia (AOR = 6.321, 95% CI = 3.158–12.650). ConclusionIn the current pandemic, the high prevalence of mental health symptoms among HCWs indicates that this occupational group being associated with increased mental distress. Increasing financial support for HCWs and providing support to female workers in care facilities could help to alleviate the burden of mental illness. Supportive, training, and educational strategies, particularly through knowledge and communication platforms, could be recommended to the care facilities, which can reduce the burden of mental health symptoms among HCWs.

Health system determinants of tuberculosis mortality in South Africa: a causal loop model

BackgroundTuberculosis (TB) is a major public health concern in South Africa and TB-related mortality remains unacceptably high. Numerous clinical studies have examined the direct causes of TB-related mortality, but its wider, systemic drivers are less well understood. Applying systems thinking, we aimed to identify factors underlying TB mortality in South Africa and describe their relationships. At a meeting organised by the ‘Optimising TB Treatment Outcomes’ task team of the National TB Think Tank, we drew on the wide expertise of attendees to identify factors underlying TB mortality in South Africa. We generated a causal loop diagram to illustrate how these factors relate to each other.ResultsMeeting attendees identified nine key variables: three ‘drivers’ (adequacy & availability of tools, implementation of guidelines, and the burden of bureaucracy); three ‘links’ (integration of health services, integration of data systems, and utilisation of prevention strategies); and three ‘outcomes’ (accessibility of services, patient empowerment, and socio-economic status). Through the development and refinement of the causal loop diagram, additional explanatory and linking variables were added and three important reinforcing loops identified. Loop 1, ‘Leadership and management for outcomes’ illustrated that poor leadership led to increased bureaucracy and reduced the accessibility of TB services, which increased TB-related mortality and reinforced poor leadership through patient empowerment. Loop 2, ‘Prevention and structural determinants’ describes the complex reinforcing loop between socio-economic status, patient empowerment, the poor uptake of TB and HIV prevention strategies and increasing TB mortality. Loop 3, ‘System capacity’ describes how fragmented leadership and limited resources compromise the workforce and the performance and accessibility of TB services, and how this negatively affects the demand for higher levels of stewardship.ConclusionsStrengthening leadership, reducing bureaucracy, improving integration across all levels of the system, increasing health care worker support, and using windows of opportunity to target points of leverage within the South African health system are needed to both strengthen the system and reduce TB mortality. Further refinement of this model may allow for the identification of additional areas of intervention.

COVID-19 in Africa: Survey Analysis of Impact on Health-Care Workers.

.As coronavirus disease 2019 (COVID-19) spreads across Africa, little is known about the impact of the pandemic on health-care workers (HCWs) in the region. We designed an anonymous survey distributed via e-mail and phone messaging to 13 countries through the African Hepatitis B Network. We obtained 489 analyzable responses. We used risk ratio analysis to quantify the relationship between binary variables and χ2 testing to quantify the statistical significance of these relationships. Median age of respondents was 30 years (interquartile range, 26–36 years) and 63% were physicians. The top three sources of information used by HCWs for COVID-19 management included the Ministry of Health of each country, the WHO, and social media. Forty-nine percent reported a decrease in income since the start of the pandemic, with the majority experiencing between a 1% and a 25% salary reduction. Sixty-six percent reported some access to personal protective equipment; only 14% reported appropriate access. Moreover, one third of respondents reported no availability of ventilators at their facility. Strikingly, the percentage of HCWs reporting never feeling depressed changed from 61% before the pandemic to 31% during the pandemic, with a corresponding increase in daily depressive symptoms from 2% to 20%. Most respondents (> 97%) correctly answered survey questions about COVID-19 symptoms, virus transmission, and prevention. Our survey revealed African HCWs face a variety of personal and professional context-dependent challenges. Ongoing support of HCWs through and after the COVID-19 pandemic is essential.

Characterization and evolution of infection control practices among severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-infected healthcare workers in acute-care hospitals and long-term care facilities in Québec, Canada, Spring 2020.

In this study, we aimed to (1) estimate the severe acute respiratory coronavirus 2 (SARS-CoV-2) infection rate and the secondary attack rate among healthcare workers (HCWs) in Québec, the most affected province of Canada during the first wave; (2) describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and (3) compare the exposures and practices between acute-care hospitals (ACHs) and long-term care facilities (LTCFs). Survey of cases. The study included Québec HCWs from private and public institutions with laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnosed between March 1 and June 14, 2020. HCWs aged ≥18 years who worked during the exposure period and survived their illness were eligible for the survey. After obtaining consent, 4,542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs. HCWs represented 13,726 (25%) of 54,005 reported COVID-19 cases in Québec and had an 11-times greater rate of COVID-19 than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs in LTCFs had less training, higher staff mobility between working sites, similar PPE use, and better self-reported compliance with at-work physical distancing. Suboptimal IPC practices declined over time but were still present at the end of the first wave. Québec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.

The future of nurse education? Studying at the Open University in Scotland.

This article describes nurse education with the Open University in Scotland (OUiS). Although there are problems with nurse recruitment and retention across the UK, in Scotland the landscape is somewhat different, with greater support for students required in remote and rural areas. Despite these challenges, the OUiS continues to recruit to the commissioned numbers of places. OUiS nursing students are primarily health care support workers who are a key group within the health and social care workforce but historically have faced many challenges in developing clear career pathways into nursing. At the heart of the OU is the fundamental recognition of distance online pedagogy, complemented by work-based learning support by employers. Partnership working between the OU, employers and education commissioners is crucial to its success.

Gender differences in mental health problems of healthcare workers during the coronavirus disease 2019 outbreak

The coronavirus disease 2019 (COVID-19) pandemic has imposed both physical and psychological burdens on healthcare workers (HCWs). What is more, few studies have focused on the gender differences in mental health problems (MHPs) among HCWs during such an outbreak. Thus, the current study investigated the prevalence and gender differences of various MHPs among HCWs in China during the COVID-19 outbreak. This nationwide survey was conducted online from January 29 to February 3, 2020. General information was collected by questions about socio-demographics, work-related factors, and living situations. Depressive, anxiety, stress, and insomnia symptoms were assessed by the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Impact of Event Scale-Revised, and the Insomnia Severity Index, respectively. Among the 2198 contacted HCWs, 1563 (71.1%) responded with valid data, of whom 1293 (82.7%) were females. The prevalences of depressive, anxiety, stress, and insomnia symptoms in participants were 50.7%, 44.7%, 52.5%, and 36.1%, respectively. Female HCWs had significantly higher scores in all four scales (p < 0.001) and higher prevalences in all MHPs involved (range, odds ratio [OR] 1.55–1.97). After adjusting for potential confounders, female HCWs still had higher risks for all MHPs involved than males (range, adjusted OR 1.36–1.96). HCWs present high prevalences of depressive, anxiety, stress, and insomnia symptoms during the COVID-19 outbreak. Furthermore, female HCWs are more vulnerable to all MHPs involved. These findings highlight the need for timely, special care and support for HCWs during the outbreak, especially for females.

100 Frailty Hot Clinics: Rapid Cga and Speciality Diagnostics Reduces Rates of Hospitalisation and Re-Attendance

Abstract Introduction Acute hospitalisation is associated with an increased risk of progressive frailty, morbidity and subsequent institutionalisation. North Middlesex University Hospital is an Acute District General Hospital with over 550 attendances to A&amp;E per day. Comprehensive Geriatric Assessment (CGA) is the gold standard approach for a holistic multi-disciplinary assessment (MDT) of frail patients. A rapid access daily hot clinic service for frail patients opened using quality improvement (QI) methodology to deliver rapid CGA focusing on admission avoidance and early supported discharge. Method 4 PDSA cycles were conducted. A process map identifying key moments in patient care was derived from time studies of the first 10 patients’ journeys. Patients were triaged through the Geriatrician “hotphone” for acute admissions into the Hot Clinic. Dedicated clinic and waiting rooms were placed on the acute frailty unit (Amber) staffed by a dedicated Consultant Geriatrician and Health Care Support Worker working with the Frailty Ward Clerk, Frailty Specialist Nurse, Therapies, specialities in-reach and same-day diagnostics. A shared clerking proforma and subsequent CGA Discharge Summary were completed and emailed to the referrer the same day. Qualitative and Quantitative feedback was gained from referrers, patients and relatives through a structured questionnaire. Metrics were gathered including rate of admissions, re-attendance and use of enhanced community services. Results From the first 48 Hot Clinic patients, there was a low 30-day re-attendance rate (17%—for unrelated reasons), low 30-day re-admission rates (4%) and low Did Not Attend rate (6%) for new referrals and high satisfaction scores for recommending the service (9-10/10) from patients, relatives and referrers. Conclusions Early rapid MDT can reduce re-attendances and re-admissions to hospital in frail patients. A streamlined patient journey can be delivered by frailty-trained staff and in a suitable environment. QI Methodology enables a structured measurable approach to development of the Acute Frailty Pathway.

Telemedicine Awareness, Knowledge, Attitude, and Skills of Health Care Workers in a Low-Resource Country During the COVID-19 Pandemic: Cross-sectional Study.

BackgroundSince the onset of the COVID-19 pandemic, several health care programs intended to provide telemedicine services have been introduced in Libya. Many physicians have used these services to provide care and advice to their patients remotely.ObjectiveThis study aimed to provide an overview of physicians’ awareness, knowledge, attitude, and skill in using telehealth services in Libya.MethodsIn this cross-sectional study, we administered a web-based survey to health care workers in Libya in May 2020. The questionnaire collected information on physicians’ general demographic characteristics, ability to use a computer, and telemedicine awareness, knowledge, attitude, and skills.ResultsAmong 673 health care workers who responded to the survey, 377 (56%) and 248 (36.8%) reported high awareness and high computer skill scores, respectively, for telemedicine. Furthermore, 582 (86.5%) and 566 (82.6%) health care workers reported high knowledge and high attitude scores, respectively. We observed no significant differences in awareness, knowledge, attitude, and skill scores among physicians employed at public, private, or both types of hospitals. We observed significant differences in the mean awareness (P<.001), attitude (P=.001), and computer skill scores (P<.001) , where the score distribution of the groups based on the ability to use computers was not similar. Knowledge scores did not significantly differ among the three groups (P=.37). Respondents with professional computer skills had significantly higher awareness (χ23=14.5; P<.001) and attitude (χ23=13.5; P=.001) scores than those without professional computer skills. We observed significant differences in the mean computer skill scores of the groups (χ23=199.6; P<.001).ConclusionsThe consequences of the COVID-19 pandemic are expected to persist for a long time. Hence, policy programs such as telemedicine services, which aim to address the obstacles to medical treatment owing to physical distancing measures, will likely continue for a long time. Therefore, there is a need to train and support health care workers and initiate government programs that provide adequate and supportive health care services to patients in transitional countries.

The development of PAT-HD: A co-designed tool to promote physical activity in people with Huntington's disease.

BackgroundHuntington's disease (HD) is a genetic condition resulting in movement, behavioural and cognitive impairments. People with HD have low levels of physical activity which may be compounded by insufficient support from health‐care professionals.ObjectiveTo evaluate the initial acceptability of a co‐designed tool used within a HD clinic to promote physical activity.DesignCo‐design of a physical activity tool; acceptability evaluation.Setting and participantsCo‐design included people with HD and health‐care professionals. Acceptability was evaluated in a HD clinic in the UK.Main variables studiedA physical activity tool was co‐designed and used within a HD clinic.Main outcome measureAcceptability as assessed by semi‐structured interviews with members of the HD clinic.ResultsForty people visited the HD clinic; 19 were given physical activity advice. Themes around who, where and how promotion of physical activity could take place were identified; concepts of benefits and barriers were threads through each theme.DiscussionWe describe for the first time the co‐design of a HD specific physical activity tool. Our associated acceptability study emphasizes the importance of individualized planning of physical activities in complex neurodegenerative conditions. Perceived barriers were time and lack of knowledge of local resources.ConclusionsA simple tool can support conversations about physical activity with people with HD and is an aid to individualized goal setting. Exploring the use of PAT‐HD within a community setting and development of support systems for health‐care professionals and support workers who are in regular contact with people with HD is required.

Healthcare workers' sleep and mood disturbances during COVID-19 outbreak in an Iranian referral center.

PurposeThis study aimed to assess the frequency of sleep and mood disturbances, and their association with COVID-like symptoms in healthcare workers (HCWs) with and without positive Coronavirus RT-PCR in a corona referral center.MethodsThis study was a cross-sectional, anonymous survey of adult HCWs. Data collection was performed in May and June 2020, while governmental restrictions were in place. The participants completed the forms including six separate parts: personal and occupational information, Insomnia Severity Index (ISI), Generalized Anxiety Disorder-7 (GAD-7), Patient’s Health Questionnaire (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and COVID-like symptoms and Coronavirus RT-PCR status.ResultsAmong the 372 HCW participants, 245 (66%) were women and mean age was 34.5 ± 7.1 years (age range 23 to 58). The mean scores of all questionnaires except ISI were significantly higher in the HCWs with positive Coronavirus RT-PCR than another group (PSQI, 9 ± 3.4 vs. 6.9 ± 3.1; GAD-7, 9.8 ± 3.6 vs. 7.9 ± 5.3; PHQ-9, 12.8 ± 6.1 vs. 9.5 ± 6.4, P < 0.05; and ISI, 13.8 ± 5.3 vs. 12.3 ± 6 P = 0.163). Positive association between COVID-like symptoms and sleep and mood disturbances was found in the group without a positive test result. Analysis of questionnaires showed higher scores in the group directly involved except for ISI (P < 0.001 and P = 0.053 respectively).ConclusionsDuring the COVID-19 pandemic, the HCWs in this sample experienced a high rate of sleep and mood disturbances. There was also a strong association between sleep and mood disturbances and COVID-like symptoms in the group without a positive RT-PCR result. With all this considered, effective psychological support for HCWs during crisis seems to be necessary.