Team Of Health Professionals Research Articles

Automated ventilator prototype for COVID-19 patient treatment: the design and development of the electronic system

<p>The coronavirus disease 2019 (COVID-19) pandemic has created an urgent global demand for ventilators, respirators and various resuscitation devices. Various research and development organizations, private companies and individual engineers have collaborated and carried out the development of low-cost ventilation prototypes. In turn, doctors and nurses are collapsed due to the exponential increase in COVID-19 cases. This scenario worsens more when the tasks are manual in nature. The article`s objective to describe the electronic system designed, developed and implemented in a functional prototype of an automatic ventilator in order to be evaluated by a team of health professionals to be later used in cases of health emergencies. This system automates the manual ventilation task aided by a few medical resources in a scenario of scarce resources and is a temporary solution when a respirator is not available.</p>

Intervensi Psikoedukasi Dapat Menurunkan depresi pada Pasien Kanker

This study aims to examine the effect of psychoeducational interventions on cancer patients who experience depression. The method used was a systematic literature search for randomized controlled trials (RCT) conducted from 2 September 2022 to 7 September 2022, using the following databases: ClinicalKeyNursing, Embase, Proquest, and Science Direct. The results showed that the psychoeducational interventions in the included studies showed beneficial effects on cancer patients who experienced depression as assessed before and after the intervention using the Patient Health Questionnaire-8 (PHQ-8), Distress Thermometer and Hospital Anxiety & Depression Scale (HADS) measurement tools. The five articles reviewed obtained statistical data on psychological outcomes, namely depression, from P <0.05-0.95. The psychoeducational interventions provided by the five articles are MBST (Mindfulness Based Swinging Technique), iCanDo, LTLWC (Learning to Live with Cancer), iCARE, and MINDCAN, which combines lecture-based education, skills practice, discussion, and counseling. Psychoeducational interventions are carried out online and offline by a team of health professionals. Five studies reported a significant effect in reducing depression in cancer patients. In conclusion, preliminary evidence suggests that psychoeducational interventions have beneficial effects and can relieve depression in cancer patients.
 
 Keywords: Depression, Psychoeducational Intervention, Cancer

Interprofessional exchanges during COVID-19 at the Bichat Claude-Bernard Hospital: insights for research

The management of the COVID-19 epidemic has disrupted the organization of healthcare in hospitals. As part of a research project on the resilience of hospitals and their staff to the COVID-19 pandemic (HoSPiCOVID), we have documented their adaptation strategies in five countries (France, Mali, Brazil, Canada, Japan). In France, at the end of the first wave (June 2020), a team of researchers and health professionals from the Bichat Claude-Bernard Hospital organized focus groups to acknowledge these achievements and to share their experiences. One year later, further exchanges were held to discuss and validate the research results. The objective of this short contribution is to describe the insights of these interprofessional exchanges conducted at the Bichat Claude-Bernard Hospital. We show that these exchanges allowed: 1) to create spaces for professionals to speak, 2) to enrich and validate the data collected through a collective acknowledgment of salient aspects related to the experiences of the crisis, and 3) to account for the attitudes, interactions, and power dynamics for these professionals in a crisis management context.

COVID-19 pandemic impact on the oncology care using a virtual survey in Peru.

e18738 Background: Advocacy programs in oncology has shown to improve outcomes through education, patient empowerment and civil society awareness, enabling better actions and efforts for patient care, especially in COVID-19 era. We present the results of a virtual survey conducted with the support of a Peruvian advocacy program for cancer patients in COVID-19 pandemic. Methods: In October 2020, a Peruvian Advocacy Program at Instituto Nacional de Enfermedades Neoplasicas (INEN) (“Club de la Mama”) formed by advocates and supported by a team of health professionals developed a virtual survey between October 2020 and July 2021 with the purpose of evaluating the impact of interruption of diagnosis or oncological treatment, detect a degree of anxiety/depression due to quarantine and provide information on the response of the oncological institution to the pandemic; from the patient’s perspective. This virtual survey includes: alternative treatment options, degree of anxiety/depression, early access to medical prescription, mode of appointment and quality of care. Patients answered the survey anonymously via web promoted on social networks (Facebook/ WhatsApp) and person-to-person diffusion. Results: A total of 244 patients were included, 78.7% females. Most of patients (86.5%) were from Lima and 86.9% had public insurance. 16.8% of patients had COVID-19 in the period of time evaluated. According to education level, 50.8% were superior, 37.7% high school, 10.7% elementary school and 0.8% illiterate. The most common cancer type was breast (36.1%), followed by hematologic (27.9%) and cervical (7.0%). The most common modality of care was in-person (73%), followed by telemedicine (15%) and only 2% not received medical consult. Regarding the degree of depression: 39% were mild, 14% moderate, 12% moderate-severe, 5% severe and 30% none. The most common degree of anxiety was 42% mild, 16% moderate, 12% severe, and 30% no degree. The most frequent reasons for not attending to hospital were unavailability of appointments (31%), followed by fear to COVID-19 (26%), geographic (10%) and difficulty in transportation (9.0%). The appointment cancellation/postponement time [reported in days] was: 18.0% not canceled, 16% [ < 15], 14% [15-30], 19% [30-60], 10% [60-90], 23% [ > 90]. Of the patients with surgical indication, 72% did not undergo surgery. Regarding prescription, 83% of patients received oncologic treatment, 10% did not received, and the remaining 7% answered that they did not need medication. Quality of care: 18% were considered excellent, 67% good, 10% fair, and 5% poor. Conclusions: Although the survey showed higher degrees of anxiety/depression in patients and longer cancellation/postponement/medication changes during COVID-19 pandemic, there was a significant adherence of medicine prescription, with no negative impact on the perception of quality of oncology care.

Expansion of testing, isolation, quarantine, e-health and telemonitoring strategies in socioeconomically vulnerable neighbourhoods at primary healthcare in the fight against COVID-19 in Brazil: a study protocol of a multisite testing intervention using a mixed method approach

IntroductionThe key tools for mitigating the impact of COVID-19 and reducing its transmission include testing, quarantine and isolation, as well as telemonitoring. Primary healthcare (PHC) can be essential in increasing...

What makes a space safe? Consumers' perspectives on a mental health safe space.

The provision of community-based space for people experiencing a mental health crisis is regarded as a favourable alternative to the emergency department. However, the only non-emergency department safe spaces in Western Australia are located within hospitals or hospital grounds. This qualitative study asked mental health consumers in Western Australia with experience of presentation at the emergency department during a mental health crisis to describe what a safe space would look and feel like. Data were collected through focus groups and thematically analysed. The findings present the voices of mental health consumers through the framework of health geography and the therapeutic landscape. These participants articulated important physical and social features of a therapeutic safe space and their symbolism as inclusive, accessible places where they would experience a sense of agency and belonging. Participants also expressed a need for trained peer support within the space to complement the skilled professional mental health team. Participants' experiences of the emergency department during mental health crises were described as contrary to their recovery needs. The research reinforces the need for an alternative to the emergency department for adults who experience mental health crises and provides consumer-led evidence to inform the design and development of a recovery-focused safe space.

Improving healthy connections in under-resourced youth: A YMCA San Diego mental health initiative

Youth who have faced multiple challenges, including navigating underresourced contexts and systems, need innovative, comprehensive, and culturally responsive mental health services. The services should also leverage the strengths of youth and peers who can be trained as paraprofessionals to work with the professional mental health team in best supporting youth with complex psychosocial challenges. The current study conducted five focus groups to explore qualitatively the experiences of 33 youth with the CAVE approach of the Connections 2020 program of YMCA San Diego; an initiative to improve the relational competencies of transitioning child-welfare involved youth. The CAVE approach is focused on creating therapeutic relationships amongst participating youth, paraprofessional peers, and the professional mental health team, with a focus on compassion, awareness, validation, and empowerment. The focus groups’ highlight the following seven themes experienced by youth: improved emotion regulation; negative life experiences before joining Connections 2020; motivated by desire for stronger relationships and work experience; positive experiences during Connections 2020; finding mentorship and support through relationships with professional and paraprofessional coaches; most helpful skills learned are acceptance, tolerance, and how to manage emotions; and more prepared to handle difficult situations after Connections 2020. The findings underscore the feasibility and acceptability of applying a youth positive development framework to improve relationships and related skills for youth, leveraging their strengths, and integrating paraprofessional youth in improving mental health services.

ITHRIVE 365: A Community-Led, Multicomponent Health Promotion Intervention for Black Same Gender Loving Men.

Although health inequities among Black same gender loving men (SGLM) are well documented (e.g., chronic psychological disorders, HIV, suicide), there are few accessible, culturally affirming, and community-led interventions designed to reduce these inequities. The present manuscript describes the process through which we developed iTHRIVE 365, a multicomponent health-promotion intervention designed by Black SGLM for Black SGLM. We utilized a community-based participatory research approach (CBPR) that included collaboration between THRIVE SS, a Black SGLM-run community-based organization, and a multisectoral team of public health, research, and digital design professionals to develop the intervention. A five-phase development process included four phases of focus groups and a technical pilot to assess community priorities and incorporate input on each feature of the intervention. Directed content analysis indicated that participants wanted a multicomponent and technology-mediated intervention that promotes health knowledge and motivation, Black SGLM social support, access to affirming healthcare, and housing and economic resources. iTHRIVE 365 combines multilevel and culturally affirming intervention features to combat the effects of oppression and ultimately promote Black SGLM's biopsychosocial health.

Spiritual and religious perspectives in persons with visual impairment due to age-related macular degeneration.

Age-related macular degeneration (AMD) is one of the global leading causes of severe vision loss. Patients suffering from AMD face complex spiritual and mental challenges that have an impact on the course of their disease, their quality of life, and their relationship with their surroundings. A survey was carried out using a 21-item questionnaire between August 2020 and June 2021 among 117 patients from different countries to investigate how spirituality, religion, and their way of practicing them affected the experiences and daily lives of patients suffering from AMD, and whether it helped them cope with the disease. Our study concluded that spirituality and religion are important factors that facilitate patients' ability to cope with a progressive degenerative disease such as AMD. Patients who are religious are more at peace with having AMD. Practices that contribute to patients being at peace in accepting the disease are regular prayers or meditation. Spirituality and religion are important components that promote a healthier and happier emotional state and mental wellbeing. In particular, by believing that death is not the end, patients feel more hopeful, which helps in their adjustment to a seemingly hopeless health condition. A significant number of AMD patients desire to talk about God with the medical staff. The profile of such patients could be those believing in a higher power, praying often, participating in religious services, being worried about the loss of vision, and needing assistance in daily life. An interdisciplinary and multidimensional team of medical health professionals including mental health workers and chaplains can be of great value in managing persons with AMD.

Perspectives on the Person-Centered Practice of Healthcare Professionals at an Inpatient Hospital Department: A Descriptive Study.

The characteristics of health professionals and their understanding of person-centeredness may have important implications for the development of person-centered practice in specific care settings. In this study, we characterized the perceptions of the person-centered practice of a multidisciplinary team of health professionals working in the internal medicine inpatient unit of a Portuguese hospital. Data were collected using a brief sociodemographic and professional questionnaire and the person-centered practice inventory-staff (PCPI-S), and the effect of different sociodemographic and professional variables on each PCPI-S domain was determined using an analysis of variance (ANOVA). The results showed that a person-centered practice was positively perceived in the major constructs of prerequisites (M = 4.12; SD = 0.36), the practice environment (M = 3.50; SD = 0.48), and person-centered process (M = 4.08; SD = 0.62) domains. The highest scored construct was developed interpersonal skills (M = 4.35; SD = 0.47), and the lowest was supportive organization systems (M = 3.08; SD = 0.80). Gender was found to influence the perceptions of knowing self (F(2,75) = 3.67, p = 0.03, partial η2 = 0.089) and the physical environment (F(2,75) = 3.63, p = 0.03, partial η2 = 0.088), as was profession on shared decision-making systems (F(2,75) = 5.38, p < 0.01, partial η2 = 0.125) and commitment to the job (F(2,75) = 5.27, p < 0.01, partial η2 = 0.123), and the educational level on being professionally competent (F(1,75) = 4.99, p = 0.03, partial η2 = 0.062) and having commitment to the job (F(2,75) = 4.49, p = 0.04, partial η2 = 0.056). In addition, the PCPI-S proved to be a reliable instrument for characterizing healthcare professionals' perceptions of the person-centeredness of care in this context. Identifying personal and professional variables that influence these perceptions could provide a starting point for defining strategies to move practice toward person-centeredness and for monitoring changes in healthcare practice.

IMPACT OF BURNOUT SYNDROME ON INTENTION TO LEAVE AMONG NURSE AT X HOSPITAL GRESIK

Background: Turnover of nurse was still a challenge and concern for nursing and hospital management. Nurses who voluntarily leave the organization were threat to nursing organization. Turnover among nurse was contributed factor to the decline in the number of nurses worldwide. High turnover among nurse causes losses to the organization in terms of costs, resources and nurses’ motivation. Turnover among nurses was ranked highest in the team of health professionals.&#x0D; &#x0D; Objectives: The aim of this study was to know how the effect of burnout syndrome on the level of intention to leave among nurses.&#x0D; &#x0D; Methods: This study was used explanatory design with a cross sectional with 126 respondents. Data were collected using a questionnaire that has been tested for validity and reliability. The variables included burnout syndrome and turnover intention. Data were analyzed using binary logistic regression techniques.&#x0D; &#x0D; Results: The significant value of logistic regression test was obtained at 0.003 (&lt;α=0.05). So, burnout syndrome has a significant direct effect to intention to leave among nurse. If burnout syndrome higher, intention to leave will be higher too.&#x0D; &#x0D; Conclusion: Dimensions of emotional and physical exhaustion are dominant to increase intention to leave of nurse. Intervention that can be made to reduce nurse burnout among nurse through personal focus to strengthen individual coping strategies to confront of stress, while organizational roles focus on reducing job demands among nurse.

Early assessment and intervention by a dedicated health and social care professional team in the emergency department in older adults compared to treatment-as-usual: Health Economic Analysis Plan for within-trial cost effectiveness analysis

Background: Older adults (aged over 65 years) experience high rates of adverse outcomes after presenting to emergency departments (EDs). The OPTI-MEND trial aimed to examine what impact intervention and early assessment by a dedicated health and social care professional (HSCP) team can have on quality of care for older adults in EDs. This paper presents the finalized Health Economic Analysis Plan (HEAP) specifying how the within-trial cost effectiveness analysis (CEA) will be conducted. Methods: This HEAP was developed retrospectively in collaboration with the OPTI-MEND team and the trial health economist to provide a plan to conduct the CEA. The HEAP aimed to fulfil international recommendations from a consensus of the required items for inclusion in HEAPs. In line with best practice guidelines, and to ensure full visibility in the scientific process, this paper makes the HEAP available in the public domain. Results: This HEAP illustrates the plan we followed when conducting our CEA. As this paper is a protocol it has no concrete results. A detailed list of all items in the HEAP are provided as Extended data on Open Science Framework at https://doi.org/10.17605/OSF.IO/YVG2P. Conclusions: Cost effectiveness analysis is an opportunity to extend beyond the primary clinical analysis of a trial. Congruent to a trial’s statistical analysis plan (SAP), a HEAP outlines the plan for estimating cost effectiveness and avoiding potentially spurious post-hoc analysis and questionable policy recommendations.

PALLIATIVE CARE IN THE HOSPITAL ENVIRONMENT

Different studies have discussed the importance of including palliative care as a mandatory component in the training of health team professionals. Currently, it is explored in different disciplines and rarely has its own curriculum, which leads to a superficial approach to this extremely relevant topic. With palliative care, the experience of anticipatory grief pains becomes more bearable, even making this experience have a new meaning and finitude is not just a place of waiting in which regrets gnaw at the conscience of patients, but of a place where these patients start to be the protagonists of their history, with the possibility of carrying out unfinished or even started things, but which they would like to accomplish before the terminality.

TOP-PIC: a new tool to optimize pharmacotherapy and reduce polypharmacy in patients with incurable cancer.

Polypharmacy is a significant problem in patients with incurable cancer and a method to optimize pharmacotherapy in this patient group is lacking. Therefore, a drug optimization tool was developed and tested in a pilot test. A multidisciplinary team of health professionals developed a "Tool to Optimize Pharmacotherapy in Patients with Incurable Cancer" (TOP-PIC) for patients with a limited life expectancy. The tool consists of five sequential steps to optimize medications, including medication history, screening for medication appropriateness and drug interactions, a benefit-risk assessment using the TOP-PIC Disease-based list, and shared decision-making with the patient. For pilot testing of the tool, 8 patient cases with polypharmacy were analyzed by 11 oncologists before and after training with the TOP-PIC tool. TOP-PIC was considered helpful by all oncologists during the pilot test. The median additional time required to administer the tool was 2min per patient (P < 0.001). For 17.4% of all medications, different decisions were made by using TOP-PIC. Among possible treatment decisions (discontinuation, reduction, increase, replacement, or addition of a drug), discontinuation of medications was the most common. Without TOP-PIC, physicians were uncertain in 9.3% of medication changes, compared with only 4.8% after using TOP-PIC (P = 0.001). The TOP-PIC Disease-based list was considered helpful by 94.5% of oncologists. TOP-PIC provides a detailed, disease-based benefit-risk assessment with recommendations specific for cancer patients with limited life expectancy. Based on the results of the pilot study, the tool seems practicable for day-to-day clinical decision-making and provides evidence-based facts to optimize pharmacotherapy.

Clinician by day, filmmaker by night: The development of a consumer inspired educational electroconvulsive therapy video.

Electroconvulsive therapy (ECT) is a highly effective form of treatment used for major psychiatric disorders. However, significant stigma surrounds ECT and mental health consumers and they often report lack of knowledge prior to receiving ECT. They complain of inadequacies in information being provided by health professionals and difficulty finding reliable, balanced information that incorporates the experience of consumers who have received ECT. To address these limitations, a collaborative team of ECT consumers and health professionals created a new ECT video to provide consumers and their relatives with up-to-date, easy to understand information about ECT. The educational video includes evidence-based information from health professionals and genuine consumer perspectives. A gap in clinical care and service provision was identified and a collaborative project was undertaken to address these limitations. In the process of creating an ECT video, many lessons were learned and a range of recommendations were implemented, including a memory rehabilitation program and new and improved access to ECT information resources.

The Perceived Ease of Use and Perceived Usefulness of a Web-Based Interprofessional Communication and Collaboration Platform in the Hospital Setting: Interview Study With Health Care Providers

Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospitals and during discharge planning. However, interprofessional communication and collaboration in inpatient settings are often fragmented and inefficient, leading to poor patient outcomes and provider frustration. Health information technology can potentially help improve team communication and collaboration; however, to date, evidence of its effectiveness is lacking. There are also concerns that current implementations might further fragment communication and increase the clinician burden without proven benefits. In this study, we aimed to generate transferrable lessons for future designers of health information technology tools that facilitate team communication and collaboration. A secondary analysis of the qualitative component of the mixed methods evaluation was performed. The electronic communication and collaboration platform was implemented in 2 general internal medicine wards in a large community teaching hospital in Mississauga, Ontario, Canada. Fifteen inpatient clinicians in those wards, including nurses, physicians, and allied health care providers, were recruited to participate in semistructured interviews about their experience with a co-designed electronic communication and collaboration tool. Data were analyzed using the Technology Acceptance Model, and themes related to the constructs of perceived ease of use (PEOU) and perceived usefulness (PU) were identified. A secondary analysis guided by the Technology Acceptance Model highlighted important points. Intuitive design precluded training as a barrier to use, but lack of training may hinder participants' PEOU if features designed for efficiency are not discovered by users. Organized information was found to be useful for creating a comprehensive clinical picture of each patient and facilitating improved handovers. However, information needs to be both comprehensive and succinct, and information overload may negatively impact PEOU. The mixed paper and electronic practice environment also negatively impacted PEOU owing to unavoidable double documentation and the need for printing. Participants perceived the tool to be useful as it improved efficiency in information retrieval and documentation, improved the handover process, afforded another mode of communication when face-to-face communication was impractical, and improved shared awareness. The PU of this tool depends on its optimal use by all team members. Electronic tools can support communication and collaboration among interprofessional teams caring for patients with complex needs. There are transferable lessons learned that can improve the PU and PEOU of future systems.

Patient safety culture in a COVID-19 ICU compared to a clinical-surgical ICU in the Brazilian Eastern Amazon: A cross-sectional study.

The COVID-19 pandemic highlighted the need for a new dynamic in the organization and practices of health services, as it required rapid restructuring to promote safe and harm-free assistance. To assess the dimensions of the patient safety culture (PSC) from the perspective of the health team professionals in clinical-surgical ICU (G1) compared to a COVID-19 ICU (G2). Cross-sectional, analytical, descriptive and inferential study, using the "Hospital Survey on Patient Safety Culture" questionnaire. The domain "Supervisor/Manager Expectations and Actions Promoting Patient Safety (PS)" was a potential weakness for G1 (p =0.003). G2 was most positive on improving PS, being informed about errors, considering PS as a top priority to management, and that the units work together to provide the best care (p >0.05). G1 was most negative about the work culture with staff from other units, exchange of information across units, and shift changes (p >0.05). The highest PS grade was related to greater communication, and a smaller frequency of events was reported only for G2 (p >0.05). There must be a balance in terms of attention focused on PS between different ICUs in times of crisis, especially regarding the supervisors/managers actions.

ATUAÇÃO DE EQUIPES DE SAÚDE NA GESTÃO DE RISCOS DE DESASTRES

ABSTRACT Objective: to understand the perceptions of Primary Health Care and Psychosocial Care professionals regarding their role in addressing the psychosocial impacts following hydrological natural disasters in southern Brazil. Method: a multiple-case, descriptive and integrated study with a qualitative approach. The participants were professionals and managers from Primary Health Care and Psychosocial Care in municipalities from southern Brazil. Data collection was carried out during the conduction of a funded project, including narrative interviews between January and May 2018. Data analysis followed the stages of Fritz Schütze's method. Results: interpretation of the narratives of the cases and their units of analysis comprised the following categories: 1) Health teams' performance in disasters; and 2) Cultural meanings and training for risk and disaster reduction. Demands for pre-flooding care, demands during the disaster event, and post-flooding demands: care in psychosocial support and territory surveillance were identified. Conclusion: the study identified actions perceived by health team professionals and municipal managers regarding disasters in a context of recurrent events. While recognizing cultural aspects for a resilient response, there are operational and training gaps for an effective management of the response and recovery plan at the community level.

A FORMAÇÃO INTERDISCIPLINAR PARA A ABORDAGEM FAMILIAR NA ATENÇÃO PRIMÁRIA À SAÚDE

ABSTRACT Objective: To reflect on the interdisciplinary training of health team professionals to work with the family in Primary Healthcare, considering the complexity of the family phenomenon in their health and illness experiences. Method: A reflection article in which the need to incorporate new concepts for training professionals to work with the family in Primary Healthcare is discussed. Results: The theoretical articulation between the Patient- and Family-Centered Care Model, Interprofessional Education and Primary Healthcare is fundamental to guide interdisciplinary training in health, aiming at including the family as the protagonist of the care of its members and active in the teaching and learning process of the healthcare professionals. Conclusion: It becomes necessary to promote changes in the training model of health professionals to incorporate collaborative practice with the family.

Continuidade do cuidado e ações no território durante a COVID-19 em municípios de São Paulo, Brasil: barreiras e facilitadores

Abstract The discontinuity of care and actions in the territory in primary health care during pandemic periods can escalate acute and chronic complications and mortality. In this sense, this article aims to present the barriers and facilitators for care continuity and actions in the territory during the COVID-19 pandemic in São Paulo municipalities. This qualitative analysis was conducted through 37 interviews with health managers and professionals from six municipalities. Two facilitators were identified: the availability of a specific service for attending COVID-19-related respiratory demands and the integration of the health team professionals before the pandemic. Two barriers were identified: a fragile primary healthcare structure before the pandemic and the lack of alignment of health professionals’ actions with the community and territorial care model. We concluded that municipalities with a structured PHC system before the pandemic faced fewer hardships in preserving care continuity and actions in the territory.