scholarly journals MO882PATIENTS' UNDERSTANDING AND EXPERIENCE OF COVID-19 PANDEMIC AMONGST IN-CENTRE HAEMODIALYSIS POPULATION IN A SINGLE UK CENTRE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Khai Ping Ng ◽  
Lisa Crowley ◽  
Yogita Aggarwal ◽  
Jyoti Baharani

Abstract Background and Aims Patients with end-stage kidney disease on dialysis are susceptible to severe COVID-19 infections. However, during the pandemic, many renal patients were unable to ‘shield’ fully due to the ongoing need to attend the dialysis unit for treatment. With a significant proportion of our haemodialysis population coming from socially deprived and ethnic minority background (38%), we aimed to explore patients’ understanding and experience of COVID-19 pandemic. Method This was a cross-sectional survey of patients receiving in-centre haemodialysis from one centre in England conducted during July 2020, three months after the first UK national lockdown. The questionnaire consisted of 18 questions exploring patients’ awareness of COVID-19 pandemic, understanding of ‘shielding’, use of face covering, and their experience of haemodialysis treatment as well as accessing healthcare during COVID-19 pandemic. Those with language barriers were offered assistance and verbal translation by haemodialysis nurses, if possible, to complete the questionnaire. Results In total, 232 patients (of a total of 479 in-centre dialysis patients, 48% response rate) completed and returned the questionnaire. Of these, 29 (12.5%) patients required help with the questionnaire due to language barrier. Mean age was 62 (SD 16) years, 63% were male, 53% were from ethnic minorities and 45% were from the most deprived area (MDI Decile 1). A third of the respondents lived with 3 or more adults at home and a quarter lived with one or more child. Majority of the patients (97%) were aware of COVID-19 pandemic, and most received information on COVID-19 from the news (87%). Dialysis staff (43.1%), family and friends (32.6%), internet (31%) and general practitioners (20.3%) were also key sources of information. Despite this, 17.2% of the patients did not know about ‘shielding’. Even though 3 in 4 patients stated that they were ‘always’ or ‘often’ able to ‘shield’, when prompted with scenarios, significant number of patients in fact felt that they were unable to shield when travelling to dialysis (56%), during dialysis (35%) or when shopping (17%). Majority of the patients (89%) said that they wore face covering and 28% self-isolated from the rest of household during the first peak of pandemic. 83% practised ‘social distancing’ at dialysis units but 5% did not and 6% felt unable to do so. Almost a quarter of the patients (23%, 54 patients) felt unwell during the first wave of COVID-19. Majority (50%) of them sought medical help by informing the dialysis unit, whilst 26% contacted their GP and 38% attended emergency departments. Of these 54 patients, 35% had difficulties accessing medical help, especially from primary care. One in four patients felt that their dialysis experience had changed during the pandemic: 10% increased use of private taxis or used different travel services, 3.5% reported increased travel time, 8% dialysed at a different unit, 5% experienced longer waiting time to start dialysis sessions and 4% had dialysis frequency reduced . Almost a third (29%) of the patients knew of someone in the dialysis unit who had COVID-19 infection during the first wave of pandemic. Conclusion COVID-19 posed significant challenges for patients receiving in-centre haemodialysis. Despite their high susceptibility to severe COVID infection, significant number of patients was not aware of ‘shielding’ or able to ‘shield’ effectively. Some also experienced difficulties accessing medical help and a quarter reported change of transport or dialysis arrangement during the pandemic.

2020 ◽  
Vol 49 (8) ◽  
pp. 543-552
Author(s):  
Qiu Ju Ng ◽  
Krystal ML Koh ◽  
Shephali Tagore ◽  
Manisha Mathur

Introduction: To assess the level of anxiety and knowledge regarding COVID-19 amongst antenatal women. Materials and Methods: This cross-sectional survey was conducted in the antenatal clinics of KK Women’s and Children’s Hospital, Singapore, from 31 March to 25 April 2020 to assess pregnant women’s knowledge of COVID-19, their perceptions of its impact upon pregnancy and psychological impact using the validated Depression, Anxiety, and Stress Scales (DASS-21). Results: Of the 324 women who participated in the study, the mean age was 31.8 years (range, 20–45). The majority (53.7%) were multiparous with mean gestational age of 23.4 weeks (SD 10). The commonest sources of information were Internet-based social media platforms. A significant proportion were unaware, or associated COVID-19 infection during pregnancy with fetal distress (82.1%), intrauterine death (71.3%), fetal anomalies (69.8%), miscarriages (64.8%), preterm labour (67.9%) and rupture of membranes (61.4%). A total of 116 (35.8%) women screened positive for anxiety, 59 (18.2%) for depression, and 36 (11.1%) for stress. There was a significant association between household size and stress scores [B = 0.0454 (95% CI, 0.0035–0.0873)]. Women who associated COVID-19 infection with fetal anomalies and intrauterine fetal death had significantly higher anxiety scores [B = −0.395 (95% CI, −0.660 to −0.130) and B = −0.291 (95% CI, −0.562 to −0.021) respectively]. Conclusion: Our study highlights that a lack of timely and reliable information on the impact of COVID-19 on pregnancy and its outcomes results in increased levels of depression, anxiety and stress. The healthcare provider must address these issues urgently by providing evidence-based information using Internet-based resources and psychological support. Key words: Depression, Anxiety, Stress, Pregnancy, Knowledge


2021 ◽  
Vol 5 (1) ◽  
pp. e000942
Author(s):  
Oliver G P Lawton ◽  
Sarah A Lawton ◽  
Lisa Dikomitis ◽  
Joanne Protheroe ◽  
Joanne Smith ◽  
...  

COVID-19 has significantly impacted young people’s lives yet little is known about the COVID-19 related sources of information they access. We performed a cross-sectional survey of pupils (11–16 years) in North Staffordshire, UK. 408 (23%) pupils responded to an online survey emailed to them by their school. Descriptive statistics were used to summarise the data. Social media, accessed by 68%, played a significant role in the provision of information, despite it not being considered trustworthy. 89% felt that COVID-19 had negatively affected their education. Gaps in the provision of information on COVID-19 have been identified.


SAGE Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 215824402110063
Author(s):  
MaryJoy Umoke ◽  
Prince Christian Ifeanachor Umoke ◽  
Chioma Adaora Nwalieji ◽  
Rosemary N. Onwe ◽  
Ifeanyi Emmanuel Nwafor ◽  
...  

Lassa fever is a zoonotic disease characterized by acute viral hemorrhagic fever, endemic in West Africa including Nigeria. The study assessed the knowledge and sources of information on Lassa fever infection among the undergraduate students of Ebonyi State University, Nigeria. This was a descriptive cross-sectional survey conducted among a sample of 389 students (18 years above). A self-administered questionnaire was used to collect data. Data were analyzed with SPSS (Version 20), and hypotheses were tested at p < .05 level of significance. Results showed that the majority of the students had good knowledge of Lassa fever description, 232 (60.75%); the signs and symptoms, 221 (57.9%); mode of transmission, 261 (68.41%); and preventive measures, 291 (76.13%). Radio, 23 (84.6%), and television, 307 (80.4%), were their major sources of information. Age ( p = .424), sex ( p = .082), and academic level ( p = .553) were not significant in the study, while faculty (social sciences; p = .000*) was strongly associated with the knowledge of Lassa fever. In conclusion, the overall knowledge of Lassa fever was good among students, though knowledge gaps were observed in the signs and symptoms. We recommend that health education on endemic diseases in the state be made a compulsory course as a general study (GST) in the university. Also, the internet, social media, and campus campaign be further used to educate and sensitize students on the effect of Lassa fever.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043421
Author(s):  
Rae Thomas ◽  
Hannah Greenwood ◽  
Zoe A Michaleff ◽  
Eman Abukmail ◽  
Tammy C Hoffmann ◽  
...  

ObjectivePublic cooperation to practise preventive health behaviours is essential to manage the transmission of infectious diseases such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission and prevention that have the potential to impact the uptake of recommended public health strategies.DesignAn online cross-sectional survey.ParticipantsA national sample of 1500 Australian adults with representative quotas for age and gender provided by an online panel provider.Main outcome measureProportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions.ResultsOf the 1802 potential participants contacted, 289 did not qualify, 13 declined and 1500 participated in the survey (response rate 83%). Most participants correctly identified ‘washing your hands regularly with soap and water’ (92%) and ‘staying at least 1.5 m away from others’ (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them from contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that ‘regular use of antibiotics’ would not prevent COVID-19.Most participants (90%) identified ‘fever, fatigue and cough’ as indicators of COVID-19. However, 42% of participants thought that being unable to ‘hold your breath for 10 s without coughing’ was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%) and the Australian Government COVID-19 information app (31%).ConclusionsPublic messaging about hand hygiene and physical distancing to prevent transmission appears to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long term. We need to develop public health messages that harness these barriers to improve future cooperation. Ensuring adherence to these interventions is critical.


2017 ◽  
Vol 79 (03) ◽  
pp. 289-296 ◽  
Author(s):  
Jamie Van Gompel ◽  
R. Wiet ◽  
Nicole Tombers ◽  
Anand Devaiah ◽  
Devyani Lal ◽  
...  

Background Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program. Sixty-three percent of respondents claimed to evaluate VS patients in clinic with both an otolaryngologist and neurosurgeon involved. Eighty-six percent of respondents claimed to operate on VS with both an otolaryngologist and neurosurgeon involved, while only 18% of neurosurgeons and 9% of otolaryngologists performed surgery alone. There was a wide range in the number of cases evaluated at each center annually. Similarly, there was wide variation in the number of patients treated with microsurgery and radiation at each center. Additional details regarding management preferences for microsurgery, stereotactic radiosurgery, stereotactic radiotherapy, and conservative observation are presented. Conclusion VS management practices vary between providers and centers. Overall, most centers employ a multidisciplinary approach to management with collaboration between otolaryngology and neurosurgery. Overall, survey responses concur with previous studies suggesting a shift toward conservatism in management.


2012 ◽  
Vol 19 (06) ◽  
pp. 808-811
Author(s):  
SAEMA TEHSEEN ◽  
AFIFA WAHEED ◽  
NABEELA SHAMI

Induced Miscarriage is defined as the elective termination of pregnancy before 24 weeks of gestation. Objectives: To determinethe frequency of sepsis associated with induced Miscarriage. Study Design: Cross-sectional survey. Setting: Department of Obstetrics andGynaecology, Unit-II, Ghurki Trust Teaching Hospital, Lahore. Duration of Study: Six months from 25-12-08 to 24-06-09. Materials andMethods: Total 110 cases were taken. Complete history including parity and mode of admission was taken. All information was recorded onspecially designed proforma. Results: A large number of patients turned out to be para 3-4 i.e. 87 (79%), 15 cases (13.7%) had the paritybetween 5-7 and only 8 cases (7.3%) were para 1-2 (Table-I).On analyzing the mode of admission it was found that 50 (45.4%) patients wereadmitted through out-patient department. 60 cases (54.6%) were admitted through emergency (Table-II). Finally the frequency of sepsisamongst women presenting with Miscarriage was calculated and it was found to be 25 (22.7%). 85 (77.3%) cases did not show any evidence ofsepsis (Table-III). Conclusions: Illegal Miscarriages are a major contribution to septic morbidity leading to a large number of maternal deathswhich is a dilemma in under developed countries like ours. Better public awareness and access to contraceptive measures has a definite role toplay in improving the outcome.


Author(s):  
Peter P. Groenewegen ◽  
Wienke G. W. Boerma ◽  
Peter Spreeuwenberg ◽  
Bohumil Seifert ◽  
Willemijn Schäfer ◽  
...  

Abstract Aim: To describe variation in task shifting from general practitioners (GPs) to practice assistants/nurses in 34 countries, and to explain differences by analysing associations with characteristics of the GPs, their practices and features of the health care systems. Background: Redistribution of tasks and responsibilities in primary care are driven by changes in demand for care, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill mix of primary care teams. However, these developments are hampered by barriers between professional domains, which can be rigid as a result of strict regulation, traditional attitudes and lack of trust. Methods: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7200 GPs in 34 countries. The dependent variable ‘task shifting’ is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are: institutional development of primary care; demand for and supply of care; nurse prescribing as an indicator for professional boundaries; professionalisation of practice assistants/nurses (indicated by professional training, professional associations and journals). Multilevel analysis is used to account for the clustering of GPs in countries. Findings: Countries vary in the degree of task shifting by GPs. Regarding GP and practice characteristics, use of electronic health record applications (as an indicator for innovativeness) and age of the GPs are significantly related to task shifting. These variables explain only little variance at the level of GPs. Two country variables are positively related to task shifting: nurse prescribing and professionalisation of primary care nursing. Professionalisation has the strongest relationship, explaining 21% of the country variation.


2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Samina Ismail ◽  
Shemila Abbasi ◽  
Sobia Khan ◽  
Abdul Monem ◽  
Gauhar Afshan

AbstractAims:The aim of this study was to evaluate the factors responsible for epidural analgesia (EA) refusal among parturient patients.Methods:In this prospective cross-sectional study of six months, we included all consenting postpartum patients having a non-operative delivery in the obstetric unit of our hospital. Data were collected on a predesigned questionnaire and included information such as parity, education, reasons for delivering with or without EA, source of information and patient satisfaction. Knowledge regarding EA was assessed from patients delivering without EA.Results:From 933 patients enrolled, 730 (78.2%) delivered without EA, and 203 (21.7%) with EA. Only 11 (1.5%) patients refused EA for the reason of having natural birth process. Otherwise common reasons were misconceptions (65.9%) and lack of awareness about EA (20.5%); 70.5% had no knowledge of common side effects of EA. Among patients delivering with EA, 92.6% were offered EA by health care providers and had obstetricians and anesthesiologists as their sources of information.Conclusions:Patients in developing countries are laboring without EA, even in centers where there is a provision for it. The main reasons for not availing themselves of EA are lack of awareness and knowledge and misconceptions, rather than the desire to have un-medicated natural birth.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
So-Sun Kim ◽  
Won-Hee Lee ◽  
JooYoung Cheon ◽  
Jung-Eun Lee ◽  
KiSun Yeo ◽  
...  

Background. The goal of advance directives is to help patients retain their dignity and autonomy by making their own decisions regarding end-stage medical treatment. The purpose of this study was to examine preferences of advance directives among general population in Korea.Method. A descriptive cross-sectional survey was performed from October 2007 to June 2008 in Seoul, Korea. A total of 336 city-dwelling adults self-administered the questionnaire and returned it via mail. Data analyses were conducted using SPSS 17.0.Results. Subjects reported the need for healthcare providers' detailed explanations and recommendations regarding end-of-life care. When there is no hope of recovery and death is imminent, most subjects did not want to receive cardiopulmonary resuscitation nor an IV or tube feeding. However, most of the subjects wanted pain management care.Conclusions. The present study showed that many Korean people have an interest in advance directives. The results show that the autonomy and dignity of patient have increased in importance. To provide better end-of-life care, there is a need to educate patients on the definition and intent of an advance directive. Additional proactive communication between patients and their caregivers should be educated to healthcare providers.


2019 ◽  
Author(s):  
Dejene Kassa ◽  
Henok Tadele ◽  
Birkneh Tilahun Tadesse ◽  
Akalewold Alemayehu ◽  
Teshome Abuka ◽  
...  

Abstract Background Institutional delivery service utilization is one of the key and proven interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries including Ethiopia occurs at home and is not attended by skilled birth attendants. This study aimed at determining the prevalence of home delivery and associated factors in three districts in Sidama Zone.Methods A cross sectional survey was conducted from 15th- 20th October 2018. A multi-stage sampling design was employed to select 507 women who gave birth 12 months preceding the survey. Quantitative data were collected by using structured, interviewer administered questionnaires. Univariate and multivariate logistic regression models were run to assess factors associated with home delivery. Measures of association between factors and the outcome variable were reported using 95% confidence intervals (CIs) and adjusted odds ratios (aORs).Results The response rate was 495(97.6%). The overall prevalence of home delivery was 113 (28%) with 95%CI (19%, 27%). Maternal rural residence, aOR=7.45(95%CI: 2.23-24.83); illiteracy of mothers, aOR=8.78 (95% CI: 2.33-33.01); those who completed grades 1-4, aOR =3.81(95% CI: 1.16-12.49); mothers who did not know the expected date of delivery, aOR=2.12 (95% CI: 1.21-3.71); mother being merchant, aOR=3.01(95%CI:1.44-6.3) and paternal illiteracy, aOR=3.27, (95% CI: 1.20-8.88) were predictors of home birth.Conclusion The prevalence of skilled birth attendance in the study area has improved from the EDHS 2016 report of 26%. Uneducated, rural and merchant mothers were more likely to deliver at home. Interventions targeting rural and uneducated mothers might help to increase skilled birth attendance in the region.


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