scholarly journals Respiratory patient experience of measures to reduce risk of COVID-19: findings from a descriptive cross-sectional UK wide survey

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040951 ◽  
Author(s):  
Keir Philip ◽  
Andrew Cumella ◽  
Joe Farrington-Douglas ◽  
Michael Laffan ◽  
Nicholas Hopkinson
Keyword(s):  
Healthcare Services ◽  
Social Consequences ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Social Distancing ◽  
Pulmonary Endometriosis ◽  
Reduce Risk ◽  
The Impact ◽  
Respiratory Conditions

ObjectivesTo assess the experience of people with long-term respiratory conditions regarding the impact of measures to reduce risk of COVID-19.DesignAnalysis of data (n=9515) from the Asthma UK and British Lung Foundation partnership COVID-19 survey collected online between 1 and 8 April 2020.SettingCommunity.Participants9515 people with self-reported long-term respiratory conditions. 81% female, age ranges from ≤17 years to 80 years and above, from all nations of the UK. Long-term respiratory conditions reported included asthma (83%), chronic obstructive pulmonary disease (10%), bronchiectasis (4%), interstitial lung disease (2%) and ‘other’ (<1%) (eg, lung cancer and pulmonary endometriosis).Outcome measuresStudy responses related to impacts on key elements of healthcare, as well as practical, psychological and social consequences related to the COVID-19 pandemic and social distancing measures.Results45% reported disruptions to care, including cancellations of appointments, investigations, pulmonary rehabilitation, treatment and monitoring. Other practical impacts such as difficulty accessing healthcare services for other issues and getting basic necessities such as food were also common. 36% did not use online prescriptions, and 54% had not accessed online inhaler technique videos. Psychosocial impacts including anxiety, loneliness and concerns about personal health and family were prevalent. 81% reported engaging in physical activity. Among the 11% who were smokers, 48% reported they were planning to quit smoking because of COVID-19.ConclusionsCOVID-19 and related social distancing measures are having profound impacts on people with chronic respiratory conditions. Urgent adaptation and signposting of services is required to mitigate the negative health consequences of the COVID-19 response for this group.

scholarly journals The Impact of the COVID-19 Pandemic on Self-Reported Management of Chronic Conditions

2021 ◽  
Vol 8 ◽  
pp. 237437352110076
Author(s):  
Hyllore Imeri ◽  
Erin Holmes ◽  
Shane Desselle ◽  
Meagen Rosenthal ◽  
Marie Barnard
Keyword(s):  
Locus Of Control ◽  
Chronic Conditions ◽  
Online Survey ◽  
Health Locus Of Control ◽  
Patient Activation ◽  
Survey Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Chronic conditions (CCs) management during the COVID-19 pandemic and the impact of the pandemic on patient activation (PA) and health locus of control (HLOC) remain unknown. This cross-sectional online survey study examined the role of COVID-19 pandemic-related worry or fear in PA and HLOC among patients with CCs. Individuals with CCs (n = 300) were recruited through MTurk Amazon. The questionnaire included sociodemographic questions, the Patient Activation Measure, and the Multidimensional Health Locus of Control–Form B. Out of the 300 participants, 9.7% were diagnosed with COVID-19, and 7.3% were hospitalized. Patients with cancer, chronic kidney disease, chronic obstructive pulmonary disease, drug abuse/substance abuse, and stroke reported significant difficulties in managing their CCs due to worry or fear because of COVID-19. More than half of the sample (45.7%) reported COVID-19-related worry or fear about managing their CCs, and these patients had lower PA and lower external HLOC compared to patients not affected by COVID-19-related worry or fear. Health professionals should provide more support for patients facing difficulties in managing their CCs during the COVID-19 pandemic.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

scholarly journals Older and Wiser? The Need to Reexamine the Impact of Health Professionals Age and Experience on Competency-Based Practices

2021 ◽  
Vol 7 ◽  
pp. 237796082110290
Author(s):  
Jing Xu ◽  
Kristen Hicks-Roof ◽  
Chloe E. Bailey ◽  
Hanadi Y. Hamadi
Keyword(s):  
Health Professionals ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Core Competencies ◽  
Healthcare Services ◽  
Interdisciplinary Teams ◽  
Evidence Based ◽  
Health Providers ◽  
Cross Sectional ◽  
The Impact

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.

scholarly journals Prevalence and correlates of forgone care among adult Israeli Jews: A survey conducted during the COVID-19 outbreak

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260399
Author(s):  
Perla Werner ◽  
Aviad Tur-Sinai
Keyword(s):  
Behavioral Model ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
The Novel ◽  
Cross Sectional ◽  
Social Distancing ◽  
The Public ◽  
The Social ◽  
Seeking Help ◽  
Novel Coronavirus

Efforts to control the spread of the novel Coronavirus (COVID-19) pandemic include drastic measures such as isolation, social distancing, and lockdown. These restrictions are accompanied by serious adverse consequences such as forgoing of healthcare. The study aimed to assess the prevalence and correlates of forgone care for a variety of healthcare services during a two-month COVID-19 lockdown, using Andersen’s Behavioral Model of Healthcare Utilization. A cross-sectional study using computerized phone interviews was conducted with 302 Israeli Jewish participants aged 40 and above. Almost half of the participants (49%) reported a delay in seeking help for at least one needed healthcare service during the COVID-19 lockdown period. Among the predisposing factors, we found that participants aged 60+, being more religious, and reporting higher levels of COVID-19 fear were more likely to report forgone care than younger, less religious and less concerned participants. Among need factors, a statistically significant association was found with a reported diagnosis of diabetes, with participants with the disease having a considerably higher likelihood of forgone care. The findings stress the importance of developing interventions aimed at mitigating the phenomenon of forgoing care while creating nonconventional ways of consuming healthcare services. In the short term, healthcare services need to adapt to the social distancing and isolation measures required to stanch the epidemic. In the long term, policymakers should consider alternative ways of delivering healthcare services to the public regularly and during crisis without losing sight of their budgetary consequences. They must recognize the possibility of having to align medical staff to the changing demand for healthcare services under conditions of health uncertainty.

scholarly journals The concept of control in chronic obstructive pulmonary disease: Development of the criteria and validation for use in clinical practice

2020 ◽  
Vol 30 (2) ◽  
pp. 135-141
Author(s):  
M. Miravitlles ◽  
B. Alcázar ◽  
J. J. Soler-Cataluña
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Status ◽  
Disease Status ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Clinical Criteria ◽  
The Impact ◽  
Control Tool

Guidelines of treatment of chronic obstructive pulmonary disease (COPD) identify symptom reduction and prevention of exacerbations as the main goals of therapy. Initial pharmacological treatment must be guided by these parameters, and effectiveness must be assessed at each clinical visit. However, there is no clear guidance as to how this assessment must be performed. The concept of control has been well developed in asthma, but it has been elusive in COPD. Patients with COPD may not be completely free from symptoms or exacerbations even under optimized therapy; therefore, control in COPD does not mean cure or absence of symptoms, but rather reaching the best clinical status possible according to the level of disease severity. A control tool has been developed based on a cross sectional evaluation of the impact of the disease and a longitudinal evaluation of stability. Low impact is a disease status defined by at least 3 of the following: low levels of dyspnoea, absence of or white sputum, low use of rescue medication and self-declared walking time of more than 30 minutes a day, and stability is the absence of moderate or severe exacerbations in the previous 3 months. Control can also be defined by COPD Assessment Test (CAT) scores ≤ 10 units for patients with FEV1 ≥ 50% and 16 for patients with FEV1 < 50% and stability as a change in CAT ≤ 2 units. Control of COPD is then defined as a status of low impact and stability. The control tool has been validated prospectively in several studies and has demonstrated to be sensitive to clinical changes and to have a good predictive value for poor outcomes. Clinical criteria are more reliable than CAT scores for the evaluation of control. The control tool is a quick and inexpensive method to evaluate clinical status and future risk of exacerbations that can be used at all levels of healthcare. 

scholarly journals Commuting mode and pulmonary function in Shanghai, China

2015 ◽  
Vol 47 (3) ◽  
pp. 733-741 ◽  
Author(s):  
Adam W. Gaffney ◽  
Jing-qing Hang ◽  
Mi-Sun Lee ◽  
Li Su ◽  
Feng-ying Zhang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Air Conditioning ◽  
Reference Group ◽  
Airflow Obstruction ◽  
Secondary Outcome ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Mode Of Transportation ◽  
Commuting Mode ◽  
The Impact

Exposure to air pollution can be particularly high during commuting and may depend on the mode of transportation. We investigated the impact of commuting mode on pulmonary function in Shanghai, China.The Shanghai Putuo Study is a cross-sectional, population-based study. Our primary outcomes were forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) % predicted, and the secondary outcome was spirometric airflow obstruction. We tested the association between mode of transportation and these outcomes after adjusting for confounders.The study population consisted of 20 102 subjects. After adjusting for confounders, the change (95% CI) in FEV1 was −2.15% pred (−2.88– −1.42% pred) among pedestrians, −1.32% pred (−2.05– −0.59% pred) among those taking buses without air conditioning, −1.33% pred (−2.05– −0.61% pred) among those taking buses with air conditioning and −2.83% pred (−5.56– −0.10% pred) among those using underground railways, as compared to cyclists (the reference group). The effects of mode on FVC % predicted were in the same direction. Private car use had a significant protective effect on FVC % predicted and the risk of airflow obstruction (defined by Global Initiative for Chronic Obstructive Lung Disease but not by lower limit of normal criteria).Mode of transportation is associated with differences in lung function, which may reflect pollution levels in different transportation microenvironments.

Care of adults with long-term conditions

2020 ◽  
pp. 597-676
Keyword(s):  
Varicose Veins ◽  
Healthcare Providers ◽  
Motor Neurone ◽  
Chronic Obstructive ◽  
Long Term Conditions ◽  
Obstructive Pulmonary Disease ◽  
Lower Back ◽  
Respiratory Conditions

Multiple comorbidities necessitate care from a number of healthcare providers. Continuity of care is important for both patient satisfaction and quality of life. This chapter outlines primary care for adults with a variety of conditions, including osteoarthritis, rheumatoid arthritis, lower back pain, asthma and acute asthma, and stable and chronic obstructive pulmonary disease. It covers drugs commonly used in the treatment of respiratory conditions, including long-term oxygen and nebulizers. It then goes on to cover coronary heart disease, angina, hypertension, cardiac rehabilitation, heart failure, abnormal cardiac rhythms and atrial fibrillation, patients on anticoagulant therapies, and drugs used in cardiovascular diseases. The chapter also includes information on anaemia, varicose veins, diabetes, multiple sclerosis, motor neurone disease, and Parkinson’s disease.

The impact of COVID-19 on residents, relatives and staff in care homes

2020 ◽  
Vol 22 (9) ◽  
pp. 1-2
Author(s):  
Adrian Ashurst
Keyword(s):  
Care Homes ◽  
Social Distancing ◽  
The Impact

We are now only beginning to realise the long-term implications of living alongside COVID-19. Adrian Ashurst investigates the impact of social distancing guidelines and restricted visitation

scholarly journals Effect of the COVID-19 lockdown on disease recognition and utilisation of healthcare services in the older population in German: a cross-sectional study

2020 ◽  
Author(s):  
Bernhard Michalowsky ◽  
Wolfgang Hoffmann ◽  
Jens Bohlken ◽  
Karel Kostev
Keyword(s):  
Hospital Admissions ◽  
Healthcare Services ◽  
Routine Care ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Long Term Effects ◽  
Older Population ◽  
Cross Sectional

Abstract Background There is little evidence about the utilisation of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdown. Objectives We aimed to describe the utilisation of physician consultations, specialist referrals, hospital admissions and the recognition of incident diseases in Germany for this age group during the COVID-19 lockdown. Design Cross-sectional observational study. Setting 1,095 general practitioners (GPs) and 960 specialist practices in Germany. Subjects 2.45 million older patients aged 65 or older. Methods The number of documented physician consultations, specialist referrals, hospital admissions and incident diagnoses during the imposed lockdown in 2020 was descriptively analysed and compared to 2019. Results Physician consultations decrease slightly in February (−2%), increase before the imposed lockdown in March (+9%) and decline in April (−18%) and May (−14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (−39 versus −6%, respectively). Overall, 15, 16 and 18% fewer incident diagnoses were documented by GPs, neurologists and diabetologists, respectively, in 2020. Diabetes, dementia, depression, cancer and stroke were diagnosed less frequently during the lockdown (−17 to −26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations. Conclusion The data suggest that organisational changes were adopted quickly by practice management but also raise concerns about the maintenance of routine care. Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes.

scholarly journals Regional Integration: Do Intra-African Trade and Migration Improve Income in Africa?

2019 ◽  
Vol 43 (6) ◽  
pp. 587-631 ◽  
Author(s):  
Blaise Gnimassoun
Keyword(s):  
Regional Integration ◽  
Capita Income ◽  
Per Capita Income ◽  
Cross Sectional ◽  
Wide Range ◽  
Per Capita ◽  
Migration Flows ◽  
And Migration ◽  
The Impact

Regional integration in Africa is a subject of great interest, but its impact on income has not been studied sufficiently. Using cross-sectional and panel estimations, this article examines the impact of African integration on real per capita income in Africa. Accordingly, we consider intra-African trade and migration flows as quantitative measures reflecting the intensity of regional integration. To address the endogeneity concerns, we use a gravity-based, two-stage least-squares strategy. Our results show that, from a long-term perspective, African integration has not been strong enough to generate a positive, significant, and robust impact on real per capita income in Africa. However, it does appear to be significantly income-enhancing in the short and medium terms but only through intercountry migration. These results are robust to a wide range of specifications.

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