Impact of the COVID-19 Pandemic on Surgical Oncology in Europe: Results of a European Survey

Background: The first COVID-19 pandemic wave hit most of the health-care systems worldwide. The present survey aimed to provide a European overview on the COVID-19 impact on surgical oncology. Methods: This anonymous online survey was accessible from April 24 to May 11, 2020, for surgeons (n = 298) who were contacted by the surgical society European Digestive Surgery. The survey was completed by 88 surgeons (29.2%) from 69 different departments. The responses per department were evaluated. Results: Of the departments, 88.4% (n = 61/69) reported a lower volume of patients in the outpatient clinic; 69.1% (n = 47/68) and 75.0% (n = 51/68) reported a reduction in hospital bed and the operating room capacity, respectively. As a result, the participants reported an average reduction of 29.3% for all types of oncological resections surveyed in this questionnaire. The strongest reduction was observed for oncological resections of hepato-pancreatico-biliary (HPB) cancers. Of the interviewed surgeons, 68.7% (n = 46/67) agreed that survival outcomes will be negatively impacted by the pandemic. Conclusion: The first COVID-19 pandemic wave had a significant impact on surgical oncology in Europe. The surveyed surgeons expect an increase in the number of unresectable cancers as well as poorer survival outcomes due to cancellations of follow-ups and postponements of surgeries.

Download Full-text

Family medicine physicians’ report strong support, barriers and preferences for Registered Dietitian Nutritionist care in the primary care setting

Family Practice ◽

10.1093/fampra/cmaa099 ◽

2020 ◽

Author(s):

Lauren R Sastre ◽

Leslie T Van Horn

Keyword(s):

Family Medicine ◽

Online Survey ◽

Interprofessional Collaboration ◽

Health Care Systems ◽

Descriptive Analysis ◽

Strong Support ◽

Full Time ◽

Registered Dietitian ◽

Cross Sectional ◽

Care Systems

Abstract Background Previous studies have examined barriers (e.g. time) for Family Medicine Providers (FMPs) to provide nutrition and lifestyle counseling, however, to date no studies have examined access or interest to Registered Dietitian Nutritionist (RDN) care for patients. Objective The objective of this study was to explore FMP access, referral practices, barriers and preferences for RDN care. Methods A cross-sectional online survey, with content and face validation was conducted with Family Medicine Departments within large academic health care systems in the Southeastern United States. The main variables of interest included: FMP access, interest, current referrals and referral preferences for RDN care, barriers to referrals and overall perceptions regarding RDN care. Descriptive analysis of close-ended responses was performed with SPSS 26.0. Open-ended responses were analysed using inductive content analysis. Results Over half of the respondents (n = 151) did not have an RDN on-site (64%) yet were highly interested in integrating an RDN (94.9%), with reported preferences for full-time on-site, part-time on-site or off-site RDN care (49.1%, 39.5% and 11.4% respectively). The greatest reported barriers to RDN referrals were perceived cost for the patient (64.47%) and uncertainty how to find a local RDN (48.6%). The most consistent theme reported in the open-ended responses were concerns regarding reimbursement, e.g. ‘Insurance does not cover all of the ways I would like to use an RDN’. Conclusions FMPs report interest and value in RDN services despite multiple perceived barriers accessing RDNs care. Opportunities exist for interprofessional collaboration between dietetic and FMP professional groups to address barriers.

Download Full-text

Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020

10.31234/osf.io/2p57j ◽

2020 ◽

Cited By ~ 10

Author(s):

Gaëtan Mertens ◽

Lotte Gerritsen ◽

Stefanie Duijndam ◽

Elske Salemink ◽

Iris Engelhard

Keyword(s):

Online Survey ◽

Media Use ◽

Health Care Systems ◽

Health Anxiety ◽

Economic Consequences ◽

World Health ◽

Vulnerability Factors ◽

Online Study ◽

Care Systems ◽

Health Organization

Fear is an adaptive response in the presence of danger. However, when threat is uncertain and continuous, as in the current coronavirus disease (COVID-19) pandemic, fear can become chronic and burdensome. To identify predictors of fear of the coronavirus, we conducted an online survey (N = 439) three days after the World Health Organization declared the coronavirus outbreak a pandemic (i.e., between March 14 and 17, 2020). Fear of the coronavirus was assessed with the newly developed Fear of the Coronavirus Questionnaire (FCQ) consisting of eight questions pertaining to different dimensions of fear (e.g., subjective worry, safety behaviors, preferential attention), and an open-ended question. The predictors included psychological vulnerability factors (i.e., intolerance of uncertainty, worry, and health anxiety), media exposure, and personal relevance (i.e., personal health, risk for loved ones, and risk control). We found four predictors for the FCQ in a simultaneous regression analysis: health anxiety, regular media use, social media use, and risks for loved ones (R2 = .37). Furthermore, 16 different topics of concern were identified based participants’ open-ended responses, including the health of loved ones, health care systems overload, and economic consequences. We discuss the relevance of our findings for managing people’s fear of the coronavirus.

Download Full-text

Shared Decision Making during the COVID-19 Pandemic

Medical Decision Making ◽

10.1177/0272989x211004147 ◽

2021 ◽

pp. 0272989X2110041

Author(s):

Anja K. Köther ◽

Katharina U. Siebenhaar ◽

Georg W. Alpers

Keyword(s):

Health Care ◽

Decision Making ◽

Shared Decision Making ◽

Online Survey ◽

Health Care Systems ◽

Shared Decision ◽

Patient Centered ◽

Convenience Sample ◽

Potential Health ◽

Care Systems

Objective The COVID-19 pandemic pushed some of the most well-developed health care systems to their limits. In many cases, this has challenged patient-centered care. We set out to examine individuals’ attitudes toward shared decision making (SDM) and to identify predictors of participation preference during the pandemic. Methods We conducted an online survey with a large convenience sample ( N = 1061). Our main measures of interest were participants’ generic and COVID-19–related participation preference as well as their acceptance and distress regarding a triage vignette. We also assessed anxiety, e-health literacy, and aspects of participants’ health. We conducted group comparisons and multiple linear regression analyses on participation preference as well as triage acceptance. Results In generic decision making, most participants expressed a strong need for information and a moderate participation preference. In the hypothetical case of COVID-19 infection, most preferred physician-led decisions. Generic participation preference was the strongest predictor of COVID-19–related participation preference, followed by age, education, and anxiety. Furthermore, both higher generic and COVID-19–related participation preferences predicted lower triage acceptance. Conclusion Our findings demonstrate potential health care recipients’ attitudes toward SDM during a severe health care crisis and emphasize that participation preference varies according to the context.

Download Full-text

Exploring resilience and well-being of family caregivers of people with dementia exposed to mandatory social isolation by COVID-19

Dementia ◽

10.1177/14713012211042187 ◽

2021 ◽

pp. 147130122110421

Author(s):

David Sánchez-Teruel* ◽

María Auxiliadora Robles-Bello* ◽

Mariam Sarhani-Robles ◽

Aziz Sarhani-Robles

Keyword(s):

Family Caregivers ◽

Social Isolation ◽

Emotional Regulation ◽

Online Survey ◽

Health Care Systems ◽

Well Being ◽

Physical And Mental Health ◽

Predictive Variables ◽

People With Dementia ◽

Care Systems

Background The COVID-19 pandemic has raised questions about the resilience of health care systems worldwide. In this regard, one group of people whose physical and mental health has been affected has been family caregivers of people with dementia. Objective This study aims to identify the variables that predict a high degree of well-being in family caregivers of people with dementia during this period of mandatory lockdown. Methods A total of 310 respondents participated in an online survey (266 women and 44 men) from various regions in Spain, aged between 20 and 73 years old (M = 46.45; SD = 15.97), and all were family members. Results The results showed that there were notable differences in all the protective variables, together with a significant strong positive relationship between well-being and resilience ( r = 0.92; p < 0.01) and with coping strategies ( r = 0.85; p < 0.01), and there were also some significant negative relationships between well-being and difficulties in emotional regulation (ρ = −.78; p < 0.01). The most predictive variables of a higher level of well-being included the type of dementia (β = 1.19; CI (95%) = 1.01-1.29; p< 0.01), living in a large house (β = 0.97; CI (95%) =. 23-0.98; p < 0.01), social support as a coping strategy (β = 1.27; CI (95%) = 1.21-1.29; p < 0.01) and mainly resilience (β = 1.34; CI (95%) = 1.30-1.37; p < 0.01). Discussion We discuss the importance of promoting higher levels of resilience through the development of protective psychosocial variables in caregivers of people with dementia exposed to situations of mandatory social isolation as a modulator of the psychosocial well-being of these family caregivers.

Download Full-text

Interdisciplinary Online Hackathons as an Approach to Combat the COVID-19 Pandemic: Case Study

Journal of Medical Internet Research ◽

10.2196/25283 ◽

2021 ◽

Vol 23 (2) ◽

pp. e25283

Author(s):

Katarina Braune ◽

Pablo-David Rojas ◽

Joscha Hofferbert ◽

Alvaro Valera Sosa ◽

Anastasiya Lebedev ◽

...

Keyword(s):

Global Economy ◽

Online Survey ◽

Digital Health ◽

Health Care Systems ◽

Interdisciplinary Teams ◽

Road Map ◽

Regional Collaboration ◽

Before And After ◽

Care Systems

Background The COVID-19 outbreak has affected the lives of millions of people by causing a dramatic impact on many health care systems and the global economy. This devastating pandemic has brought together communities across the globe to work on this issue in an unprecedented manner. Objective This case study describes the steps and methods employed in the conduction of a remote online health hackathon centered on challenges posed by the COVID-19 pandemic. It aims to deliver a clear implementation road map for other organizations to follow. Methods This 4-day hackathon was conducted in April 2020, based on six COVID-19–related challenges defined by frontline clinicians and researchers from various disciplines. An online survey was structured to assess: (1) individual experience satisfaction, (2) level of interprofessional skills exchange, (3) maturity of the projects realized, and (4) overall quality of the event. At the end of the event, participants were invited to take part in an online survey with 17 (+5 optional) items, including multiple-choice and open-ended questions that assessed their experience regarding the remote nature of the event and their individual project, interprofessional skills exchange, and their confidence in working on a digital health project before and after the hackathon. Mentors, who guided the participants through the event, also provided feedback to the organizers through an online survey. Results A total of 48 participants and 52 mentors based in 8 different countries participated and developed 14 projects. A total of 75 mentorship video sessions were held. Participants reported increased confidence in starting a digital health venture or a research project after successfully participating in the hackathon, and stated that they were likely to continue working on their projects. Of the participants who provided feedback, 60% (n=18) would not have started their project without this particular hackathon and indicated that the hackathon encouraged and enabled them to progress faster, for example, by building interdisciplinary teams, gaining new insights and feedback provided by their mentors, and creating a functional prototype. Conclusions This study provides insights into how online hackathons can contribute to solving the challenges and effects of a pandemic in several regions of the world. The online format fosters team diversity, increases cross-regional collaboration, and can be executed much faster and at lower costs compared to in-person events. Results on preparation, organization, and evaluation of this online hackathon are useful for other institutions and initiatives that are willing to introduce similar event formats in the fight against COVID-19.

Download Full-text

COVID-19 in Gastroenterology Departments: The Impact of the First Wave

GE Portuguese Journal of Gastroenterology ◽

10.1159/000516019 ◽

2021 ◽

pp. 1-7

Author(s):

Tiago Leal ◽

Margarida Gonçalves ◽

Irina Mocanu ◽

Rita Carvalho ◽

Luísa Glória ◽

...

Keyword(s):

Online Survey ◽

Screening Program ◽

Health Care Systems ◽

Recovery Period ◽

Cross Sectional Study ◽

Cross Sectional ◽

District Hospitals ◽

Care Systems ◽

Almost All ◽

The Impact

Introduction: Coronavirus disease 2019 (COVID-19) is a global pandemic that has severely affected health care systems around the world. During the emergency state declared in Portugal in the months of March and April 2020, there was a severe reduction in medical activity in order to reduce the pressure on health systems. This study aimed to assess the impact of COVID-19 in gastroenterology departments across Portugal and the strategies developed to overcome this challenge. Methods: This was a cross-sectional study based on an online survey. A detailed questionnaire concerning different aspects of gastroenterology department activity was sent via e-mail to the heads of gastroenterology departments of Portuguese District Hospitals (Núcleo de Gastroenterologia dos Hospitais Distritais). Two periods were assessed, i.e., the emergency state and the recovery period between May and September. The responses were collected between September and October 2020. Results: A total of 21 hospitals were enrolled (80.8% response rate). Twenty-eight percent of the responders reported healthcare professionals from their unit infected with COVID-19. At least 1 member (mostly fellows) of the department was deployed to another workplace in 66.7% of the hospitals. During the emergency state, 47.6% of the hospitals only performed urgent/emergent endoscopic procedures. In 38.5% of the hospitals the need to ration personal protective equipment led to the suspension of endoscopic training. Regarding the recovery period, nonurgent procedures were restarted in almost all of the centers. The same was reported for the colorectal cancer screening program. Remarkably, 81% of the responders confirmed that they had postponed procedures at patients’ request for “fear of getting infected.” Remote consultation was maintained in 81% of the hospitals. Globally, the fellows had resumed their training. Discussion/Conclusion: This study provides a snapshot of the impact and consequences of the first wave of the COVID-19 pandemic across Portuguese hospitals. It is important to understand how the gastroenterology world dealt with the first impact of COVID-19 and what strategies were implemented in order to better prepare for what might follow.

Download Full-text