Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

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The Use of Twitter as an Interactive Learning Tool Within a Postgraduate Public Health Course: A Pilot Study

Pedagogy in Health Promotion ◽

10.1177/2373379920978429 ◽

2020 ◽

pp. 237337992097842

Author(s):

Rimante Ronto ◽

Alexandra Bhatti ◽

Josephine Chau

Keyword(s):

Public Health ◽

Online Survey ◽

Learning Experience ◽

Empirical Studies ◽

Teaching Staff ◽

Learning Tool ◽

Interactive Approach ◽

Master Of Public Health ◽

Use Of Social Media ◽

The Impact

Twitter has gained attention in recent years as a tool to use in higher education to enhance students’ learning, engagement, and reflective writing. This study explored public health students’ perceptions on the usefulness of Twitter as a learning tool, engagement with their peers, staff, and the broader public health community. Participants were Master of Public Health students from a public university based in Sydney, Australia. A mixed methods approach was used combining content analysis of tweets, an online survey and two focus groups. Students were asked to engage with Twitter by reflecting on each week’s teaching content and by liking and replying to their peers’ tweets. Participation and engagement in this task were high initially and declined toward the end of semester. Most student tweets aligned with topics taught during the semester. Survey and focus group data indicated most students had positive views on using Twitter and reported finding engagement with Twitter beneficial in obtaining current information on health promotion news and trends, increasing their professional networks and allowing them to connect with their peers and teaching staff. Results indicate Twitter is a promising interactive approach to enhance public health students’ engagement and overall learning experience, as well as being useful for professional networking. Larger scale empirical studies are needed to investigate the impact of the use of social media platforms such as Twitter to various learning outcomes longitudinally and beyond this course.

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The Influence of Human–Animal Interactions on Mental and Physical Health during the First COVID-19 Lockdown Phase in the U.K.: A Qualitative Exploration

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18030976 ◽

2021 ◽

Vol 18 (3) ◽

pp. 976 ◽

Cited By ~ 1

Author(s):

Emily Shoesmith ◽

Lion Shahab ◽

Dimitra Kale ◽

Daniel S. Mills ◽

Catherine Reeve ◽

...

Keyword(s):

Mental Health ◽

Online Survey ◽

Positive Impact ◽

Companion Animals ◽

Free Text ◽

Physical And Mental Health ◽

Human Animal ◽

Human Animal Interaction ◽

Animal Interaction ◽

The Impact

The coronavirus disease 2019 (COVID-19) pandemic presents an opportunity to explore the role of animals as sources of emotional and physical support during a period when most of the population is experiencing social and environmental challenges. We investigated how companion animal owners perceived the influence of human–animal interaction on their physical and mental health during the first COVID-19 lockdown phase in the U.K., and what concerns they had regarding their animals at this time. We also explored the impact of participants’ interaction with non-companion animals during this phase. A cross-sectional online survey of U.K. residents aged over 18 was conducted between April and June 2020. The final item of the survey invited open-ended free-text responses, allowing participants to describe any experiences and/or perceptions of their human–animal relationships during the COVID-19 lockdown phase. A qualitative thematic analysis of responses was undertaken. Four main themes related to the following aspects of human–animal interactions during the COVID-19 lockdown phase were identified: the positive impact of animal ownership during the COVID-19 lockdown (e.g., amelioration of wellbeing and mental health), concerns relating to animal ownership during the COVID-19 lockdown (e.g., concerns over animals carrying the COVID-19 virus), grief and loss of an animal during the COVID-19 lockdown and the impact of engaging with non-companion animals during the COVID-19 lockdown. The findings complement and extend previous insights into the impact of human–animal interaction with both companion and non-companion animals. They also highlight the challenges of caring for an animal during the lockdown phase and indicate the need to consider the development of further targeted support strategies, such as “day care” for the companion animals of key workers in this context.

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A tale of two parts of Switzerland: regional differences in the impact of the COVID-19 pandemic on parents

BMC Public Health ◽

10.1186/s12889-021-11315-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michelle Seiler ◽

Georg Staubli ◽

Julia Hoeffe ◽

Gianluca Gualco ◽

Sergio Manzano ◽

...

Keyword(s):

Public Health ◽

Regional Differences ◽

Online Survey ◽

Pediatric Emergency ◽

The South ◽

Public Health Agencies ◽

The North ◽

Regional Strategies ◽

Health Agencies ◽

The Impact

Abstract Background We aimed to document the impact of the coronavirus disease 2019 (COVID-19) pandemic on regions within a European country. Methods Parents arriving at two pediatric emergency departments (EDs) in North of Switzerland and two in South of Switzerland completed an online survey during the first peak of the pandemic (April–June 2020). They were asked to rate their concern about their children or themselves having COVID-19. Results A total of 662 respondents completed the survey. Parents in the South were significantly more exposed to someone tested positive for COVID-19 than in the North (13.9 and 4.7%, respectively; P < 0.001). Parents in the South were much more concerned than in the North that they (mean 4.61 and 3.32, respectively; P < 0.001) or their child (mean 4.79 and 3.17, respectively; P < 0.001) had COVID-19. Parents reported their children wore facemasks significantly more often in the South than in the North (71.5 and 23.5%, respectively; P < 0.001). Conclusion The COVID-19 pandemic resulted in significant regional differences among families arriving at EDs in Switzerland. Public health agencies should consider regional strategies, rather than country-wide guidelines, in future pandemics and for vaccination against COVID-19 for children.

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The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

Primary Health Care Research & Development ◽

10.1017/s146342362100030x ◽

2021 ◽

Vol 22 ◽

Author(s):

Chris Bullen ◽

Jessica McCormack ◽

Amanda Calder ◽

Varsha Parag ◽

Kannan Subramaniam ◽

...

Keyword(s):

Public Health ◽

Healthcare Workers ◽

Online Survey ◽

World Health ◽

Noncommunicable Diseases ◽

Middle Income ◽

Middle Income Countries ◽

Health Measures ◽

The Impact ◽

Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

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Use of Artificial Intelligence to understand adults’ thoughts and behaviours relating to COVID-19

Perspectives in Public Health ◽

10.1177/1757913920979332 ◽

2021 ◽

pp. 175791392097933

Author(s):

SW Flint ◽

A Piotrkowicz ◽

K Watts

Keyword(s):

Artificial Intelligence ◽

Online Survey ◽

Severe Illness ◽

Free Text ◽

Community Recovery ◽

Substantial Impact ◽

Lifestyle Behaviours ◽

Artificial Intelligence Methods ◽

High Concern ◽

The Impact

Aims: The outbreak of severe acute respiratory syndrome coronavirus 2 (COVID-19) is a global pandemic that has had substantial impact across societies. An attempt to reduce infection and spread of the disease, for most nations, has led to a lockdown period, where people’s movement has been restricted resulting in a consequential impact on employment, lifestyle behaviours and wellbeing. As such, this study aimed to explore adults’ thoughts and behaviours in response to the outbreak and resulting lockdown measures. Methods: Using an online survey, 1126 adults responded to invitations to participate in the study. Participants, all aged 18 years or older, were recruited using social media, email distribution lists, website advertisement and word of mouth. Sentiment and personality features extracted from free-text responses using Artificial Intelligence methods were used to cluster participants. Results: Findings demonstrated that there was varied knowledge of the symptoms of COVID-19 and high concern about infection, severe illness and death, spread to others, the impact on the health service and on the economy. Higher concerns about infection, illness and death were reported by people identified at high risk of severe illness from COVID-19. Behavioural clusters, identified using Artificial Intelligence methods, differed significantly in sentiment and personality traits, as well as concerns about COVID-19, actions, lifestyle behaviours and wellbeing during the COVID-19 lockdown. Conclusions: This time-sensitive study provides important insights into adults’ perceptions and behaviours in response to the COVID-19 pandemic and associated lockdown. The use of Artificial Intelligence has identified that there are two behavioural clusters that can predict people’s responses during the COVID-19 pandemic, which goes beyond simple demographic groupings. Considering these insights may improve the effectiveness of communication, actions to reduce the direct and indirect impact of the COVID-19 pandemic and to support community recovery.

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Investigating Community Pharmacy Take Home Naloxone Dispensing during COVID-19: The Impact of One Public Health Crisis on Another

Pharmacy ◽

10.3390/pharmacy9030129 ◽

2021 ◽

Vol 9 (3) ◽

pp. 129

Author(s):

George Daskalakis ◽

Ashley Cid ◽

Kelly Grindrod ◽

Michael A. Beazely

Keyword(s):

Public Health ◽

Community Pharmacy ◽

Online Survey ◽

Comfort Level ◽

Future Research ◽

Health Crisis ◽

Public Health Crisis ◽

Pharmacy Technicians ◽

The Impact ◽

Overdose Deaths

A recent report found that the number of opioid-related deaths in Ontario in the first 15 weeks of the COVID-19 pandemic was 38.2% higher than in the 15 weeks before the pandemic. Our study sought to determine if pharmacy professionals self-reported an increase or decrease in naloxone provision due to the pandemic and to identify adjustments made by pharmacy professionals to dispense naloxone during the pandemic. A total of 231 Ontario community pharmacy professionals completed an online survey. Pharmacy professionals’ barriers, facilitators, and comfort level with dispensing naloxone before and during the pandemic were identified. The sample consisted of mostly pharmacists (99.1%). Over half (51.1%) reported no change in naloxone dispensing, while 22.9% of respondents reported an increase and 24.7% a decrease. The most common adjustments made during the pandemic were training patients how to administer naloxone over video or phone, delivering naloxone kits, and pharmacy technicians offering naloxone at prescription intake. Over half (55%) of participants said the top barrier for dispensing was that patients did not request naloxone. Naloxone distribution through pharmacies could be further optimized to address the increased incidence of overdose deaths during the pandemic. Future research should investigate the reasons for changes in naloxone dispensing.

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Experiences of nurses caring for respiratory patients during the first wave of the COVID-19 pandemic: an online survey study

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2021-000987 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000987

Author(s):

Nicola J Roberts ◽

Carol A Kelly ◽

Kate A Lippiett ◽

Emma Ray ◽

Lindsay Welch

Keyword(s):

Mental Health ◽

Online Survey ◽

Demographic Data ◽

Geographical Location ◽

Working Environment ◽

Survey Study ◽

British Thoracic Society ◽

Healthcare Team ◽

Free Text ◽

The Impact

BackgroundNurses have been at the forefront of the pandemic response, involved in extensive coordination of services, screening, vaccination and front-line work in respiratory, emergency and intensive care environments. The nature of this work is often intense and stress-provoking with an inevitable psychological impact on nurses and all healthcare workers. This study focused on nurses working in respiratory areas with the aim of identifying and characterising the self-reported issues that exacerbated or alleviated their concerns during the first wave of the COVID-19 pandemic.MethodsAn online survey was developed consisting of 90 questions using a mixture of open-ended and closed questions. Participant demographic data were also collected (age, gender, ethnicity, number of years qualified, details of long-term health conditions, geographical location, nursing background/role and home life). The online survey was disseminated via social media and professional respiratory societies (British Thoracic Society, Primary Care Respiratory Society, Association of Respiratory Nurse Specialists) over a 3-week period in May 2020 and the survey closed on 1 June 2020.ResultsThe study highlights the experiences of nurses caring for respiratory patients during the first wave of the pandemic in early 2020. Concerns were expressed over the working environment, the supply and availability of adequate protective personal equipment, the quality of care individuals were able to deliver, and the impact on mental health to nurses and their families. A high number provided free-text comments around their worries and concerns about the impact on their household; these included bringing the virus home, the effect on family members worrying about them, mental health and the impact of changing working patterns, and managing with children. Although both formal and informal support were available, there were inconsistencies in provision, highlighting the importance of nursing leadership and management in ensuring equity of access to services.ConclusionsSupport for staff is essential both throughout the pandemic and afterwards, and it is important that preparation of individuals regarding building resilience is recognised. It is also clear that psychological support and services for nurses and the wider healthcare team need to be available and quickly convened in the event of similar major incidents, either global or local.

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Gender differences in barriers to mental healthcare for UK military veterans: a preliminary investigation

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001754 ◽

2021 ◽

pp. bmjmilitary-2020-001754

Author(s):

Lauren Rose Godier-McBard ◽

G Cable ◽

A D Wood ◽

M Fossey

Keyword(s):

Gender Differences ◽

Help Seeking ◽

Online Survey ◽

Mental Health Problems ◽

Military Veterans ◽

Preliminary Investigation ◽

Mental Healthcare ◽

Armed Forces ◽

Free Text ◽

The Impact

IntroductionLimited UK research focuses on female military veterans’ gender-related experiences and issues when accessing civilian mental healthcare support. This study sought to illuminate a preliminary understanding of any gender differences in barriers that may discourage them accessing mental healthcare support.MethodsA total of 100 participants completed an open online survey of UK triservice veterans who identified as having experienced postmilitary mental health problems. They completed a 30-item Barriers to Access to Care Evaluation scale and were asked to elaborate using free-text questions. Resulting quantitative data were analysed for gender-related differences, while the qualitative text was thematically explored.ResultsWhile stigma, previous poor experience of mental healthcare and a lack of trust in civilian providers were found to act as barriers to postmilitary support for both men and women, significantly more women reported that their gender had also impacted on their intention to seek help. Women also commented on the impact of gender-related discrimination during service on their help-seeking experiences.ConclusionsWhile efforts are being made by the UK Ministry of Defence to reduce barriers to mental healthcare for those still serving in the Armed Forces, it has been more difficult to provide a similar level of support to the veteran population. With little veteran research focusing on the specific experiences of women, this study suggests that female veterans encounter specific access barriers and issues related to their gender. Further research is therefore needed to ensure these findings are addressed.

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Regulation

Oxford Handbook of Public Health Practice ◽

10.1093/med/9780198800125.003.0034 ◽

2020 ◽

pp. 372-381

Author(s):

Lawrence Gostin

Keyword(s):

Public Health ◽

International Law ◽

Legal Change ◽

The Face ◽

Public Health Officials ◽

The Law ◽

The Impact

The objectives of this chapter are to help you understand: the impact of legislation, regulations, and litigation on the public’s health; the powers, duties, and restraints imposed by the law on public health officials; the potential of legal change to improve the public’s health; the role of international law and institutions in securing public health in the face of increasing globalization.

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Apathy and Ignorance: False Prophets of Autism and the Anti-Vaccine Movement

Viruses, Plagues, and History ◽

10.1093/oso/9780190056780.003.0019 ◽

2020 ◽

pp. 389-398

Author(s):

Michael B. A. Oldstone

Keyword(s):

Public Health ◽

Health Workers ◽

Vaccination Rate ◽

Personal Beliefs ◽

The United Kingdom ◽

False Reporting ◽

The Face ◽

Public Health Workers ◽

The Impact ◽

The Brain

This chapter highlights the story of autism, the widespread acceptance of its incorrect cause, and the impact on use of vaccines, all stemming directly from deliberate, false reporting. The basic conflict is twofold. First, involvement of a scientific method that must be reproducible, be reliable, and possess substantial proof is in conflict with common/personal beliefs. Second, doctors, scientists, and public health workers, despite their mandate to listen to parents and patients concerning their opinions, must base medical conclusions on evidence that validates the outcome of each patient’s health issue. It is in this milieu that autism and the anti-vaccine groups still do battle. In 1998, Lancet, a usually respectable and reputable English journal, published Dr. Andrew Wakefield’s opinion that the measles, mumps, rubella (German measles) vaccine injected into the arms of children caused inflammation, leading to harmful chemicals entering the bloodstream through the gut (intestine). These factors, he said, traveled to the brain, where the harmful chemicals/toxins caused autism. In the face of this “fake news” about the source of autism and measles, the vaccination rate for measles dropped in the United Kingdom and Ireland.

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