AIDS Dementia Complex: The Perception of Loss of Functional Ability

2002 ◽  
Vol 65 (11) ◽  
pp. 509-514
Author(s):  
Kate Gregory ◽  
Deanna Gibbs

AIDS Dementia Complex (ADC) is a subcortical dementia often associated with HIV disease. Despite undergoing numerous assessments of cognition and function to determine their need for personal care assistance, there is limited information on how individuals with ADC view their functional and cognitive impairments and the subsequent effect on their lifestyle. This study investigated issues of concern to clients with ADC in order to provide a greater understanding of the psychological effect of the loss of functional ability. A qualitative design was used to explore individuals' experience of ADC and clarify their insight and perception regarding the loss of function. The participants were selected by the use of purposeful sampling techniques. Information was obtained through semi-structured interviews and analysed using an analytic induction method. Five main themes were identified as being important in relation to the perception of functional ability. Discrepancies emerged between the insights of individuals with ADC regarding their level of function and their need for assistance and support with activities of daily living, compared with those of the health care workers involved in their care. Health care workers need to have an awareness of the insight that individuals with ADC may have into their functional ability when addressing issues of supported accommodation and level of assistance required.

2020 ◽  
Vol 66 (6) ◽  
pp. 560-565 ◽  
Author(s):  
Mirna Fawaz ◽  
Ali Samaha

Background: Since the outbreak of the novel Coronavirus (COVID-19), health care professionals in Lebanon have been diligently serving as the frontline of defense. In the light of challenging economic and political circumstances, putting their community wellbeing as a priority, and abiding by quarantine and strict infection control measures, health care professionals risk both their physical and mental wellbeing. Objective: The aim of this study is to explore the psychosocial effects of being quarantined following exposure to COVID-19 among Lebanese health care professionals. Method: An exploratory qualitative research design was employed, where semi-structured interviews were carried out involving a sample of 13 Lebanese health care providers working at various COVID-19 units. Results: The qualitative analysis has revealed four themes namely ‘Fears of contracting and spreading the virus’, ‘Conflict between professional duty and family obligation’, ‘Stigma of being infected’, and ‘Inadequate or inaccurate information’. Conclusion: COVID-19 quarantine has been posing intense psychological challenges among Lebanese health care workers which are worsened at times by the economic instability; thus, health care policymakers are urged to take proper action nationwide to alleviate longlisting implications and support the health care providers in fulfilling their mission.


2020 ◽  
pp. 136346152093376 ◽  
Author(s):  
Sanja Kilian ◽  
Leslie Swartz ◽  
Xanthe Hunt ◽  
Ereshia Benjamin ◽  
Bonginkosi Chiliza

In South Africa, clinicians working in public psychiatric hospitals are mainly fluent in English and Afrikaans, while the majority of patients are not proficient in these languages. Due to a lack of professional interpreting services, informal, ad hoc interpreters are commonly employed in public psychiatric hospitals. We collected data on language practices in public psychiatric care in South Africa, and provide a detailed account of what happens when bilingual health care workers and cleaners haphazardly take on the additional role of interpreter. Data were collected during 2010 at a public psychiatric hospital in the Western Cape, South Africa. Thirteen interpreter-mediated psychiatric consultations were video-recorded, and 18 audio-recorded semi-structured interviews were conducted with the interpreters and clinicians who participated in the interpreter-mediated psychiatric consultations. Patients were proficient in isiXhosa (one of the 11 official languages of South Africa), the clinicians (all registrars) were first language English or Afrikaans speakers, while the health care workers (nurses and social workers) and cleaners were fluent in both the patients’ and clinician’s language. Our findings suggest that interpreters took on the following four roles during the interpreter-mediated psychiatric consultations: regulating turn-taking, cultural broker, gatekeeper and advocate. Our findings suggest that, despite interpreters and clinicians having the patient’s best interests at heart, it is the patient’s voice that becomes lost while the clinician and interpreter negotiate the roles played by each party.


2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Agneta Kallström ◽  
Orwa Al-Abdulla ◽  
Jan Parkki ◽  
Mikko Häkkinen ◽  
Hannu Juusola ◽  
...  

Abstract Background The Syrian conflict has endured for a decade, causing one of the most significant humanitarian crises since World War II. The conflict has inflicted massive damage to civil infrastructure, and not even the health care sector has been spared. On the contrary, health care has been targeted, and as a result, many health professionals have left the country. Despite the life-threatening condition, many health professionals continued to work inside Syria even in the middle of the acute crisis. This qualitative study aims to determine the factors that have motivated Syrian health professionals to work in a conflict-affected country. Methods The research is based on 20 semi-structured interviews of Syrian health care workers. Interviews were conducted in 2016–2017 in Gaziantep, Turkey. A thematic inductive content analysis examined the motivational factors Syrian health care workers expressed for their work in the conflict area. Results Motivating factors for health care workers were intrinsic and extrinsic. Intrinsic reasons included humanitarian principles and medical ethics. Also, different ideological reasons, patriotic, political and religious, were mentioned. Economic and professional reasons were named as extrinsic reasons for continuing work in the war-torn country. Conclusions The study adds information on the effects of the Syrian crisis on health care—from healthcare workers' perspective. It provides a unique insight on motivations why health care workers are continuing their work in Syria. This research underlines that the health care system would collapse totally without local professionals and leave the population without adequate health care.


2020 ◽  
Author(s):  
Thomas Reiter ◽  
Sahra Pajenda ◽  
Ludwig Wagner ◽  
Martina Gaggl ◽  
Johanna Atamaniuk ◽  
...  

Background: Chronic kidney disease patients show a high mortality in case of a SARS-CoV-2 infection. Thus, to be informed on Nephrology personnel's sero-status might be crucial for patient protection. However, limited information exists about the presence of SARS-CoV-2 antibodies in asymptomatic individuals. Methods: We examined the seroprevalence of SARS-CoV-2 IgG and IgM antibodies among health care workers of a tertiary care kidney center during the peak phase of the Covid-19 crisis in Austria using an orthogonal test strategy and a total of 12 commercial nucleocapsid protein or spike glycoprotein based assays as well as Western blotting and a neutralization assay. Results: At baseline 60 of 235 study participants (25.5%, 95% CI: 20.4-31.5) were judged to be borderline positive or positive for IgM or IgG using a high sensitivity/low specificity threshold in one test system. Follow-up analysis after about two weeks revealed IgG positivity in 12 (5.1%, 95% CI: 2.9-8.8) and IgM positivity in six (2.6%, 95% CI: 1.1-5.6) in at least one assay. 2.1% (95% CI: 0.8-5.0) of health care workers showed IgG nucleocapsid antibodies in at least two assays. By contrast, positive controls with proven Covid-19 showed antibody positivity among almost all test systems. Moreover, serum samples obtained from health care workers did not show SARS-CoV-2 neutralizing capacity, in contrast to positive controls. Conclusions: Using a broad spectrum of antibody tests the present study revealed inconsistent results for SARS-CoV-2 seroprevalence among asymptomatic individuals, while this was not the case among Covid-19 patients.


2020 ◽  
Vol 12 (6) ◽  
pp. 63
Author(s):  
Snenhlanhla Kelly Dlamini ◽  
Maureen Nokuthula Sibiya

Communication between a health care provider and a patient is a pre-requisite for any intervention to occur in the process of health care. Deaf patients depend on interpreters when seeking health care. Confidentiality is an issue since interpreters are involved in the Deaf community. Health care workers (HCWs) are tasked to ensure that the delivery of information to the patient is accurate and kept confidential. A descriptive exploratory qualitative design was used to explore the experiences of HCWs regarding the maintenance of confidentiality for hard of hearing patients. The study population comprised HCWs who worked with hearing challenged patients. Purposive sampling, which is a type of non-probability sampling, was utilized to select the study participants from the population. This research study was conducted at two hospitals in eThekwini District. Structured interviews, using an interview schedule, were used to collect data. The actual sample size was 10 participants. Data was analysed using Tesch’s eight steps of thematic analysis. Six major themes emerged from the data analysis namely training of health care workers, communication preferences for hard of hearing patients, communication challenges, health care worker-patient relationship, involvement of family members as interpreters and measures to maintain confidentiality. Majority of participants experienced communication challenges with patients who are hard of hearing since only few HCWs are trained in sign language. The findings of this study will contribute to addressing issues related to the maintenance of confidentiality of hard of hearing patients. This study does not claim to exhaust the subject but to raise awareness of new investigations in other realities. Further research in the larger representative population of HCWs and hard of hearing patients is necessary to make the health care system more accessible and communication with HCWs more satisfying and effective.


1999 ◽  
Vol 35 (3) ◽  
pp. 312-330 ◽  
Author(s):  
Roger S. Magnusson ◽  
Peter H. Ballis

This paper reports on research into the practice of euthanasia amongst Australian health care professionals specialising in HIV/AIDS. It draws on data from thirty-nine semi-structured interviews carried out in Sydney, Melbourne, Brisbane and Canberra with physicians, general practitioners, hospital and community nurses, therapists and community workers. Using a qualitative methodology, the study seeks to identify how (illegal) euthanasia is currently practised, the degrees of involvement, the various forms that involvement takes, and the social relations which provide the context for involvement. In this paper we outline three categories of 'doers' to illustrate the range of attitudes and practices concerning euthanasia. This 'typology' carries a number of implications for recent policy debates over the legalisation of euthanasia. In particular it illustrates, at least within the context of AIDS care, the fragmentation of consensus over euthanasia amongst health care workers, the reality of current illegal euthanasia practices, and the limitations of a prohibitionist policy. While the legalisation of euthanasia within a regulatory framework is sometimes portrayed as an extreme or 'radical' response to terminal illness, the data presented in this paper suggest that prohibitionism is also radical in its failure to control euthanasia practice.


Author(s):  
Nipun Shrestha ◽  
Shiva Raj Mishra ◽  
Saruna Ghimire ◽  
Bishal Gyawali ◽  
Sujan Babu Marahatta ◽  
...  

Abstract Background: Rapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the health system preparedness for COVID-19 and its impacts on frontline health care workers in Nepal. Methods: Semi-structured interviews were conducted among 32 health care workers who were involved in clinical care of COVID-19 patients and four policymakers who were responsible for COVID-19 control and management at central and provincial level. All interviews were conducted through telephone or internet-based tools such as Zoom and Skype. All interviews were audio-recorded, transcribed into English, and coded using inductive and deductive approaches. Results: Both health care workers and policymakers reported failure to initiate pre-emptive control measures at the early stages of the outbreak as the pivot in pandemic control. Although several measures were rolled out when cases started to appear, the overall health system preparedness was low. The poor governance, and coordination between three tiers of government was compounded by the inadequate personal protective equipment for health care workers, insufficient isolation beds for patients, and poor engagement of the private sector. Additionally, health care workers experienced various degrees of stigma because of their profession and yet were able to maintain their motivation to continue working in the forefront. Conclusion: Preparedness for COVID-19 was affected by the poor coordination between three tiers of governance. Specifically, the lack of human resources, inadequate logistic chain management and laboratory facilities for testing COVID-19 appeared to have jeopardized the health system preparedness and escalated the pandemic in Nepal. Despite the poor preparedness, and health and safety concerns, health care workers maintained their motivation. There is an urgent need for an effective coordination mechanism between various tiers of health structure (including private sector) in addition to incentivizing the health care workers for the current and future pandemics.


Author(s):  
Katharina Müller ◽  
Philipp Girl ◽  
Michaela Ruhnke ◽  
Mareike Spranger ◽  
Klaus Kaier ◽  
...  

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is associated with a potentially severe clinical manifestation, coronavirus disease 2019 (COVID-19), and currently poses a worldwide challenge. Health care workers (HCWs) are at the forefront of any health care system and thus especially at risk for SARS-CoV-2 infection due to their potentially frequent and close contact with patients suffering from COVID-19. Serum samples from 198 HCWs with direct patient contact of a regional medical center and several outpatient facilities were collected during the early phase of the pandemic (April 2020) and tested for SARS-CoV-2-specific antibodies. Commercially available IgA- and IgG-specific ELISAs were used as screening technique, followed by an in-house neutralization assay for confirmation. Neutralizing SARS-CoV-2-specific antibodies were detected in seven of 198 (3.5%) tested HCWs. There was no significant difference in seroprevalence between the regional medical center (3.4%) and the outpatient institution (5%). The overall seroprevalence of neutralizing SARS-CoV-2-specific antibodies in HCWs in both a large regional medical center and a small outpatient institution was low (3.5%) at the beginning of April 2020. The findings may indicate that the timely implemented preventive measures (strict hygiene protocols, personal protective equipment) were effective to protect from transmission of an airborne virus when only limited information on the pathogen was available.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249186
Author(s):  
Mario Brondani ◽  
Fernanda Almeida ◽  
Denise Cua ◽  
Tala Maragha ◽  
Kavita Mathu-Muju ◽  
...  

Background The first wave of COVID-19 infections caused disturbances in all aspects of personal and professional lives. The aim of this study was to explore the ways in which that first wave of novel coronavirus infections resulted in uncertainties, as experienced by members of the oral health care workforce in British Columbia, Canada. Methods This qualitative inquiry purposefully recruited frontline oral health care workers, including dentists, dental hygienists, certified dental assistants, and administrative staff, via remote semi-structured interviews between April 20 and May 4, 2020. Coding, categories, and themes were inductively assigned. Results A total of 45 interviews, lasting between 39 and 74 minutes each, were conducted involving 18 dentists (6 females), 12 dental hygienists (11 females), 6 certified dental assistants (all females), and 9 administrators/front-desk staff (7 females). Fifty-one hours of audio recordings and more than 650 single-spaced pages of transcripts were produced. Five main themes emerged pertaining to uncertainties surrounding COVID-19, patient care, personal lives and infectiousness, concern for the future, and variations among different pandemics. Certitudes were less evident, but surfaced mostly when considering a potential new normal resulting from the pandemic. Conclusion Participants indicated that the uncertainties they felt were dependent upon what is known, and unknown, about the pandemic and the provision of oral health care during the first wave of infections. Future studies are needed to include the viewpoints of oral health care workers from other provinces, as well the perceptions of patients who received oral health care during the height of the first wave of the pandemic.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257423
Author(s):  
Oluwatosin O. Adeyemo ◽  
Stephanie Tu ◽  
Danya Keene

Health Care Leaders (HCLs) faced unprecedented challenges during the initial phases of the COVID-19 pandemic. Leaders played an important role in shaping the experiences of Health Care Workers (HCWs) during this time. However, research is needed on how HCWs experienced and characterized HCLs’ response and support. The aim of our study was to examine HCWs’ experiences with leadership and to identify aspects of HCLs’ response that were effective in supporting HCWs in their roles during the early phases of the pandemic. This was a qualitative study based on open-ended semi-structured interviews conducted (June 1- July 18, 2020) with frontline HCWs during the first wave of the COVID-19 pandemic in Connecticut, USA. Participants (N = 45) included physicians, nurses, respiratory therapists and patient care assistants who worked in inpatient and outpatient settings in various specialties, roles and 3 health systems across Connecticut, USA during the COVID-19 pandemic. Participants were offered a $25 gift card as an incentive for participation. We used inductive techniques derived from grounded theory to develop themes. We identified 6 main themes related to leadership response and support of HCWs during the pandemic namely: 1) Effective communication and transparency; 2) Prioritizing their health and safety; 3) Employee scheduling considerations: autonomy, assignment support and respite; 4) Appreciation- financial and nonfinancial; 5) Showing up and listening and 6) Stepping up with resources. Our findings can inform leadership responses to future pandemics and other unanticipated crises leading to strengthening of the health care system as a whole.


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