scholarly journals Digital Interventions to Reduce Distress Among Health Care Providers at the Frontline: Protocol for a Feasibility Trial (Preprint)

2021 ◽  
Author(s):  
Binh Nguyen ◽  
Andrei Torres ◽  
Walter Sim ◽  
Deborah Kenny ◽  
Lindsay Beavers ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Test Data ◽  
Healthcare Workers ◽  
Moral Distress ◽  
Feasibility Trial ◽  
Care Providers ◽  
Digital Platforms ◽  
Future Studies ◽  
Digital Intervention ◽  
Challenging Situation

BACKGROUND Stress, anxiety, distress and depression are high among healthcare workers during the COVID-19 pandemic and they have reported acting in ways that are contrary to their moral values, integrity, and professional commitments that degrade their integrity. This creates moral distress and injury as a result of constraints they have encountered, such as limited resources. OBJECTIVE The purpose of this study is to develop and show feasibility of digital platform (Virtual Reality (VR) and mobile platform) to understand the causes and ultimately reduce the moral distress of healthcare providers during the COVID-19 pandemic. This project is a proof-of-concept integration of concepts/applications to demonstrate viability over six months and serve as a guide for future studies to develop these state-of-the-art technologies to help frontline healthcare workers work in complex moral contexts. The project will develop innovations which can be used for future pandemics and in other contexts prone to producing moral distress and injury. METHODS This will be a prospective, single cohort, pre- and post-test study examining the effect of brief informative video describing moral distress on perceptual, psychological, and physiological indicators of stress and decision-making during the scenario known to potentially elicit moral distress. To accomplish this, we have developed a VR simulation scenario that will be used before and after the digital intervention for monitoring of short-term impacts. The simulation involves an ICU setting during the COVID-19 pandemic and participants will be placed in a morally challenging situation, the participants will be engaged at the individual, team, and organizational levels. During each test, data will be collected for a) physiological measures of stress and after each test, data will be collected regarding b) thoughts, feelings and behaviors during a morally challenging situation, and c) perceptual estimates of psychological stress. We aim to create an effective compound intervention that is composed of the VR-based simulation educational intervention that is verified through the data collection of mental health questionnaires. In addition, participants will continue to be monitored for moral distress and other psychological stresses for 8 weeks through our Digital intervention/intelligence Group mobile (DiiG) platform for longer-term impact. A baseline comparison will be conducted using machine learning and statistical techniques to analyze the short- and long-term impacts of the VR intervention. RESULTS Funded in (November, 2020), approved by REB in (March, 2021), study is ongoing. CONCLUSIONS This project aims to demonstrate the feasibility of using digital platforms to understand the continuum of moral distress that can lead to moral injury. Demonstration of feasibility will lead to future studies to examine the efficacy of digital platforms to reduce moral distress. CLINICALTRIAL Trial registry name: ClinicalTrials.gov Registration/identifier number: NCT05001542 URL: https://clinicaltrials.gov/ct2/show/NCT05001542

scholarly journals Prevalence, risk factors and sources of anxiety among Emergency Department healthcare workers in Pakistan during COVID-19 pandemic: A single center survey

2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Work Performance ◽  
Nonparametric Tests ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frontline Workers

Summary COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.

scholarly journals Impact of COVID-19 Pandemic among Health Care Providers in Bangladesh: A Systematic Review

2020 ◽  
pp. S8-S15
Author(s):  
Md Jamal Hossain
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Health Workers ◽  
Critical Time ◽  
Social Effects ◽  
Care Providers ◽  
Study Results ◽  
The World ◽  
Numerous People

Background: The world has been passing the most critical time of the century with the COVID-19 pandemic since late December 2019, and numerous people, including a significant portion of health care providers, got the infection and are still sacrificing their lives. Objective: The study was aimed systematically to assess the severity of the SARS-CoV-2 infection, especially in health care sectors, and to appraise the physical, psychological, and social effects of the COVID-19 epidemic among frontline fighters in Bangladesh. Methodology: The keywords: “COVID-19”, “SARS-CoV-2”, “health care system in Bangladesh”, “health care providers”, etc. were searched to collect the desired articles by utilizing various search engines like google, google scholar, pub med, and science direct journals. Data were extracted and finally, were summarized, discussed, analysed, and reported the study results. Result: Numerous specialist doctors, nurses, and all other healthcare workers are immolating their lives to save human entities amid the current coronavirus pandemic, 2019 (COVID-19). In Bangladesh, till August 9, 2020, 73 doctors, including some senior specialists, died of COVID-19 infection reported by various national newspapers. At the early phase of this epidemic in Bangladesh, around 10% of the total infection was found among health workers, alarmingly reported by the Bangladesh Medical Association (BMA). These frontline fighters are additionally confronting numerous challenges, including psychological sufferings, and furthermore, they are assaulted by the society. Conclusion: Since these fighters are relinquishing their beloved lives to protect us from this brutal virus, we are trying to show our profound gratitude, appreciation, thousands of salutes, and undying tribute to these health care fighters with this publication. Bangladesh Journal of Infectious Diseases, October 2020;7(suppl_2):S8-S15

Caring ethics and a Somali reproductive dilemma

2012 ◽  
Vol 20 (4) ◽  
pp. 366-381 ◽  
Author(s):  
Robin Narruhn ◽  
Ingra R Schellenberg
Keyword(s):  
Health Care Providers ◽  
Moral Distress ◽  
Cross Cultural ◽  
Cultural Safety ◽  
Care Providers ◽  
Relational Ontology ◽  
Authoritative Knowledge ◽  
Relational Approach ◽  
Power Differentials ◽  
Fetal Rights

The use of traditional ethical methodologies is inadequate in addressing a constructed maternal–fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring ethics and a relational approach can alleviate moral distress in health-care providers, while promoting collaboration and trust between providers and their patients and ultimately decreasing reproductive disparities. This article examines how a relational approach can be applied to a cross-cultural reproductive dilemma.

Truth Telling as an Element of Culturally Competent Care at End of Life

2016 ◽  
Vol 28 (1) ◽  
pp. 48-55 ◽  
Author(s):  
Margaret L. Rising
Keyword(s):  
Health Care ◽  
Latin American ◽  
Health Care Providers ◽  
Moral Distress ◽  
The United States ◽  
Biomedical Ethics ◽  
Cultural Humility ◽  
Care Providers ◽  
Truth Telling ◽  
Intercultural Interactions

Purpose: Nondisclosure of terminal prognosis in the context of intercultural interactions can cause moral distress among health care providers guided exclusively by informed consent. However, cultural humility can show that revealing and withholding prognostic information are two equally valid paths to the goal of protecting the patient from harm. Design: Assumptions and history giving rise to the preference for truth telling in the United States(US) are examined. Principles of biomedical ethics are described within the context of US, Chinese, and Latin American cultures. The process of cultural competence in the delivery of health care services is explained and introduces the concept of cultural humility. Implications for Practice: By focusing more on biases and assumptions brought forth from the dominant culture, health care providers may experience less moral distress and convey increased caring in the context of intercultural interactions and nondisclosure of prognosis of a terminal illness.

scholarly journals Stress, Resilience and Moral Distress among Health Care Providers During COVID-19 Pandemic

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ahmed Latif ◽  
◽  
Sobia Yaqub ◽  
Qudsia Anwar Dar ◽  
Umer Sultan Awan ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
High Stress ◽  
Care Providers ◽  
Online Questionnaire ◽  
Stress Resilience ◽  
Stress Scale ◽  
Distress Score ◽  
The Mean

Objective: This study aims to determine level of stress, resilience and moral distress among health care providers during covid-19 pandemic. Methods: This is a cross-sectional study performed using an online questionnaire. Data was collected from Health Care Providers, working in various tertiary care hospitals of Lahore, using an online questionnaire. Perceived stress scale (PSS), Connor-Davidson Resilience Scale (CD-RISC 10) and Moral Distress Thermometer were used to determine level of stress, resilience and moral stress respectively among the HCPs. Scores on the PSS can range from 0 to 40 with scores of 0-13, 14-26 and 27-40 being considered as low, moderate and high stress respectively. The Moral Distress Thermometer has scores ranging from 0-10 with value of ≥4 considered high. Data was analyzed using SPSS version.23.Descriptive variables were reported as means and frequencies. Intergroup analysis was done using Chi square test with p<0.05 taken as significant. Results: A total of 278 (n=278) HCPs participated in study. According to the PSS (Perceived Stress Scale) scores, 5.03% (14) reported low, 86.69% (241) moderate and 8.27% (23) high stress levels. The mean stress score is 21.56+/-4.32. Providing patient care (mean = 2.28+/-1.15 SD) and transmitting infection to others (mean = 3.02+/-1.10 SD) were deemed major causes of stress. The mean CD-RISC score was 23.14+/-7.81 SD. Only 10.8% (30) had a score of ≥ 32. The mean Moral Distress score was 4.2+/-2.98 SD, with 53.2% (149) participants reporting high Moral distress (score ≥4). Conclusion: The high level of stress among HCPs during COVID-19 pandemic highlights the need of urgent measures to overcome this psychological issue which if left un-addressed can affect performance of HCPs. Key Words: Stress, Resilience, HCPs How to cite: Latif A., Yaqub S., Dar A.Q., Awan S.U., Farhat Hina., Khokhar A.M., Stress, Resilience and Moral Distress among Health care Providers during COVID-19 pandemic. Esculapio 2021;17 (01):79-82

scholarly journals Management of chlamydia and gonorrhoea infections diagnosed in primary care using a centralised nurse-led telephone-based service: mixed methods evaluation

2020 ◽  
Author(s):  
Emer Brangan ◽  
Jeremy Horwood ◽  
Petra Manley ◽  
Paddy Horner ◽  
Peter Muir ◽  
...  
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Health Care Providers ◽  
Partner Notification ◽  
Text Message ◽  
Feasibility Trial ◽  
Chlamydia Screening ◽  
Care Providers ◽  
National Guidelines ◽  
Sexually Transmitted

Abstract Background Up to 18% of genital Chlamydia infections and 9% of Gonorrhoea infections in England are diagnosed in Primary Care. Evidence suggests that a substantial proportion of these cases are not managed appropriately in line with national guidelines. With the increase in sexually transmitted infections and the emergence of antimicrobial resistance, their timely and appropriate treatment is a priority. We investigated feasibility and acceptability of extending the National Chlamydia Screening Programme’s centralised, nurse-led, telephone management (NLTM) as an option for management of all cases of chlamydia and gonorrhoea diagnosed in Primary Care. Methods Randomised feasibility trial in 11 practices in Bristol with nested qualitative study. In intervention practices patients and health care providers (HCPs) had the option of choosing NLTM or usual care for all patients tested for Chlamydia and Gonorrhoea. In control practices patients received usual care. Results 1154 Chlamydia/gonorrhoea tests took place during the 6-month study, with a chlamydia positivity rate of 2.6% and gonorrhoea positivity rate of 0.8%. The NLTM managed 335 patients. Interviews were conducted with sixteen HCPs (11 GPs, 5 nurses) and 12 patients (8 female). HCPs were positive about the NLTM, welcomed the partner notification service, though requested more timely feedback on the management of their patients. Explaining the NLTM to patients didn’t negatively impact on consultations. Patients found the NLTM acceptable, more convenient and provided greater anonymity than usual care. Patients appreciated getting a text message regarding a negative result and valued talking to a sexual health specialist about positive results. Conclusion Extension of this established NLTM intervention to a greater proportion of patients was both feasible and acceptable to both patients and HCP, could provide a better service for patients, whilst decreasing primacy care workload. The study provides evidence to support the wider implementation of this NLTM approach to managing chlamydia and gonorrhoea diagnosed in primary care.

scholarly journals Management of chlamydia and gonorrhoea infections diagnosed in primary care using a centralised nurse-led telephone-based service: mixed methods evaluation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeremy Horwood ◽  
Emer Brangan ◽  
Petra Manley ◽  
Paddy Horner ◽  
Peter Muir ◽  
...  
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Health Care Providers ◽  
Partner Notification ◽  
Text Message ◽  
Feasibility Trial ◽  
Chlamydia Screening ◽  
Care Providers ◽  
National Guidelines ◽  
Sexually Transmitted

Abstract Background Up to 18% of genital Chlamydia infections and 9% of Gonorrhoea infections in England are diagnosed in Primary Care. Evidence suggests that a substantial proportion of these cases are not managed appropriately in line with national guidelines. With the increase in sexually transmitted infections and the emergence of antimicrobial resistance, their timely and appropriate treatment is a priority. We investigated feasibility and acceptability of extending the National Chlamydia Screening Programme’s centralised, nurse-led, telephone management (NLTM) as an option for management of all cases of chlamydia and gonorrhoea diagnosed in Primary Care. Methods Randomised feasibility trial in 11 practices in Bristol with nested qualitative study. In intervention practices patients and health care providers (HCPs) had the option of choosing NLTM or usual care for all patients tested for Chlamydia and Gonorrhoea. In control practices patients received usual care. Results One thousand one hundred fifty-four Chlamydia/gonorrhoea tests took place during the 6-month study, with a chlamydia positivity rate of 2.6% and gonorrhoea positivity rate of 0.8%. The NLTM managed 335 patients. Interviews were conducted with sixteen HCPs (11 GPs, 5 nurses) and 12 patients (8 female). HCPs were positive about the NLTM, welcomed the partner notification service, though requested more timely feedback on the management of their patients. Explaining the NLTM to patients didn’t negatively impact on consultations. Patients found the NLTM acceptable, more convenient and provided greater anonymity than usual care. Patients appreciated getting a text message regarding a negative result and valued talking to a sexual health specialist about positive results. Conclusion Extension of this established NLTM intervention to a greater proportion of patients was both feasible and acceptable to both patients and HCP, could provide a better service for patients, whilst decreasing primacy care workload. The study provides evidence to support the wider implementation of this NLTM approach to managing chlamydia and gonorrhoea diagnosed in primary care.

The ethics of interprofessional collaboration

2013 ◽  
Vol 20 (4) ◽  
pp. 426-435 ◽  
Author(s):  
Joyce Engel ◽  
Dawn Prentice
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Ethical Issues ◽  
Interprofessional Collaboration ◽  
Care Providers ◽  
Quality Health Care ◽  
Health Care Outcomes ◽  
Quality Health ◽  
Interprofessional Competencies

Interprofessional collaboration has become accepted as an important component in today’s health care and has been guided by concerns with patient safety, quality health-care outcomes, and economics. It is widely accepted that interprofessional collaboration improves patient outcomes through enhanced communication among health-care providers and increased accessibility to services. Although there is a paucity of research that provides confirmatory evidence, interprofessional competencies continue to be incorporated into the curricula of health-care students. This article examines the ethics of interprofessional collaboration and ethical issues that arise from the mainstream adoption of interprofessional competencies and the potential for moral distress in nursing.

Abstract 480: Feasibility of an Augmented Reality Cardiopulmonary Resuscitation Training System for Health Care Providers

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Steve Balian ◽  
Shaun McGovern ◽  
Benjamin Abella ◽  
Audrey Blewer ◽  
Marion Leary
Keyword(s):  
Health Care ◽  
Augmented Reality ◽  
Health Care Providers ◽  
Training System ◽  
Feasibility Trial ◽  
Care Providers ◽  
Educational Approach ◽  
Convenience Sample ◽  
Resuscitation Training ◽  
Cpr Training

Introduction: Augmented reality (AR) has the potential to offer a novel approach to CPR training that supplements conventional training methods with gamification and a more interactive learning experience. This is done through computer-generated imagery superimposed on users’ view of the real environment to simulate interactive training scenarios. Objective: We sought to test the feasibility of an AR CPR training system (CPReality) for health care providers (HCPs). Methods: In this feasibility trial, a CPR training manikin was integrated with a commercial AR device (Microsoft HoloLens) to provide participants with real-time audio-visual feedback via a holographic overlay of blood flow to vital organs dependent on CC quality. In this system, higher quality CC visually improved virtual blood circulation. HCPs performed a 2-minute cycle of hands-only CPR using only the AR system, and CC parameters were recorded. Descriptive data on participants’ demographics, CC quality, and satisfaction with the training environment were reported. Results: Between 10/2019-11/2019, we enrolled a convenience sample of 51 HCPs. The median age of participants was 31 years (IQR 27-41), 71% (36/51) were female, and 67% (34/51) were registered nurses. CC rates (mean 126 ± 12.9 cpm), depths (median 53 mm, IQR 46-58), and percent with complete recoil (median 80%, IQR 12-100) were consistent with guideline recommendations for good quality CPR. Participants were predominantly satisfied with the system, with 82% perceiving the experience as realistic, 98% recognizing the visualizations as helpful for training, and 94% willing to use the application in future CPR training. Conclusions: As AR is increasingly applied in the healthcare setting, integration in CPR training offers a novel and promising educational approach. In this convenience sample of trained HCPs, high quality CC delivery was feasible using the AR CPR training system which was received favorably by most participants.

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