scholarly journals The preparedness of emergency care providers to deal with death, dying and bereavement in the pre-hospital setting in Dubai

2021 ◽  
Vol 18 ◽  
Author(s):  
Reon Conning ◽  
Raveen Naidoo ◽  
Raisuyah Bhagwan
Keyword(s):  
Social Sciences ◽  
Emergency Care ◽  
Formal Education ◽  
Hospital Setting ◽  
Self Report ◽  
Care Providers ◽  
Work Related ◽  
Quantitative Descriptive ◽  
Grief Reactions ◽  
Professional Counselling

Introduction This study sought to investigate how prepared emergency care providers are to deal with death, dying and bereavement in the pre-hospital setting in Dubai, and to make recommendations related to such events. Methods A quantitative descriptive prospective design was utilised. Data was collected using an online self-report questionnaire sent to all operational emergency care providers in the Dubai Corporation of Ambulance Services. The data was analysed using the IBM Statistical Package for Social Sciences version 25.0. Results Nearly 65% of participants (n=316) reported that they had not received any formal education or training on death, dying and bereavement. Those that did, reported that the training was conducted mainly by nursing (25.9%; n=124) and paramedic (13.6%; n=65) instructors. One-quarter of participants (25.4%; n=126) reported experiencing intrusive symptoms such as sleep loss, nightmares and missing work as a result of a work-related death or dying incident, but only 4.1% (n=20) had received professional counselling. Conclusion This study found that emergency care providers are underprepared to deal with death, dying and bereavement. A comprehensive death education program encompassing the unique challenges that emergency and pre-hospital setting presents should be implemented to reduce emotional anxiety and help emergency care providers cope better with death, and decrease abnormal grief reactions of the bereft. Abnormal grief reactions can include restlessness, searching for the lost person and disrupted autonomic nervous system functions.

scholarly journals Preparedness of emergency care providers to deal with death, dying and bereavement in the prehospital setting

2018 ◽  
Author(s):  
◽  
Reon Johnathan Conning
Keyword(s):  
Emergency Care ◽  
Formal Education ◽  
Prehospital Setting ◽  
Self Report ◽  
Care Providers ◽  
Trauma Symptoms ◽  
Design Data ◽  
Efficient Manner ◽  
Emotional Strain ◽  
Grief Reactions

Introduction: Emergency care providers are exposed to events involving suffering and tragedy as part of their routine work in the field. They are accordingly expected to deal with death, dying and bereavement in a safe, sensitive, efficient manner, showing empathy and compassion while managing their own emotions. This can be stressful and lead to trauma symptoms, anxiety and depression. Purpose: To investigate how prepared emergency care providers are to deal with death, dying and bereavement in the prehospital setting in order to recommend strategies that will diminish the emotional strain they experience, as well as decrease the trauma of sudden death and the number of abnormal grief reactions for the bereft. Methods: The study used a quantitative descriptive prospective design. Data was collected using an online self-report questionnaire that was sent to all operational emergency care providers in the Dubai Corporation of Ambulance Services (DCAS). The data from consenting participants (n = 496) was analysed using the IBM Statistical Package for Social Sciences (SPSS) version 25.0. Inferential statistical techniques such as correlations and chi-square test values were used and interpreted using the p-values. Factor analysis was also conducted for the purpose of data reduction. Results: The majority of respondents (n = 316; 64.4%) reported that they had not received any formal education or training on death, dying and bereavement. Those that had received formal education or training reported that this training was conducted mainly by nursing (n = 124; 25.9%) and paramedic (n = 65; 13.6%) instructors. A quarter of the respondents (n = 126; 25.4%) reported experiencing intrusive symptoms such as loss of sleep, missing work and nightmares as a result of a work-related death or dying incident, but only a few (n = 20; 4.1%) had received professional counselling. Conclusion: This study found that emergency care providers are underprepared to deal with death, dying and bereavement and reported discomfort and anxiety associated with this aspect of their job. A comprehensive death education programme that encompasses the diversity of death and the unique challenges that the emergency and prehospital setting presents should be implemented to reduce emotional anxiety, help emergency care providers cope better with death and decrease the number of abnormal grief reactions on the part of the bereft.

scholarly journals Emergency centre handover from the perspective of prehospital emergency care providers in Johannesburg, South Africa

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrew William Makkink ◽  
Christopher Owen Alexander Stein ◽  
Stevan Raynier Bruijns
Keyword(s):  
South Africa ◽  
Emergency Care ◽  
Geographical Area ◽  
Relevant Information ◽  
Self Report ◽  
Prehospital Emergency Care ◽  
Care Providers ◽  
Cross Sectional ◽  
Content Type ◽  
Prehospital Emergency

PurposeThe purpose of this paper is to describe handover in the emergency centre from the perspective of prehospital emergency care providers in Johannesburg, South Africa. Reference to emergency centre handover from the prehospital perspective will have particular relevance to all deliverers of emergency centre handover.Design/methodology/approachA purposive, cross-sectional design addressed the study aim by using a purpose-designed, validated, paper-based questionnaire to collect data relating to prehospital emergency care personnel's perspectives on emergency centre handover.FindingsThere were 175 completed questionnaires collected from South African prehospital personnel within the Johannesburg area. The response rate was 175/290 or 62%. Training on handover was described as poor. There was a general appreciation of mnemonics and how well they ensured that all relevant information was handed over. However, this was countered by poor familiarity of common mnemonics. Perception of the accuracy of their own and observed prehospital handovers was generally positive. Handover length was generally perceived to be appropriate. The qualification of emergency centre personnel was perceived to impact on how handovers were received.Research limitations/implicationsThe study was limited to one geographical area and did not include all potential participants in the study area. The self-reported data collection meant that there was a risk of self-report bias. These factors may have negatively affected the generalisability of the data.Originality/valueThis paper seeks to describe perceptions related to emergency centre handover from the perspective of prehospital emergency care personnel. In doing so, it is postulated that there is the potential to use these findings to improve certain aspects of emergency centre handover.

Moral Reasoning Among Croatian Students of Different Academic Orientations

2017 ◽  
Vol 6 (2) ◽  
pp. 208
Author(s):  
Andrea Tokić ◽  
Matilda Nikolić
Keyword(s):  
Social Sciences ◽  
Nursing Students ◽  
Social Studies ◽  
Moral Reasoning ◽  
Formal Education ◽  
Law Students ◽  
Academic Disciplines ◽  
Social Sciences And Humanities ◽  
Humanities Students ◽  
Health Care Law

Previous studies demonstrated that different academic contexts could have different effects on moral development, i.e. in most cases formal education enhances moral reasoning, but sometime erodes it (for example for medical students). The aim of this study was to examine differences in moral reasoning among students of different academic disciplines (health care, law, social sciences and humanities). In research participated 386 students (Mage=23,12): 154 law students, 55 nursing students, 123 other social sciences students, a 53 humanities students. Participants took Test of Moral Reasoning (TMR) (Proroković, 2016) which measures index of moral reasoning (in range from 0 to 1), and idealistic orientations (humanistic and conservative). The results showed that there was no difference in the moral reasoning index among students of different academic orientations. Furthermore, students of different academic disciplines differed in the humanistic orientation in a way that students of social studies were more humanistically oriented than law students. Some of the possible explanations for the lack of differences with regard to academic orientations is that overall stimulating environment that college provides is perhaps more important for moral reasoning development than specific academic contexts. Findings of this study are consistent with the findings of some of the previous studies.

Perception of irrigation farmers’ livelihood on a changing climate in the Upper West region of Ghana

2017 ◽  
Vol 3 (2) ◽  
pp. 30-36
Author(s):  
E. Amankwah, V. Hans-Jürgen
Keyword(s):  
Social Sciences ◽  
Food Production ◽  
Formal Education ◽  
Anthropogenic Activities ◽  
Primary Data ◽  
Crop Failure ◽  
Statistical Tools ◽  
Changing Climate ◽  
West Region ◽  
Irrigation Practice

Agriculture in the Upper West region is primarily subsistence and rain-fed, and irrigation practice is significantly furrow andthe use of traditional watering can. This historical approach to agriculture is predicted to suffer severe setbacks due to climatechange. This research therefore explores farmers’ perception of climate change and its impact and how the farmers can cope withthe changing climate. The primary data was gathered through field observation, interviews and administration of questionnairesto about 400 irrigation farmers in three districts of the Upper West region. The data was analysed using 1. Statistical Packagefor Social Sciences (SPSS) and basic statistical tools. It was discovered that 62% of the farmers had no formal education withmajority above 50 years of age. Over 80% have observed rising temperatures and declining rainfall over the last few decades.This has led to higher evaporation and siltation of irrigation dams, higher transpiration of crops and water stress resultingin low crop yield, crop failure and food insecurity. The research also highlights anthropogenic activities that have influencedclimate variability and food production in the region. The research was concluded with suggested strategies to facilitate farmers’adaptation to climate variability.

scholarly journals The Learning to Learn Competence in Early Childhood Preservice Teachers: An Outdoor and e/m-Learning Experience in the Museum

2021 ◽  
Vol 13 (2) ◽  
pp. 25
Author(s):  
Daniel Abril-López ◽  
Hortensia Morón-Monge ◽  
María del Carmen Morón-Monge ◽  
María Dolores López Carrillo
Keyword(s):  
Social Sciences ◽  
Preservice Teachers ◽  
Early Childhood ◽  
Teaching And Learning ◽  
Formal Education ◽  
Learning Experience ◽  
Point Of View ◽  
Learning To Learn ◽  
Outdoor Experience ◽  
Outdoor Experiences

This study was developed with Early Childhood Preservice Teachers within the framework of the Teaching and Learning of Social Sciences over three academic years (2017–2018, 2018–2019, and 2019–2020) at the University of Alcalá. The main objective was to improve the learning to learn competence during teacher training from an outdoor experience at the Museum of Guadalajara (Spain), using e/m-learning tools (Blackboard Learn, Google Forms, QR codes, and websites) and the inquiry-based learning approach. To ascertain the level of acquisition of this competence in those teachers who were being trained, their self-perception—before and after—of the outdoor experience was assessed through a system of categories adapted from the European Commission. The results show a certain improvement in this competence in Early Childhood Preservice Teachers. Additionally, this outdoor experience shows the insufficient educational adaptation of the museum to the early childhood education stage from a social sciences point of view. Finally, we highlight the importance of carrying out outdoor experiences from an inquiry-based education approach. These outdoor experiences should be carried out in places like museums to encourage contextualized and experiential learning of the youngest in formal education.

scholarly journals Delivering Community Emergency Medicine during the COVID-19 pandemic: the Physician Response Unit

2021 ◽  
Vol 38 (5) ◽  
pp. 371-372
Author(s):  
Rich Carden ◽  
Bill Leaning ◽  
Tony Joy
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Response Unit ◽  
Care Services ◽  
Vulnerable Patients ◽  
Palliative Care Services ◽  
Alternative Solutions ◽  
Physician Response

The COVID-19 pandemic has presented significant challenges to services providing emergency care, in both the community and hospital setting. The Physician Response Unit (PRU) is a Community Emergency Medicine model, working closely with community, hospital and pre-hospital services. In response to the pandemic, the PRU has been able to rapidly introduce novel pathways designed to support local emergency departments (EDs) and local emergency patients. The pathways are (1) supporting discharge from acute medical and older people’s services wards into the community; (2) supporting acute oncology services; (3) supporting EDs; (4) supporting palliative care services. Establishing these pathways have facilitated a number of vulnerable patients to access patient-focussed and holistic definitive emergency care. The pathways have also allowed EDs to safely discharge patients to the community, and also mitigate some of the problems associated with trying to maintain isolation for vulnerable patients within the ED. Community Emergency Medicine models are able to reduce ED attendances and hospital admissions, and hence risk of crowding, as well as reducing nosocomial risks for patients who can have high-quality emergency care brought to them. This model may also provide various alternative solutions in the delivery of safe emergency care in the postpandemic healthcare landscape.

scholarly journals A Systematic Review of Self-Report Instruments for the Measurement of Anxiety in Hospitalized Children with Cancer

2021 ◽  
Vol 18 (4) ◽  
pp. 1911
Author(s):  
Gomolemo Mahakwe ◽  
Ensa Johnson ◽  
Katarina Karlsson ◽  
Stefan Nilsson
Keyword(s):  
Hospital Setting ◽  
Self Report ◽  
Hospitalized Children ◽  
Abstract Concepts ◽  
Children With Cancer ◽  
Language Difficulties ◽  
Self Reports ◽  
Psychometric Quality ◽  
Communication Challenge

Anxiety has been identified as one of the most severe and long-lasting symptoms experienced by hospitalized children with cancer. Self-reports are especially important for documenting emotional and abstract concepts, such as anxiety. Children may not always be able to communicate their symptoms due to language difficulties, a lack of developmental language skills, or the severity of their illness. Instruments with sufficient psychometric quality and pictorial support may address this communication challenge. The purpose of this review was to systematically search the published literature and identify validated and reliable self-report instruments available for children aged 5–18 years to use in the assessment of their anxiety to ensure they receive appropriate anxiety-relief intervention in hospital. What validated self-report instruments can children with cancer use to self-report anxiety in the hospital setting? Which of these instruments offer pictorial support? Eight instruments were identified, but most of the instruments lacked pictorial support. The Visual Analogue Scale (VAS) and Pediatric Quality of Life (PedsQL™) 3.0 Brain Tumor Module and Cancer Module proved to be useful in hospitalized children with cancer, as they provide pictorial support. It is recommended that faces or symbols be used along with the VAS, as pictures are easily understood by younger children. Future studies could include the adaptation of existing instruments in digital e-health tools.

scholarly journals The accuracy of initial diagnoses in coma: an observational study in 835 patients with non-traumatic disorder of consciousness

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Maximilian Lutz ◽  
Martin Möckel ◽  
Tobias Lindner ◽  
Christoph J. Ploner ◽  
Mischa Braun ◽  
...  
Keyword(s):  
Emergency Care ◽  
Final Diagnosis ◽  
Class I ◽  
Prehospital Emergency Care ◽  
Unknown Etiology ◽  
Care Providers ◽  
Cohen’S Kappa ◽  
Disorder Of Consciousness ◽  
Cohen's Kappa ◽  
Suspected Diagnosis

Abstract Background Management of patients with coma of unknown etiology (CUE) is a major challenge in most emergency departments (EDs). CUE is associated with a high mortality and a wide variety of pathologies that require differential therapies. A suspected diagnosis issued by pre-hospital emergency care providers often drives the first approach to these patients. We aim to determine the accuracy and value of the initial diagnostic hypothesis in patients with CUE. Methods Consecutive ED patients presenting with CUE were prospectively enrolled. We obtained the suspected diagnoses or working hypotheses from standardized reports given by prehospital emergency care providers, both paramedics and emergency physicians. Suspected and final diagnoses were classified into I) acute primary brain lesions, II) primary brain pathologies without acute lesions and III) pathologies that affected the brain secondarily. We compared suspected and final diagnosis with percent agreement and Cohen’s Kappa including sub-group analyses for paramedics and physicians. Furthermore, we tested the value of suspected and final diagnoses as predictors for mortality with binary logistic regression models. Results Overall, suspected and final diagnoses matched in 62% of 835 enrolled patients. Cohen’s Kappa showed a value of κ = .415 (95% CI .361–.469, p < .005). There was no relevant difference in diagnostic accuracy between paramedics and physicians. Suspected diagnoses did not significantly interact with in-hospital mortality (e.g., suspected class I: OR .982, 95% CI .518–1.836) while final diagnoses interacted strongly (e.g., final class I: OR 5.425, 95% CI 3.409–8.633). Conclusion In cases of CUE, the suspected diagnosis is unreliable, regardless of different pre-hospital care providers’ qualifications. It is not an appropriate decision-making tool as it neither sufficiently predicts the final diagnosis nor detects the especially critical comatose patient. To avoid the risk of mistriage and unnecessarily delayed therapy, we advocate for a standardized diagnostic work-up for all CUE patients that should be triggered by the emergency symptom alone and not by any suspected diagnosis.

scholarly journals SARS-CoV-2 detection status associates with bacterial community composition in patients and the hospital environment

Microbiome ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Clarisse Marotz ◽  
Pedro Belda-Ferre ◽  
Farhana Ali ◽  
Promi Das ◽  
Shi Huang ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Rna Virus ◽  
Bacterial Community Composition ◽  
Hospital Setting ◽  
Amplicon Sequencing ◽  
Hospital Environment ◽  
Rrna Gene ◽  
Sequence Variant ◽  
Care Providers ◽  
Single Amplicon

Abstract Background SARS-CoV-2 is an RNA virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. Viruses exist in complex microbial environments, and recent studies have revealed both synergistic and antagonistic effects of specific bacterial taxa on viral prevalence and infectivity. We set out to test whether specific bacterial communities predict SARS-CoV-2 occurrence in a hospital setting. Methods We collected 972 samples from hospitalized patients with COVID-19, their health care providers, and hospital surfaces before, during, and after admission. We screened for SARS-CoV-2 using RT-qPCR, characterized microbial communities using 16S rRNA gene amplicon sequencing, and used these bacterial profiles to classify SARS-CoV-2 RNA detection with a random forest model. Results Sixteen percent of surfaces from COVID-19 patient rooms had detectable SARS-CoV-2 RNA, although infectivity was not assessed. The highest prevalence was in floor samples next to patient beds (39%) and directly outside their rooms (29%). Although bed rail samples more closely resembled the patient microbiome compared to floor samples, SARS-CoV-2 RNA was detected less often in bed rail samples (11%). SARS-CoV-2 positive samples had higher bacterial phylogenetic diversity in both human and surface samples and higher biomass in floor samples. 16S microbial community profiles enabled high classifier accuracy for SARS-CoV-2 status in not only nares, but also forehead, stool, and floor samples. Across these distinct microbial profiles, a single amplicon sequence variant from the genus Rothia strongly predicted SARS-CoV-2 presence across sample types, with greater prevalence in positive surface and human samples, even when compared to samples from patients in other intensive care units prior to the COVID-19 pandemic. Conclusions These results contextualize the vast diversity of microbial niches where SARS-CoV-2 RNA is detected and identify specific bacterial taxa that associate with the viral RNA prevalence both in the host and hospital environment.

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