Identification of Children of Mentally Ill Patients and Provision of Support According to the Norwegian Health Legislation: A 11-Year Review

Background:According to amended legislation implemented in Norway in 2010, personnel in healthcare services for adults are obligated to identify patients' minor children and to assess the family situation. Health personnel is also obligated to contribute to adequate support to families affected by parental mental illness or substance use disorders. The intention behind the amendment was to support and protect children of mentally ill parents, as they are at risk of developing problems of their own. The aim of the present study was to evaluate health personnel's practice during the years 2010-2020, more specifically; (a) to what extent children of patients with mental illness and substance use disorders are registered in patient records, and (b) to what extent activities relating to the assessment and support of patients' minor children are documented in patient records.Method:The participants in the study are patients admitted to Division for Mental Health and Substance Use at the University Hospital of North Norway in the years 2010–2020. The data was drawn from patient records during October 2021.Results:The registration of patients' minor children is considerably strengthened since the introduction of the new Norwegian Health Personnel Act in 2010, and estimates show that 56% of patients' minor children are identified. However, only 31% of cases where patients have identified minor children this result in health personnel performing activities to support the children.Discussion:Based on the rising proportion of identified minor children throughout the 10-year period, it seems evident that the dissemination efforts have contributed to the development of some new skills among health personnel. However, compared with the national estimation that 35% of mentally ill and substance abusing patients have minor children, a large proportion of children remains unidentified. After identification, there seem to still be a long way to go before minor children are systematically offered support. Different solutions to strengthen the implementation of new skills in clinical practice, to ensure the identification of minor children and provision of necessary support for them is discussed.

SARS-CoV-2 mRNA Vaccine Breakthrough Infections in Fully Vaccinated Healthcare Personnel: A Systematic Review

The number of people vaccinated against COVID-19 increases worldwide every day; however, it is important to study the risk of breakthrough infections in vaccinated individuals at high risk of exposure such as healthcare personnel (HCP). A systematic literature review (SLR) applying the PRISMA declaration and the PECOS format using the following entry terms was used: “Health Personnel OR Healthcare Worker OR Healthcare Provider OR Healthcare Personnel AND breakthrough OR infection after vaccine*”. The research was carried out utilizing the following databases: SCOPUS, PubMed, Embase, and Web of Sciences. An overall very low incidence of post-vaccination breakthrough infections was found, ranging from 0.011 to 0.001 (per 100 individuals at risk). Our findings further support the published high effectiveness rates of mRNA vaccines in preventing SARS-CoV-2 infections among fully vaccinated HCP. Additional studies are needed to define the duration of the vaccine-induced protection among HCP.

‘Every Woman Wants to Know What Came out of Her Body’: Grief Experiences of Women After Stillbirth in Nigeria

Stillbirth commonly affects women in Nigeria, but their experiences of grief following stillbirth is under explored. This study aimed to describe Nigerian women’s experiences of grief after stillbirth. Face-to-face, semi-structured interviews were conducted with 20 women in Nigeria who experienced stillbirth. The results from the thematic analysis suggest that mothers had an unmet need to see their stillborn baby, and they experienced communication challenges such as being blindsided/misled about the baby during their interactions with health personnel. The participants experienced emotional and psychological reactions to grief that manifested in the form of emotional pain, sadness, blame and shock, but having a sense of gratitude helped them cope. The findings of this study highlight gaps in bereavement care and suggest the need for basic bereavement training for health personnel.

Existential Dimension and Spiritual Assistance in the “A. Gemelli” University Hospital in Rome: A Cross-Disciplinary and Sacramental Enhanced Dynamical Approach in Palliative Care

In the A. Gemelli university hospital in Rome, the presence of highly specialized inter-professional palliative care teams and spiritual assistants who are dedicated to their role in the service of inpatients is valuable to person-centered healthcare. Spiritual needs are commonly experienced by patients with sudden illness, chronic conditions, and life-limiting conditions, and, consequently, spiritual care is an intrinsic and essential component of palliative care. This paper focuses on the sacrament of the Anointing of the Sick to demonstrate the importance of spiritual care as an integral part of palliative care and highlights the need for all interdisciplinary team members to address spiritual issues in order to improve the holistic assistance to the patient. Over a 3-year period (October 2018–September 2021), data about the sacrament of the Anointing of the Sick administered by the hospitaller chaplaincy were collected. A total of 1541 anointings were administered, with an average of 514 anointings per year, excluding reductions related to the COVID-19 pandemic. In 98% of cases, the sacrament was requested by health personnel, and in 96% of cases, the same health personnel participated in the sacrament. These results demonstrate that, at the A. Gemelli polyclinic in Rome, the level of training that the care team has received in collaboration with the chaplains has generated a good generalized awareness of the importance of integrating the spiritual needs of patients and their families into their care, considering salvation as well as health, in a model of dynamic interprofessional integration.

The incorporation of ethical and bioethical rules in Law

The ethics of the health professions and bioethics constitute a source for the legal norm, especially for those of health law. The provision of health services, eventually, due to its experimental and interventionist nature, can put at risk the legal assets of the person such as dignity, life and integrity, so that the obligations derived from ethics and bioethics, As a normative framework, they must be observed by health personnel.

EL ROL DEL PERSONAL DE ENFERMERÍA EN LA PROMOCIÓN DEL BIENESTAR BIOPSICOSOCIAL DURANTE LA EXPERIENCIA DE HOSPITALIZACIÓN PEDIÁTRICA.

La estancia en el hospital de niños y niñas es desafortunadamente común y está asociada a regresión en los comportamientos, agresión, falta de cooperación, retraimiento, dificultad para recuperarse, llanto excesivo, y disminución de la comunicación y/o actividad, por lo que el proceso atención enfermero necesita no solo una perspectiva biológica, sino también incluir a las esferas psicológicas y sociales. El rol del personal de enfermería, al ser los principales referentes de cuidado dentro del contexto sanitario, resulta esencial pues son percibidos como la mayor fuente de apoyo e información de los padres, madres y pacientes. En el documento se proporcionan algunas pautas, dirigidas al personal de salud, para aumentar el bienestar integral a través de acciones concretas y de fácil ejecución. Palabras clave: hospitalización, personal de enfermería, humanización de la atención. ABSTRACT The hospital stay of children is unfortunately common and is associated with regression in behaviors, aggression, lack of cooperation, withdrawal, difficulty in recovering, excessive crying, and decreased communication and / or activity, so The nursing care process needs not only a biological perspective, but also includes the psychological and social spheres. The role of the nursing staff, being the main care references within the healthcare context, is essential since they are perceived as the greatest source of support and information from parents and patients. The document provides some guidelines, aimed at health personnel, to increase comprehensive well-being through concrete and easy-to-implement actions. Keywords: hospitalization, nursing staff, humanization of care.

Caring for the Caregivers Through Healthy Human Resource Practices

India has a colossal shortage of human resources for health. The management of human resources in a healthcare institution is vital to enable the delivery of efficient and effective medical services and to achieve patient satisfaction. Everyone proclaims that the human asset is the most important asset. On the other side, health is declared to be one of the most important wealth. Hospitals and pharmaceutical companies constitute two arms of the “health management/ maintenance” effort of humanity. Human resource professionals face many hurdles in their attempt to deliver high-quality health care to citizens. Some of these constraints include budgets, lack of congruence between different stakeholders' values, absenteeism rates, high rates of turnover, and low morale of health personnel.

Medical Burnout

The WHO defines burnout as an inadequate response to chronic workplace stress, with emotional exhaustion, depersonalization, and reduced professional efficacy. Its growing incidence among physicians may adversely affect their personal and professional lives. Mindfulness aims to reach a state of consciousness in which one's attention is purposefully focused on the present. This chapter uses a narrative review of articles published between 2015 and 2019, with the MeSH terms “Burnout,” “Professional,” “Mindfulness,” and “Health Personnel.” Sixty-six articles were obtained, of which one meta-analysis, two systematic reviews, and two randomized clinical trials (RCT) met the inclusion criteria. All studies showed some degree of burnout improvement, more statistically significant as regards emotional exhaustion. One RCT also showed a reduction in heart rate. Available evidence suggests that mindfulness may improve physicians' well-being, mental health, and resilience, asserting itself as a possible coping strategy for burnout, namely regarding emotional exhaustion.

Implementasi Sistem Rujukan Layanan Kesehatan: Systematic Literature Review

The Health Care Referral System is a service system that controls the delegation of authority and responsibility for health problems which is carried out reciprocally vertically or horizontally, in the sense of a unit with less capability to a more capable unit. The purpose of this study was to determine the implementation of the health service referral system in terms of regulations, health personnel resources and infrastructure. This research is a systematic review (Systematic Literature Review). The data synthesis process was carried out by comparing 15 literatures that met the quality assessment as well as inclusion and exclusion criteria with the database sources used, namely, Google Scholar, Pubmed, ScienceDirect. The data is processed and presented in tabulated form. The results showed that several countries such as Indonesia, Iran, Northern Tanzania, Riyadh, Ghana, Zambia and Hoduras from the articles reviewed used a referral system starting from the basic level (Primary), secondary level (Secondary) and tertiary level (Tertiary). Judging from the three aspects of the implementation of the health service referral system reviewed, it shows that there are problems in its implementation, including; the regulatory aspect found only 2 literatures that discussed regulations in the implementation of the referral system, the aspect of health personnel resources was found to be unavailability of health workers in health services causing patient referral and infrastructure aspects found obstacles in inadequate infrastructure resulting in referral.Keywords: implementation, referral system, health care AbstrakSistem Rujukan Pelayanan Kesehatan merupakan sistem pelayanan yang mengendalikan pelimpahan wewenang serta tanggung jawab atas permasalahan kesehatan yang dilakukan secara timbal balik secara vertikal ataupun horizontal, dalam makna dari unit yang berkemampuan kurang ke unit yang lebih, terjangkau dan rasional. Tujuan penelitian ini untuk mengetahui implementasi sistem rujukan layanan kesehatan dilihat dari aspek regulasi, sumber daya tenaga kesehatan dan sarana prasarana. Penelitian ini merupakan tinjauan sistematis (Systematic Literature Review). Proses data sintesis dalam penelitian ini dilakukan dengan cara membandingkan 15 literature yang memenuhi penilaian kualitas serta kriteria inklusi dan ekslusi dengan sumber database yang digunakan yaitu, Google Scholar, Pubmed, ScienceDirect. Data diolah dan disajikan dalam bentuk tabulasi. Hasil penelitian menunjukan beberapa negara seperti Indonesia, Iran, Tanzania Utara, Riyadh, Ghana, Zambia dan Hoduras dari artikel yang direview menggunakan sistem rujukan yang dimulai dari tingkat dasar (Primary), tingkat menengah (Secondary) dan tingkat tersier (Tertiary). Dilihat dari ketiga aspek implementasi sistem rujukan layanan kesehatan yang direview menunjukkan adanya permasalahan dalam pengimplementasiannya diantaranya; aspek regulasi ditemukan hanya 2 literature yang membahas regulasi dalam pengimplementasian sistem rujukan, aspek sumber daya tenaga kesehatan ditemukannya ketidaktersediaan tenaga kesehatan di layanan kesehatan sehingga menyebabkan terjadinya rujukan pasien dan aspek sarana prasarana ditemukannya hambatan pada infrastruktur yang tidak memadai sehingga menyebabkan terjadinya rujukanKata Kunci: implementasi, sistem rujukan, layanan kesehatan