Psychosocial Distress in Parents with Children Awaiting Surgery during the COVID-19 Pandemic

Due to resource restrictions related to the COVID-19 pandemic, many pediatric patients are facing substantial delays for surgery, potentially resulting in additional distress for caregivers. We aimed to assess the experiences and psychosocial distress of parents during COVID-19 as they relate to the pandemic, waiting for surgery, and the combined effects of both events. The was a cross-sectional qualitative study. Parents with children who faced treatment delays during the initial wave of the COVID-19 pandemic for elective, non-emergent procedures across a variety of surgical specialties were recruited. Semi-structured telephone interviews and thematic analysis were utilized. Thematic saturation was reached with eighteen participants. Four themes were identified: coping with COVID-19, distress levels, quality and nature of communication with the surgical team, and the experience of COVID-19 related hospital restrictions. Participants reported varying levels of distress due to the delay in surgery, such as the fear of developmental delay or disease progression for their child. They also indicated their own physical and mental health had been impacted by emotional distress related to both COVID-19 and delays in treatment. Most participants experienced the COVID-19-related hospital restrictions as distressing. This related predominantly to limiting in-hospital caregivers to only one caregiver. Participants were found to have substantial levels of psychosocial distress. Targeted social and emotional support may be helpful in reducing parental distress as the pandemic timeframe continues. Within the limits of individual health systems, reducing restrictions to the number of allowed care givers may help allay distress felt by parents.

COVID-19 IN CHILDREN AND ADOLESCENT: CHARACTERISTICS AND SPECIFICITIES IN IMMUNOCOMPETENT AND ONCOHEMATOLOGICAL PATIENTS

SARS-CoV-2 pandemic affected less children and adolescents, morbidity and mortality figures being inferior to that reported for adults. In this review we focused on the clinical course, risk factors for severe COVID-19, mortality, treatment options and prevention measures in the pediatric and adolescent setting with special attention to the pediatric oncohematological patients. In this subgroups of patients, SARS-CoV-2 infection was often asyntomatic but 47 to 68% of patients require hospitalization and 9-10% of those hospitalized needed intensive care with a COVID-19 attributable mortality of about 4%. The multisystem inflammatory syndrome associated to Coronavirus 2019 was less frequent than that reported in the non-oncohematological pediatric population. Noteworthy, the course of COVID-19 was more severe in low-middle income countries. The key measures to prevent SARS-CoV-2 infection are the reduction of patients exposure to the SARS-CoV-2 and vaccination, now available fore care givers and parents and for patients and siblings > 12 years old. The treatment of COVID-19 in pediatric patients was mainly based on supportive care with dexamethasone and heparin prophylaxis for severely ill patients. Other measures, such as convalescent plasma, remdesivir and monoclonal antibodies have been used in limited case or within experimental protocols. Further studies are needed on the risk factors and outcome of SARS-CoV-2 infection in the pediatric immunocompromised patients.

Ethics in Clinical Studies: The Dilemma of very Young and Old

The objectives of the research are to percolate knowledge which can improve health and improve understanding of human physiology. Pervasive exclusion of children and elderly in clinical trials as is happening today is not justified. Children have different physiology and pharmacology from adults; often adverse effects are also different and specific. Diseases like neonatal hyperbilirubinemia, infantile spasms are very age specific. Elderly too, have age specific issues like dementias, malignancies, weakened systems and polypharmacy that make them a special cohort. Clinical trials in these age groups are essential so as to gather comprehensive data about a medication across all age groups. Informed consent is a challenge in both these groups. It can be remedied by obtaining consent from parents, or legally acceptable representative in case of children and care givers and/or LARs in case of the elderly. Oral assent from 7 to 11 years, and written assent from 12 to 18 years and in the elderly, along with consent from the LAR, parents, care givers as the case may be, forms the bedrock of good clinical trial ethics.

Care-giver wellbeing: exploring gender, relationship-to-care-recipient and care-giving demands in the Canadian Longitudinal Study on Aging

The three-way intersection of gender, relationship-to-care-recipient and care-giving demands has not, to our knowledge, been examined in relation to the wellbeing of family care-givers. We explore inequalities in depressive symptoms and life satisfaction, comparing wives, husbands, daughters and sons providing very-intensive care (36+ hours/week) with those providing less care and disparities between these groups in the factors related to disadvantage. Data from the Canadian Longitudinal Study on Aging (N = 5,994) support the existence of differences between the groups. Very-intensive care-giving wives report the most depressive symptoms and lowest life satisfaction; less-intensive care-giving sons report the fewest depressive symptoms, and less-intensive care-giving daughters report the highest life satisfaction. However, group differences in life satisfaction disappear among very-intensive care-givers. Drawing on Intersectionality and Stress Process theories, data from regression analyses reveal a non-significant gender–relationship–demand interaction term, but, health, socio-economic and social support resources play a strong mediating role between care demand and wellbeing. Analyses of the eight groups separately reveal diversity in the care-giving experience. Among less-intensive care-givers, the mediating role of resources remains strong even as differences are evident. Among very-intensive care-givers, the role of resources is less and differences in wellbeing between the groups are magnified. Policy implications emphasise the imperative to personalise services to meet the varied needs of care-givers.

The Impact of Human Resource Practices on Nurses’ Turnover Intention: An Empirical Study of Hospitals in North Lebanon

Nurse turnover has become a continuous and increasing challenging problem in the healthcare system worldwide; and this became a priority that needs to be adequately managed. As a matter of fact, nurses are care givers and represent the frontline services that hospitals deliver to their patients, so it is an indispensable necessity to retain this workforce through both job satisfaction and job motivation. Providing the nurse workforce an appropriate treatment will surely lead to retention of talent that is critical to the continuity of the healthcare organizations. This research aims to assess the impact of Human Resource Management (HRM) practices mainly in relation to job satisfaction on nurses’ turnover intention, especially that Lebanon is one of the countries where the healthcare system is suffering from nurses’ shortage. This study uses a descriptive correlational study based on a structured questionnaire administered to 100 nurses within North Lebanon Hospitals. The collected data statistical analysis is carried out via the Statistical Product and Service Solutions SPSS-version 25. Results revealed that the absence of efficient HR practices forces nurses toward turnover decision. Thus, the creation of supported and motivated environment will positively affect the nurses’ decision to stay, and thus minimize the turnover rate.

To assess the Effectiveness of Psychoeducation Intervention on Reducing the Burden of Caring of Alcoholic Dependence Syndrome Patients among Family Caregivers

Background: Alcohol dependence is considered as a “family disease.” In terms of occupational and social instability, physical and emotional distress, and financial burden, alcohol dependency affects the person as well as those around them, which has a major effect on the lives of significant others. Aim: Study aims to assess the effectiveness of psychoeducation intervention on reducing the burden of caring for alcoholic dependence syndrome patients among family caregivers. Objective: 1.To identify the existing burden of caring of alcoholic dependence syndrome patients among family care givers in experimental group and control group.2.To evaluate the effectiveness of psycho education intervention on reducing the burden of caring of alcoholic dependence syndrome patients among family care givers in experimental group and control group at post-test. 3. To evaluate the effectiveness of psycho education intervention on reducing the burden of caring of alcoholic dependence syndrome patients among family care givers between experimental group and control group. 4. To compare the effectiveness of psycho education intervention on reducing the burden of caring of alcoholic dependence syndrome patients among family care givers between experimental and control group.5.To associate post-test score of psycho education intervention on reducing the burden of caring of alcoholic dependence syndrome patients among family care givers with their selected demographic variables in experimental and control group. Methodology: The research design is experimental one group pre-test post with control group, and participants are, the Family caregivers of alcohol dependence syndrome patients. The aging population will be selected according to the criteria of inclusion and exclusion, and the sampling technique will be selected as the technique of purposive sampling technique. Data will be obtained by participants’ demographic variables and the use of a modified standardized scale for burden assessment and all scales distributed for reducing the burden of caring of alcoholic dependence syndrome patients among family caregivers. The literature review was identified through Pub MED, Medline, Cochran, computerized, books, library. Result: There may be effectiveness of psychoeducation intervention on reducing the burden of caring of alcoholic dependence syndrome patients among family caregivers and this effectiveness will be tested with demographic variables by regression analysis. Conclusion: findings will be drawn from the statistical analysis.

Choosing and Managing Aged Care Services from Afar: What Matters to Australian Long-Distance Care Givers

This research aims to identify the factors that influence caregivers’ decisions about the aged care providers they select for their elder relatives when caring from a distance and what they value once they have engaged a service. Adult long-distance carers for older relatives living within Australia were purposively sampled and they participated in audio-recorded interviews. A thematic analysis was employed to investigate the data. A sample of 13 participants enabled data saturation with no new major themes identified in the final three interviews. Participants were 50 to 65 years (Mean = 59.8) and mostly (77%) female. Four themes emerged relating to selection of care providers: (1) availability of care, (2) financial arrangements, (3) proximity and location, and (4) reputation of care provider. Five themes detailed valued qualities of care: (1) vigilant monitoring and responsivity, (2) communication with family, (3) flexibility and proactiveness of care, (4) staffing, and (5) access to appropriate and holistic care to maintain wellbeing. Long-distance caregivers face barriers in selecting and managing aged care services from afar within a complex Australian aged care system. They strongly value regular, proactive communication about the wellbeing of their relatives and may be particular beneficiaries of communication and assistive monitoring technologies.