Substantial Impact of COVID-19 on Self-Reported Mental Health of Healthcare Professionals in the Netherlands

Initially, the COVID-19 pandemic caused a continued pressure on professionals working in hospitals due to the increase of affected patients. At the moment, the pandemic continues but thanks to all kinds of measures (e.g., social distancing) workload seems to decrease at the hospitals. On the contrary, patients with long-lasting symptoms due to COVID-19 infection or the pandemic begin to merge at the mental healthcare institutions in the Netherlands but this also holds true for other countries. Furthermore, healthcare professionals are affected by safety measures such as working from home, which led to an increased feeling of stress and may have led to a misbalance in work and private life. As a result, the question whether healthcare employees in mental healthcare experience impaired mental health remains unclear and chances are fair that mental health problems such as exhaustion and burnout may be prevalent. This study describes an online survey in which mental health amongst mental healthcare professionals is investigated. About 1,300 professionals from a large number of mental healthcare institutions replied the survey. Around 50% of the respondents experienced increased levels of stress. Feelings of anxiety, anger, and sadness were also increasingly experienced due to the COVID-19 pandemic. Furthermore, 4.2% replied that they were considering resigning their jobs which is alarming considering the shortage of healthcare professionals in mental healthcare institutions. The results support the importance of treatment or support of professionals in mental healthcare that experience psychological ailments.

Termination of Pregnancy for Fetal Anomaly: A Systematic Review of the Healthcare Experiences and Needs of Parents

BackgroundImproved technology and advances in clinical testing have resulted in increased detection rates of congenital anomalies during pregnancy, resulting in more parents being confronted with the possibility of terminating a pregnancy for this reason. There is a large body of research on the psychological experience and impact of terminating a pregnancy for fetal anomaly. However, there remains a lack of evidence on the holistic healthcare experience of parents in this situation. To develop a comprehensive understanding of the healthcare experience and needs of parents, this systematic review sought to summarise and appraise the literature on parents’ experiences following a termination of pregnancy for fetal anomaly.Review Question:What are the healthcare experiences and needs of parents who undergo a termination of pregnancy following an antenatal diagnosis of a fetal anomaly?MethodsA systematic review was undertaken with searches completed across six multi-disciplinary electronic databases (Medline, Embase, PsycINFO, CINAHL, Web of Science, and Cochrane). Eligible records were qualitative, quantitative or mixed methods studies, published between January 2010 and August 2021, reporting the results of primary data on the healthcare experiences or healthcare needs in relation to termination of pregnancy for fetal anomaly for either or both parents. Findings were synthesised using Thematic Analysis.ResultsA total of 30 records were selected for inclusion in this review of which 24 were qualitative, five quantitative and one mixed-methods. Five overarching themes emerged from the synthesis of findings: (1) Context of Care, (2) Person-centred Care, (3) Compassionate Care, (4) Co-ordinated Care, and (5) Inclusive Care.ConclusionCompassionate healthcare professionals who provide non-judgemental and sensitive care can impact positively on parents’ satisfaction with the care they receive. A well organised and co-ordinated healthcare system is needed to provide an effective and high-quality service.Registration:PROSPERO registration number: CRD42020175970

Receiving healthcare for drug-resistant TB: a cross-sectional survey from Pakistan

OBJECTIVE: To describe and quantify patients’ self-reported experiences of receiving healthcare from Pakistan’s Programmatic Management of Drug-Resistant Tuberculosis (PMDT) model of care, and to understand these experiences within the broader context of Pakistan’s health system.METHOD: This was a cross-sectional survey of patients attending three PMDT clinics in Khyber-Pakhtunkhwa Province in Pakistan.RESULTS: The median consultation time at the PMDT clinics was 10 minutes. In their most recent visit to the PMDT clinic, 34.9% of patients spent >40% of their monthly income to access treatment. To specify, 71% of patients reported spending out-of-pocket for ancillary medicines and 44.7% for laboratory tests. In 10.5% of cases, medicines for drug-resistant TB (DR-TB) were dispensed without the patient attending the clinic. Only 43.7% of treatment supporters regularly accompanied patients to the clinic, and 6% supervised the patient’s intake of medicines. Disbursement of financial support was irregular in 98.6% of cases. Only 6.2% of patients received their daily injections from a public facility, the rest went elsewhere.CONCLUSION: Several shortcomings in PMDT services, including hurried consultations, irregularities in financial support, and gaps in Pakistan’s broader health system undermined healthcare experience of patients with DR-TB. To improve health outcomes and patients’ care experience these service gaps need to be addressed.

Rare Disease Healthcare Experience: Qualitative Survey and Workshop Findings in the Context of UK Policy Development

Background: the UK Rare Diseases Framework is the latest policy initiative that aims to improve healthcare for rare diseases in the UK, with four priorities focussed on faster diagnosis, increasing awareness among healthcare professionals, better care coordination and improved access to specialist care and treatment. A survey of over 1,000 people living with rare diseases in the UK immediately prior to the publication of the Framework captured quantitative and qualitative data about their experiences. The qualitative analysis is presented here and compared with the content of the Framework.Results: People living with a rare condition in the UK continue to have very mixed experiences of healthcare and our findings illustrate substantial continuing unmet needs that fall under each of the four priorities of the Framework. Conclusions: Comparing the findings with what is emphasised in the Framework suggests specific key changes to policy and practice which might be missed by action plans developed under the Framework. The overall provision in the UK for people living with rare conditions needs to be improved and regularly reviewed, to ensure they are not being unfairly excluded from appropriate diagnosis, treatment or support.

Does prior healthcare experience predict success on clinical courses and add value to admissions processes?

Objectives: This work sought to assess whether prior clinical experience provided any guide to likely course achievement from three completed cohorts of Physician Associates at the University of Sheffield. Methods: Sixty students who entered the PA course at TUoS since it began in 2016 were included in the study. Each students' original course application was reviewed for healthcare experience and mapped against first sit examination scores. Statistical analysis was undertaken with a two-tailed t-test. Results: No correlation was found between previous healthcare experience and performance in examinations. Students with previous healthcare experience performed slightly worse than those without in the OSCE examination but not at a level of statistical significance. Conclusions: The use of clinical experience as part of the criteria of entry does not predict success on a Physician Associate course. We support the position of the 2010 Ottawa conference that quality assured methodologies along with objective cut offs for previous academic attainment are the most appropriate way to select students for clinical courses.

Healthcare experience disrupts representational similarity between one's and others' pain in anterior insula

Medical students and professional healthcare providers often underestimate patients' pain, an effect associated with decreased neural response of the anterior insula to pain information. However, the functional significance of these neural modulations is still debated. We recruited university medical students and emergency caregivers to test the role of healthcare experience on the behavioral/neural reactivity to other's pain, emotions, and beliefs. We confirmed that healthcare experience decreased the sensitivity to others' suffering, as measured by subjective ratings and insular response. This effect was independent from stimulus modality (pictures, texts), but specific for pain, as it did not generalize to emotions or beliefs. Critically, multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others' pain shared with that of first-hand nociception. This suggests a reduced likelihood of appraising others' sufferance as one's own, and might offer a mechanistic explanation for pain underestimation in clinical settings.

726 Return to Sport, Patient Reported Outcomes and Satisfaction Following Anterior Cruciate Ligament Reconstruction

Introduction Anterior Cruciate Ligament(ACL) rupture is a common sporting injury. Return to sport is a key objective for patients. The aim of this study was to investigate return to pre-injury level sport at 12- and 24-months post reconstruction and to relate this to types of sport and to patient satisfaction. Method A questionnaire was developed, piloted, and then completed by 77 patients that had undergone ACL reconstruction between 2013-2016. Results 30% of patients returned to pre-injury level of sport at 12 months and 43% by 24 months’ post ACL reconstruction. There was a significant(P = 0.037) relationship between the type of sports that participants played prior to injury and the return to pre-injury level. Sports that involved jumping, hard pivoting and cutting were associated with a lower rate of return to sport. General health profile of the patients was found to be significantly higher in patients that returned to sport(P = 0.024). There was a significant association with return to sport and higher satisfaction and healthcare experience score(P = 0.001). Conclusions Patient satisfaction correlated with return to sport. This was inversely related to sports involving jumping, hard pivoting and cutting. Which further illustrates how patient satisfaction post ACL reconstruction was linked to type of sport.

Factors Influencing Healthcare Experience of Patients with Self-Declared Diabetes: A Cross-Sectional Population-Based Study in the Basque Country

Background: Diabetes affects more than 400 million people around the world. Few published studies incorporate questionnaires that comprehensively cover every aspect of a patient’s experience of healthcare. This study analyzes potential differences in the healthcare experience for patients with diabetes based on their sociodemographic, economic, and health-related characteristics from a comprehensive viewpoint in an integrated delivery system. Methods: We used data from the 2018 Basque Health Survey, which includes a questionnaire for the measurement of the experiences of patients with chronic problems. We present descriptive and regression analyses to explore differences by sociodemographic, economic, and health-related characteristics of patients’ experiences with different healthcare services. Results: Having diabetes plus other comorbidities significantly decreases the quality of the experience with all healthcare services and decreases the global healthcare experience score. When comorbidities are present, the elderly seem to report better experiences than younger patients. Some differences in experience can be explained by sociodemographic and economic factors. No differences exist between conditions co-occurring with diabetes. Conclusion: Patients with diabetes who also suffer from other conditions report worse experiences than individuals who suffer from diabetes only. No specific conditions explain the differences in care experience.