Confronting the unknown-Nursing surveillance of COVID-19-infected patients through remote telephone calls and in an on-site urgent clinic.

AIM: To describe nursing surveillance of coronavirus disease 2019 (COVID-19)-infected patients through remote telephone calls and in an on-site urgent clinic during the first wave of the pandemic as experienced by nurses providing the care. DESIGN: Qualitative descriptive study. METHODS: Data were collected through seven semi-structured, audio-recorded, focus group interviews with 24 nurses. Interviews were conducted in May and June 2020, transcribed and analysed using deductive and inductive content analysis into an overarching category, main categories and subcategories. Reporting followed the COREQ guidelines. RESULTS: Nurses relied on intensive listening when assessing and caring for COVID-19-infected patients. They realized that the patients had complex needs for nursing and healthcare which was beyond the scope of a tentatively prescribed assessment scheme. They designed their care to ensure holistic care, reflected in the overarching category, 'Confronting an unfamiliar health condition in unprecedented circumstances' and the categories: 'Digging into the unknown' and 'Ensuring holistic nursing care'. The category 'Contributing to averting catastrophe' reflects the wealth of knowledge, support and experience that the nurses used to independently deliver care, albeit in interdisciplinary collaboration, working to their greatest potential. They were proud of the significance of their work. CONCLUSION: Novel nursing surveillance through remote telephone calls and in an on-site urgent care clinic delivered to COVID-19 patients self-managing at home resulted in holistic nursing care during the first wave of the pandemic. This has relevance for professionalism in nursing. IMPACT: Findings give a unique insight into nursing surveillance of COVID-19-infected patients provided through telephone calls and in on-site urgent care clinics. The potential of intensive listening as conducted in the study suggests that it may be feasible to assess and holistically take care of COVID-19-infected patients, and other patient groups as well, with this form of healthcare. This has relevance for healthcare beyond crisis management during pandemics. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution as the study only concerned the providers of the service, i.e. the nurses themselves.

[Long term effects of burn injury on health-related quality of life of adult burn survivors in Iceland: a descriptive cross-sectional study and validation of the Icelandic version of the Burn Specific Health Scale-Brief (BSHS-B)].

OBJECTIVES: The aim of the study was to assess the long-term effects of burn injury on the health-related quality of life of adult burn survivors in Iceland and to validate the translated Icelandic version of the Burn Specific Health Scale-Brief (BSHS-B). MATERIALS AND METHODS: The participants of this descriptive cross-sectional study were all burn survivors, 18 years or older, admitted to hospital for 24 hours or more because of skin burn during a 15 years period (N=196). They completed questionnaire about their health (BSHS-B), health related quality of life (EQ-5D-5) and additional questions on burn-related symptoms and their burn experience. RESULTS: Response rate was 34% (N=66). Men were 77%, mean age 45.7 years (sf=18.3 and range 18-82 years), mean age when burned was 34.0 (sf=20,1, range 1-75), median time from burn accident was 11.5 years (range 1-44 years) and 32% had been burned when under 18 years of age. Burn-specific health was 4.4-4.0 (median) and health on the EQ5D-5vas scale was 80 (median, range 10-100). Those who lost a body part or had skin transplantation had more negative body image and needed more selfcare than others (p<). A significant proportion of participants reported physical and psychosocial symptoms such as itch (48%), persistent pain (37%), anxiety/depression (29%) and negative self-image (37%). Majority (67%) believed they did not get enough information, follow-up, or support after discharge from hospital. The Icelandic version of the Burn Specific Health Scale-Brief (BSHS-B) was reliable, but more research is needed to establish its validity. CONCLUSION: These findings suggest that most Icelandic burn survivors report acceptable health and health-related quality of life. The study identified a subgroup of survivors that experience persistent physical and psychosocial symptoms. Team approach with holistic support after discharge, for a prolonged period of time aiming at preventing physical and psychiatric morbidity, is recommended.