Comparative analysis of COVID-19 guidelines from six countries: a qualitative study on the US, China, South Korea, the UK, Brazil, and Haiti.

BACKGROUND: In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. METHODS: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N = 55) and analyzed using content analysis. RESULTS: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country's healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. CONCLUSION: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus's spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries' response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country's communities and healthcare systems.

Gender Differences Regarding the Impact of Change in Cognitive Function on the Functional Status of Intensive Care Unit Survivors: A Prospective Cohort Study.

PURPOSE: This study aimed to identify gender differences with regard to the impact of change in cognitive function on functional status 3 months after receiving critical care. DESIGN AND METHODS: This prospective cohort study investigated 152 intensive care unit (ICU) patients. Their functional status and cognitive function were assessed using the validated Korean version of the Modified Barthel Index and Mini-Mental State Examination, respectively. Hierarchical regression was used to evaluate the impact of change in cognitive function on functional status in ICU survivors by gender. FINDINGS: The proportion of women suffering from consistent cognitive impairment was significantly higher than that of men. Women had a rate of improvement to normal cognitive function within 3 months after discharge that was higher than that of men. Functional status 3 months after discharge was significantly lower for patients whose cognitive impairment was consistent than that for those whose cognitive function was normal. The impact of change in cognitive function on men (R2 change = .28) was greater than that on women (R2 change = .13). CONCLUSIONS: Persistent cognitive impairment after critical illness had a negative effect on functional status in ICU survivors. Importantly, the negative impact of consistent cognitive impairment was greater in men than in women. CLINICAL RELEVANCE: Early careful assessment of functional and cognitive status after critical illness is warranted. Strategies addressing the gender-specific characteristics related to cognitive improvement should also be developed.

The relationship between professional communication competences and nursing performance of critical care nurses in South Korea.

BACKGROUND: Ineffective communication of critical care nurses can lead to higher levels of burnout and negatively affect quality of patient care and patient outcomes such as higher mortality. AIM: The purpose of this study is to describe the relationship between professional communication competences and nursing performance of critical care nurses in South Korea. METHOD: This cross-sectional study collected data on 197 intensive care unit staff nurses in 3 tertiary academic medical centres in South Korea from July to November 2014. RESULTS: In the hierarchical regression analysis, the professional communication competences were the only significant predictors of nursing performance after adjusting for sociodemographic characteristics. In addition, the greater professional communication competences of nurses were associated with being older and having a higher education level, more years of overall clinical and intensive care unit experience, and a higher monthly salary. CONCLUSION: Our findings indicate that communication skills-related training should be included in the practical education to improve nursing performance for the quality of intensive care. Further research is needed to identify the comprehensive factors on professional communication competences of nurses in intensive care units.