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1.
BMC Health Serv Res ; 20(1): 1007, 2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33148229

RESUMO

BACKGROUND: The COVID-19 has been a pandemic around the world, which affirmatively brought mental health problems to medical staff. We aimed to investigate the prevalence of anxiety in Chinese medical staff and examine the mediation effects of coping styles on the relationship between social support and anxiety. METHODS: A cross-sectional study via internet survey was conducted from 15 March to 30 March, 2020. The social demographic data, Self-rated Anxiety Scale, Social Support Rate Scale and Trait Coping Style Scale were collected. Pearson correlation and a structural equation model were performed to examine the relationships of these variables. The bootstrap analysis was conducted to evaluate the mediation effects. RESULTS: A total of 453 medical staff participated in this study. The mean score of SAS was 46.1 (SD = 10.4). Up to 40.8% of the participants had anxiety symptoms. The participants lived with family members had lower SAS score (45.1 ± 9.8 vs 49.6 ± 11.8). Social support was negatively associated with anxiety, mediated by positive coping and negative coping partially significantly with an effect size of - 0.183. CONCLUSIONS: Chinese medical staff had a high level of anxiety during the COVID-19 pandemic. Coping styles had effects on the association between social support and anxiety. Sufficient social support and training on positive coping skills may reduce anxiety in medical staff.


Assuntos
Adaptação Psicológica , Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Corpo Clínico/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Apoio Social , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Corpo Clínico/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
2.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(4): 474-479, 2020 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-32985161

RESUMO

OBJECTIVE: To investigate the psychological and behavior status of minor children of medical staff in Hubei province during the coronavirus disease 2019 (COVID-19) epidemic. METHODS: A cross-sectional questionnaire survey was conducted through WeChat from March 13 to 15, 2020, which included a general data questionnaire and Conners parental assessment questionnaire (PSQ). The questionnaires received from outside of Hubei province were excluded through IP address, and the questionnaires with answer time <150 s were also excluded. The influence of parental work status on the psychological behavior was analyzed in children of different age groups. RESULTS: A total of 391 valid questionnaires were collected, there were 207 males (52.9%) and 184 females (47.1%); 91 (23.3%) aged 3 to 6, 183 (46.8%) aged 6 to 10, and 117 (29.9%) aged 10 to 16. Both parents were medical staff in 87 participants(22.3%), one parent was medical staff in 139(35.5%) participants, and no parents were medical staff in 165 (42.2%) participants. In 3-<6 years group, there was no significant difference in the PSQ scores of the children in each factor level (all P>0.05) between children with parents as medical staff and those without. In 6-<10 years group, children with both parents as medical staff had higher hyperactivity-impulse factor score, learning problem factor score and total score than those without parents as medical staff (all P<0.05), while they had higher learning problem factor score than those with one parent as medical staff (P<0.05); the anxiety score of children with one or both parents as medical staff was higher than that of those without parents as medical staff (all P<0.05). In 10 to 16 years group, the behavior problems, learning problems, hyperactivity-impulse, more dynamic index and the total score in children with one parent as medical staff were lower than those with both parents as medical staff or without parents as medical staff (P<0.05 or P<0.01); while there were no significant differences in psychosomatic problems, anxiety factor scores between children with one parent as medical staff and other two groups (all P>0.05). CONCLUSIONS: s During COVID-19 epidemic period, the psychological and behavior status of minor children of Hubei medical staff with different ages shows differences with those without parents as medical staff, particularly in 6-<10 years and 10 to 16 year groups. It is necessary to pay attention to the psychological and behavioral status of children of medical staff in these age groups.


Assuntos
Infecções por Coronavirus , Coronavirus , Corpo Clínico , Saúde Mental , Pandemias , Pneumonia Viral , Adolescente , Betacoronavirus , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Corpo Clínico/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Inquéritos e Questionários
3.
Epidemiol Serv Saude ; 29(5): e2020277, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32997079

RESUMO

OBJECTIVE: To describe COVID-19 hospitalized health worker cases in Brazil. METHODS: This was a descriptive case series study; it included cases that became ill between February 21st and April 15th, 2020 registered on the Influenza Surveillance Information System (SIVEP-Gripe, acronym in Portuguese). RESULTS: Of the 184 cases, 110 (59.8%) were female and median age was 44 years (min-max: 23-85); 89 (48.4%) were nursing professionals and 50 (27.2%) were doctors. Ninety-two (50.0%) presented comorbidity, with heart disease predominating (n=37; 40.2%). Of the 112 professionals with a record of case progression, 85 (75.9%) were cured and 27 (24.1%) died, 18 of whom were male. CONCLUSION: The profile of COVID-19 hospitalized health workers is similar to that of the general population with regard to age and comorbidities, but different in relation to sex. The most affected areas were nursing and medicine.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Comorbidade , Infecções por Coronavirus/mortalidade , Progressão da Doença , Feminino , Cardiopatias/epidemiologia , Humanos , Masculino , Corpo Clínico/estatística & dados numéricos , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem/estatística & dados numéricos , Pandemias , Pneumonia Viral/mortalidade , Distribuição por Sexo , Fatores de Tempo , Adulto Jovem
4.
J Infect ; 81(4): 621-624, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32735893

RESUMO

BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England. METHODS: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. RESULTS: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9-4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes. CONCLUSIONS: SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises.


Assuntos
Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Corpo Clínico/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/epidemiologia , Betacoronavirus/genética , Infecções por Coronavirus/transmissão , Inglaterra/epidemiologia , Genoma Viral/genética , Humanos , Controle de Infecções/métodos , Londres/epidemiologia , Pandemias , Pneumonia Viral/transmissão , Sequenciamento Completo do Genoma
5.
Updates Surg ; 72(3): 693-700, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32816284

RESUMO

BACKGROUND: Observing cyclic patterns in surgical outcome is a common experience. We aimed to measure this phenomenon and to hypothesize possible causes using the experience of a high-volume pancreatic surgery department. METHODS: Outcomes of 2748 patients who underwent a Whipple procedure at a single high-volume center from January 2000 to December 2018 were retrospectively analyzed. Three different hypotheses were tested: the effect of climate changes, the "July effect" and the effect of vacations. RESULTS: Clavien-Dindo ≥ 3 morbidity was similar during warm vs. cold months (22.5% vs. 19.8%, p = 0.104) and at the beginning of activity of new trainees vs. the rest of the year (23.5 vs. 22.5%, p = 0.757). Patients operated when a high percentage of staff is on vacation showed an increased Clavien-Dindo ≥ 3 morbidity (22.3 vs. 18.5%, p = 0.022), but similar mortality (2.3 vs. 1.8%, p = 0.553). The surgical waiting list was also significantly longer during these periods (37 vs. 27 days, p = 0.037). Being operated in such a period of the year was an independent predictor of severe morbidity (OR 1.271, CI 95% 1.086-1.638, p = 0.031). CONCLUSION: Being operated when more staff is on vacation significantly affects severe morbidity rate. Future healthcare system policies should prevent the relative shortage of resources during these periods.


Assuntos
Pancreatectomia/métodos , Pancreatectomia/estatística & dados numéricos , Estações do Ano , Absenteísmo , Idoso , Feminino , Recursos em Saúde/estatística & dados numéricos , Humanos , Masculino , Corpo Clínico/estatística & dados numéricos , Pessoa de Meia-Idade , Morbidade , Pancreatectomia/mortalidade , Estudos Retrospectivos , Resultado do Tratamento
6.
Int J Infect Dis ; 98: 390-397, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32623086

RESUMO

RATIONALE: In 2019, a small HAdV55-associated outbreak of adenovirus infection occurred among the intensive care unit (ICU) staff in Xiangya Hospital of Central South University in Hunan Province, China, during the treatment of a patient. OBJECTIVE: To investigate the characteristics of a nosocomial adenovirus outbreak in an ICU. METHODS: We evaluated all the patients treated and the medical staff working in the ICU from August 1 to September 4, 2019. We further performed an epidemiological and molecular analysis for this outbreak from patient to healthcare workers and between healthcare workers. After the outbreak, we adopted exposure prevention and droplet prevention measures based on standard precautions. MEASUREMENTS AND MAIN RESULTS: Between August 1 and August 27, 2019, 27 cases of human adenovirus cross-infection were reported in our institution. Among the cases, eleven were doctors (41%), eleven were nurses (41%), three were respiratory therapists (11%), and two were caregivers (7%). The attack rate was 28.4%, and the fatality rate was 0. The results showed that contact with the index case, lack of hand hygiene or gloving adherence were risk factors for infection after adenovirus exposure. After taking specific precautions, no new cases of infection have appeared since August 27. CONCLUSIONS: Our results show that HAdV55 in a single patient had strong transmission potential in an intensive care unit with adequate facilities and standardized operation. We provide convincing evidence indicating that attention could be highlighted on the role of standard and specific precautions for controlling the spread of adenovirus in ICUs.


Assuntos
Infecções por Adenovirus Humanos/epidemiologia , Infecção Hospitalar/epidemiologia , Corpo Clínico/estatística & dados numéricos , Infecções por Adenovirus Humanos/prevenção & controle , Infecções por Adenovirus Humanos/virologia , Adenovírus Humanos/classificação , Adenovírus Humanos/genética , Adenovírus Humanos/isolamento & purificação , Adenovírus Humanos/fisiologia , Adulto , China/epidemiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/virologia , Feminino , Higiene das Mãos , Hospitais de Ensino/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Filogenia , Atenção Terciária à Saúde/estatística & dados numéricos , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32650614

RESUMO

INTRODUCTION: The ongoing severe acute respiratory syndrome (SARS)-CoV-2 pandemic has expanded globally. The aim of the current study is to investigate the knowledge, attitudes, and practices (KAP) of health care professionals in Greece towards SARS-CoV-2. METHODS: From 10-25 February 2020, 500 health care workers were approached. Knowledge, attitudes, and practices towards SARS-CoV-2 were assessed via a personal interview questionnaire. For knowledge, each correct answer was given 1 point; attitudes, or concerns aimed at prevention of SARS-CoV-2 infection, and practices, or behaviors towards performing preventive practices, were assigned 1 point each. Points were summed and a score for each category was calculated. RESULTS: A total of 461 health care workers returned the questionnaire and were included in the analysis (mean age ± SD: 44.2 ± 10.78 years, 74% females). The majority were nurses (47.5%), followed by physicians (30.5%) and paramedics (19%). The majority of subjects (88.28%) had a good level of knowledge (knowledge score equal to 4, or more). The majority of participants (71%) agreed with the temporary traveling restrictions ban. The uptake of a future vaccine against SARS-CoV-2 was estimated at 43%. Knowledge score was significantly associated with both attitudes score (p = 0.011) and practices score (p < 0.001), indicating that subjects with a high knowledge score demonstrated a more positive perception on preventive measures and would practice more preventive measures. Attitudes score was significantly associated with practices score (p = 0.009) indicating that subjects with a higher attitudes score are more likely to perform practices towards the prevention of SARS-CoV-2 transmission. CONCLUSION: There is a high level of knowledge concerning SARS-CoV-2 pandemic among Greek health care workers and this is significantly associated with positive attitudes and practices towards preventive health measures. The high level of knowledge of health professionals about SARS-CoV-2 may have contributed considerably to the successful management of the pandemic in Greece. Tailored educational campaigns aiming to increase the proportion of health care workers willing to accept a potential SARS-CoV-2 vaccine could be of paramount importance in future proactive vaccine educational campaigns.


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus , Conhecimentos, Atitudes e Prática em Saúde , Corpo Clínico/estatística & dados numéricos , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Feminino , Grécia , Pessoal de Saúde , Humanos , Masculino , Corpo Clínico/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Vacinas Virais
8.
Graefes Arch Clin Exp Ophthalmol ; 258(10): 2271-2274, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32567041

RESUMO

PURPOSE: To evaluate the risk of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after exposure to a COVID-19+ physician in a retina clinic. METHODS: A retrospective observational study. Records of 142 patients and 11 staff members from a single retina clinic that were exposed to a COVID-19+ ophthalmologist were reviewed. All 153 individuals were placed in quarantine for 14 days. They were contacted after the quarantine period to inquire about symptoms consistent with COVID-19, and the results of diagnostic test for SARS-CoV-2 when performed. RESULTS: All patients (n = 142) were contacted successfully. The mean age was 72.8 ± 13.6 years; 54.2% (n = 77) were females. Twenty-three patients (16.2%) were exposed during an ophthalmic exam, 111 (78.2%) during intraocular injection, 4 (2.8%) underwent exam and injection, 3 (2.1%) underwent surgery, and one patient (0.7%) had laser photocoagulation. Half of the patients (50%; n = 71) were in contact with the COVID-19+ physician while he was symptomatic. Forty-four patients (31%) wore a mask on the day of their visit. 11.3% (n = 16) of the patients, and all involved staff had been tested for the virus and all were negative. One patient (0.7%) reported transient cough and sore throat, and the remaining 141 (99.3%) patients and 11 (100%) staff did not develop symptoms. CONCLUSIONS: Low risk for SARS-CoV-2 transmission in the ophthalmic setting was observed when universal safety measures such as social distancing, meticulous hand hygiene, enlarged breath shields, and mask wear during procedures were taken.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa do Profissional para o Paciente/estatística & dados numéricos , Corpo Clínico/estatística & dados numéricos , Oftalmologistas/estatística & dados numéricos , Pneumonia Viral/transmissão , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas de Laboratório Clínico , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Quarentena , Reação em Cadeia da Polimerase em Tempo Real , Dispositivos de Proteção Respiratória , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
11.
Eur Heart J Acute Cardiovasc Care ; 9(3): 241-247, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: covidwho-133576

RESUMO

The COVID-19 pandemic is an unprecedented challenge for society. Supporting the mental health of medical staff and affiliated healthcare workers (staff) is a critical part of the public health response. This paper details the effects on staff and addresses some of the organisational, team and individual considerations for supporting staff (pragmatically) during this pandemic. Leaders at all levels of health care organisations will find this a valuable resource.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Corpo Clínico/psicologia , Saúde Mental/normas , Pneumonia Viral/psicologia , Comunicação , Infecções por Coronavirus/epidemiologia , Intervenção na Crise/organização & administração , Cuidados Críticos/psicologia , Cuidados Críticos/estatística & dados numéricos , Assistência à Saúde/organização & administração , Empoderamento , Pessoal de Saúde/estatística & dados numéricos , Humanismo , Humanos , Controle de Infecções/métodos , Relações Interpessoais , Liderança , Corpo Clínico/estatística & dados numéricos , Pandemias , Médicos/psicologia , Pneumonia Viral/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Traumático Agudo/epidemiologia , Transtornos de Estresse Traumático Agudo/psicologia
12.
Eur Heart J Acute Cardiovasc Care ; 9(3): 241-247, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32342698

RESUMO

The COVID-19 pandemic is an unprecedented challenge for society. Supporting the mental health of medical staff and affiliated healthcare workers (staff) is a critical part of the public health response. This paper details the effects on staff and addresses some of the organisational, team and individual considerations for supporting staff (pragmatically) during this pandemic. Leaders at all levels of health care organisations will find this a valuable resource.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Corpo Clínico/psicologia , Saúde Mental/normas , Pneumonia Viral/psicologia , Comunicação , Infecções por Coronavirus/epidemiologia , Intervenção na Crise/organização & administração , Cuidados Críticos/psicologia , Cuidados Críticos/estatística & dados numéricos , Assistência à Saúde/organização & administração , Empoderamento , Pessoal de Saúde/estatística & dados numéricos , Humanismo , Humanos , Controle de Infecções/métodos , Relações Interpessoais , Liderança , Corpo Clínico/estatística & dados numéricos , Pandemias , Médicos/psicologia , Pneumonia Viral/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Traumático Agudo/epidemiologia , Transtornos de Estresse Traumático Agudo/psicologia
14.
Am Surg ; 86(2): 140-145, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32167057

RESUMO

Perception of physician reimbursement for surgical procedures is not well studied. The few existing studies illustrate that patients believe compensation to be higher than in reality. These studies focus on patient perceptions and have not assessed health-care workers' views. Our study examined health-care workers' perception of reimbursement for complex surgical oncology procedures. An anonymous online survey was distributed to employees at our cancer center with descriptions and illustrations of three oncology procedures-hepatectomy, gastrectomy, and pancreaticoduodenectomy. Participants estimated the Medicare fee and gave their perceived value of each procedure. Participants recorded their perception of surgeon compensation overall, both before and after revealing the Medicare fee schedule. Most of the 113 participants were physicians (33.6%) and nurses (28.3%). When blinded to the Medicare fee schedules, most felt that reimbursements were too low for all procedures (60-64%) and that surgeons were overall undercompensated (57%). Value predictions for each procedure were discordant from actual Medicare fee schedules, with overestimates up to 374 per cent. After revealing the Medicare fee schedules, 55 per cent of respondents felt that surgeons were undercompensated. Even among health-care workers, a large discrepancy exists between perceived and actual reimbursement. Revealing actual reimbursements did not alter perception on overall surgeon compensation.


Assuntos
Gastrectomia/economia , Pessoal de Saúde/psicologia , Hepatectomia/economia , Reembolso de Seguro de Saúde/economia , Medicare/economia , Pancreaticoduodenectomia/economia , Institutos de Câncer , Honorários e Preços , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Corpo Clínico/economia , Corpo Clínico/estatística & dados numéricos , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem/economia , Recursos Humanos de Enfermagem/estatística & dados numéricos , Estados Unidos
15.
Rev Epidemiol Sante Publique ; 68(2): 125-132, 2020 Apr.
Artigo em Francês | MEDLINE | ID: mdl-32035728

RESUMO

BACKGROUND: French Guiana faces singular health challenges: poverty, isolation, structural lag, difficulties in attracting health professionals. Hospital stays exceed the recommended durations. The present study aimed to model the impact of precariousness and geographic isolation on the hospital duration performance indicator and to recalculate the indicator after incrementing severity by 1 unit when patients were socially precarious. METHODS: Cayenne hospital data for 2017 were used to model the hospital duration performance indicator (IP-DMS) using quantile regression to study the impact of geographic and social explanatory variables. This indicator was computed hypothesizing a 1 unit increment of severity for precarious patients and by excluding patients from isolated regions. RESULTS: Most excess hospitalization days were linked to precariousness: the sojourns of precarious patients represented 47% of activity but generated 71% of excess days in hospital. Quantile regression models showed that after adjustment for potential confounders, patients from western French Guiana and Eastern French Guiana, precarious patients and the interactions terms between residence location and precariousness were significantly associated with IP-DMS increases. Recalculating the IP-DMSafter exclusion of patients from the interior and after increasing severity by 1 notch if the patient was precarious led to IP-DMS levels close to 1. CONCLUSION: The results show the nonlinear relationship between the IP-DMS and geographical isolation, poverty, and their interaction. These contextual variables must be taken into account when choosing the target IP-DMS value for French Guiana, which conditions funding and number of hospital beds allowed in a context of rapid demographic growth.


Assuntos
Procedimentos Clínicos , Acesso aos Serviços de Saúde , Tempo de Internação/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Isolamento Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/normas , Procedimentos Clínicos/estatística & dados numéricos , Feminino , Guiana Francesa/epidemiologia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Corpo Clínico/organização & administração , Corpo Clínico/normas , Corpo Clínico/estatística & dados numéricos , Corpo Clínico/provisão & distribução , Pessoa de Meia-Idade , Administração em Saúde Pública/normas , Administração em Saúde Pública/estatística & dados numéricos , Encaminhamento e Consulta/organização & administração , Encaminhamento e Consulta/normas , Encaminhamento e Consulta/estatística & dados numéricos , Tempo para o Tratamento/organização & administração , Tempo para o Tratamento/normas , Tempo para o Tratamento/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
16.
J Headache Pain ; 21(1): 5, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937239

RESUMO

BACKGROUND: A previous study by our team reported the prevalence of primary headache disorders and factors associated with headache among nurses in three hospitals in North China. The aim of this cross-sectional survey was to learn more about how medical nurses in South China were affected by headache. Additionally, we determined the prevalence of headache and measured the impact of headache among doctors in mainland China for the first time. METHODS: Stratified random cluster sampling was used to select 280 physicians and 365 nurses from various departments in four hospitals in Sanya, which is one of southernmost cities in China. Information was collected on demographic data, occupational factors and headache characteristics by using a structured questionnaire. RESULTS: Among 645 medical staff, 548 (85%) responded (doctors = 240, nurses = 308). Among the medical staff, the 1-year prevalence of primary headache disorders was 50%, with 25.9% experiencing migraine and 24.1% experiencing tension-type headache (TTH). The prevalence of migraine in female doctors was higher than that in female nurses, although this difference was not significant (32.4% vs. 29.8%, P = 0.628). Multivariate analysis showed that being female and working in other specialties (Emergency Department & Radiology Department) remained independent risk factors for migraine in doctors (OR 2.314 and 3.223). In nurses, being married was a risk factor for migraine (OR 3.728), and job titles remained an independent risk factor for migraine and TTH (OR 2.294 and 4.695). Working more than 6 night-shifts per month was associated with an increased prevalence of migraine and TTH in doctors; the same was true in nurses for migraine, but not for TTH. CONCLUSION: The prevalence of primary headache disorders in both nurses and doctors is higher than that in the general population in South China. Our study shows that occupation, geography and sex may play an important role. Further, female doctors are more susceptible than female nurses to migraine. The risk factors relevant to headache that were found in this study should provide an important reference for promoting occupational health in medical staff, especially female doctors in China.


Assuntos
Transtornos da Cefaleia Primários/epidemiologia , Corpo Clínico/estatística & dados numéricos , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Prevalência , Fatores de Risco , Distribuição por Sexo , Jornada de Trabalho em Turnos/estatística & dados numéricos , Inquéritos e Questionários , Cefaleia do Tipo Tensional/epidemiologia
17.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(11): 835-839, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31826549

RESUMO

Objective: To explore the mental health status and influencing factors of medical staff after blood-borne occupational exposure, and to provide scientific basis for effective psychological intervention. Methods: From January 2017 to December 2018, 178 medical staff with blood-borne occupational exposure in three hospitals of Shandong Province were collected as the contact group, and 100 routine medical staff as the control group during the same period. Questionnaires were conducted among medical staff in the two groups, including general information questionnaire, symptom checklist 90 (SCL-90) , post-traumatic stress disorder self-rating scale (PCL-C) , coping style scale (CPS) , social support scale (SSRS) . The basic situation and mental health level of medical staff in the two groups, as well as the coping and social support status of medical staff exposed to hematogenous occupational exposure were analyzed. Relevant influencing factors. Results: The total score of SCL-90 was 1.66+0.33, 45 (38.14%) were positive, and 21 (21.00%) were positive in the control group. The difference was statistically significant (χ(2)=7.529, P<0.05) . Compared with the control group, the scores of SCL-90 somatization, obsessive-compulsive symptoms, depression, anxiety, hostility, paranoia and total scores of medical staff in the exposure group increased significantly (P<0.05) . The total PCL-C score of exposure group was 36.84+9.50, PTSD positive 47 (39.83%) and control group 13 (13.00%) . The difference was statistically significant (χ(2)=19.534, P<0.05) . Compared with the control group, PCL-C re-experience, avoidance, vigilance factor scores and total scores of medical staff in the contact group increased significantly (P<0.05) . The problem solving, help seeking and subjective support of the medical staff in the positive mental health group with blood-borne occupational exposure were significantly lower than those in the negative group, while self-blame, fantasy and withdrawal were significantly higher than those in the negative group (P<0.05) . The mental health level of medical staff with occupational exposure was negatively correlated with problem solving, help seeking and subjective support, and positively correlated with self-blame, fantasy and withdrawal (P<0.05) . Problem solving, help seeking and subjective support were protective factors of mental health (OR=2.121, 1.616, 1.371) , and self-blame and withdrawal were risk factors of mental health (OR=0.160, 0.484) . Conclusion: Medical personnel exposed to blood-borne occupational exposure are prone to psychological problems and PTSD. Solving problems, seeking help and subjective support are protective factors for mental health, while self-blame and withdrawal are risk factors for mental health.


Assuntos
Corpo Clínico , Saúde Mental , Exposição Ocupacional , Humanos , Corpo Clínico/psicologia , Corpo Clínico/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Inquéritos e Questionários
18.
Biomed Eng Online ; 18(1): 118, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31829225

RESUMO

BACKGROUND: The objective of this study was to develop a strategy to optimize medical health surveillance protocols for administrative employees using video display terminals (VDTs). A total of 2453 medical examinations were analysed for VDT users in various sectors. From these data, using Bayesian statistics we inferred which factors were most relevant to medical diagnosis of the main disorders affecting VDT users. This information was used to build an influence diagram to evaluate the time and monetary costs associated with each diagnostic test and define an optimal protocol strategy based on occupational risks. RESULTS: Musculoskeletal and ophthalmological diseases were identified as the most frequent disorders among VDT users. The Bayesian network inferred age, sleep quality, activity level, smoking and the consumption of alcohol as risk factors. The blood count was the most costly test (5.23 USD/employee) and the second most costly test in time terms (4 min/employee), yet is a diagnostic test that has little influence on the medical decision regarding an employee's capacity to perform their job. CONCLUSIONS: Current occupational health surveillance protocols for VDT users may lead to expenditure that is 54% greater than necessary. For many employees and employers, failure to perform a wide range of medical tests for occupational health surveillance purposes is subjectively perceived as a threat to health. Awareness needs to be raised of the appropriate role of different health areas, so as to optimize diagnostic efficiency on the basis of greater flexibility.


Assuntos
Terminais de Computador , Corpo Clínico/estatística & dados numéricos , Vigilância em Saúde Pública/métodos , Adulto , Feminino , Humanos , Masculino
19.
Crit Care Resusc ; 21(4): 299-302, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31778637

RESUMO

OBJECTIVE: To develop a library of delirium-suggestive words. DESIGN: Cross-sectional survey. SETTING: Single tertiary referral hospital. PARTICIPANTS: Medical, nursing and allied health staff and medical coders. MAIN OUTCOME MEASURES: Frequency of graded response on a 5-point Likert scale to individual delirium-suggestive words. RESULTS: Two-hundred and three complete responses were received from 227 survey respondents; the majority were medical and nursing staff (42.4% and 43.8% respectively), followed by allied health practitioners and medical coders (10.3% and 3.4%). Words that were "very likely" to suggest delirium were "confused/ confusion", "delirious", "disoriented/disorientation" and "fluctuating conscious state". Differences in word selection were noted based on occupational background, prior knowledge of delirium, and experience in caring for intensive care unit patients. Distractor words included in the survey were rated as "unlikely" or "very unlikely" by respondents as expected. Textual responses identified several other descriptors of delirium-suggestive words. CONCLUSION: A comprehensive repertoire of delirium-suggestive words was validated using a multidisciplinary survey and new words suggested by respondents were added. The use of natural language processing algorithms may allow for earlier detection of delirium using our delirium library and be deployed for real-time decision making and clinical care.


Assuntos
Codificação Clínica , Cuidados Críticos/normas , Delírio/diagnóstico , Idioma , Inquéritos e Questionários , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Unidades de Terapia Intensiva , Corpo Clínico/estatística & dados numéricos , Médicos/estatística & dados numéricos
20.
G Ital Nefrol ; 36(5)2019 09 24.
Artigo em Italiano | MEDLINE | ID: mdl-31580549

RESUMO

In 2017 the Italian Society of Nephrology operating in the Triveneto area investigated through a questionnaire, distributed to the various nephrological centers in the regions of Friuli Venezia Giulia, Trentino Alto Adige and Veneto, the differences concerning organizational models, choice of dialysis, creation and management of vascular access. The results emerging from the analysis of the collected data are presented.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Diálise Renal/estatística & dados numéricos , Insuficiência Renal Crônica/epidemiologia , Dispositivos de Acesso Vascular/estatística & dados numéricos , Instituições de Assistência Ambulatorial/provisão & distribução , Análise de Dados , Pesquisas sobre Serviços de Saúde , Humanos , Itália/epidemiologia , Corpo Clínico/estatística & dados numéricos , Modelos Organizacionais , Nefrologia , Diálise Peritoneal/estatística & dados numéricos , Densidade Demográfica , Prevalência , Encaminhamento e Consulta , Insuficiência Renal Crônica/terapia , Sociedades Médicas
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