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1.
BMC Infect Dis ; 21(1): 915, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488680

RESUMO

BACKGROUND: The aims of this study are to determine (i) SARS-CoV-2 antibody positive employees in Austrian trauma hospitals and rehabilitation facilities, (ii) number of active virus carriers (symptomatic and asymptomatic) during the study, (iii) antibody decline in seropositive subjects over a period of around 6 months, (iv) the usefulness of rapid antibody tests for outpatient screening. METHOD: A total of 3301 employees in 11 Austrian trauma hospitals and rehabilitation facilities of the Austrian Social Insurance for Occupational Risks (AUVA) participated in this open uncontrolled prospective cohort study. Rapid lateral flow tests, detecting a combination of IgM and IgM against SARS-CoV-2), two different types of CLIA (Diasorin, Roche), RT-PCR tests and serum neutralization tests (SNTs) were performed. The tests were conducted twice, with an interval of 42.4 ± 7.7 (Min = 30, Max = 64) days. Positive participants were re-tested with CLIA/SNT at a third time point after 188.0 ± 12.8 days. RESULTS: Only 27 out of 3301 participants (0.82%) had a positive antibody test at any time point during the study confirmed via neutralization test. Among positively tested participants in either test, 50.4% did not report any symptoms consistent with common manifestations of COVID-19 during the study period or within the preceding 6 weeks. In the group who tested positive during or prior to study inclusion the most common symptoms of an acute viral illness were rhinitis (21.9%), and loss of taste and olfactory sense (21.9%). Based on the neutralization test as the true condition, the rapid antibody test performed better on serum than whole blood as 84.6% instead of 65.4% could be detected correctly. Concerning both CLIA tests overall the Roche test detected 24 (sensitivity = 88.9%) and the Diasorin test 22 positive participants (sensitivity = 81.5%). In participants with a positive SNT result, a significant drop in neutralizing antibody titre from 31.8 ± 22.9 (Md = 32.0) at T1 to 26.1 ± 17.6 (Md = 21.3) at T2 to 21.4 ± 13.4 (Md = 16.0) at T3 (χ2 = 23.848, df = 2, p < 0.001) was observed (χ2 = 23.848, df = 2, p < 0.001)-with an average time of 42.4 ± 7.7 days between T1 and T2 and 146.9 ± 13.8 days between T2 and T3. CONCLUSIONS: During the study period (May 11th-August 3rd) only 0.82% were tested positive for antibodies in our study cohort. The antibody concentration decreases significantly over time with 14.8% (4 out of 27) losing detectable antibodies.


Assuntos
COVID-19 , SARS-CoV-2 , Anticorpos Antivirais , Infecções Assintomáticas , Áustria/epidemiologia , Humanos , Recursos Humanos em Hospital , Estudos Prospectivos , Estudos Soroepidemiológicos
2.
PLoS One ; 16(9): e0257002, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34506487

RESUMO

BACKGROUND: COVID-19 vaccine hesitancy seems to be universal across countries and subgroups, and so are its determinants. We studied the willingness and factors associated with the decision to be vaccinated against COVID-19 in healthcare workers (HCW) in a Spanish tertiary hospital. Furthermore, we compared the percentage of willingness to vaccinate against COVID with actual vaccination rates among HCW in our hospital. METHODS: From December 21, 2020 to January 4, 2021, before initiation of the COVID-19 HCW vaccination campaign at Germans Trias i Pujol University Hospital (HUGTiP), an anonymous self-administered questionnaire was administered to HCW. Univariate and multivariate logistic regression of the association of variables with the outcome "intention to receive the COVID-19 vaccine as soon as possible" was conducted. Vaccination rates were extracted from the hospital information systems. RESULTS: Forty-four percent of HCW included in the study declared a willingness to be vaccinated against COVID-19 as soon as possible. This was associated with male sex [1.66 (95%CI 1.13-2.43); p = 0.009], older age [1.02 (95%CI 1.00-1.03); p = 0.014], belonging to the occupational groups "physician" or "other" [5.76 (95%CI 3.44-9.63) and 2.15 (95%CI 1.25-3.70); p<0.001], respectively, and reporting influenza vaccination during the last three seasons or at least one of the last three seasons [3.84 (95%CI 2.56-5.75) and 2.49 (95%CI 1.71-3.63); p<0.001]. One in ten hospital workers reported they were unwilling to receive COVID-19 vaccination. Actual COVID-19 vaccination uptake among HCW was higher (80.4%) than the percentage of willingness to vaccinate estimated from the questionnaire. Physicians not only had the highest vaccination rate, but also the highest correlation between the reported intention to vaccinate and the final decision to receive COVID-19 vaccination. CONCLUSIONS: COVID-19 vaccination uptake was higher than previously estimated according to the stated intentions of HCW. Doubts and fears must be addressed, particularly in persons less inclined to be vaccinated: females, younger people and those not vaccinated against influenza in recent seasons. The study of barriers and strategies aimed at promoting COVID-19 vaccination must be adapted in relation to occupational groups' attitudes, understanding their idiosyncrasies with respect to this and other vaccines.


Assuntos
Atitude do Pessoal de Saúde , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Recursos Humanos em Hospital/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Inquéritos e Questionários , Centros de Atenção Terciária
3.
Pak J Biol Sci ; 24(9): 920-927, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34585544

RESUMO

<b>Background and Objective:</b> COVID-19 is a fast-spreading worldwide pandemic caused by SARS-CoV-2. The World Health Organization recommended wearing face masks. Masks have become an urgent necessity throughout the pandemic, the study's goal was to track the impact of wearing masks on immunological responses. <b>Materials and Methods:</b> This study was conducted on 40 healthy people who were working in health care at Nineveh Governorate Hospitals from September-December, 2020. They wore face masks at work for more than 8 months for an average of 6 hrs a day. The control sample included 40 healthy individuals, who wore masks for very short periods. All samples underwent immunological and physiological tests to research the effects of wearing masks for extended periods within these parameters. <b>Results:</b> The results showed a significant decrease in total White Blood Count and the absolute number of neutrophils, lymphocytes, monocytes and phagocytic activity. However, there was a significant increase in the absolute number of eosinophils in participants compared with the control. The results also suggested there were no significant differences in IgE, haemoglobin concentration and blood O<sub>2 </sub>saturation in participants who wore masks for more than 6 hrs compared to the control group. The results showed a significant increase in pulse rate in participants who wore masks for more than 6 hrs compared to the control group. The results also showed a strong correlation coefficient between the time of wearing masks and some immunological, haematological parameters. <b>Conclusion:</b> Wearing masks for long periods alters immunological parameters that initiate the immune response, making the body weaker in its resistance to infectious agents.


Assuntos
COVID-19/prevenção & controle , Exposição por Inalação/prevenção & controle , Leucócitos/imunologia , Máscaras , Exposição Ocupacional/prevenção & controle , Fagócitos/imunologia , SARS-CoV-2/patogenicidade , Adulto , Biomarcadores/sangue , COVID-19/transmissão , Estudos de Casos e Controles , Feminino , Frequência Cardíaca , Hemoglobinas/metabolismo , Humanos , Imunoglobulina E/sangue , Exposição por Inalação/efeitos adversos , Contagem de Leucócitos , Masculino , Máscaras/efeitos adversos , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Oxigênio/sangue , Recursos Humanos em Hospital , Fagocitose , Fatores de Tempo
4.
Ann R Coll Surg Engl ; 103(8): 589-598, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34464553

RESUMO

INTRODUCTION: Otolaryngology health personnel are at high risk of acquiring COVID-19 disease and, hence, are likely to have high stress levels. This study was designed to evaluate the feedback of otolaryngology healthcare workers in ENT departments who are managing patients in the coronavirus pandemic. METHODS: A questionnaire focused on all aspects of healthcare delivery was completed by otolaryngology healthcare workers. RESULTS: The findings, based on statistical analyses, included high stress levels and inadequate disease-related information in these workers. CONCLUSIONS: Healthcare authorities need to take care of issues related to mental health in healthcare professionals in addition to spreading awareness about safe practices. Further studies are needed to continuously monitor feedback from personnel as the coronavirus pandemic unravels in the future.


Assuntos
COVID-19 , Competência Clínica , Pessoal de Saúde , Otolaringologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/epidemiologia , Pandemias , Equipamento de Proteção Individual , Recursos Humanos em Hospital , Inquéritos e Questionários , Reino Unido/epidemiologia , Adulto Jovem
5.
BMJ Open ; 11(8): e049945, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-34389578

RESUMO

OBJECTIVE: Development of initiatives to reduce hospitalisations is a major focus of healthcare planning. Strengthening the community with municipal acute care teams or units is a newly implemented Danish initiative aimed at preventing hospitalisations and supporting more flexible services. This study aims to describe patients treated by a municipal acute care team and to explore patients' and caregivers' experiences with at-home treatment. DESIGN: A mixed-method study consisting of descriptive statistics of patients treated by an acute care team, and quantitative and qualitative data from follow-up telephone questionnaires with patients and caregivers. SETTING: The acute care team, 'Acute Team Odense' (ATO), in the Odense Municipality, Denmark. PARTICIPANTS: Patients treated by ATO and their caregivers. ATO treated 3231 patients (5676 contacts) in the period of 2018-2019. RESULTS: Average number of new contacts per day was 7.8, and the median treatment-length was 1 day. Patients were referred by various healthcare providers and most often by general practitioners, municipal staff and hospital staff. The median age of the patients was 80 years, and 20% were independent before the treatment. In total, 787/5676 contacts received at-home intravenous therapy, which corresponded to 3.6 hospital beds saved per day. The questionnaires were completed by 307/478 patients and 168/254 caregivers. Most respondents stated they would prefer at-home treatment in future similar situations as it enabled them to maintain their lives. Several respondents also experienced that ATO avoided hospitalisations or reduced hospital stays, which was described as a relief. CONCLUSION: ATO was frequently used, indicating the demand for community-based acute healthcare. The patients and caregivers experienced that this solution avoided hospitalisations and allowed them to maintain their lives, and this was described as less burdensome. As a result of these findings, this initiative has been continued with an ongoing focus on searching for possibilities aimed to prevent hospitalisations.


Assuntos
Cuidadores , Cuidados Críticos , Idoso de 80 Anos ou mais , Hospitalização , Humanos , Equipe de Assistência ao Paciente , Recursos Humanos em Hospital
6.
Rev Med Suisse ; 17(746): 1371-1373, 2021 Aug 04.
Artigo em Francês | MEDLINE | ID: mdl-34397184

RESUMO

During the COVID-related health crisis, many healthcare professionals felt the demands of the pandemic firsthand, presenting mainly psychological disorders. To anticipate the latter, the University Hospitals of Geneva began to offer psychological support to employees. Based on emergency psychology, a new service has been developed: proximity psychology. The support deployed within all departments enabled employees to express their difficulties in the moment and to normalize their experiences. This new role of local psychologists requires professionals who demonstrate the adaptability to meet employees where they are.


Assuntos
COVID-19 , Hospitais Universitários , Humanos , Pandemias , Recursos Humanos em Hospital , SARS-CoV-2
7.
Epidemiol Infect ; 149: e172, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34372955

RESUMO

Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is lasting for more than 1 year, the exposition risks of health-care providers are still unclear. Available evidence is conflicting. We investigated the prevalence of antibodies against SARS-CoV-2 in the staff of a large public hospital with multiple sites in the Antwerp region of Belgium. Risk factors for infection were identified by means of a questionnaire and human resource data. We performed hospital-wide serology tests in the weeks following the first epidemic wave (16 March to the end of May 2020) and combined the results with the answers from an individual questionnaire. Overall seroprevalence was 7.6%. We found higher seroprevalences in nurses [10.0%; 95% confidence interval (CI) 8.9-11.2] than in physicians 6.4% (95% CI 4.6-8.7), paramedical 6.0% (95% CI 4.3-8.0) and administrative staff (2.9%; 95% CI 1.8-4.5). Staff who indicated contact with a confirmed coronavirus disease 2019 (COVID-19) colleague had a higher seroprevalence (12.0%; 95% CI 10.7-13.4) than staff who did not (4.2%; 95% CI 3.5-5.0). The same findings were present for contacts in the private setting. Working in general COVID-19 wards, but not in emergency departments or intensive care units, was also a significant risk factor. Since our analysis points in the direction of active SARS-CoV-2 transmission within hospitals, we argue for implementing a stringent hospital-wide testing and contact-tracing policy with special attention to the health care workers employed in general COVID-19 departments. Additional studies are needed to establish the transmission dynamics.


Assuntos
COVID-19/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , Adolescente , Adulto , Idoso , Bélgica/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Feminino , Hospitais/estatística & dados numéricos , Humanos , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Fatores de Risco , Estudos Soroepidemiológicos , Inquéritos e Questionários , Adulto Jovem
9.
Acta Otolaryngol ; 141(8): 791-795, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34340651

RESUMO

BACKGROUND: Health care workers (HCW) at otorhinolaryngological departments have an increased risk of contracting COVID-19, due to aerosol-inducing diagnostic and surgical procedures in the airways. The ongoing exposure to physical and psychological stressors could impact the mental health of HCW. AIM/OBJECTIVE: To investigate the impact on mental health in an otorhinolaryngological department during the COVID-19 pandemic. MATERIALS/METHOD: Cross-sectional questionnaire study, assessing symptoms of depression (PHQ-9) and anxiety (GAD-10). Physicians, nurses, and secretaries were included at a tertiary department of otorhinolaryngology in the Capital Region of Denmark during the COVID-19 lockdown in spring 2020. RESULTS: Positive screenings for stress reactions were found in 22% for depressive symptoms and 15.5% anxiety. 27% feared becoming infected, 47% feared infecting their families in relation to work. 27% felt others were distancing from them, and 38% isolated themselves from others because of their work. Women had an odds ratio of 9.18 (CI 1.49-179) for depressive stress reactions. CONCLUSION: HCW were primarily concerned with transmitting COVID-19 to their relatives. Secondarily, there was a concern about becoming infected despite feeling adequately protected by personal protective equipment. Women were at higher risk of more severe depressive symptoms when corrected for professions.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Estresse Ocupacional/epidemiologia , Otolaringologia , Recursos Humanos em Hospital/psicologia , Adulto , COVID-19/prevenção & controle , COVID-19/psicologia , Estudos Transversais , Dinamarca , Feminino , Departamentos Hospitalares , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Centros de Atenção Terciária
10.
BMJ Open ; 11(8): e048984, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344683

RESUMO

OBJECTIVE: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases. DESIGN AND SETTING: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique. PARTICIPANTS: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers. RESULTS: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced by front-line healthcare providers working in COVID-19 wards. Healthcare workers experienced increased anxiety due to the fear of acquiring infection and transmitting it to their family members. They felt overwhelmed due to the exhaustive donning and doffing process, intense work and stigmatisation. The second theme was 'enablers supporting healthcare providers to deal with the COVID-19 pandemic'. Front liners pointed out several enabling factors that supported hospital staff including a safe hospital environment, adequate training, a strong system of information sharing and supportive management. The third theme was 'recommendations to support the healthcare workforce during the COVID-19 crisis'. Healthcare workers recommended measures to mitigate current challenges including providing risk allowance to front-line healthcare providers, preparing a backup health workforce, and establishing a platform to address the mental health needs of the healthcare providers. CONCLUSION: This study provides an initial evidence base of healthcare providers' experiences of managing patients with COVID-19 in the early stage of the pandemic and highlights measures needed to address the encountered challenges. It offers lessons for hospitals in low-income and middle-income countries to ensure a safe working environment for front-line workers in their fight against COVID-19.


Assuntos
COVID-19 , Pandemias , Humanos , Paquistão/epidemiologia , Percepção , Recursos Humanos em Hospital , Pesquisa Qualitativa , SARS-CoV-2
11.
Dtsch Med Wochenschr ; 146(16): e58-e64, 2021 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-34243217

RESUMO

BACKGROUND: Since December 27, 2020, employees of the health system in Germany have been vaccinated against the SARS coronavirus-2 with the vaccine BNT162B2. Initial observations show that especially among younger vaccinated people side effects are common. In this study, using the example of clinic employees, the self-perceived well-being after the first and second dose of the vaccine was examined. METHODS: Anonymized online questionnaire to be filled out once by all employees after the second dose of BNT162B2 was offered. The severity of side effects was queried using an ordinal numerical rating scale with values between 0 and 10. Other key data points were age, gender, and occupational group. The ability to work in the days following the injections was recorded by self-reporting. RESULTS: Data from 555 respondents were evaluated. The mean age was 40.25 years (standard deviation 12.35). 56 % of the respondents were female, 44.3 % belonged to the medical service, 42.9 % to the nursing service and 12.8 % were assigned to other professional groups with COVID-19 patient contact. Around 2 % of all employees did not experience any side effects at all. The most common side effect was pain at the injection site. Fatigue, headaches and myalgia followed with decreasing frequency. After the first dose, ¾ of the respondents said they had tolerated the vaccination well overall, after the second dose it was only half. After the first dose, over 90 % of the respondents felt that they were able to work again on the following day, after the second dose one third stated that they were only able to work again on the second day. 2.2 % of all employees had to report that they were unable to work for at least one day after the first dose and 19.5 % after the second dose. CONCLUSIONS: Vaccination with BNT162B2 frequently leads to side effects, especially after the second dose. Perception of side effects resulted in 19 % of those questioned being sick after the second dose. Nevertheless, 95 % of all respondents would choose a coronavirus vaccination again.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Recursos Humanos em Hospital , Vacinas Sintéticas/efeitos adversos , Adulto , Fatores Etários , Vacinas contra COVID-19/administração & dosagem , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos em Hospital/psicologia , Autoimagem , Fatores Sexuais , Inquéritos e Questionários , Vacinas Sintéticas/administração & dosagem
12.
Int Immunopharmacol ; 98: 107884, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34246041

RESUMO

Performing a cohort-based SARS-CoV-2 antibody assay is crucial for understanding infection status and future decision-making. The objective of this study was to examine consecutive antibody seroprevalence changes among hospital staff, a high-risk population. A two-time survey was performed in May and October 2020 for 545 hospital staff to investigate the changes in the results of the rapid kit test and chemiluminescence immunoassay (CLIA). The seroprevalence of each assay was summarized at both the survey periods. The proportion of seropositive individuals in the CLIA for each survey period and the number of confirmed COVID-19 cases in Central Fukushima were then compared. We chose 515 participants for the analysis. The proportion of IgM seroprevalence in CLIA increased from 0.19% in May to 0.39% in October, and IgG seroprevalence decreased from 0.97% in May to 0.39% in October. The proportion of IgM seroprevalence in the rapid kit test decreased from 7.96% in May to 3.50% in October, and IgG seroprevalence decreased from 7.77% in May to 2.14% in October. The IgG and IgM antibody seroprevalence among hospital staff in rural Central Fukushima decreased; the seroprevalence among hospital staff was consistent with the number of confirmed COVID-19 cases in the Central Fukushima area. Although it is difficult to interpret the results of the antibody assay in a population with a low prior probability, constant follow-up surveys of antibody titers among hospital staff had several merits in obtaining a set of criteria regarding the accuracy of measures against COVID-19 and estimating the COVID-19 infection status among hospital staff.


Assuntos
Anticorpos Antivirais/sangue , Antígenos Virais/imunologia , COVID-19/epidemiologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recursos Humanos em Hospital , Saúde da População Rural , SARS-CoV-2/imunologia , Adulto , Biomarcadores/sangue , COVID-19/diagnóstico , COVID-19/imunologia , COVID-19/virologia , Estudos de Casos e Controles , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Vigilância da População , Estudos Soroepidemiológicos , Fatores de Tempo
13.
Infect Dis Now ; 51(6): 560-563, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34245939

RESUMO

We launched a survey in April 2020 to assess the number and proportion of hospital workers infected during the first wave of the COVID-19 pandemic in France, and to assess the attributable mortality. All French hospital settings (HS) were invited to declare new cases and attributable deaths by occupation category each week. Between March 1 and June 28, 2020, participating HS accounted for 69.5% of the total number of HS workers in France, and declared 31,088 infected workers; 16 died from the infection. We estimated that 3.43% (95% CI: 3.42-3.45) of French workers in HS, and 3.97% (95% CI: 3.95-3.99) of healthcare workers were infected during the first wave. Workers in regions with a cumulative rate of hospitalized COVID-19 patients equal or above the national rate, HS other than tertiary hospitals, or occupations with frequent patient contacts were particularly impacted. Targeted prevention campaigns should be elaborated.


Assuntos
COVID-19/epidemiologia , Hospitais/estatística & dados numéricos , Pandemias , Recursos Humanos em Hospital/estatística & dados numéricos , COVID-19/mortalidade , França/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Inquéritos e Questionários
14.
Healthc Q ; 24(2): 27-32, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34297660

RESUMO

The onset of the COVID-19 pandemic in March 2020 required hospitals to respond quickly and effectively to ensure the availability of healthcare professionals to care for patients. The Ottawa Hospital in Ottawa, ON, used a five-step process to ensure organizational readiness for redeployment of regulated health professionals as and when necessary: (1) define current scopes of practice; (2) obtain discipline-specific input; (3) develop strategies based on literature review and government dictates; (4) identify potential duties; and (5) ensure support for staff. With hospital management support, this plan was readily implemented. Results are discussed in terms of operational outcomes (e.g., number and type of deployments) and staff experience. Outcomes were positive and led to recommendations for improved organizational readiness.


Assuntos
COVID-19/epidemiologia , Educação Interprofissional , Administração de Recursos Humanos em Hospitais , Planejamento Hospitalar , Humanos , Educação Interprofissional/métodos , Educação Interprofissional/organização & administração , Liderança , Ontário/epidemiologia , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital/provisão & distribuição
16.
BMC Public Health ; 21(1): 1372, 2021 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246247

RESUMO

BACKGROUND: The Nice terror attack of July 14, 2016 resulted in 84 deaths and 434 injured, with many hospital staff exposed to the attack, either as bystanders on site at the time of the attack ('bystander exposure') who may or may not have provided care to attack victims subsequently, or as care providers to victims only ('professional exposure only'). The objective of this study is to describe the impact on mental health among hospital staff by category of exposure with a particular focus on those with 'professional exposure only', and to assess their use of psychological support resources. METHOD: An observational, cross-sectional, multicenter study conducted from 06/20/2017 to 10/31/2017 among all staff of two healthcare institutions in Nice, using a web questionnaire. Collected data included social, demographic and professional characteristics; trauma exposure category ('bystanders to the attack'; 'professional exposure only'; 'unexposed'); indicators of psychological impact (Hospital Anxiety and Depression Scale); PTSD (PCL-5) level; support sought. Responders could enter open comments in each section of the questionnaire, which were processed by inductive analysis. RESULTS: 804 staff members' questionnaires were analysed. Among responding staff, 488 were exposed (61%): 203 were 'bystanders to the attack', 285 had 'professional exposure only'. The staff with 'professional exposure only' reported anxiety (13.2%), depression (4.6%), suicidal thoughts (5.5%); rates of full PTSD was 9.4% and of partial PTSD, 17.7%. Multivariate analysis in the 'professional exposure only' category showed that the following characteristics were associated with full or partial PTSD: female gender (OR = 2.79; 95% CI = 1.19-6.56, p = 0.019); social isolation (OR = 3.80; 95% CI = 1.30-11.16, p = 0.015); having been confronted with an unfamiliar task (OR = 3.04; 95% CI = 1.18-7.85; p = 0.022). Lastly, 70.6% of the staff with 'professional exposure only' with full PTSD did not seek psychological support. CONCLUSION: Despite a significant impact on mental health, few staff with 'professional exposure only' sought psychological support. Robust prevention and follow-up programs must be developed for hospital staff, in order to manage the health hazards they face when exposed to exceptional health-related events such as mass terror attacks. STUDY REGISTRATION: Ethical approval for the trial was obtained from the National Ethics Committee for Human Research (RCBID N° 2017-A00812-51).


Assuntos
Saúde Mental , Transtornos de Estresse Pós-Traumáticos , Transtornos de Ansiedade , Estudos Transversais , Feminino , Humanos , Recursos Humanos em Hospital , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia
17.
Vaccine ; 39(32): 4481-4488, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34210575

RESUMO

BACKGROUND: Healthcare professionals, because they recommend vaccines to their patients, answer their questions, and vaccinate them, are the cornerstone of vaccination in France. They can nonetheless be affected by vaccine hesitancy (VH). AIMS: We sought to study the opinions, practices, and perceptions of French hospital staff physicians (HSPs) toward vaccination and the prevalence and correlates of VH among them. METHODS: We conducted a cross-sectional survey in 14 public hospitals in France from September 2018 to October 2019. HSPs completed a standardized questionnaire -most of the time face-to-face - about their vaccine-related attitudes and practices. Data were weighted for age and sex. An agglomerative hierarchical cluster analysis of the HSPs' perceptions and opinions toward vaccination allowed us to identify vaccine-hesitant HSPs, and multiple Poisson regression with robust standard errors let us study the factors associated with VH. RESULTS: The study included 1,795 HSPs (participation rate: 86%). Almost all (93.7%) were strongly favorable to vaccination, even though 42.2% (95CI = 39.8-44.6) showed moderate VH. VH prevalence was lowest among infectious disease specialists (12.3%; 95CI = 6.7-21.3) and pediatricians (27.7%; 95CI = 21.4-35.2). Hesitant HSPs were less trustful of vaccination information sources and doubted the safety of vaccines more often than HSPs with almost no VH. Compared with non-hesitant HSPs, those with higher VH had less often taken a medical course about vaccination and were less likely to be vaccinated against seasonal influenza, to recommend vaccines to their patients and to try to convince vaccine-hesitant patients to be vaccinated. CONCLUSIONS: Strong favorability to vaccination does not prevent VH, which was observed in most specialties. Interventions are required to help hesitant HSPs to adopt more proactive vaccination practices.


Assuntos
Vacinas contra Influenza , Médicos , Estudos Transversais , França/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recursos Humanos em Hospital , Inquéritos e Questionários , Vacinação
18.
BMC Psychiatry ; 21(1): 349, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-34253168

RESUMO

BACKGROUND: Mental-somatic multimorbidity in general hospital settings is associated with long hospital stays, frequent rehospitalization, and a deterioration of disease course, thus, highlighting the need for treating hospital patients more holistically. However, there are several challenges to overcome to address mental health conditions in these settings. This study investigated hospital personnel's perceived importance of and experiences with mental-somatic multimorbidities of patients in hospital settings in Basel, Switzerland, with special consideration of the differences between physicians and nurses. METHODS: Eighteen semi-structured interviews were conducted with nurses (n = 10) and physicians (n = 8) in different hospitals located in Basel, Switzerland. An inductive approach of the framework analysis was used to develop the themes. RESULTS: Four themes emerged from the data analysis: 1) the relevance of mental-somatic multimorbidity within general hospitals, 2) health professionals managing their emotions towards mental health, 3) knowledge and competencies in treating patients with mental-somatic multimorbidity, and 4) interprofessional collaboration for handling mental-somatic multimorbidity in hospital settings.The mental-somatic multimorbidities in general hospital patients was found to be relevant among all hospital professionals, although the priority of mental health was higher for nurses than for physicians. This might have resulted from different working environments or in efficient interprofessional collaboration in general hospitals. Physicians and nurses both highlighted the difficulties of dealing with stigma, a lack of knowledge of mental disorders, the emphasis place on treating somatic disorders, and competing priorities and work availability, which all hindered the adequate handling of mental-somatic multimorbidity in general hospitals. CONCLUSION: To support health professionals to integrate mental health into their work, proper environments within general hospitals are needed, such as private rooms in which to communicate with patients. In addition, changes in curriculums and continuing training are needed to improve the understanding of mental-somatic multimorbidities and reduce negative stereotypes. Similarly, interprofessional collaboration between health professionals needs to be strengthened to adequately identify and treat mentally multimorbid patients. A stronger focus should be placed on physicians to improve their competencies in considering patient mental health in their daily somatic treatment care.


Assuntos
Hospitais Gerais , Multimorbidade , Humanos , Recursos Humanos em Hospital , Pesquisa Qualitativa , Suíça
19.
J Korean Med Sci ; 36(27): e196, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34254475

RESUMO

BACKGROUND: This is an observational study to analyze an emergency department (ED) utilization pattern of coronavirus disease 2019 (COVID-19) vaccinated in-hospital healthcare workers (HCWs). METHODS: We included 4,703 HCWs who were administered the first dose of the COVID-19 vaccine between March 4 and April 2, 2021, in a tertiary hospital in Korea where fast-track and post-vaccination cohort zone (PVCZ) were introduced in ED. We analyzed data of participants' age, sex, occupation, date and type of vaccination, and their clinical information using SPSS v25.0. RESULTS: The sample comprised HCWs, who received either the ChAdOx1 (n = 4,458) or the BNT162B2 (n = 245) vaccines; most participants were female (73.5%), and 81.1% were under 50 years old. Further, 153 (3.3%) visited the ED and reported experiencing fever (66.9%) and myalgia (56.1%). Additionally, 91 (59.5%) of them were in their 20s, and 106 (67.5%) were assigned to the PVCZ. Lastly, 107 (68.2%) of the patients received parenteral management. No patient required hospitalization. CONCLUSION: In conclusion, vaccinated HCWs who visited the ED with adverse events had a high incidence of fever and a low likelihood of developing serious illnesses. As the COVID-19 vaccination program for Korean citizens continues to expand, strategies to minimize unnecessary ED overcrowding should be put into effect.


Assuntos
Vacinas contra COVID-19/efeitos adversos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Recursos Humanos em Hospital/estatística & dados numéricos , Vacinação/efeitos adversos , Adulto , Antieméticos/uso terapêutico , Antipiréticos/uso terapêutico , Teste para COVID-19/estatística & dados numéricos , Calafrios/induzido quimicamente , Calafrios/epidemiologia , Protocolos Clínicos , Serviço Hospitalar de Emergência/organização & administração , Feminino , Febre/induzido quimicamente , Febre/tratamento farmacológico , Febre/epidemiologia , Cefaleia/induzido quimicamente , Cefaleia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia/induzido quimicamente , Mialgia/epidemiologia , Náusea/induzido quimicamente , Náusea/tratamento farmacológico , Náusea/epidemiologia , Readmissão do Paciente/estatística & dados numéricos , República da Coreia , Estudos Retrospectivos , Design de Software , Centros de Atenção Terciária/estatística & dados numéricos , Triagem , Adulto Jovem
20.
Front Public Health ; 9: 580427, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34277529

RESUMO

Background: The outbreak of Coronavirus disease (COVID-19) caused by a novel coronavirus (named SARS-CoV-2) has gained attention globally and has been recognized as a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) due to the rapidly increasing number of deaths and confirmed cases. Health care workers (HCWs) are vulnerable to this crisis as they are the first frontline to receive and manage COVID-19 patients. In this multicenter multinational survey, we aim to assess the level of awareness and preparedness of hospital staff regarding COVID-19 all over the world. Methods: From February to March 2020, the web-based or paper-based survey to gather information about the hospital staff's awareness and preparedness in the participants' countries will be carried out using a structured questionnaire based on the United States Centers for Disease Control and Prevention (CDC) checklist and delivered to participants by the local collaborators for each hospital. As of March 2020, we recruited 374 hospitals from 58 countries that could adhere to this protocol as approved by their Institutional Review Boards (IRB) or Ethics Committees (EC). Discussion: The awareness and preparedness of HCWs against COVID-19 are of utmost importance not only to protect themselves from infection, but also to control the virus transmission in healthcare facilities and to manage the disease, especially in the context of manpower lacking and hospital overload during the pandemic. The results of this survey can be used to inform hospitals about the awareness and preparedness of their health staff regarding COVID-19, so appropriate policies and practice guidelines can be implemented to improve their capabilities of facing this crisis and other future pandemic-prone diseases.


Assuntos
COVID-19 , SARS-CoV-2 , Surtos de Doenças/prevenção & controle , Humanos , Estudos Multicêntricos como Assunto , Pandemias , Recursos Humanos em Hospital , Estados Unidos
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