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3.
J Headache Pain ; 21(1): 115, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32972360

RESUMO

BACKGROUND: Since the declaration COVID-19 as a pandemic, healthcare systems around the world have faced a huge challenge in managing patients with chronic diseases. Patients with migraine were specifically vulnerable to inadequate medical care. We aimed to investigate the "real-world" impact of COVID-19 pandemic on migraine patients, and to identify risk factors for poor outcome. METHODS: We administered an online, self-reported survey that included demographic, migraine-related, COVID-19-specific and overall psychosocial variables between July 15 and July 30, 2020. We recruited a sample of patients with migraine from headache clinic registry and via social media to complete an anonymous survey. Outcomes included demographic variables, change in migraine frequency and severity during the lockdown period, communication with treating physician, compliance to migraine treatment, difficulty in getting medications, medication overuse, symptoms of anxiety and/or depression, sleep and eating habits disturbance, screen time exposure, work during pandemic, use of traditional medicine, effect of Botox injection cancellation, and overall worries and concerns during pandemic. RESULTS: A total of 1018 patients completed the survey. Of the respondents, 859 (84.3%) were females; 733 (71.9%) were aged 20 to 40 years, 630 (61.8%) were married, and 466 (45.7%) reported working during the pandemic. In comparison to pre-pandemic period, 607 respondents (59.6%) reported increase in migraine frequency, 163 (16%) reported decrease in frequency, and 105 (10.3%) transformed to chronic migraine. Severity was reported to increase by 653 (64.1%) respondents. The majority of respondents; 626 (61.5%) did not communicate with their neurologists, 477 (46.9%) reported compliance to treatment, and 597 (58.7%) reported overuse of analgesics. Botox injections cancellation had a negative impact on 150 respondents (66.1%) from those receiving it. Forty-one respondents (4%) were infected with COVID-19; 26 (63.4%) reported worsening of their headaches amid infection period. Sleep disturbance was reported by 794 (78.1%) of respondents, and 809 (79.5%) reported having symptoms of anxiety and/or depression. CONCLUSIONS AND RELEVANCE: COVID-19 pandemic had an overall negative impact on patients with migraine. Several risk factors for poor outcome were identified. Long-term strategies should be validated and implemented to deliver quality care for patients with migraine, with emphasis on psychosocial well-being.


Assuntos
Infecções por Coronavirus/epidemiologia , Transtornos de Enxaqueca/fisiopatologia , Pneumonia Viral/epidemiologia , Uso Excessivo de Medicamentos Prescritos/estatística & dados numéricos , Adulto , Analgésicos/uso terapêutico , Ansiedade/psicologia , Betacoronavirus , Toxinas Botulínicas Tipo A/uso terapêutico , Comunicação , Depressão/psicologia , Feminino , Acesso aos Serviços de Saúde , Humanos , Internet , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/prevenção & controle , Transtornos de Enxaqueca/psicologia , Fármacos Neuromusculares/uso terapêutico , Pandemias , Relações Médico-Paciente , Fatores de Risco , Sono , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Inquéritos e Questionários , Adulto Jovem
6.
S Afr Med J ; 110(6): 461-462, 2020 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-32880552

RESUMO

Given the increasing numbers of ethical and legal issues arising from the COVID-19 epidemic, particularly in respect of patient-doctor confidentiality, doctors must explain to patients how the measures taken to combat the spread of the virus impact on their confidentiality. Patients must be reassured that doctors are ethically bound to continue to respect such confidentiality, but it should be made clear to them that doctors must also comply with the demands of the law. While the Constitution, statutory law and the common law all recognise a person's right to privacy, during extraordinary times such as the COVID-19 pandemic, confidentiality must be breached to a degree to halt the spread of the virus.


Assuntos
Confidencialidade/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Ética Médica , Relações Médico-Paciente/ética , Pneumonia Viral/epidemiologia , Confidencialidade/ética , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
9.
Rev Med Suisse ; 16(708): 1818-1821, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: mdl-32997453

RESUMO

This study focuses on the management of chronic depression at the general practitioner's office and the collaboration between general practitioner (GP)-psychiatrist. Our study's highlights two different situations: patients able to verbalize their psychological suffering and who can be directly referred to the psychiatrist and patients expressing their psychological suffering mainly by physical symptoms. GPs consider they first have to work with their patient to help them connect their somatic symptoms and their psychological suffering, which will allow them to refer their patient to the psychiatrist. If this work does not succeed, the GP remains at the forefront of medical care. Long-term support continues, where the GP sometimes ends up giving up on curing and focusing on the doctor/patient relationship.


Assuntos
Depressão/terapia , Medicina de Família e Comunidade , Clínicos Gerais , Psiquiatria , Doença Crônica/psicologia , Doença Crônica/terapia , Depressão/psicologia , Humanos , Relações Médico-Paciente , Estresse Psicológico
11.
Ann Fam Med ; 18(5): 461-462, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32928765

RESUMO

Covid-19 has rapidly changed physician-patient interaction, from hands-on to hands-off medicine. In this essay, 2 family physicians on different continents reflect on the meaning of touch in clinical practice and how virtual care is transforming this tacit aspect of patient care. Although technology enables physicians to stay in touch with patients verbally, we have lost the ability to physically touch. Traditionally, touch is central to medical practice, physical examination guides diagnosis and informs management. But the silent language of touch fulfills a deeper symbolic function, enabling physicians to acknowledge patient concerns in a tangible way. Touch expresses healing, extending beyond skin-to-skin contact to express humanity, caring, and connection. As we adapt to novel technologies, we wonder how, as family physicians, we will adapt our clinical acumen to extend our ability to connect with patients.


Assuntos
Medicina de Família e Comunidade , Relações Médico-Paciente , Telemedicina , Canadá , Humanos , Irlanda , Tato
20.
Orv Hetil ; 161(33): 1355-1362, 2020 08.
Artigo em Húngaro | MEDLINE | ID: mdl-32749235

RESUMO

INTRODUCTION: During the state of emergency caused by the coronavirus pandemic, the Doctor-patient communication training for medical students at the University of Szeged was moved online. The training is based on the method of video analysis, involving simulated patients, making online implementation extremely challenging. AIM: The study aims to present our experiences with the online training and to analyse the students' evaluations. METHOD: We used the free version of Zoom for small groups of five students, a trainer and a simulated patient. All students participated in a situation that we recorded. The viewing of the recordings was followed by group discussion. Then, the students evaluated the course using an online questionnaire. We used descriptive statistics and content analysis. RESULTS: 74.4% of the students (n = 64) completed the questionnaire. 78.1-100% of them gave a good (4) or excellent (5) evaluation for the questions. The highest average score (4.95 ± 0.21) was given to the professionalism of the trainers, the lowest was given to the choice of topic of the theoretical part (4.06 ± 1.02). The majority of the students were satisfied with the course, they would be happy to attend it again; however, in-person learning still seems to be the preferred option. CONCLUSION: The online practice was a success. In many ways, it proved to be an adequate replacement for the traditional form. The students evaluated the training similarly to those of previous years. The lack of personal contact is a limiting factor, thus, online practice should not be seen as an alternative to personal communication trainings; however, as an independent form of training, it can make a significant contribution to effective, modern education. Orv Hetil. 2020; 161(33): 1355-1362.


Assuntos
Coronavirus , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/organização & administração , Simulação de Paciente , Relações Médico-Paciente , Estudantes de Medicina/psicologia , Adulto , Competência Clínica , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias
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