Communication in the ICU during the COVID-19 pandemic.
Ontology highlight
ABSTRACT:
SUBMITTER: Barreras-Espinoza JA
PROVIDER: S-EPMC8459910 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ContextIn the name of public safety, a general suspension on hospital visiting was imposed in the U.K., prohibiting family and friends to visit hospitalized patients, even if they were critically ill.Objectiveswe aimed to assess the impact of the FLT on the communication with patients' family and friends (PFF), especailly around end-of-life care, and their interaction with CC clinicians.MethodsA retrospective, mixed-methods analysis of a family liaison team (FLT) formed by redeployed clinicians in critical care (CC) during the first surge of the 2020 COVID 19 pandemic.ResultsThe FLT was constituted predominantly of non-ICU consultants (30/39, 77%). Following two one-hourly webinars around basic communication skills, the FLT facilitated over 12,000 video and telephone calls with 172 patients' family and friends (PFF). The majority of the PFF interviewed were mostly, very or extremely satisfied with the frequency, ease, understanding, honesty, completeness, and consistency of the information provided. Approximately 5% of the interviewees reported to be slightly or very dissatisfied in one or more of the following 3 categories: frequency, consistency, and ease of getting the information. The thematic analysis identified 3 themes: 1) being there with/ for the patient; 2) breakdown in communication; 3) disbelief at the speed of deterioration. In 14.9% of cases there was documented discrepancy between the information transmitted by the CC team and that by the FLT, particularly around the severity of the patient's illness and their imminent death.ConclusionThe formation of a dedicated FLT was feasible and associated with high levels of satisfaction by the PFF. Friction was created when communication was not consistent and did not convey the severity of the patient's condition, to prepare the PFF for a bad outcome.
| S-EPMC8057931 | biostudies-literature
Project description:BackgroundDuring COVID-19 pandemic, visits have been prohibited in most French ICUs. Psychological effects, for reference persons (RPs), of remote-only communication have been assessed.MethodsAll RPs of patients referred to ICU for COVID-19 were included. HADS, IES-R, and satisfaction were evaluated at admission, discharge/death, and 3 months. At 3 months, a psychologist provided a qualitative description of RPs' psychological distress.ResultsEighty-eight RPs were included. Prevalence of anxiety and depression was 83% and 73% respectively. At 3 months, lower HADS decrease was associated with patient death/continued hospitalization, and/or sleeping disorders in RPs (p < 0.01). Ninety-nine percent RPs felt the patient was safe (9 [7; 10]/10 points, Likert-type scale), confident with caregivers (10 [9; 10]/10 points), and satisfied with information provided (10 [9; 10]/10 points). All RPs stressed the specific-type of "responsibility" associated with being an RP in a remote-only context, leading RPs to develop narrow diffusion strategies (67%) and restrict the array of contacted relatives to a very few and/or only contacting them rarely. 10 RPs (30%) related the situation to a prior traumatic experience.ConclusionRPs experienced psychological distress and reported that being an RP in a remote-only communication context was a specific responsibility and qualified it as an overall negative experience.Trial registrationNCT04385121 . Registered 12 May 2020. https://clinicaltrials.gov/ .
| S-EPMC7794617 | biostudies-literature
Project description: Not available
| S-BSST1055 | biostudies-other
Project description:To understand and analyse the global impact of COVID-19 on outpatient services, inpatient care, elective surgery, and perioperative colorectal cancer care, a DElayed COloRectal cancer surgery (DECOR-19) survey was conducted in collaboration with numerous international colorectal societies with the objective of obtaining several learning points from the impact of the COVID-19 outbreak on our colorectal cancer patients which will assist us in the ongoing management of our colorectal cancer patients and to provide us safe oncological pathways for future outbreaks.
| 2346925 | ecrin-mdr-crc
Project description:ObjectivesTo describe the short term ability of Australian intensive care units (ICUs) to increase capacity in response to heightened demand caused by the COVID-19 pandemic.DesignSurvey of ICU directors or delegated senior clinicians (disseminated 30 August 2021), supplemented by Australian and New Zealand Intensive Care Society (ANZICS) registry data.SettingAll 194 public and private Australian ICUs.Main outcome measuresNumbers of currently available and potentially available ICU beds in case of a surge; available levels of ICU-relevant equipment and staff.ResultsAll 194 ICUs responded to the survey. The total number of currently open staffed ICU beds was 2183. This was 195 fewer (8.2%) than in 2020; the decline was greater for rural/regional (18%) and private ICUs (18%). The reported maximal ICU bed capacity (5623) included 813 additional physical ICU bed spaces and 2627 in surge areas outside ICUs. The number of available ventilators (7196) exceeded the maximum number of ICU beds. The reported number of available additional nursing staff would facilitate the immediate opening of 383 additional physical ICU beds (47%), but not the additional bed spaces outside ICUs.ConclusionsThe number of currently available staffed ICU beds is lower than in 2020. Equipment shortfalls have been remediated, with sufficient ventilators to equip every ICU bed. ICU capacity can be increased in response to demand, but is constrained by the availability of appropriately trained staff. Fewer than half the potentially additional physical ICU beds could be opened with currently available staff numbers while maintaining pre-pandemic models of care.
| S-EPMC8661872 | biostudies-literature
Project description:How do people balance concerns for general health and economic outcomes during a pandemic? And, how does the communication of this trade-off affect individual preferences? We address these questions using a field experiment involving around 2000 students enrolled in a large university in Italy. We design four treatments where the trade-off is communicated using different combinations of a positive framing that focuses on protective strategies and a negative framing which refers to potential costs. We find that positive framing on the health side induces students to give greater relevance to the health dimension. The effect is sizeable and highly effective among many different audiences, especially females. Importantly, this triggers a higher level of intention to adhere to social distancing and precautionary behaviors. Moreover, irrespective of the framing, we find a large heterogeneity in students' preferences over the trade-off. Economics students and students who have directly experienced the economic impact of the pandemic are found to give greater value to economic outcomes.
| S-EPMC8437286 | biostudies-literature
Project description:While Twitter has grown popular among political leaders as a means of computer-mediated mass media communication alternative, the COVID-19 pandemic required new strategies for socio-political communication to handle such a crisis. Using the case of India, which was one of the worst-hit countries and is also the world's largest democracy, this research explicates how political leaders responded to the COVID-19 crisis on Twitter during the first wave as it was the first time such a crisis occurred. Theoretical frameworks of discursive leadership and situational crisis communication theory have been used to analyze interactions based on the usage patterns, the content of communication, the extent of usage in relation to the severity of the crisis, and the possible role of leaders' position along with the status of their political party. The sample consisted of tweets posted by six prominent political leaders in India across the four consecutive lockdown periods from 25th March to 31st May 2020. A total of 4,158 tweets were scrapped and after filtering for retweets, the final dataset consisted of 2,809 original tweets. Exploratory data analysis, sentiment analysis, and content analysis were conducted. It was found that the tweets had an overall positive sentiment, an important crisis management strategy. Four main themes emerged: crisis management information, strengthening followers' resilience and trust, reputation management, and leaders' proactiveness. By focusing on such discursive aspects of crisis management, the study comprehensively highlights how political interactions on twitter integrated with politics and governance to handle COVID-19 in India. The study has implications for the fields of digital media interaction, political communication, public relations, and crisis leadership.
| S-EPMC8740330 | biostudies-literature
Project description:Background:Brazil faces some challenges in the battle against the COVID-19 pandemic, including: the risks for cross-infection (community infection) increase in densely populated areas; low access to health services in areas where the number of beds in intensive care units (ICUs) is scarce and poorly distributed, mainly in states with low population density. Objective:To describe and intercorrelate epidemiology and geographic data from Brazil about the number of intensive care unit (ICU) beds at the onset of COVID-19 pandemic. Methods:The epidemiology and geographic data were correlated with the distribution of ICU beds (public and private health systems) and the number of beneficiaries of private health insurance using Pearson's Correlation Coefficient. The same data were correlated using partial correlation controlled by gross domestic product (GDP) and number of beneficiaries of private health insurance. Findings:Brazil has a large geographical area and diverse demographic and economic aspects. This diversity is also present in the states and the Federal District regarding the number of COVID-19 cases, deaths and case fatality rate. The effective management of severe COVID-19 patients requires ICU services, and the scenario was also dissimilar as for ICU beds and ICU beds/10,000 inhabitants for the public (SUS) and private health systems mainly at the onset of COVID-19 pandemic. The distribution of ICUs was uneven between public and private services, and most patients rely on SUS, which had the lowest number of ICU beds. In only a few states, the number of ICU beds at SUS was above 1 to 3 by 10,000 inhabitants, which is the number recommended by the World Health Organization (WHO). Conclusions:Brazil needed to improve the number of ICU beds units to deal with COVID-19 pandemic, mainly for the SUS showing a late involvement of government and health authorities to deal with the COVID-19 pandemic.
| S-EPMC7427679 | biostudies-literature
Project description:The main objective of this study is to offer and evaluate an interim triage approach for patients waiting for surveillance colonoscopies. This will reduce the waiting period and the psychological stressors for our patients and from a scientific point of view allow us to compare the yield of findings for each approach.
| 2383510 | ecrin-mdr-crc
Project description:ObjectiveTo assess the impact of the COVID-19 pandemic on the activity of a tertiary fertility service and compare telemedicine and face-to-face meetings during this time.MethodsThis was a retrospective cohort study conducted in a university affiliated tertiary medical center. Included were patients scheduled for an appointment in the in-vitro fertilization (IVF) unit between March 18th and April 15th. A comparison was made between patients who chose telemedicine as opposed to face-to-face meetings. Additionally, the population of patients who chose to cancel their appointment was characterized. IVF cycle outcomes were additionally compared between the groups.ResultsOverall, 90 IVF clinic appointments were scheduled during the study period. Thirty-four (37.8 %) patients chose to arrive to the clinic in spite of the COVID 19 pandemic and partial quarantine, 27 (30.0 %) patients chose to avoid in person meeting and scheduled a telemedicine appointment and 29 (32.2 %) patients cancelled their appointment. On comparison between patients who chose telemedicine vs. face-to-face meeting, the telemedicine group had lower prevalence of primary infertility (20.0 % vs. 47.1 %, p = 0.037) and higher rates of preimplantation genetic testing indication for in-vitro fertilization (48.2 % vs. 20.6 %, p = 0.026). Rate of a first-ever clinic visit was higher in patients that arrived for a face-to-face meeting, as compared to telemedicine encounter (55.9 % vs. 28.0 %, respectively; p = 0.036). Patients that opted to avoid attending the clinic or meeting via telemedicine had higher rates of medical comorbidities compared to patients who chose to attend their appointment (51.7 % vs. 29.5 %, p = 0.016). Rate of appointments that led to fresh or frozen-thawed embryo transfer and these transfers' outcomes (clinical pregnancy rate) were similar in the telemedicine and face-to-face meeting groups (72.2 % vs. 88.0 % and 30.8 % vs. 31.8 %, p = 0.73 and p = 1.00; respectively).ConclusionTelemedicine is a valuable tool for delivering fertility care during the COVID-19 pandemic. There is need to determine which patients will benefit most from this modality.
| S-EPMC7968226 | biostudies-literature