What Is the Role of Pharmacists in Treating COVID-19 Patients? The Experiences and Expectations of Front Line Medical Staff.
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ABSTRACT:
SUBMITTER: Jia X
PROVIDER: S-EPMC8720774 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThis research analyses the relations between anxiety symptoms from the network perspective to deepen the understanding of anxiety in front-line medical staff during the COVID-19 pandemic and can also provide a reference for determining potential goals of clinical interventions.MethodsA convenience sampling was adopted, and the Generalized Anxiety Disorder 7-item scale (GAD-7) was administered to front-line medical staff through online platforms. A regularized partial correlation network of anxiety was constructed and then we evaluated its accuracy and stability. The expected influence and predictability were used to describe the relative importance and the controllability, using community detection to explore community structure. The gender-based differences and the directed acyclic graph were implemented.ResultsThe connections between A1 "Feeling nervous, anxious or on edge" and A2 "Not being able to stop or control worrying", A6 "Becoming easily annoyed or irritable" and A7 "Feeling afraid as if something awful might happen", etc., were relatively strong; A2 "Not being able to stop or control worrying" and A3 "Worrying too much about different things" had the highest expected influence, and A2 "Not being able to stop or control worrying" had the highest predictability. The community detection identified two communities. The results of the gender network comparison showed the overall intensity of the anxiety network in women was higher than that in men; DAG indicated that A2 "Not being able to stop or control worrying" had the highest probabilistic priority; the lines from A2 "Not being able to stop or control worrying" to A1 "Feeling nervous, anxious or on edge" and A2 "Not being able to stop or control worrying" to A7 "Feeling afraid as if something awful might happen" represented the most important arrows.ConclusionThere exist broad interconnections among anxiety symptoms of front-line medical staff on the GAD-7. A2 "Not being able to stop or control worrying" might be the core symptom and a potential effective intervention target. It was possible to bring an optimal result for the entire GAD symptom network by interfering with A2 "Not being able to stop or control worrying". GAD may have two "subsystems". The modes of interconnection among anxiety may be consistent between genders.
| S-EPMC10452648 | biostudies-literature
Project description:BackgroundThe 2019 coronavirus disease (COVID-19) pandemic is a public health emergency of international concern and poses a challenge to the mental health and sleep quality of front-line medical staff (FMS). The aim of this study was to investigate the sleep quality of FMS during the COVID-19 outbreak in China and analyze the relationship between mental health and sleep quality of FMS.MethodsFrom February 24, 2020 to March 22, 2020, a cross-sectional study was performed with 543 FMS from a medical center in Western China. A self-reported questionnaire was used to collect data anonymously. The following tests were used: The Self-Rating Anxiety Scale (SAS) for symptoms of anxiety, the Beck Depression Inventory (BDI) for depressive symptoms, and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality assessment.ResultsOf the 543 FMS, 216 (39.8%) were classified as subjects with poor sleep quality. Anxiety (P<0.001), depression (P<0.001), and the prevalence of those divorced or widowed (P<0.05) were more common in FMS with poor sleep quality than in participants with good sleep quality. The FMS exhibiting co-occurrence of anxiety and depression were associated with worse scores on sleep quality than those medical staff in the other three groups/categories. The difference in sleep quality between the FMS with only depression and the FMS experiencing co-occurrence of anxiety and depression was statistically significant (P<0.05). However, there was no significant difference in sleep quality between the FMS experiencing only anxiety and the FMS with co-occurrence of anxiety and depression (P > 0.05).ConclusionsDuring the COVID-19 pandemic, there was a noteworthy increase in the prevalence of negative emotions and sentiments among the medical staff, along with poor overall sleep quality. We anticipate that this study can stimulate more research into the mental state of FMS during outbreaks and other public health emergencies. In addition, particular attention must be paid to enhance the sleep quality of FMS, along with better planning and support for FMS who are continuously exposed to the existing viral epidemic by virtue of the nature of their profession.
| S-EPMC8224907 | biostudies-literature
Project description:BackgroundThe environment for medical education in Iraq has been difficult for many years. The 2003 invasion of Iraq accelerated a steady emigration of faculty and graduates. Kidnappings and deaths of doctors became commonplace. To understand current career plans, expectations and perceptions of medical students, three Baghdad medical schools were surveyed.MethodsWritten questionnaires were completed by 418 medical students variously in their 4th, 5th and 6th (final)years of training. We asked about perceptions of the quality of their medical education, the quality of health services in Iraq generally, and about deaths, injuries and migration of faculty, classmates and family.ResultsThe average age of students was 22 years, with 59% women. Most students (90%) were originally from Baghdad. Although there were some positive responses, many students (59%) rated the overall quality of their medical education as fair or poor. Three-fourths of students believed the quality of hospital care in Iraq to be only fair or poor. A majority of students (57%) stated they were thinking frequently or all the time about leaving Iraq after graduation. Reasons given for leaving included the desire for further education, seeking a better lifestyle and fleeing conflict. Leading reasons for staying included the pull of friends and family, familiarity with the health system, and a sense of responsibility to the country. Nearly one in five (18%) students reported the death of a family member attributable to intentional violence, and 15% reported the violent death of a medical school classmate or faculty member since the 2003 invasion. Half the students reported at least one school faculty members had left Iraq because of the war.ConclusionMedical students hold a mediocre view of the quality of their medical education and of Iraq's health system. Many of their faculty members have left the country. The majority of students may leave Iraq after graduation, afforded the opportunity. This poses a significant problem for staffing an already demoralized and stressed health system. Current circumstances suggest the situation will continue to deteriorate.
| S-EPMC5870482 | biostudies-literature
Project description:BackgroundDespite the increased visibility of transgender and gender diverse (TGD) people, little is known about their interactions with pharmacists and pharmacy staff while accessing care from the pharmacies.ObjectivesThe objective of this study was to explore the experiences and expectations of the TGD people regarding their interactions with pharmacists and pharmacy staff in Queensland, Australia.MethodsThis study is situated in a transformative paradigm and utilized narrative inquiry to conduct semi-structured interviews with TGD participants. An interview guide based on the relevant literature and the constructs of the Theoretical Framework of Accessibility was developed. Purposive and snowball sampling was used to recruit people who identified as TGD and had previously visited pharmacies to access care. Depending on participants' preferences, interviews were conducted face-to-face or via phone or Zoom application. Interviews were recorded, transcribed, and organized in chronological stories. Data were analyzed to derive themes from the participant stories.ResultsA total of 22 participants (transwomen = 11, transmen = 8, non-binary trans masculine = 3) were interviewed. Two major themes were identified, (1) Challenges of accessing care from the pharmacy and (2) Making the most of the interactions between TGD people and pharmacists. Major challenges of accessing care from pharmacies included anticipated anxiety of accessing care, healthcare system constraints, compromised privacy and confidentiality at the pharmacy, and being challenged about their gender. Many avoided interacting with pharmacists and staff or kept their interactions minimal. Participants recognized that pharmacists play a meaningful role in TGD health and provided insights about how pharmacists can improve care provision to TGD people.ConclusionCultural and pharmacotherapeutic education in transgender health are crucial for Australian pharmacists and staff to provide inclusive, respectful, and person-centered care to TGD people.
| S-EPMC9634356 | biostudies-literature
Project description:OBJECTIVE:This study sought to quantitatively characterize medical students' expectations and experiences of an electronic health record (EHR) system in a hospital setting, and to examine perceived and actual impacts on learning. METHODS:Medical students from July to December 2016 at a tertiary pediatric institution completed pre- and postrotation surveys evaluating their expectations and experience of using an EHR during a pediatric medicine rotation. Survey data included past technology experience, EHR accessibility, use of learning resources, and effect on learning outcomes and patient-clinician communication. RESULTS:Students generally reported high computer self-efficacy (4.16 ± 0.752, mean ± standard deviation), were comfortable with learning new software (4.08 ± 0.771), and expected the EHR to enhance their overall learning (4.074 ± 0.722). Students anticipated the EHR to be easy to learn, use, and operate, which was consistent with their experience (pre 3.86 vs. post 3.90, p = 0.56). Students did not expect nor experience that the EHR reduced their interaction, visual contact, or ability to build rapport with patients. The EHR did not meet expectations to facilitate learning around medication prescribing, placing orders, and utilizing online resources. Students found that the EHR marginally improved feedback surrounding clinical contributions to patient care from clinicians, although not to the expected levels (pre 3.50 vs. post 3.17, p < 0.01). CONCLUSION:Medical students readily engaged with the EHR, recognized several advantages in clinical practice, and did not consider their ability to interact with patients was impaired. There was widespread consensus that the EHR enhanced their learning and clinician's feedback, but not to the degree they had expected.
| S-EPMC6221827 | biostudies-other
Project description:BackgroundThe outbreak of Coronavirus Disease 2019 (COVID-19) has been raising global anxiety and fear to the real or perceived health threat from the virus. This study aimed to investigate the psychological impacts and depression in the front-line non-medical workers in Wuhan, the first and the worst hit place by COVID-19.MethodsA total of 191 front-line non-medical workers in Wuhan were recruited by online survey. The Positive and Negative Affect Schedule (PANAS), the Stress Reaction Questionnaire (SRQ) and the Patient Health Questionnaire-9 (PHQ) were used.ResultsThe results showed that 50.3% (96) participants reported the clinically significant symptoms of depression. Among them, 33.0% (63) participants were with mild depression, 10.5% (20) participants with moderate depression, 5.8% (11) with moderately severe depression, and 1.0% (2) with severe depression. Participants with depression tend to be post-90 s (the generation born after 1990s), females, with increased levels of stress reactions, increased negative affects, but lower positive affects compared to these without depression. The stepwise logistic regression analysis revealed that post-90 s (β = 0.908, P = 0.016), the emotional reaction (β = 0.122, P = 0.005) and physical reaction (β = 0.124, P = 0.020) in SQR were significant independent responsible for the development of depression.ConclusionThe findings of the present study suggest the targeted psychological intervention measures should be developed to improve the mental health of non-medical workers on the front-line of COVID-19 epidemic, especially the females and younger individuals.
| S-EPMC7365080 | biostudies-literature
Project description:BackgroundThe coronavirus disease 2019 (COVID-19) pandemic is having a well-documented impact on the mental health of front-line health and social care workers (HSCWs). However, little attention has been paid to the experiences of, and impact on, the mental health professionals who were rapidly tasked with supporting them.AimsWe set out to redress this gap by qualitatively exploring UK mental health professionals' experiences, views and needs while working to support the well-being of front-line HSCWs during the COVID-19 pandemic.MethodMental health professionals working in roles supporting front-line HSCWs were recruited purposively and interviewed remotely. Transcripts of the interviews were analysed by the research team following the principles of reflexive thematic analysis.ResultsWe completed interviews with 28 mental health professionals from varied professional backgrounds, career stages and settings across the UK. Mental health professionals were motivated and driven to develop new clinical pathways to support HSCWs they perceived as colleagues and many experienced professional growth. However, this also came at some costs, as they took on additional responsibilities and increased workloads, were anxious and uncertain about how best to support this workforce and tended to neglect their own health and well-being. Many were professionally isolated and were affected vicariously by the traumas and moral injuries that healthcare workers talked about in sessions.ConclusionsThis research highlights the urgent need to consider the mental well-being, training and support of mental health professionals who are supporting front-line workers.
| S-EPMC8007934 | biostudies-literature
Project description:ObjectivesThis study aimed to investigate the presence of perceived stressors, psychological safety and teamwork in healthcare professionals. As the timeframe for this study spanned the first wave of the COVID-19 pandemic, data were captured demonstrating the impact of the pandemic on these factors.DesignQualitative interview study.SettingAll staff working within the emergency and critical care departments of one National Health Service Trust in London, UK.ParticipantsForty-nine participants were recruited using a purposive sampling technique and interviewed when the first wave of the COVID-19 pandemic had subsided.Main outcome measuresEvaluation of changes in perceived stressors, psychological safety and teamwork in individuals working during the COVID-19 pandemic.ResultsThe thematic analysis relating to a participant's lived experiences while working during COVID-19 led to the construction of five key themes, including 'psychological effects' and 'changes in team dynamics'. Several psychological effects were described, including the presence of psychological distress and insights into the aetiology of moral injury. There was marked heterogeneity in participants' response to COVID-19, particularly with respect to changes in team dynamics and the perception of a psychologically safe environment. Descriptions of improved team cohesiveness and camaraderie contrasted with stories of new barriers, notably due to the high workload and the impact of personal protective equipment. Building on these themes, a map of key changes arising due to the pandemic was developed, highlighting potential opportunities to provide targeted support.ConclusionsWorking on the front line of a pandemic can have significant implications for healthcare workers, putting them at risk of psychological distress and moral injury, as well as affecting team dynamics. There is striking heterogeneity in the manifestation of these challenges. Team leaders can use the themes and qualitative data from this study to help identify areas for management focus and individual and team support.
| S-EPMC8719006 | biostudies-literature
Project description:ObjectiveTo identify challenges faced by Australian hospital healthcare staff during the COVID-19 pandemic.MethodsWe conducted an online survey (30 June-15 August 2020) of healthcare staff from Australian emergency and infectious disease departments. Participants were contacted via professional organisations and asked about preparedness, personal protective equipment (PPE), information flow, patient care, infection concerns, workload and mental health. We calculated the proportion of answers to yes/no and Likert-style questions; free-text responses were analysed thematically.ResultsRespondents (n = 162) were 23-67 years old, 98% worked in EDs, 68% were female, 87% from Queensland, and most worked as nurses (46%) or specialists (31%). Respondents felt their workplace was prepared for the pandemic (79%), had sufficient information about PPE (83%); none were sent home because of PPE shortages. Eighty-five percent received sufficient information from official bodies and 50% were aware of the National COVID-19 Clinical Evidence Taskforce guidelines. Most (83%) had sufficient information to provide optimal patient care, but 24% experienced unfair/abusive patient behaviour. Most (76%) were concerned about becoming infected by patients, 67% about infecting patients, and 78% about infecting someone at home. Workload decreased for 82% but 42% looked after more patients. Fifty-seven percent experienced additional work-related stress: 60% reporting experiencing anxiety and 53% experiencing burnout, with 36% and 46% continuing to experience these, respectively. Key challenges included: emotional, workplace/organisational, family/loved ones and PPE factors.ConclusionThe Australian system provided sufficient information and PPE. Staff experienced considerable stress, infection concerns and emotional challenges, which merit consideration in preparing for the future.
| S-EPMC9111308 | biostudies-literature
Project description:BackgroundPharmacists in many countries have long been involved in some aspect of assisted dying. Since 2016, when Canada enacted legislation permitting medical assistance in dying (MAiD), the number of patients seeking the procedure has increased yearly. Despite the global nature of pharmacists' involvement, little is known about how they experience MAiD practice.ObjectiveTo study how pharmacists experience the practice of caring for patients who seek MAiD.MethodsThis qualitative study used semistructured interviews with pharmacists who had cared for patients seeking MAiD. Interviews, conducted between June 2019 and October 2020, were audio-recorded and transcribed verbatim. Data were examined using a modified framework analysis approach. Data were coded and sorted using Quirkos and Microsoft Excel software. Themes were defined through an iterative process involving constant comparison.ResultsNineteen hospital pharmacists representing a range of practice settings in Alberta participated in the study. The experience of caring for patients seeking assistance in dying brought to light 3 themes: finding a place in the process, serving in a caring role, and bearing emotional burdens. Pharmacists' experiences were personal, relational, emotional, and dynamic.ConclusionsEach of the pharmacists experienced MAiD practice in a unique way. Although their roles in MAiD were primarily medication-focused, their experiences highlighted the centrality of patient choices, autonomy, and needs. The results of this study will inform pharmacists (including those not yet engaged in MAiD practice) about the role, and will also be valuable for pharmacy organizations and educators seeking to support pharmacists and the profession, as well as policy-makers seeking to expand pharmacists' roles in MAiD.
| S-EPMC9524557 | biostudies-literature