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《Clinical therapeutics》2020,42(11):2124-2133
PurposeThis study determined the predictors of caregivers' willingness to accept an accelerated regulatory process for the development of vaccines against coronavirus disease 2019 (COVID-19).MethodsAn international cross-sectional survey was administered to 2557 caregivers of children in 17 pediatric emergency departments (EDs) across 6 countries from March 26, 2020, to June 30, 2020. Caregivers were asked to select 1 of 4 choices with which they most agreed regarding a proposed COVID-19 vaccine–approval process, in addition to questions regarding demographic characteristics, the ED visit, and attitudes about COVID-19. Univariate analyses were conducted using the Mann–Whitney U test for comparing non–normally distributed continuous variables, an independent t test for comparing normally distributed continuous variables, and a χ2 or Fisher exact test for categorical variables. Multivariate logistic regression analysis was used for determining independent factors associated with caregivers' willingness to accept abridged development of a COVID-19 vaccine. A P value of <0.05 was considered significant.FindingsAlmost half (1101/2557; 43%) of caregivers reported that they were willing to accept less rigorous testing and postresearch approval of a new COVID-19 vaccine. Independent factors associated with caregivers' willingness to accept expedited COVID-19 vaccine research included having children who were up to date on the vaccination schedule (odds ratio [OR] = 1.72; 95% CI, 1.29–2.31), caregivers' concern about having had COVID-19 themselves at the time of survey completion in the ED (OR = 1.1; 95% CI, 1.05–1.16), and caregivers' intent to have their children vaccinated against COVID-19 if a vaccine were to become available (OR = 1.84; 95% CI, 1.54–2.21). Compared with fathers, mothers completing the survey were less likely to approve of changes in the vaccine-development process (OR = 0.641; 95% CI, 0.529–0.775).ImplicationsLess than half of caregivers in this worldwide sample were willing to accept abbreviated COVID-19 vaccine testing. As a part of an effort to increase acceptance and uptake of a new vaccine, especially in order to protect children, public health strategies and individual providers should understand caregivers' attitudes toward the approval of a vaccine and consult them appropriately. 相似文献
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《The Journal for Nurse Practitioners》2023,19(3):104513
BackgroundThe COVID-19 pandemic placed a spotlight on health care workers as the world struggled with mental health crises. As the number of COVID-19 cases rose exponentially, this also paralleled health care workers’ perceived stress burden and increased risk for mental health trauma. This research project assessed the impact of a mobile mindful meditation application on health care workers’ perceived stress levels during a pandemic.MethodologyThrough quasi-experimental design, researchers assessed the effect of using a mobile mindful meditation (Synctuition) app on health care workers’ stress levels. Participants listened for 20 to 30 minutes daily for 30 days. Participants perceived stress levels were measured with Cohen’s Perceived Stress Scale.ResultsOf the 100 participants, there was a statistically significant decrease in perceived stress reduction between the groups across various categories. The pretest perceived stress scores were reduced from moderate to low stress postintervention after using the mindful meditation application.Implications for PracticeReducing stress in health care workers can potentially increase the quality of life for health care workers. and lowering stress levels can potentially improve the quality of care provided. 相似文献
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《Journal of emergency nursing》2023,49(5):755-764
IntroductionThere was a significant decrease in emergency department encounters during the COVID-19 pandemic. Our large urban emergency department observed decreased encounters and admissions by youths with chronic health conditions. This study aimed to compare the frequency of emergency department encounters for certain young adults before the pandemic and during the COVID-19 pandemic.MethodsA retrospective cohort study using medical records of patients ages 20 to 26 years from October 2018 to September 2019 and February 2020 to February 2021. Files set for inclusion were those with a primary diagnosis of human immunodeficiency virus, diabetes mellitus, epilepsy, cerebral palsy, sickle cell disease, asthma, and certain psychiatric disorders for potentially preventable health events.ResultsWe included 1203 total encounters (853 before the pandemic and 350 during the pandemic), with the total number of subjects included in the study 568 (293 before the pandemic to 239 during the pandemic). During the pandemic, young adults with mental health conditions (53.1%) accounted for most encounters. Encounters requiring hospital admissions increased from 27.4% to 52.5% during the pandemic, primarily among patients with diabetes (41.8% vs 61.1%) and mental health conditions (50% vs 73.3%).DiscussionThe number of young adults with certain chronic health conditions decreased during COVID-19, with encounters for subjects with mental health conditions increasing significantly. The proportion of admissions increased during the pandemic with increases for subjects with mental health disorders and diabetes. The number of frequent users decreased during COVID-19. Future research is needed to understand better the causes for these disparities in young adults with chronic conditions who use the emergency department as a source of care. 相似文献
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Ali Jasem Buabbas Sarah Ebraheem Albahrouh Hesham N. Alrowayeh Hamza Alshawaf 《Medical principles and practice》2022,31(2):156
ObjectivesThis study aimed to explore satisfaction and attitudes of patients towards the use of telerehabilitation during the COVID-19 pandemic and to report the experience of physical therapists (PTs) with the use of telerehabilitation.Subjects and MethodsA modified Telemedicine Satisfaction and Usefulness Questionnaire was used to assess the satisfaction and attitudes of musculoskeletal patients who had received telerehabilitation services during the COVID-19 pandemic. Face-to-face semi-structured interviews were conducted with eight PTs to explore their experiences with telerehabilitation, including difficulties and benefits.ResultsOut of 53 patients who received telerehabilitation, 46 questionnaires were completed, with a response rate of 86.8%. In general, the patients were satisfied with and had positive attitudes towards the telerehabilitation services. The majority (89.2%) of the patients felt more involved in their care via telerehabilitation and a majority (93.5%) believed that video call sessions were a convenient form of telerehabilitation during the COVID-19 pandemic. Seven out of 8 PTs reported benefits of telerehabilitation (i.e., reduced patients'' waiting lists and improved access to physical therapy care). Also, they were in favour of continuing using telerehabilitation to support the conventional physical therapy care, despite the lack of technological infrastructure.ConclusionThe patients as well as the PTs were generally satisfied with their telerehabilitation experiences. Using telerehabilitation in Kuwait was favoured as an adjunct method during and after the COVID-19 pandemic. However, with extensive training, optimal allocation of resources, and the development of local guidelines, telerehabilitation would become an effective mean for the health delivery system in Kuwait. 相似文献
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《Seminars in Oncology Nursing》2022,38(4):151257
ObjectivesSince March 2020, the severe acute respiratory syndrome coronavirus-2 pandemic has affected the global community, but poses unique challenges for individuals with cancer. Patients diagnosed with hematologic malignancies undergo aggressive therapies followed by hematopoietic cell transplantation (HCT) as a potential curative treatment. HCT recipients can be immunocompromised for extended periods of time, and even pre-pandemic, transplant patients reported depression and anxiety due to restrictions and infection prevention measures they had to adhere to as part of transplant precautions. This study aimed to understand psychological distress and capture perspectives on coping strategies and access to healthcare in the HCT population during the COVID-19 pandemic.Data SourcesAdult patients who received a transplant or were awaiting transplant and had a scheduled appointment at the transplant clinic were eligible to participate in this cross-sectional study. Participants completed an online survey that included questionnaires, clinical data and demographic information.ConclusionFifty-four participants completed the survey. HCT participants reported relatively high psychological distress during the initial phase of the COVID-19 pandemic, but indicated use of healthy coping mechanisms to deal with stress.Implication for Nursing PracticeStudy data informs healthcare providers that psychological distress and mental health warrants increased attention during periods of heightened stress. Education and resources on healthy, beneficial coping strategies should be provided to support HCT patients. Nurses and advanced nurse practitioners are well poised to interact with HCT patients and provide necessary support or appropriate referral during routine clinical interactions, preparing patients for prolonged effects of the pandemic and similar future events. 相似文献
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Emily L. Morrow Nirav N. Patel Melissa C. Duff 《Archives of physical medicine and rehabilitation》2021,102(6):1075-1083
ObjectivesTo identify the consequences of the coronavirus 2019 (COVID-19) pandemic for individuals with traumatic brain injury (TBI), with particular attention to unique effects for individuals with chronic disability.DesignIndividuals with and without a history of TBI completed a web-based survey.SettingParticipants were recruited from the Vanderbilt Brain Injury Patient Registry in Nashville, TN, and completed the survey from their homes between May and June 2020, during social distancing related to the COVID-19 pandemic.ParticipantsParticipants (N=47) in the chronic phase of moderate-severe TBI (>6mo postinjury) and 51 noninjured comparison (NC) peers completed the survey.InterventionsNot applicable.Main Outcome MeasuresParticipants, or respondents, answered a mix of multiple choice and free text questions about how the COVID-19 pandemic has affected their work, education, medical care, social communication, sources of information and decision making, and mental and physical well-being. Individuals with TBI also answered questions about how TBI has affected their experiences of the pandemic.ResultsAs a group, respondents with TBI reported less pandemic-related behavior change (eg, daily habits, virtual social visits, and masking) than NC peers. Both NCs and respondents with TBI identified health care providers as trusted sources of public health information. One-third of individuals with TBI indicated that brain injury has made coping with the pandemic more difficult, and respondents identified mental health challenges and social isolation as key barriers.ConclusionsThese results suggest that health care providers should look for ways to provide tailored education and reduce social isolation for individuals with disability during the ongoing COVID-19 pandemic. We discuss several direct suggestions from participant responses. 相似文献
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Andrew J. Houtenville Shreya Paul Debra L. Brucker 《Archives of physical medicine and rehabilitation》2021,102(7):1420-1423
ObjectiveUsing data from the monthly Current Population Survey, this paper provides monthly employment and unemployment statistics for people with and without disabilities in the United States before and during the coronavirus disease 2019 pandemic to date (January 2021).DesignCross-sectional analysis of the Current Population Survey.SettingThe United States.ParticipantsPeople with and without disabilities ages 16-64 years.InterventionN/AMain Outcome MeasuresPercentage employed, percentage unemployed, percentage not in labor force, percentage on temporary layoff, percentage looking for work.ResultsEstimates show that, like workers without disabilities, workers with disabilities experienced increases in unemployment at the beginning of the pandemic but continued to remain engaged in the labor force. Our analysis finds that employment rates dropped from 74.8% to 63.2% for those without disabilities and from 31.1% to 26.4% for those with disabilities between February 2020 and April 2020 but gradually improved in the succeeding months.ConclusionsAs the pandemic continued, the percentage of unemployed people with and without disabilities on temporary layoff decreased and those looking for work increased. 相似文献
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Case-Mix Adjustment and Enabled Reporting of the Health Care Experiences of Adults With Disabilities
Susan E. Palsbo Guoqing Diao Gregory A. Palsbo William F. Rosenberger Margaret F. Mastal 《Archives of physical medicine and rehabilitation》2010,91(9):1339-1346
Palsbo SE, Diao G, Palsbo GA, Tang L, Rosenberger WF, Mastal MF. Case-mix adjustment and enabled reporting of the health care experiences of adults with disabilities.
Objectives
To develop activity limitation clusters for case-mix adjustment of health care ratings and as a population profiler, and to develop a cognitively accessible report of statistically reliable quality and access measures comparing the health care experiences of adults with and without disabilities, within and across health delivery organizations.Design
Observational study.Setting
Three California Medicaid health care organizations.Participants
Adults (N = 1086) of working age enrolled for at least 1 year in Medicaid because of disability.Interventions
Not applicable.Main Outcome Measures
Principal components analysis created 4 clusters of activity limitations that we used to characterize case mix. We indentified and calculated 28 quality measures using responses from a proposed enabled version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. We calculated scores for overall care as the weighted mean of the case-mix adjusted ratings.Results
Disability caused a greater bias on health plan ratings and specialist ratings than did demographic factors. Proxy respondents rated care the same as self-respondents. Telephone and mail administration were equivalent for service reports, but telephone respondents tended to offer more positive global ratings. Plan-level reliability estimates for new composites on shared decision making and advice on healthy living are .79 and .87, respectively. Plan-level reliability estimates for a new composite measure on family planning did not discriminate between health plans because respondents rated all health plans poorly. Approximately 125 respondents per site are necessary to detect group differences.Conclusions
Self-reported activity limitations incorporating standard questions from the American Community Survey can be used to create a disability case-mix index and to construct profiles of a population's activity limitations. The enabled comparative report, which we call the Assessment of Health Plans and Providers by People with Activity Limitations, is more cognitively accessible than typical CAHPS report templates for state Medicaid plans. The CAHPS Medicaid reporting tools may provide misleading ratings of health plan and physician quality by people with disabilities because the mean ratings do not account for systematic biases associated with disability. More testing on larger populations would help to quantify the strength of various reporting biases. 相似文献15.
《Nurse Leader》2022,20(3):306-315
This project used the Council Health Survey to evaluate the effectiveness of shared governance councils in a children’s hospital during the COVID-19 pandemic. A SWOT analysis was performed to assess the organization’s strengths, weaknesses, opportunities, and threats regarding council health and to inform strategies to sustain the shared governance environment. The well-established shared governance infrastructure allowed the organization to rapidly pivot council operations to sustain nurse engagement while balancing the unprecedented staffing and resource challenges of the pandemic. Organizations must remain flexible and innovative to maintain an environment supportive of nurse empowerment and shared governance during public health emergencies. 相似文献
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《The journal of pain》2014,15(5):507-515
Chronic widespread pain (CWP) is a common and potentially debilitating disorder. Patterns of physical activity (PA) in adults with CWP have primarily been investigated using subjective, self-report measures. The current study sought to characterize PA among community-dwelling individuals with CWP, chronic regional pain, or no chronic pain using objective measurements obtained via accelerometry in the 2003 to 2004 National Health and Nutrition Examination Survey. Data from 3,952 participants ages 20 and older were analyzed to assess relationships between pain status and objective measurements of PA. Prevalence of CWP was 3.3% and 5.4% in men and women, respectively. In men and women, the average activity counts per minute and time spent in moderate-to-vigorous PA were significantly lower for the CWP group than for the no chronic pain group. Interestingly, time spent in sedentary, light, and lifestyle activities was not associated with pain status. Statistical interaction tests indicated that the effects of chronic pain on counts per minute were stronger in men than in women. Despite recommendations for increased moderate-to-vigorous PA as a pain management strategy for CWP, results from this nationally representative study indicate that adults with CWP participate in less moderate-to-vigorous PA than individuals without chronic pain.PerspectiveUsing objective measurement of PA in a nationally representative sample, this study demonstrates that adults with CWP participate in reduced daily and moderate-to-vigorous PA in comparison to people with no chronic pain. Findings indicate that clinicians should emphasize the importance of increasing PA in patients with CWP. 相似文献
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Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation
《Archives of physical medicine and rehabilitation》2022,103(9):1874-1882
Health care delivery shifted and adapted with the COVID-19 pandemic caused by the novel severe acute respiratory syndrome coronavirus 2. Stroke care was negatively affected across the care continuum and may lead to poor community living outcomes in those who survived a stroke during the ongoing pandemic. For instance, delays in seeking care, changes in length of stays, and shifts in discharge patterns were observed during the pandemic. Those seeking care were younger and had more severe neurologic effects from stroke. Increased strain was placed on caregivers and public health efforts, and community-wide lockdowns, albeit necessary to reduce the spread of COVID-19, had detrimental effects on treatment and recommendations to support community living outcomes. The American Congress of Rehabilitation Medicine Stroke Interdisciplinary Special Interest Group Health and Wellness Task Force convened to (1) discuss international experiences in stroke care and rehabilitation and (2) review recently published literature on stroke care and outcomes during the pandemic. Based on the findings in the literature, the task force proposes recommendations and interdisciplinary approaches at the (1) institutional and societal level; (2) health care delivery level; and (3) individual and interpersonal level spanning across the care continuum and into the community. 相似文献
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Daniel R. Tilden Karishma A. Datye Daniel J. Moore Benjamin French Sarah S. Jaser 《Diabetes care》2021,44(6):1447
OBJECTIVEWe compared the uptake of telemedicine for diabetes care across multiple demographic groups during the coronavirus disease 2019 pandemic to understand the impact of telemedicine adoption on access to care.RESEARCH DESIGN AND METHODSThe study analyzed demographic information of patients with type 1 diabetes seen between 1 January 2018 and 30 June 2020 at a single center. We compared the odds of completing a visit via telemedicine across multiple demographic characteristics.RESULTSAmong 28,977 patient visits, the odds of completing a visit via telemedicine were lower among non-English-speaking (1.7% vs. 2.7%; adjusted odds ratio [aOR] 0.45, 95% CI 0.26–0.79) and Medicaid-insured (32.0% vs. 35.9%; aOR 0.83, 95% CI 0.72–0.95) pediatric patients. No clinically significant differences were observed for other demographic factors.CONCLUSIONSRapid transition to telemedicine did not significantly impact access to diabetes care for most demographic groups. However, disparities in access to care for historically marginalized groups merit close attention to ensure that use of telemedicine does not exacerbate these inequities. 相似文献
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《Archives of physical medicine and rehabilitation》2022,103(7):1379-1386
ObjectiveThe current study examined health care disruptions and use of telehealth services among people with multiple sclerosis (pwMS) during the COVID-19 pandemic.DesignCross-sectional survey.SettingGeneral community.ParticipantsParticipants (N=163) included 70 pwMS and 93 healthy controls (HCs). The majority of respondents were from the United States (88%).InterventionsNot applicable.Main Outcome MeasuresRates of health care disruptions (eg, missing/canceling appointments, experiencing delays) and telehealth use for MS and non-MS medical care and mental health care.ResultsIn this U.S. majority, predominantly White, and high socioeconomic status sample, 38% to 50% of pwMS reported experiencing disruptions in their MS and non-MS medical care and 20% to 33% reported disruptions in their mental health care; this was significantly lower than the rates observed among HCs. Compared with HCs, pwMS were more likely to use telehealth than in-person services, especially for mental health care. The majority of pwMS and HCs reported being satisfied with telehealth services. Individuals with higher degrees of functional limitation experienced more health care disruptions and were more likely to use telehealth services than individuals with lower degrees of functional limitation.ConclusionsDespite high health care disruption rates, pwMS frequently used and were highly satisfied with telehealth services during the COVID-19 pandemic. Due to physical limitations commonly observed in the MS population that may preclude travel, telehealth services should be continued even after resolution of the pandemic to expand access and reduce health care disparities. 相似文献