Project description:BackgroundThanks to recent advancement in cancer treatment, an increasing number of cancer patients are expected to live longer with cancer. The ambulatory ability is essential for cancer patients to spend their own independent lives, but locomotive syndrome (LS), a condition of reduced mobility due to impairment of locomotive organs, in cancer patients has been seldom examined.MethodsThis was a single-institutional cross-sectional study. Cancer patients receiving cancer therapy between April 2020 and March 2021 were asked to participate. LS was classified as stage 0-3, and compared with their performance status (PS). Physical component summary (PCS) and mental component summary (MCS) were calculated from the results of Short Form-8. Logistic regression analysis was performed to identify risk factors for LS stage 3.ResultsOne hundred and seventy-six cancer patients were included. The rate of LS was 96.0%. That of LS stage 3 was 40.9% and as high as 29.7% even if limited to those with PS 0. The mean PCS and MCS were both inferior to the national averages. PCS decreased as the LS stage advanced. Old age and underweight were revealed as independent risk factors for LS stage 3.ConclusionsThe ratio of LS in cancer patients was extremely high, and the LS stage correlated with physical QOL. Even those with PS 0 can have severe LS; thus, LS can be a sensitive detector of physical disability of cancer patients than PS. The improvement of LS can be a key to the preservation of their ADL and QOL.
Project description:ObjectivesTo determine the impact of coronavirus disease 2019 on burnout syndrome in the multiprofessional ICU team and to identify factors associated with burnout syndrome.DesignLongitudinal, cross-sectional survey.SettingAll adult ICUs within an academic health system.SubjectsCritical care nurses, advanced practice providers, physicians, respiratory therapists, pharmacists, social workers, and spiritual health workers were surveyed on burnout in 2017 and during the coronavirus disease 2019 pandemic in 2020.InterventionsNone.Measurements and main resultsBurnout syndrome and contributing factors were measured using the Maslach Burnout Inventory of Health and Human Service and Areas of Worklife Survey. Response rates were 46.5% (572 respondents) in 2017 and 49.9% (710 respondents) in 2020. The prevalence of burnout increased from 59% to 69% (p < 0.001). Nurses were disproportionately impacted, with the highest increase during the pandemic (58-72%; p < 0.0001) with increases in emotional exhaustion and depersonalization, and personal achievement decreases. In contrast, although burnout was high before and during coronavirus disease 2019 in all specialties, most professions had similar or lower burnout in 2020 as they had in 2017. Physicians had the lowest rates of burnout, measured at 51% and 58%, respectively. There was no difference in burnout between clinicians working in ICUs who treated coronavirus disease 2019 than those who did not (71% vs 67%; p = 0.26). Burnout significantly increased in females (71% vs 60%; p = 0.001) and was higher than in males during the pandemic (71% vs 60%; p = 0.01).ConclusionsBurnout syndrome was common in all multiprofessional ICU team members prior to and increased substantially during the pandemic, independent of whether one treated coronavirus disease 2019 patients. Nurses had the highest prevalence of burnout during coronavirus disease 2019 and had the highest increase in burnout from the prepandemic baseline. Female clinicians were significantly more impacted by burnout than males. Different susceptibility to burnout syndrome may require profession-specific interventions as well as work system improvements.
Project description:The global coronavirus disease 2019 (COVID-19) pandemic has drastically disrupted cancer care, potentially exacerbating patients' distress levels. Patients undergoing hematopoietic stem cell transplantation (HSCT) may be especially vulnerable to this pandemic stress. However, the associations of the COVID-19 pandemic with distress, fatigue, and quality of life (QoL) are not well understood in this population. In a cross-sectional analysis of data from 205 patients undergoing HSCT enrolled in a supportive care trial, we compared baseline pre-HSCT distress symptoms (depression, anxiety, and posttraumatic stress disorder [PTSD]), fatigue, and QoL between enrollees before (ie, March 2019-January 2020) and during (ie, March 2020-January 2021) the COVID-19 pandemic. We used linear regression models adjusting for sociodemographics and cancer diagnosis to examine the associations between enrollment period and patient-reported outcomes. We used semistructured qualitative interviews in 20 allogeneic HSCT recipients who were ≥3-months post-HSCT to understand the impact of the COVID-19 pandemic on their recovery post-HSCT. One hundred twenty-four participants enrolled before COVID-19, and 81 participants enrolled during the pandemic. The 2 cohorts had similar baseline demographics and disease risk factors. In multivariate regression models, enrollment during COVID-19 was not associated with pre-HSCT symptoms of depression, anxiety, PTSD, fatigue, or QoL impairment. COVID-19-era participants reported themes of negative (eg, increased isolation) and positive (eg, engagement with meaningful activities) implications of the pandemic on HSCT recovery. We found no differences in pre-HSCT distress, fatigue, or QoL in patients undergoing HSCT before or during the COVID-19 pandemic; however, patients in early recovery post-HSCT report both negative and positive implications of the COVID-19 pandemic in their lives.
Project description:IntroductionDuring the current pandemic, there has been a paucity of Greek data in terms of recording the general long-term functional status of patients after coronavirus disease 2019 (COVID-19) hospitalizations, as well as very little information regarding rehabilitation services nationwide and their utilization.Objective-designThis is a prospective cohort study, including 92 adults discharged from the Infectious Disease Unit of a third-level hospital in Greece after hospitalization with COVID-19. Demographics and disease severity data was collected upon admission and symptoms at discharge, 4 months and 1 year. Following rating of 12 common symptoms on a Likert scale, quality-of-life data and accessibility to rehabilitation services were compared among the 3 time points.ResultsAt discharge, the most prevalent complaints were fatigue, exertional dyspnoea and difficulty walking. At 4 months, these 3 remained among the most prevalent symptoms, while pain and memory/loss concentration remained at high numbers as well. Finally, at the 1-year mark, the percentages of patients reporting fatigue, exertional dyspnoea and pain were the highest. At the 4-month follow-up, only 4.3% of the study participants had visited a rehabilitation facility of any kind, whereas at the 1-year mark the percentage rose to 10.9%.ConclusionA clinically relevant number of participants experienced at least one post-COVID-19 hospitalization symptom. Quality of life was markedly affected by the longer-term effects of the disease. The percentage of people finally attending any kind of rehabilitation service was poor. With thousands more being infected and needing hospitalization nationwide daily, the need for the inclusion of relevant rehabilitation programmes in the Greek healthcare system appears imminent.
Project description:IntroductionThe coronavirus disease 2019 pandemic spurred unprecedented public health measures to curb its spread. Such measures might have negatively impacted adolescents' participation in physical activity and health-related quality of life. However, the evidence is unclear in Nigerian adolescents. This study assessed the physical activity domains, levels, and health-related quality of life in Nigerian adolescents during the coronavirus disease 2019 pandemic.MethodsThe sample consisted of 430 students in public secondary schools in Nsukka, Enugu State. The students were randomly selected to participate in the cross-sectional study between November 2020 and April 2021. The Demographic Profile Form, International Physical Activity Questionnaire, Short Form-36 Health Survey, and Perceived Susceptibility to coronavirus disease 2019 Infection Questionnaire were used for data collection. Descriptive statistics, Chi-square test, independent-samples t-test, univariate ANOVA, and multiple linear regressions were conducted using SPSS version 25.ResultsThe mean score of total physical activity (MET-min/week) was 1651.3 (SD = 842.18). The mean overall score of health-related quality of life was 78.30 (SD = 16.43). The mental health component of health-related quality of life showed that adolescents had poor mental health status. Female adolescents had higher mean scores in physical component summary (M = 83.03; SD = 27.36) and mental component summary (M = 51.19; SD = 8.69) than the male adolescents, physical component summary (M = 69.0; SD = 21.65) and mental component summary (M = 46.15; SD = 10.71).ConclusionThe findings showed a significant positive association among gender, class of study, parental type, perceived susceptibility to coronavirus disease 2019, and physical activity domains, levels, and health-related quality of life. In addition, boys had a higher mean score of total physical activity (MET-min/week) than the girls. More girls were less active than the boys. However, concerning the health-related quality of life, girls had higher mean scores in physical component summary and mental component summary than boys. Physical activity interventions that specifically target female adolescents' physical activity participation are needed. Also, mental health interventions are needed to improve the mental health status of adolescents, especially boys in the post-coronavirus disease 2019 era.
Project description:Background and aimGastrointestinal manifestations of the coronavirus disease 2019 (COVID-19) pandemic may mimic irritable bowel syndrome (IBS), and social distancing measures may affect IBS patients negatively. We aimed to study the impact of COVID-19 on respondents with self-reported IBS.MethodsWe conducted an anonymized survey from May to June 2020 in 33 countries. Knowledge, attitudes, and practices on personal hygiene and social distancing as well as psychological impact of COVID-19 were assessed. Statistical analysis was performed to determine differences in well-being and compliance to social distancing measures between respondents with and without self-reported IBS. Factors associated with improvement or worsening of IBS symptoms were evaluated.ResultsOut of 2704 respondents, 2024 (74.9%) did not have IBS, 305 (11.3%) had self-reported IBS, and 374 (13.8%) did not know what IBS was. Self-reported IBS respondents reported significantly worse emotional, social, and psychological well-being compared with non-IBS respondents and were less compliant to social distancing measures (28.2% vs 35.3%, P = 0.029); 61.6% reported no change, 26.6% reported improvement, and 11.8% reported worsening IBS symptoms. Higher proportion of respondents with no change in IBS symptoms were willing to practice social distancing indefinitely versus those who deteriorated (74.9% vs 51.4%, P = 0.016). In multivariate analysis, willingness to continue social distancing for another 2-3 weeks (vs longer period) was significantly associated with higher odds of worsening IBS.ConclusionOur study showed that self-reported IBS respondents had worse well-being and compliance to social distancing measures than non-IBS respondents. Future research will focus on occupational stress and dietary changes during COVID-19 that may influence IBS.
Project description:AimTo determine prevalence, predictors and change over time of nurses' and student nurses' mental health and well-being, and explore nurses' perceptions, barriers and enablers of well-being.DesignLongitudinal mixed-methods survey.MethodsForty-nine students and registered nurses participated from Victoria, Australia. Data were collected from December 2019 to July 2020. Validated psychometrics and free-text response questions were employed. Analysis used latent growth curve modelling, Pearson product-moment correlations and thematic analysis.ResultsA strong positive correlation was found between self-determination and work well-being, and a strong negative correlation between work well-being and flight risk. Several moderate relationships were found; a moderate positive correlation between work well-being and nurse manager ability, leadership and support, and a moderate negative correlation between burnout and staffing and resource adequacy. Collegial nurse-physician relationships deteriorated. Three themes, physical health, psychological well-being and social connection, were identified as important for nurses' well-being.
Project description:BackgroundThe prevalence of coronavirus disease 2019 (COVID-19) has endangered the psychological health of individuals. This study aimed to assess the quality of life and its related psychological problems during COVID-19 pandemic.MethodsIn this cross-sectional study, 559 citizens above the age of 16 years, in Isfahan and Bandar Abbas cities in Iran were selected with a convenient sampling method. An online questionnaire was used to collect the data, which consisted of five sections: demographic information, short health anxiety inventory (SHAI), perceived stress scale (PSS), world health organization quality of life questionnaire (WHOQOL-BREF) and Padua inventory. Data were analyzed using statistical tests including t-test, path analysis and structural equation modeling (SEM) using SPSS 24 and Amos 21 statistical software.ResultsA total of 559 subjects with the mean age of 37.34 ± 11.19 years participated in this study. Most of the participants were female (78.5%), married (71.6%) and employed (40.9%). The majority of them also had a bachelor's degree (42.9%). There were significant negative correlations between perceived helplessness (r = -.597, p = .000), perceived stress (r = -.715, p = .000), risk of disease (r = -.302, p = .000), negative effect of disease (r = -.424, p = .000), health anxiety (r = -.366, p = .000), contamination obsessions (r = -.187, p = .000) and washing compulsions (r = -.193, p = .000) with quality of life. On other hand, significant positive correlation was found between perceived self-efficacy (r = .665, p = .000) and quality of life.ConclusionsAccording to our findings, health anxiety, perceived stress and obsessive-compulsive disorder were negatively affected psychological health during COVID-19 which in turn decreased quality of life. Therefore, we suggest considering prevention and treatment of theses psychological problems to diminish the risk of reduced quality of life during COVID-19 global pandemic crisis.
Project description:This study investigated the impact of the 2019 coronavirus disease (COVID-19) pandemic on health-related quality of life (HRQoL) and psychological status among Saudi adults, and whether physical activity modifies this association. The participants were 518 adults aged ≥18 years (67.4% men). Using an online survey, data regarding demographic information, the impact of COVID-19 (assessed by the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5), HRQoL (Short Form-8), psychological distress (Depression, Anxiety and Stress Scale), and physical activity behavior (International Physical Activity Questionnaire-Short Form) were collected. The results demonstrate that adults reporting moderate or high levels of impact of COVID-19 had a lower HRQoL and higher psychological distress than adults reporting a low impact. HRQoL was higher for adults reporting any level impact (low, moderate, or high) of COVID-19 when they participated in recommended levels of physical activity (≥600 metabolic equivalent (MET)-min/week of total physical activity). Psychological distress was lower for adults reporting a high level of impact when they participated in recommended physical activity. Moderate or high levels of impact of COVID-19 were associated with a significantly lower HRQoL and higher psychological distress than the low impact of COVID-19. However, these associations were moderated by the recommended levels of physical activity.
Project description:Patient- and family-centered end-of-life care can be difficult to achieve in light of visitation restrictions and infection-prevention measures. We evaluated how the 3 Wishes Program evolved to allow continued provision of compassionate end-of-life care for critically ill patients during the coronavirus disease 2019 pandemic.DesignThis is a prospective observational study where data were collected 1 year prior to the coronavirus disease 2019 pandemic and 1 year after (from March 1, 2019, to March 31, 2021). The number of deceased patients whose care involved the 3 Wishes Program, their characteristics, and wishes were compared between prepandemic and pandemic periods.SettingSix adult ICUs of a two-hospital health system in Los Angeles.PatientsDeceased patients whose care involved the 3 Wishes Program.InterventionsThe 3 Wishes Program is a palliative care intervention in which individualized wishes are implemented for dying patients and their families.Measurements and main resultsDuring the study period, the end-of-life care for 523 patients involved the 3 Wishes Program; more patients received the 3 Wishes Program as part of their end-of-life care during the pandemic period than during the prepandemic study period (24.8 vs 17.6 patients/mo; p = 0.044). Patients who died during the pandemic compared with prepandemic were less likely to have family at the bedside and more likely to have postmortem wishes fulfilled for their families. Compared with the 736 wishes implemented during the prepandemic period, the 969 wishes completed during the pandemic were more likely to involve keepsakes. Wishes were most commonly implemented by bedside nurses, although the 3 Wishes Program project manager (not involved in the patient's clinical care) was more likely to assist remotely during the pandemic (24.8% vs 12.1%; p < 0.001).ConclusionsBedside innovations, programmatic adaptations, and institutional support made it possible for healthcare workers to continue the 3 Wishes Program and provide compassionate end-of-life care in the ICU during this pandemic.