COVID-19 has had a negative impact on family caregivers, whether the care receivers lived with the caregiver, in a separate community home, in supportive living, or in long-term care. This qualitative study examines the points of view of family caregivers who care in diverse settings. Family caregivers were asked to describe what could have been done to support them during the COVID-19 pandemic and to suggest supports they need in the future as the pandemic wanes. Thorne’s interpretive qualitative methodology was employed to examine current caregiver concerns. Thirty-two family caregivers participated. Family caregivers thought the under-resourced, continuing care system delayed pandemic planning, and that silos in health and community systems made caregiving more difficult. Family caregivers want their roles to be recognized in policy, and they cite the need for improvements in communication and navigation. The growth in demand for family caregivers and their contributions to the healthcare system make it critical that the family caregiver role be recognized in policy, funding, and practice.
Background While family caregivers provide 70-90% of care for people living in the community and assist with 10-30% of the care in congregate living, most healthcare providers do not meaningfully involve family caregivers as partners in care. Recent research recommends that the healthcare workforce receive competency-based education to identify, assess, support, and partner with family caregivers across the care trajectory. Objective This paper reports a mixed-methods evaluation of a person-centered competency-based education program on Caregiver-Centered Care for the healthcare workforce. Methods This foundational education was designed for all healthcare providers and trainees who work with family caregivers and is offered free online (caregivercare.ca). Healthcare providers from five healthcare settings (primary, acute, home, supportive living, long-term care) and trainees in medicine, nursing, and allied health were recruited via email and social media. We used the Kirkpatrick-Barr health workforce training evaluation framework to evaluate the education program, measuring various healthcare providers’ learner satisfaction with the content (Level 1), pre-post changes in knowledge and confidence when working with family caregivers (Level 2), and changes in behaviors in practice (Level 3). Results Participants were primarily healthcare employees (68.9%) and trainees (21.7%) and represented 5 healthcare settings. Evaluation of the first 161 learners completing the program indicated that on a 5-point Likert scale, the majority were satisfied with the overall quality of the education (Mean(M) = 4.69; SD = .60). Paired T-tests indicated that out of a score of 50, post-education changes in knowledge and confidence to work with family caregivers was significantly higher than pre-education scores (pre M = 38.90, SD = 6.90; post M = 46.60, SD = 4.10; t(150) = − 16.75, p < .0001). Qualitative results derived from open responses echoed the quantitative findings in satisfaction with the education delivery as well as improvements in learners’ knowledge and confidence. Conclusion Health workforce education to provide person-centered care to all family caregivers is an innovative approach to addressing the current inconsistent system of supports for family caregivers. The education program evaluated here was effective at increasing self-reported knowledge and confidence to work with family caregivers.
Introduction. The incidence of COVID-19 continues to rise rapidly worldwide, leading to significant socio-economic damage to health and economic systems.Objective. To determine the effectiveness of intravenous immunoglobulin G (IVIG) in combination with a basic therapy in severe COVID-19.Materials and methods. A retrospective cohort study of 8 case histories of patients with severe COVID-19 for the period from 27.08.2020 to 20.03.2021 was conducted in the intensive care unit (ICU) of the infectious diseases department of the Municipal Non-Profit Enterprise «Kyiv City Clinical Hospital №17» (MNE KCCH №17).Results and discussions. During the period from 27.08.20 to 20.03.21 in the intensive care unit (ICU) of the infectious department of the Municipal Non-Profit Enterprise «Kyiv City Clinical Hospital №17» (MNE KCCH №17) there were 163 patients, of whom 79 died and the mortality rate was 48.4%. The mean age of patients was 63.5 ± 12.9 years (19 to 95 years). The mean age of death was 66.9 ± 9.9 years (40 to 87 years).During the study period, 8 patients received IVIG (5%) together with a basic therapy. The mean age of patients was 51.4 ± 14.7 years (from 29 to 69 years). Mortality among patients receiving IVIG was 37.5%.Conclusions. Mortality of patients who received IVIG in addition to a basic therapy was significantly lower compared to patients who received only basic therapy, 37.5% and 48.4%, respectively.
Optimizing heath care services for seniors in emergency departments (ED) is a core component of the "Senior Friendly Hospital Approach" being implemented in Quebec. We measured the availability of geriatric expertise in Quebec EDs and its relationship with ED characteristics such as university affiliation, number of stretchers, and geographical location.We surveyed (2013)(2014) head nurses and head physicians at 116 adult, non-psychiatric Quebec EDs. We defined high level of availability in the three following components of geriatric expertise: 1) geriatric care coordinatioN = a designated clinician coordinating the care of older adults available every day; 2) multidisciplinarity = 4 or 5 different nonmedical professionals, i.e., specialized nurse, social worker, occupational therapist, physiotherapist, and pharmacist, available almost always/often (nursereported); and 3) geriatric consultation = a specialist or a general practitioner specialized in geriatrics available almost always/often (physician-reported). We performed descriptive analyses and Fisher's exact test.Among participating EDs (N = 83), 73 (88%) nurses and 67 (81%) physicians participated in the survey. 18% of EDs had high level of geriatric care coordination, 41% provided high level of multidisciplinarity, and 33% received high level of geriatric consultation. We found that EDs that had greater number of stretchers were more likely to have high level of geriatric care coordination (p < .05) and consultation (p < .001). EDs in metropolitan areas were also more likely to receive high level of geriatric consultation (p < .01). High level of multidisciplinarity was not associated with any ED characteristics.2/5 of Quebec EDs provide high level of multidisciplinarity varying in their characteristics, whereas smaller and non-metropolitan EDs lack geriatric care coordination and consultation.There is a need for reorganisation and finding innovative ways to use existing human resources in Quebec EDs. Background: Use of potentially inappropriate medication (PIMs) in the hospitalized elderly can lead to adverse drug events, and contribute to geriatric syndromes. PIMs are frequently prescribed to elderly hospitalized patients, indicating the need to develop strategies to reduce their use. A Pharmacist-Physician Intervention Model Using a Computerized Alert System to Reduce High-Risk Medication Use in Elderly Inpatients Objectives:To assess 1) the applicability of a pharmacistphysician intervention model to reduce the use of highrisk medications and 2) the clinical relevance of the alerts generated by a computerized alert system (CAS). Methods:The study was conducted in patients aged 65 or older admitted to a teaching hospital between April and June 2014. In the intervention model, the pharmacist determined the clinical relevance of the CAS alerts, analyzed the patient's pharmacotherapy, and elaborated a geriatric pharmacotherapeutic plan to be discussed with the treating physician. The alerts were based on the Beers criteria. The main outcome was the change...
The article substantiates of the clinical relevance problem of HPV-associated chronic cervicitis in reproductive age women. The study used modern diagnostic methods for this disease. The article based an analysis of the literature and our own observations, we studied some methods of treatment of HPV-associated cervicitis and made a clinical comparison of the use of suppositories and proteflazide alcohol solution, combined therapy of inozine pranobex with simultaneous local ectocervix destruction (laser vaporization) as part of complex treatment and relapse prevention of this pathology in reproductive age women. The effectiveness of therapy of 80 reproductive age patients with verified chronic cervicitis against the background of high oncogenic risk papillomavirus infection and the results of complex treatment were analyzed.Key words: Human papillomavirus infection, cervicitis, diagnosis, antiviral therapy, complex treatment.
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