Effective health communication – a key factor in fighting the COVID-19 pandemic

Lavanco

2020

JCM

Corona Virus Disease-19 (COVID-19) is a catastrophic health risk, with psychological, emotional, social, and relational implications. From the early stages of the virus spread, the elderly population was identified as the most vulnerable, and health authorities have rightly focused on this frailer population. Conversely, less attention was given to the emotional and psychological dimensions of children and adolescents. Moreover, even though they were the subjects whose lives and health were at low risk, they, nevertheless, had to face a reality full of anxiety, fears, and uncertainties. The current study investigated the state of anxiety and emotional awareness in a sample of healthy older adolescents, 84 females and 64 males, aged 17 to 19, during the pandemic lockdown, using the Self-Rating Anxiety Scale and the Italian Emotion Awareness Questionnaire. An unexpected anxious phenomenology was found, affecting anxiety and the ideo-affective domain, while somatic symptomatology appeared to be less severe. The highest anxiety symptoms were breathing difficulties. These findings supported the hypothesis that the COVID-19 pandemic may be a risk condition for an increased state of anxiety in older adolescents and suggested the need to provide (1) an effective, empathic communication system with direct participation of older adolescents, (2) a psychological counseling service for the stress management of adolescents.

Section: Discussionmentioning

confidence: 99%

Anxiety in Older Adolescents at the Time of COVID-19

Lavanco

2020

JCM

“…Similarly, approximately 25% of 7143 Chinese students experienced anxiety during the COVID-19 epidemic [ 102 ]. This symptom may be even increased in subjects with CV disease and comorbidities, where mood alterations and/or lockdown may worsen lifestyle habits and cause poor therapy adherence [ 103 ].…”

Section: Covid-related Fear and Distressmentioning

confidence: 99%

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

Gorini

Chatzianagnostou

Mazzone

et al. 2020

IJERPH

Coronavirus disease 2019 (COVID-19) has quickly become a worldwide health crisis.Although respiratory disease remains the main cause of morbidity and mortality in COVID patients,myocardial damage is a common finding. Many possible biological pathways may explain therelationship between COVID-19 and acute myocardial infarction (AMI). Increased immune andinflammatory responses, and procoagulant profile have characterized COVID patients. All theseresponses may induce endothelial dysfunction, myocardial injury, plaque instability, and AMI.Disease severity and mortality are increased by cardiovascular comorbidities. Moreover, COVID-19has been associated with air pollution, which may also represent an AMI risk factor. Nonetheless,a significant reduction in patient admissions following containment initiatives has been observed,including for AMI. The reasons for this phenomenon are largely unknown, although a real decreasein the incidence of cardiac events seems highly improbable. Instead, patients likely may presentdelayed time from symptoms onset and subsequent referral to emergency departments because offear of possible in-hospital infection, and as such, may present more complications. Here, we aim todiscuss available evidence about all these factors in the complex relationship between COVID-19and AMI, with particular focus on psychological distress and the need to increase awareness ofischemic symptoms.

“…11 Because communication is an essential clinical skill, considerable scientific evidence has been produced to understand it. 12,13 There is now a sufficient body of research to inform evidence-based practice when communicating with patients and their families about difficult matters. This review aims to critically review this research and highlight its implications for clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Communicating with patients and families about difficult matters: A rapid review in the context of the COVID-19 pandemic

Ekberg

2020

Preprint

Background: Pandemics pose significant challenges for healthcare systems, including an increase in difficult discussions about future illness progression and end of life.Objectives: To synthesise existing evidence about communication practices used to discuss difficult matters, including prognosis and end of life, and to use this evidence to make recommendations for clinical practice. The aim of this study was to use rapid review methods to update findings from a previous systematic review published in 2014.Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, Web of Science, Scopus, ASSIA and Amed.Study eligibility criteria: Studies using conversation analysis or discourse analysis to examine recordings of actual conversations about difficult matters relating to future illness progression and end of life.Study appraisal and synthesis methods: Data appraisal and extraction procedures used in the 2014 review were modified for this rapid review.Results: Following screening, 18 sources were deemed to meet eligibility criteria, which were added to the 19 sources included in the 2014 systematic review. Synthesis of study findings identified 11 communication practices: providing opportunities for patient or family members to propose matters to discuss (7 out of 37 included sources); seeking a patient or family member's perspective (6/37); discussing the future indirectly (11/37); discussing the future explicitly (7/37) linking to something previously said or done (11/37); using hypothetical scenarios (13/37); framing a difficult matter as universal (5/37); acknowledging uncertainty (3/37); exploring options (2/37); displaying sensitivity (7/37); emphasising the positive (7/37).Limitations: Dividing work amongst the study authors to enable rapid review may have created inconsistencies. Conclusions and implications of key findings:This synthesis of high-quality evidence from actual clinical practice supports a series of recommendations for communicating about difficult matters during and beyond the COVID-19 pandemic. : medRxiv preprint Emphasising positive things, such as what can be done for a patient, can be useful for sustaining hope. When people are discussing difficult matters, however, starting to talk about positive things can end the difficult discussion. For this reason, consider when is the right time to move from the difficult aspects of a discussion, to the more positive dimensions. DiscussionThis rapid review has synthesised findings from studies examining difficult conversations about illness progression and end of life. The review focuses on high-quality evidence delivered by studies examining real-world conversations to understand how specific communication practices function in particular contexts. 14,17,18 Since publication of a systematic review on this topic in 2014, 19 evidence in this area has almost doubled. As reported in Box 1, the synthesis of findings from these studies has enabled the generation of 10 recommendations for clinicians who find themselves needing to discuss diff...