12 de jul. 2020

Alert: health care professionals and stress impact during the COVID-19

Healthcare professionals (HCPs) on the front lines against COVID-19 may face increased workload, and stress. Understanding HCPs’ risk for burnout is critical to supporting HCPs and maintaining the quality of healthcare during the pandemic.

Large numbers of healthcare professionals (HCPs) on the frontlines against COVID-19 face high adversity, workloads, and stress, making them vulnerable to burnout.
  • Burnout: Defined as emotional exhaustion, depersonalization, and low personal achievement, is known to detract from optimal working capacities, It has been found to be driven by high job stress, high time pressure and workload, and poor organizational support.

We present a preprint article: Factors Contributing to Healthcare Professional Burnout During the COVID-19 Pandemic: A Rapid Turnaround Global Survey (2020)

Method: To assess exposure, perceptions, workload, and possible burnout of HCPs during the COVID-19 pandemic the authors conducted a cross-sectional survey.

The main outcomes and measures were HCPs’ self-assessment of burnout and other experiences and attitudes associated with working during the COVID-19 pandemic.

Results: Burnout was associated with:
  • Work impacting household activities
  • Feeling pushed beyond training
  • Exposure to COVID-19 patients
  • Making life prioritizing decisions
  • Lack of adequate personal protective equipment (PPE)
  • Limited organizatins support
Implications: Athough the results have multiple limitations including a non-validated questionnaire, minimal demographic data collection, and sampling method using social media the institutions should put the emphasis in support these individuals as they face enormous stress that can negatively impact their emotional and physical well-being.

Some actions that proactively instituions should do:
  • Develop a resilience training: resilience refers to an individual’s ability to handle stress and recover quickly from the effects of adversity
  • Cut drastically the belief of  HCP feeling that their organization doesn’t value their well-being.
  • HCPs should feel secure knowing that management care about them and the management are doing as much as possible to handle with the adverse situation
  • Support for HCPs’ families,
  • Provide PPE,
  • Provide mental health resources

photo: Life

3 de maig 2020

Florence Nightingale bicentenary 2020

Florence Nightingale "the Lady of the Lamp" was born on May 12, 1820, in Florence. This 2020 the worldwide celebrates of Florence Nightingale’s bicentenary. In her honour The World Health Organisation have named 2020 the Year of the Nurse and Midwife.

Despite family pressures to marry and live as a conventional wealthy woman, she considered her dedication to nursing to be a response to the call of God to care for the sick. Her success in radically lowering the death rate of wounded soldiers in the Crimean War led to society’s acceptance of her proposals for better sanitation and nutrition, accurate medical knowledge, and professionally trained nurses.

While Nightingale is best known worldwide for revolutionising nursing and healthcare through her campaigning for health reform, her far-reaching recommendations were based on impressive statistical work and popularised through pioneering data visualisation and her evidence-based approach to healthcare.

Florence Nigthtingale was the first female fellow in 1858 from Royal Statistical Society. The Significance magazine from Royal Statistical Society and American Statistical Association has published a special issue: Significance magazine, 2020, Volume 17, Issue 2: Florence Nightingale

More information:
Celebrating Nightingale 2020 Bicentenary
Mujeres con ciencia: Florence Nightingale (in spanish)
Florence Nightingale foundation
Guys and St Thomas Hospital

picture: Helping the wounded. Shutterstock/Everett Historical

19 d’abr. 2020

stay at home

Image: Milo Manara 2020

Milo Manara is an Italian comic book writer and artist.

2 d’abr. 2020

stay at home

photo: Sabadell (AHS, 1936...)

5 de març 2020

What Works to Prevent Violence Against Women and Girls (VAWG)

Violence against women and girls (VAWG) is preventable.

Over the last two decades, the global community has come to recognise the profound impact of violence on the lives of women and girls. This fundamentally undermines their health and well-being, and stands as a barrier to women’s full participation in global development and the economic and civic life of their communities.

What works to prevent violence published last january 2020 a brief where evaluated the design and implementation of diferent interventions designed to reduce VAWG. The interventions were included in four different groups:
  • Community activism approaches to shift harmful gender attitudes, roles and social norms
  • Combined gender transformation and economic empowerment interventions
  • Couples’ interventions and special populations
  • Prevention of violence among and against children
The brief show many examples of well-designed, well-implemented interventions of different modalities. Ten core elements of the design and implementations have contributed to their success.

Eight elements related to the design of the interventions:
  1. Rigorously planned, with a robust theory of change, rooted in knowledge of local context.
  2. Address multiple drivers of VAW, such as gender inequity, poverty, poor communication and marital conflict
  3. Especially in highly patriarchal contexts, work with women and men, and where relevant, families.
  4. Based on theories of gender and social empowerment that view behaviour change as a collective rather than solely individual process, and foster positive interpersonal relations and gender equity
  5. Use group-based participatory learning methods, for adults and children, that emphasise empowerment, critical reflection, communication and conflict resolution skills building.
  6. Age-appropriate design for children with a longer time for learning and an engaging pedagogy such as sport and play
  7. Carefully designed, user-friendly manuals and materials supporting all intervention components to accomplish their goals.
  8. Integrate support for survivors of violence.
Two elements related to the implementation of the interventions:
  1. Optimal intensity: duration and frequency of sessions and overall programme length enables time for reflection and experiential learning
  2. Staff and volunteers are selected for their gender equitable attitudes and non-violence behaviour, and are thoroughly trained, supervised and supported.
What Works to Prevent Violence Against Women and Girls is an innovative global programme working in 13 countries across the world building the evidence base on What Works to prevent violence in low-middle income settings.

Access article (pdf) 2020 What works brief

photo: Vivian Maier (1980)

12 de gen. 2020

clinical practice guidelines and the voice of patients

Clinical practice guidelines (CPG) are the user manuals of modern medicine. If the human body can suffer it, chances are there's a guideline for treating it, from burns and breaks to cancers and strokes. At their best, they provide gold-standard guidance to doctors: how to diagnose and treat a condition, what symptoms to watch for, what tests to order. But that's not always the reality. Clinicians are experts, but the patients with the disease are also experts. They're the ones living with it on a daily basis.

Guideline development could be unsatisfactory and unreliable. Because it so often fails to engage any patients or caregivers. Usually guidelines are developed without any input from the people who would actually experience them. Also, there is no consensus on what exactly patients and their representatives should be asked to do during CPG development. For example, should they be active members of guideline groups, or should patient input and preferences be shared only with clinicians in guideline groups. Moreover, there is little clarity about how guidelines should reflect patient-based evidence, or information generated by patients about different aspects of care, patient preferences, and care experience.

Rand (2019) in an interdisciplinary team of researchers, patient representatives from the Parent Project Muscular Dystrophy (PPMD) and clinicians developed the RAND/PPMD Patient-Centeredness Method (RPM) - a version of a Delphi method- with a online approach to engaging patients and their representatives in Clinicial Practice Guildelines.

The authors said that Duchenne was a good test case, because the disease is so rare, so complex, and the balance between treatment and quality of life is so precarious. but this method should be formally validated and tested in the context of other clinical conditions and compared to other ways of engaging patients in CPG development.

Open access article

photo: Moda ald carrer 1971. Joana Biarnés (1935-2018)