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Palliative Medicine May 2024Caring for parents continuing pregnancy after learning about a severe life-limiting condition in their unborn is challenging. Most existing studies focus on affected...
BACKGROUND
Caring for parents continuing pregnancy after learning about a severe life-limiting condition in their unborn is challenging. Most existing studies focus on affected families, whereas research on the subjective experience of care professionals is scarce.
AIM
We aimed to (1) explore experiences and needs of involved care professionals, (2) obtain information about existing care structures, and (3) identify requirements for a structured perinatal palliative care program.
DESIGN
Grounded Theory study using theoretical sampling. Data was collected by semi-structured interviews and analyzed following the principles of grounded theory coding and situational analysis.
SETTING
A total of 18 professionals from 12 different services in Munich and surroundings participated in the study: 8 physicians, 3 midwives, 2 nurses, 1 each pregnancy counselor, grief counselor, chaplain, clinical psychologist, and undertaker.
RESULTS
Several organizations provide support for affected parents, but inter-institutional communication is scarce. Due to the lack of a dedicated perinatal palliative care program, professionals make immense and partly unpaid efforts to support concerned parents. Providers experience "collateral beauty" in their work despite all the suffering and grief. This includes the development of a humble attitude and feelings of gratitude toward life, the feeling of having a meaningful task and professional as well as personal growth. Requirements for a structured perinatal palliative care program include: fostering peer support, ensuring regular supervision, and enhancing interdisciplinary exchange.
CONCLUSIONS
Perinatal palliative care demands a high level of personal engagement but is experienced as highly rewarding by care professionals.
PubMed: 38813757
DOI: 10.1177/02692163241255509 -
Public Health in Practice (Oxford,... Jun 2024The failure to detect PDG and lack of providing essential interventions accordingly can disrupt the lives of survivors of natural disasters years after the death of... (Review)
Review
OBJECTIVE
The failure to detect PDG and lack of providing essential interventions accordingly can disrupt the lives of survivors of natural disasters years after the death of their loved ones. The present study aims to investigate PGD after natural disasters using a systematic review and meta-analysis.
STUDY DESIGN
This study was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.
METHODS
With the focus on the prevalence of PGD after natural disasters, studies conducted until the end of 2021 were collected without a time limit. To do this, reputable databases such as PubMed, Web of Science, Scopus, Embase, Google Scholar, and Science Direct were used. The random effects model was used to perform a meta-analysis of the studies. To check the heterogeneity between the studies, the I2 index was used. The publication bias of the study was evaluated using Begg's test. Data were analyzed using the STATA software.
RESULTS
Primarily, 2566 studies were collected based on the initial search, from which 12 final studies were entered into the analysis. The results showed that the prevalence of PGD after natural disasters was 38.81 % (95 % CI: 24.12-53.50, I2 = 99.7 %, p = 0 < 001).
CONCLUSIONS
It is recommended that policies and plannings of the organizations responsible for disaster management be prepared to send specialized teams of psycho-spiritual counseling, quickly accommodate the injured, and reconstruct the damaged buildings in the shortest time possible.
PubMed: 38803465
DOI: 10.1016/j.puhip.2024.100508 -
Indian Journal of Psychiatry Apr 2024Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their... (Review)
Review
Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their work. Added to the stress of work, malpractice lawsuits add to their burden. In India, most doctors work in compromised settings with poor infrastructure and manpower but are expected to follow the best practices. In court, they are judged with the Bolam and Bolitho tests being essential considerations. Several tragic incidents have been reported, including depression, anger issues, and even suicide deaths of healthcare professionals (HCPs) after accusations of negligence and subsequent inquiry. Such incidents demonstrate the multitude of challenges an HCP faces in day-to-day practice. It is crucial to find ways to tackle these problems and enhance the capacity of HCP to handle such demanding circumstances. Malpractice litigation can significantly impact the mental health of HCPs. It is common to experience emotional turmoil when faced with a lawsuit. Second victim syndrome (SVS) is a term used to describe a set of symptoms experienced by HCPs who make an error leading to injury to a patient. However, it also happens if he is traumatized by the consequences of violence during healthcare services or a lawsuit or defamation article in newspaper/social media. Following a litigation crisis in their career, many HCPs go through various stages of grief, including shock, denial, anger, bargaining, depression, and acceptance. At times, death by suicide of the HCPs is well known. SVS is known to profoundly affect the personal, family, economic, professional (defensive practice), and social life of HCPs. HCPs should accept the allegations of negligence as an occupational hazard and prepare for the eventual litigation at least once in a lifetime by knowing about the medical laws, HCP's rights, becoming aware of the emotional turmoil of the lawsuit, preparing to cope with the lawsuit, and seeking help from colleagues and indemnity insurance. Frequent training of the HCPs is strongly recommended to know about the changing laws and also to undergo periodic professional competence enhancement to reduce the incidents of errors amounting to medical negligence. Medical and hospital administration should debrief after any incident and conduct internal investigations to identify systemic flaws and prevent future recurrence, resolve issues within their control at their level, and manage media (mainstream and social media) appropriately. If established, a reporting system with online and offline services will ease the internal administrative investigation process and take appropriate, timely actions. During the crisis, HCPs should have adequate and appropriate insurance or indemnity coverage and mental health support systems.
PubMed: 38778854
DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_799_23 -
PloS One 2024Foster care programs at animal shelters have emerged as an important tool for promoting animal welfare and supporting shelter life-saving efforts. Preliminary evidence...
Foster care programs at animal shelters have emerged as an important tool for promoting animal welfare and supporting shelter life-saving efforts. Preliminary evidence suggests that foster caregiving may also be health-promoting for humans. The goals of this study were to investigate the experiences of foster caregivers at animal shelters based on measures of positive and negative affect, quality of life, and grief, and to describe human-animal attachment among foster populations. Between March 2022 and 2023, 131 foster caregivers from five shelters in the United States completed three online surveys before, during and after providing foster care to a shelter animal. Positive affect decreased significantly from baseline to post-foster (F = 5.71, p<0.01), particularly among dog caregivers (F = 6.17, p<0.01). Negative affect remained unchanged (F = 0.47, p = 0.63). Foster caregivers perceived their foster animal provided companionship, affection and emotional support, although dog foster caregivers reported significantly higher emotional (U = 313.50, p<0.01) and social/physical quality of life (t = 4.42, p<0.01) than cat foster caregivers. Caregivers reported low mean avoidant and anxious attachment, suggesting they were able to develop secure bonds with their foster animals. Retention of fosters was also strong, with 86% of caregivers reporting they were likely to provide foster care in the future. Our findings suggest that fostering at animal shelters may serve as a One Health intervention to offer companionship, affection and emotional support to human caregivers while promoting animal welfare. However, these benefits did not translate to improvements in caregiver mental wellbeing, so caution should be applied when considering foster caregiving as a potential mental health promotion tool.
Topics: Humans; Quality of Life; Animals; Caregivers; Dogs; Female; Male; Human-Animal Bond; Grief; Adult; Mental Health; Middle Aged; Prospective Studies; Animal Welfare; Surveys and Questionnaires; Foster Home Care; Young Adult; Aged
PubMed: 38776263
DOI: 10.1371/journal.pone.0301661 -
Experimental and Clinical... Apr 2024In nations where organ donation is governed by the opt-in policy, the most crucial stage in the organ procurement process is the family approach and gaining the approval...
OBJECTIVES
In nations where organ donation is governed by the opt-in policy, the most crucial stage in the organ procurement process is the family approach and gaining the approval of families of decedents with brain death. In times of grief and sorrow, the ability of health care workers to communicate and have donation conversations is vital to the decision-making process of families and the subsequent consent rate. In this study, we investigated the effects of teaching important points to coordinators in the family approach and gaining consent of families for organ donation.
MATERIALS AND METHODS
A new training program for Iranian coordinators was designed to increase the skills and knowledge of interviewers and increase the self-confidence of the coordinators. In the training program, 15 golden key points to have when meeting with families of brain dead decedents regarding organ donation consent were presented and discussed with participants. Three coordinating groups participated in this training program. The satisfaction rate of the families was assessed at comparable intervals (12 months for group 1, 6 months for group 2, and 3 months for group 3) before and after the training session to assess the continuity of the training impact. We used the Wilcoxon signed rank test for comparisons.
RESULTS
The family consent rate was significantly different for all participants, before and after the 15 golden key points were presented, increasing from 50% to 62.5% (P = .037). In addition, participant sex (P = .051), previous training (P = .090), education (P = .068), and cooperation time (P = .008) had significant effects on family consent rate.
CONCLUSIONS
Our training approach can increase the performance of coordinators in achieving family satisfaction.
Topics: Humans; Iran; Tissue and Organ Procurement; Professional-Family Relations; Brain Death; Health Knowledge, Attitudes, Practice; Third-Party Consent; Male; Female; Tissue Donors; Family; Time Factors; Adult; Attitude of Health Personnel; Inservice Training; Program Evaluation; Communication; Middle Aged
PubMed: 38775698
DOI: 10.6002/ect.BDCDSymp.L14 -
PloS One 2024To describe the implementation of a test-negative design case-control study in California during the Coronavirus Disease 2019 (COVID-19) pandemic.
OBJECTIVE
To describe the implementation of a test-negative design case-control study in California during the Coronavirus Disease 2019 (COVID-19) pandemic.
STUDY DESIGN
Test-negative case-control study.
METHODS
Between February 24, 2021 - February 24, 2022, a team of 34 interviewers called 38,470 Californians, enrolling 1,885 that tested positive for SARS-CoV-2 (cases) and 1,871 testing negative for SARS-CoV-2 (controls) for 20-minute telephone survey. We estimated adjusted odds ratios for answering the phone and consenting to participate using mixed effects logistic regression. We used a web-based anonymous survey to compile interviewer experiences.
RESULTS
Cases had 1.29-fold (95% CI: 1.24-1.35) higher adjusted odds of answering the phone and 1.69-fold (1.56-1.83) higher adjusted odds of consenting to participate compared to controls. Calls placed from 4pm to 6pm had the highest adjusted odds of being answered. Some interviewers experienced mental wellness challenges interacting with participants with physical (e.g., food, shelter, etc.) and emotional (e.g., grief counseling) needs, and enduring verbal harassment from individuals called.
CONCLUSIONS
Calls placed during afternoon hours may optimize response rate when enrolling controls to a case-control study during a public health emergency response. Proactive check-ins and continual collection of interviewer experience(s) and may help maintain mental wellbeing of investigation workforce. Remaining adaptive to the dynamic needs of the investigation team is critical to a successful study, especially in emergent public health crises, like that represented by the COVID-19 pandemic.
Topics: Humans; COVID-19; Case-Control Studies; California; Male; Female; Adult; SARS-CoV-2; Middle Aged; Telephone; Surveys and Questionnaires; Pandemics; Adolescent; Aged; Young Adult; COVID-19 Testing
PubMed: 38771784
DOI: 10.1371/journal.pone.0301070 -
Cureus Apr 2024HIV represents a "biographical disruption", interrupting the continuity of life and fostering a sense of vulnerability. The transition of HIV into a chronic condition,...
BACKGROUND
HIV represents a "biographical disruption", interrupting the continuity of life and fostering a sense of vulnerability. The transition of HIV into a chronic condition, coupled with extended life expectancy, necessitates significant lifestyle adjustments, making adaptation and navigation through uncertainties essential.
METHOD
Interpretative phenomenological analysis was used to investigate the lived experiences and adaptation processes of gay men in Greece who are living with HIV. Semi-structured interviews were conducted with seven HIV-positive gay men, recruited from two Greek NGOs that support individuals living with HIV. Investigator triangulation was used to interpret textual material, heightening credibility and reducing bias, thereby enhancing the findings' reliability.
RESULTS
The analysis identified a superordinate theme, "Being Vulnerable Enough: Negotiating Uncertainties and Adapting in the HIV Experience", which encompasses three themes: "The Moment of Division: Fear, Uncertainty, and Vulnerability after an HIV Diagnosis", "Grief and Negotiation: Navigating Daily Life Through the Lens of Loss", and "Reclaiming Self: Shaping 'My HIV Identity' to Fit on My Terms".
CONCLUSIONS
The initial shock of HIV diagnosis introduces a sense of vulnerability, with participants confronting fear, despair, and grief over the loss of health and the disruption of their anticipated life flow. Being vulnerable enough enables individuals to adapt to life with HIV by managing uncertainties through creating certainties with small daily decisions, in a non-linear, ongoing process of negotiation and reassessment, without the need to eliminate all uncertainties.
PubMed: 38765420
DOI: 10.7759/cureus.58432 -
Methodist DeBakey Cardiovascular Journal 2024Ovid's tells the story of Icarus - his tragic flight with man-made wings, the melting of the wax that bound them, and the ensuing fall to his death. This moment has...
Ovid's tells the story of Icarus - his tragic flight with man-made wings, the melting of the wax that bound them, and the ensuing fall to his death. This moment has been immortalized across the arts and through several mediums, but none are more notable than Bruegel's . Described as a "painter for poets," Bruegel's work served as inspiration for several writers, with this piece in particular providing the basis for ekphrastic poems by W.H. Auden and William Carlos Williams. Though each of these works has a different focus, the unifying theme is that human tragedy is too often placed on the periphery of notice. They are effective reminders to physicians and other healthcare providers about the human aspect of suffering and pain in medicine.
Topics: Humans; Famous Persons; Poetry as Topic; Medicine in Literature
PubMed: 38765218
DOI: 10.14797/mdcvj.1377 -
PloS One 2024Which kinds of grievances garner support from the public on online platforms? Focusing on national online petitioning, one of the forms of direct democracy in...
Which kinds of grievances garner support from the public on online platforms? Focusing on national online petitioning, one of the forms of direct democracy in contemporary politics, we examine the content and characteristics of petitions that succeeded in attracting public attention and support. Using our comprehensive data on online petitions that were submitted to the executive office between 2017 and 2022 in South Korea, our analysis yields three important findings. First, a mix of post-materialist topics such as human rights and gender equality and materialist topics such as safety and environment turn out to be salient among petitions that meet the signature threshold. Second, online petitions the contents of which reveal either moral emotions or Confucian attitudes are more likely to gain public support compared to others. Third, keywords that are related to moral claims asking for the apprehension of perpetrators on behalf of victims, such as 'victim,' 'perpetrator,' 'kid,' and 'punishment,' appear most frequently inside the petitions that cross the signature threshold. Such findings provide implications for understanding both the potentials and limitations of national online petitioning in contemporary democracies.
Topics: Republic of Korea; Humans; Internet; Politics; Democracy; Grief
PubMed: 38753871
DOI: 10.1371/journal.pone.0302373 -
Prolonged grief disorder symptomology in three African countries: A network analysis and comparison.Global Mental Health (Cambridge,... 2024Bereavement is a globally prevalent life stressor, but in some instances, it may be followed by a persistent condition of grief and distress, codified within the 11th...
BACKGROUND
Bereavement is a globally prevalent life stressor, but in some instances, it may be followed by a persistent condition of grief and distress, codified within the 11th edition of the International Classification of Diseases (ICD-11) as prolonged grief disorder (PGD). Network analysis provides a valuable framework for understanding psychological disorders at a nuanced symptom-based level.
AIM
This study novelly explores the network structure of ICD-11 PGD symptomology in a non-Western sample and assesses the replication of this across three African country sub-samples in these data.
METHODOLOGY
Network models were estimated using the "Inventory of Complicated Grief-Revised" in a sample of trauma-exposed individuals who experienced bereavement throughout life ( = 1,554) from three African countries (Ghana, = 290; Kenya, = 619; Nigeria, = 645). These networks were statistically evaluated using the network comparison test.
RESULTS
It was found that "Feelings of Loss" and "Difficulty moving on" were the most central symptoms in the combined sample network. These findings were largely consistent for the Ghana and Nigeria sub-samples, however, network structure differences were noted in the Kenya sub-sample.
CONCLUSION
The identified PGD network highlights particular indicators and associations across three African samples. Implications for the assessment and treatment of PGD in these cultural contexts warrant consideration.
PubMed: 38751724
DOI: 10.1017/gmh.2024.54