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Sultan Qaboos University Medical Journal May 2024This study aimed to investigate the variables that influenced a sample of Omani mothers' support for mandatory COVID-19 vaccines for children. The vaccination against...
OBJECTIVES
This study aimed to investigate the variables that influenced a sample of Omani mothers' support for mandatory COVID-19 vaccines for children. The vaccination against COVID-19 averted millions of fatalities during the COVID-19 pandemic. Nevertheless, a considerable number of parents and caregivers opposed mandating COVID-19 vaccines for children.
METHODS
This cross-sectional study was conducted at several healthcare facilities in Oman using a structured questionnaire between February and March 2022. Univariable and multivariable logistic regression models were used to analyse the data.
RESULTS
A total of 700 Omani mothers (response rate = 73.4%) who had children aged 5-11 years old were included. The median age of the mothers was 38 ± 5.19 years. The results of multivariable logistic regression were generally consistent with those of the univariable analysis except for age (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 0.58-1.93; = 0.86) and income (OR = 1.09, 95% CI: 0.58-2.03; = 0.79). Mothers who were vaccine hesitant (OR = 9.82, 95% CI: 5.27-18.28; <0.001), tested positive for COVID-19 (OR = 3.25, 95% CI: 1.80-5.86; <0.001) and had one or two doses of COVID-19 vaccines (OR = 5.41, 95% CI: 2.92-10.03; <0.001) were more likely to refuse mandating COVID-19 vaccines for children 5-11 years old.
CONCLUSION
Mothers who were vaccine hesitant, tested positive for COVID-19 and had one or two doses of COVID-19 vaccines were more likely to oppose mandatory COVID-19 vaccines for young children. The findings should aid public health authorities in designing future childhood vaccine literacy programmes with specific attention to some subgroups in Oman to help reduce opposition to vaccines in future pandemics among mothers.
Topics: Humans; Cross-Sectional Studies; Female; Oman; Child; Child, Preschool; Mothers; COVID-19; Adult; COVID-19 Vaccines; Surveys and Questionnaires; Male; SARS-CoV-2; Vaccination; Vaccination Hesitancy
PubMed: 38828250
DOI: 10.18295/squmj.1.2024.005 -
Frontiers in Immunology 2024The COVID vaccination program with new types of vaccinations and early reports of allergic reactions to vaccines led to vaccination hesitancy in patients with allergies....
INTRODUCTION
The COVID vaccination program with new types of vaccinations and early reports of allergic reactions to vaccines led to vaccination hesitancy in patients with allergies. In this study, we aimed to characterize patients who present at an allergy center with specific questions regarding risk assessment to COVID vaccines in comparison to regular allergy center patients.
METHODS
A total of 50 patient charts of patients with risk assessment for COVID vaccination (COV group) and 50 regular allergy center patients (ALL group) were assessed for documented allergies, comorbidities, total IgE, and tryptase levels and hospital anxiety and depression score (HADS). Skin prick testing (SPT) with additives of COVID vaccines [polyethylene glycol (PEG), polysorbate] were performed if indicated based on medical history.
RESULTS
Patients who presented for examination prior to a possible COVID vaccination were mostly female (86%) and had more frequently reported allergic reactions to drugs in the past, but only in a minor group (28%) were the reactions qualified as anaphylaxis. The group COV patients scored significantly higher in the HADS for anxiety and depression than the regular group ALL patients. The same trend was observed when data were corrected for gender. It is worth noting that patients without any prior contact to COVID vaccines scored comparable regarding anxiety to patients with prior reaction to COVID vaccinations, but significantly higher in the depression score. In 19 patients (38%) who met the indications for SPT for the suspicious contents PEG and Polysorbate 80, the tests did not show a positive result. Furthermore, 84% of patients underwent the prick test, but only 15% of patients who received consultation alone agreed to vaccination at our center. No vaccination-related event was documented in these patients.
DISCUSSION
In conclusion, vaccination hesitancy was frequently elicited by negative experiences with drugs and putative drug allergies. Female patients predominate in this patient group, and the anxiety and depression scores were significantly elevated. Allergological workup, including SPT, led to a high rate of subsequent vaccinations, whereas a discussion with the patients about risks and individualized advice for vaccination without testing only rarely resulted in documented vaccinations.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Anxiety; COVID-19; COVID-19 Vaccines; Depression; Hypersensitivity; Mental Health; Skin Tests; Vaccination; Vaccination Hesitancy
PubMed: 38827735
DOI: 10.3389/fimmu.2024.1324987 -
Journal of Patient Experience 2024Patient-centered care is a salient value expressed by stakeholders, but a commitment to implementing patient-centered care environments lags in the context of inpatient...
Patient-centered care is a salient value expressed by stakeholders, but a commitment to implementing patient-centered care environments lags in the context of inpatient psychiatry. The current study aimed to describe patients' suggestions for improving the quality of inpatient psychiatry. We fielded a national survey online in 2021, in which we asked participants to report their recommendations for care improvement through a free-response box. We used an inductive qualitative approach to synthesize responses into themes. Most responses described negative experiences, with suggested improvements implied as the inverse or absence of the respondent's negative experience. Among 510 participants, we identified 10 themes: personalized care, empathetic connection, communication, whole health approach, humane care, physical safety, respecting patients' rights and autonomy, structural environment, equitable treatment, and continuity of care and systems. To implement the value of patient-centered care, we suggest that those in positions of power prioritize improvement initiatives around these aspects of care that patients find most in need of improvement.
PubMed: 38827226
DOI: 10.1177/23743735241257810 -
Human Vaccines & Immunotherapeutics Dec 2024To investigate the dynamic evolution of vaccine hesitancy toward both COVID-19 and influenza in a context characterized by the compresence of SARS-CoV-2 pandemic and...
To investigate the dynamic evolution of vaccine hesitancy toward both COVID-19 and influenza in a context characterized by the compresence of SARS-CoV-2 pandemic and seasonal flu epidemics, a two times repeated cross-sectional exploratory design was performed at Udine Hospital (Italy) following a cohort of 479 adult patients with a previous history of SARS-CoV-2 infection in 2020. Vaccine attitude was assessed through standardized telephone interviews performed at 12 and 18 months after the acute illness. The first interview reported the success of the 2020/21 seasonal influenza immunization with 46.8% (224/479) of the participants showing a positive attitude, especially the elderly and people with comorbidities ( < .001), but the investigation conducted at 18 months showed a drastic drop in flu shot acceptance (30/166, 18.1%). On the other hand, a great increase in vaccinations against SARS-CoV-2 occurred after the introduction of Green Pass (26.7% vs 72.9%). The major drivers of flu vaccine skepticism were represented by the feeling of protection regardless of prevention and by concerns regarding vaccines safety and efficacy; conversely compulsory strategies seemed to play a secondary role, since only a minority of the participants identified in the restrictions induced by the certification the major incentive to get immunized against SARS-CoV-2. The focus on this peculiar historical period helps to take a step forward in the comprehension of the complexity and dynamicity of the vaccine hesitancy phenomenon. Future vaccination campaigns will need to consider the role of personal opinions and emotions, interpreted according to the social and political context.
Topics: Humans; Influenza Vaccines; COVID-19; Male; Female; Middle Aged; Influenza, Human; Cross-Sectional Studies; Aged; Italy; COVID-19 Vaccines; Adult; Vaccination Hesitancy; SARS-CoV-2; Vaccination; Young Adult; Aged, 80 and over; Patient Acceptance of Health Care; Adolescent; Pandemics
PubMed: 38825984
DOI: 10.1080/21645515.2024.2358565 -
Spinal Cord Series and Cases May 2024
Review
Topics: Humans; Health Services Accessibility; Patient Rights; Intermittent Urethral Catheterization; Human Rights
PubMed: 38821946
DOI: 10.1038/s41394-024-00651-4 -
Journal of Medical Internet Research May 2024Mobile health (mHealth) apps have the potential to enhance health care service delivery. However, concerns regarding patients' confidentiality, privacy, and security... (Review)
Review
BACKGROUND
Mobile health (mHealth) apps have the potential to enhance health care service delivery. However, concerns regarding patients' confidentiality, privacy, and security consistently affect the adoption of mHealth apps. Despite this, no review has comprehensively summarized the findings of studies on this subject matter.
OBJECTIVE
This systematic review aims to investigate patients' perspectives and awareness of the confidentiality, privacy, and security of the data collected through mHealth apps.
METHODS
Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted in 3 electronic databases: PubMed, Ovid, and ScienceDirect. All the retrieved articles were screened according to specific inclusion criteria to select relevant articles published between 2014 and 2022.
RESULTS
A total of 33 articles exploring mHealth patients' perspectives and awareness of data privacy, security, and confidentiality issues and the associated factors were included in this systematic review. Thematic analyses of the retrieved data led to the synthesis of 4 themes: concerns about data privacy, confidentiality, and security; awareness; facilitators and enablers; and associated factors. Patients showed discordant and concordant perspectives regarding data privacy, security, and confidentiality, as well as suggesting approaches to improve the use of mHealth apps (facilitators), such as protection of personal data, ensuring that health status or medical conditions are not mentioned, brief training or education on data security, and assuring data confidentiality and privacy. Similarly, awareness of the subject matter differed across the studies, suggesting the need to improve patients' awareness of data security and privacy. Older patients, those with a history of experiencing data breaches, and those belonging to the higher-income class were more likely to raise concerns about the data security and privacy of mHealth apps. These concerns were not frequent among patients with higher satisfaction levels and those who perceived the data type to be less sensitive.
CONCLUSIONS
Patients expressed diverse views on mHealth apps' privacy, security, and confidentiality, with some of the issues raised affecting technology use. These findings may assist mHealth app developers and other stakeholders in improving patients' awareness and adjusting current privacy and security features in mHealth apps to enhance their adoption and use.
TRIAL REGISTRATION
PROSPERO CRD42023456658; https://tinyurl.com/ytnjtmca.
Topics: Humans; Confidentiality; Telemedicine; Mobile Applications; Computer Security; Privacy
PubMed: 38820572
DOI: 10.2196/50715 -
The American Journal of Managed Care May 2024To examine patient and provider perspectives on privacy and security considerations in telemedicine during the COVID-19 pandemic.
OBJECTIVE
To examine patient and provider perspectives on privacy and security considerations in telemedicine during the COVID-19 pandemic.
STUDY DESIGN
Qualitative study with patients and providers from primary care practices in 3 National Patient-Centered Clinical Research Network sites in New York, New York; North Carolina; and Florida.
METHODS
Semistructured interviews were conducted, audio recorded, transcribed verbatim, and coded using an inductive process. Data related to privacy and information security were analyzed.
RESULTS
Sixty-five patients and 21 providers participated. Patients and providers faced technology-related security concerns as well as difficulties ensuring privacy in the transformed shared space of telemedicine. Patients expressed increased comfort doing telemedicine from home but often did not like their providers to offer virtual visits from outside an office setting. Providers initially struggled to find secure and Health Insurance Portability and Accountability Act-compliant platforms and devices to host the software. Whereas some patients preferred familiar platforms such as FaceTime, others recognized potential security concerns. Audio-only encounters sometimes raised patient concerns that they would not be able to confirm the identity of the provider.
CONCLUSIONS
Telemedicine led to novel concerns about privacy because patients and providers were often at home or in public spaces, and they shared concerns about software and hardware security. In addition to technological safeguards, our study emphasizes the critical role of physical infrastructure in ensuring privacy and security. As telemedicine continues to evolve, it is important to address and mitigate concerns around privacy and security to ensure high-quality and safe delivery of care to patients in remote settings.
Topics: Humans; Telemedicine; COVID-19; Primary Health Care; Female; Computer Security; Male; Middle Aged; Confidentiality; Adult; Qualitative Research; Privacy; SARS-CoV-2; United States; Aged; Health Insurance Portability and Accountability Act
PubMed: 38820187
DOI: 10.37765/ajmc.2024.89553 -
Frontiers in Psychiatry 2024People with dementia and their carers experience social stigma and often refrain from social participation. Significant improvement might be achieved by creating...
INTRODUCTION
People with dementia and their carers experience social stigma and often refrain from social participation. Significant improvement might be achieved by creating Dementia Friendly communities (DFCs) for which dementia friendly initiatives (DFIs) are needed. DFIs are developed by a variation of stakeholders. However, people with dementia and their carers are often unrepresented herein. This study aims to get insight into the perspectives of stakeholders (e.g., health- and social care professionals, volunteers, people with dementia and their carers) about the involvement of people with dementia and their carers during the development and sustainment of DFIs.
METHODS
Descriptive qualitative study, using a co-research design with a carer as co-researcher. Nineteen semi-structured interviews with stakeholders, including people with dementia and their carers, were performed. Inductive content analysis took place using Atlas Ti.
RESULTS
Four themes were found: 1) the involvement of people with dementia and their carers is important for both people with dementia and their carers and other stakeholders; 2) personal character traits, life histories, and associated emotions evoke the need for involvement; 3) involvement requires an open, responsive stance and building relationships; and 4) the estimation of one's own and others' capacities influences perspectives on involvement. As such, practice what you preach means actively adopting an open, responsive approach and acknowledging the unique abilities and backgrounds of people with dementia and their carers. It emphasizes the importance of actually living by the values you advocate for.
CONCLUSION
Central to perspectives on involving people with dementia and their carers is the emphasis on working relationally, differing from service-led and pre-structured patient and public involvement (PPI). Working relationally calls for organizational shifts aligned with a rights-based perspective to avoid tokenism, and promotion of user-led organizations with genuine partnerships. Creative methods, problem-solving, and communication skills are essential for the development and sustainment of inclusive, supportive, person-centered DFIs. Future studies should explore the long-term impact of the involvement and working relationally on the well-being of people with dementia and their carers.
PubMed: 38818024
DOI: 10.3389/fpsyt.2024.1387536 -
BMC Medical Informatics and Decision... May 2024Securing adequate data privacy is critical for the productive utilization of data. De-identification, involving masking or replacing specific values in a dataset, could...
BACKGROUND
Securing adequate data privacy is critical for the productive utilization of data. De-identification, involving masking or replacing specific values in a dataset, could damage the dataset's utility. However, finding a reasonable balance between data privacy and utility is not straightforward. Nonetheless, few studies investigated how data de-identification efforts affect data analysis results. This study aimed to demonstrate the effect of different de-identification methods on a dataset's utility with a clinical analytic use case and assess the feasibility of finding a workable tradeoff between data privacy and utility.
METHODS
Predictive modeling of emergency department length of stay was used as a data analysis use case. A logistic regression model was developed with 1155 patient cases extracted from a clinical data warehouse of an academic medical center located in Seoul, South Korea. Nineteen de-identified datasets were generated based on various de-identification configurations using ARX, an open-source software for anonymizing sensitive personal data. The variable distributions and prediction results were compared between the de-identified datasets and the original dataset. We examined the association between data privacy and utility to determine whether it is feasible to identify a viable tradeoff between the two.
RESULTS
All 19 de-identification scenarios significantly decreased re-identification risk. Nevertheless, the de-identification processes resulted in record suppression and complete masking of variables used as predictors, thereby compromising dataset utility. A significant correlation was observed only between the re-identification reduction rates and the ARX utility scores.
CONCLUSIONS
As the importance of health data analysis increases, so does the need for effective privacy protection methods. While existing guidelines provide a basis for de-identifying datasets, achieving a balance between high privacy and utility is a complex task that requires understanding the data's intended use and involving input from data users. This approach could help find a suitable compromise between data privacy and utility.
Topics: Humans; Confidentiality; Data Anonymization; Emergency Service, Hospital; Length of Stay; Republic of Korea; Male
PubMed: 38816848
DOI: 10.1186/s12911-024-02545-9 -
BMJ Open Quality May 2024Patient safety is a high priority in the Danish health care system, including that hospital patients get the proper nutrition during their stay. A Nutrition Committee at...
INTRODUCTION
Patient safety is a high priority in the Danish health care system, including that hospital patients get the proper nutrition during their stay. A Nutrition Committee at Odense University Hospital is responsible for policy regarding nourishment at the hospital. If patients experience suboptimal treatment, i.e. improper nourishment, in the Danish health care system, they have the right to file a complaint. These complaints enable the improvement potentials based on the patients' first hand experiences. Therefore, our aim was to examine the nutrition complaint pattern and to get a deeper understanding of the context surrounding nutrition problems, allowing the extraction of learning potentials.
METHODS
We analysed complaints submitted to Odense University Hospital between 2018 and 2022 using the Healthcare Complaint Analysis Tool. The complaints were categorised into categories, levels of severity and overall patient harm. The complaints containing a high-severity nutrition problem were read through and thematised into aspects not defined in the Healthcare Complaint Analysis Tool.
RESULTS
Between 2018 and 2022, 60 complaint cases containing 89 nutrition problems were filed to Odense University Hospital. Most (58.3%) of these were filed by the patients' relatives. The nutrition problems were mostly of low severity (56.2%), while 23.6% were severe, and 20.2% were very severe. The reading of 18 very severe nutrition complaints revealed a cascade of problems triggered by the nutrition problem in six cases. Moreover, we saw that two high-severity nutrition problems led to catastrophic harm.
DISCUSSION
A low proportion of nutrition problems may express an underestimation regarding nourishment at the hospital. A patient's threshold may not be exceeded by suboptimal nutrition and therefore does not file a complaint. However, complaints contain important insights contributing to wider learning, given that improvements at the hospital so far are based on clinicians' reporting, overlooking the patient perspective.
Topics: Humans; Denmark; Patient Safety; Hospitals; Female; Male
PubMed: 38816005
DOI: 10.1136/bmjoq-2024-002745