Health Professional Well-being and Preparedness During the Covid-19 Pandemic in Trinidad and Tobago: an Online Survey

Introduction: Poor well-being impacts mental health and subsequently affects personal lives, leads to absenteeism, poor productivity, and compromised patient safety. Frontline healthcare workers are highly vulnerable to COVID-19 pandemic-related mental health strain. This study assessed the well-being and preparedness of frontline healthcare workers in Trinidad and Tobago during the pandemic. Methods: An online cross-sectional survey was sent to doctors, nurses, and prehospital providers from public and private healthcare sectors. Data was collected from May to June 2020 utilizing a self- administered online platform. The WHO Five Well-being Index (WHO-5) was used to assess well-being. Raw scores less than 13 indicated that participants were at risk for depression. Descriptive statistics and content analysis were used to analyze data. Results: There were 296 respondents comprising 55.4% (n=164) doctors, 30.1% (n=90) nurses and 14.5% (n=43) prehospital care providers. More than half of participants (55.4%, n=158) scored less than 13 on the WHO-5 indicating that these participants were at risk for developing depression. Approximately 80% of participants did not feel supported by their workplaces. Resident doctors had lower well-being levels (59.4% (n=60), i.e., well-being scores less than 13) compared to attending physicians (45.6% (n=26)), but this was not statistically significant (p = 0.516). Two main categories were identified in the content analysis: factors related to the working environment and coping with COVID-19. Conclusion: Levels of well-being indicated that more than half of the participants were at risk for developing depression. The findings also suggested that workplaces should provide health workers with the basic protective resources required to perform their roles. It is imperative that health organizations increase awareness of well-being and mental health in workplaces and develop interventions to support healthcare workers

A perspectiva dos enfermeiros sobre o acompanhante na UTI em tempos de COVID-19

The aim was to know the perspective of nurses in relation to the presence of a companion in the ICU in times of COVID-19. This is an exploratory research with a qualitative approach, carried out in the ICU of a Hospital located in the city of Florianópolis. Eight nurses from the unit participated. Data collection took place online through a semi-structured questionnaire instrument, via Google Forms. It highlights the benefits of the presence of a companion in the ICU and the harm that their absence causes to the hospitalized patient. Difficulties can be found in the implementation of strategies, such as: limited structure, non-compliance with protocols and nurses' work overload. The companion transforms the ICU environment, reduces delirium and depression rates for patients and stress for the nursing staff. Professionals experience a period of pressure, which makes them feel guilty about the patient's pain process without the family's face-to-face assistance at this time. The companion in the ICU brings several benefits to the patient, but it is observed that humanization in the ICU still consists of many taboos and barriers to the creation of strategies and protocols, in relation to the companion's stay. The nurse is extremely important in this process.Objetivou-se conhecer a perspectiva dos enfermeiros em relação à presença do acompanhante na UTI em tempos de COVID-19. Trata-se de uma pesquisa exploratória de abordagem qualitativa, realizada na UTI de um Hospital localizado na cidade de Florianópolis. Participaram 8 enfermeiros da unidade. A coleta de dados ocorreu por meio online através de instrumento questionário semiestruturado, via Google Forms. Evidencia-se os benefícios da presença do acompanhante na UTI e os malefícios que sua ausência acarreta ao paciente internado. Dificuldades podem ser encontradas para a implementação de estratégias, como: a estrutura limitada, o não cumprimento de protocolos e a sobrecarga de trabalho dos enfermeiros. O acompanhante transforma o ambiente da UTI, diminui o delirium e índices de depressão aos pacientes e o estresse a equipe de enfermagem. Os profissionais vivenciam um período de pressão, do qual os faz sentir culpados pelo processo de dor do paciente sem a assistência presencial da família neste momento. O acompanhante na UTI traz diversos benefícios ao paciente, porém observa-se que a humanização em UTI ainda consiste em muitos tabus e barreiras para a criação de estratégias e protocolos, em relação a permanência do acompanhante. O enfermeiro tem suma importância nesse processo

A perspectiva dos enfermeiros sobre o acompanhante na UTI em tempos de COVID-19

The aim was to know the perspective of nurses in relation to the presence of a companion in the ICU in times of COVID-19. This is an exploratory research with a qualitative approach, carried out in the ICU of a Hospital located in the city of Florianópolis. Eight nurses from the unit participated. Data collection took place online through a semi-structured questionnaire instrument, via Google Forms. It highlights the benefits of the presence of a companion in the ICU and the harm that their absence causes to the hospitalized patient. Difficulties can be found in the implementation of strategies, such as: limited structure, non-compliance with protocols and nurses' work overload. The companion transforms the ICU environment, reduces delirium and depression rates for patients and stress for the nursing staff. Professionals experience a period of pressure, which makes them feel guilty about the patient's pain process without the family's face-to-face assistance at this time. The companion in the ICU brings several benefits to the patient, but it is observed that humanization in the ICU still consists of many taboos and barriers to the creation of strategies and protocols, in relation to the companion's stay. The nurse is extremely important in this process.Objetivou-se conhecer a perspectiva dos enfermeiros em relação à presença do acompanhante na UTI em tempos de COVID-19. Trata-se de uma pesquisa exploratória de abordagem qualitativa, realizada na UTI de um Hospital localizado na cidade de Florianópolis. Participaram 8 enfermeiros da unidade. A coleta de dados ocorreu por meio online através de instrumento questionário semiestruturado, via Google Forms. Evidencia-se os benefícios da presença do acompanhante na UTI e os malefícios que sua ausência acarreta ao paciente internado. Dificuldades podem ser encontradas para a implementação de estratégias, como: a estrutura limitada, o não cumprimento de protocolos e a sobrecarga de trabalho dos enfermeiros. O acompanhante transforma o ambiente da UTI, diminui o delirium e índices de depressão aos pacientes e o estresse a equipe de enfermagem. Os profissionais vivenciam um período de pressão, do qual os faz sentir culpados pelo processo de dor do paciente sem a assistência presencial da família neste momento. O acompanhante na UTI traz diversos benefícios ao paciente, porém observa-se que a humanização em UTI ainda consiste em muitos tabus e barreiras para a criação de estratégias e protocolos, em relação a permanência do acompanhante. O enfermeiro tem suma importância nesse processo

Women's alcohol consumption in the early parenting period and influences of socio-demographic and domestic circumstances: A scoping review and narrative synthesis

Numerous studies have explored alcohol consumption in pregnancy, but less is known about women's drinking in the early parenting period (EPP, 0-5 years after childbirth). We synthesise research related to three questions: (i) How are women's drinking patterns and trajectories associated with socio-demographic and domestic circumstances?; (ii) What theoretical approaches are used to explain changes in consumption?; (iii) What meanings have been given to mothers' drinking? Three databases (Ovid-MEDLINE, Ovid-PsycINFO and CINAHL) were systematically searched. Citation tracking was conducted in Web of Science Citation Index and Google Scholar. Eligible papers explored mothers' alcohol consumption during the EPP, focusing on general population rather than clinical samples. Studies were critically appraised and their characteristics, methods and key findings extracted. Thematic narrative synthesis of findings was conducted. Fourteen quantitative and six qualitative studies were identified. The (sub)samples ranged from n = 77,137 to n = 21 women. Mothers' consumption levels were associated with older age, being White and employed, not being in a partnered relationship, higher education and income. Three theoretical approaches were employed to explain these consumption differences: social role, role deprivation, social practice theories. By drinking alcohol, mothers expressed numerous aspects of their identity (e.g., autonomous women and responsible mothers). Alcohol-related interventions and policies should consider demographic and cultural transformations of motherhood (e.g., delayed motherhood, changes in family structures). Mothers' drinking should be contextualised carefully in relation to socio-economic circumstances and gender inequalities in unpaid labour. The focus on peer-reviewed academic papers in English language may limit the evidence

Teoria do elo: relação entre maus-tratos a animais e violência doméstica no município de Boa Vista/RR nos anos de 2018 e 2019 / The link: relationship between animal abuse and domestic violence in the municipality of Boa Vista/RR in the years 2018 and 2019

A relação entre a violência contra os animais e a violência interpessoal denomina-se Teoria do Elo e é caracterizada por estudos que identificam a capacidade de um agressor em agir de forma violenta, seja por ações diretas ou indiretas, contra animais e pessoas, principalmente os mais vulneráveis. Este trabalho teve como objetivo demonstrar essa relação no município de Boa Vista/RR. Dados coletados na Secretaria de Estado da Segurança Pública de Roraima foram analisados com o intuito de observar a associação de violência doméstica e maus-tratos a animais nos anos de 2018 e 2019. Os resultados obtidos demonstraram um total de 2.845 casos de violência doméstica e 42 casos de maus-tratos a animais. A Região Oeste do município foi a que apresentou um maior número de casos de violência doméstica (2328) e de maus-tratos a animais (31) no período de 2018 e 2019. Através da análise dos dados possível concluir que pode haver um grande número de subnotificações de maus-tratos a animais no município de Boa Vista e que a população desconhece as situações que se caracterizam como violência contra os animais

An exploration of the implementation of open disclosure of adverse events in the UK : a scoping review and qualitative exploration

Background: In 2009 the UK National Patient Safety Agency relaunched its Being Open framework to facilitate the open disclosure of adverse events to patients in the NHS. The implementation of the framework has been, and remains, challenging in practice. Aim: The aim of this work was to both critically evaluate and extend the current evidence base relating to open disclosure, with a view to supporting the implementation of a policy of open disclosure of adverse events in the NHS. Methods: This work was conducted in three phases. The first phase comprised two focused systematic literature reviews, one summarising empirical research on the effectiveness of interventions to enhance open disclosure, and a second, broader scoping review, looking at reports of current opinion and practice and wider knowledge. The second phase involved primary qualitative research with the objective of generating new knowledge about UK-based stakeholders' views on their role in and experiences of open disclosure. Stakeholder interviews were analysed using the framework approach. The third phase synthesised the findings from the first two phases to inform and develop a set of short pragmatic suggestions for NHS trust management, to facilitate the implementation and evaluation of open disclosure. Results: A total of 610 papers met the inclusion criteria for the broad review. A large body of literature discussed open disclosure from a number of related, but sometimes conflicted, perspectives. Evidential gaps persist and current practice is based largely on expert consensus rather than evidence. There appears to be a tension between the existing pragmatic guidance and the more in-depth critiques of what being consistent and transparent in health care really means. Eleven papers met the inclusion criteria for the more focused review. There was little evidence for the effectiveness of disclosure alone on organisational or individual outcomes or of interventions to promote and support open disclosure. Interviews with stakeholders identified strong support for the basic principle of being honest with patients or relatives when someone was seriously harmed by health care. In practice however, the issues are complex and there is confusion about a number of issues relating to disclosure policies in the UK. The interviews generated insights into the difficulties perceived within health care at individual and institutional levels, in relation to fully implementing the Being Open guidance. Conclusions: There are several clear strategies that the NHS could learn from to implement and sustain a policy of openness. Literature reviews and stakeholder accounts both identified the potential benefits of a culture that was generally more open (not just retrospectively open about serious harm). Future work could usefully evaluate the impact of disclosure on legal challenges within the NHS, best practice in models of support and training for open disclosure, embedding disclosure conversations in critical incident analysis and disclosure of less serious events