RESUMEN
ObjectivesWe examined whether providing different types of information about Long COVID would affect expectations about the illness. DesignA 2 (Illness description: Long COVID vs ongoing COVID-19 recovery) x 2 (Illness uncertainty: uncertainty emphasised vs uncertainty not emphasised) x 2 (Efficacy of support: enhanced support vs basic support) between-subjects randomised online experimental study. SettingThe online platform Prolific, collected in October 2021. ParticipantsA representative sample of 1110 members of the public in the UK. InterventionsParticipants were presented with a scenario describing a positive COVID-19 test result and then presented with one of eight scenarios describing a Long COVID diagnosis. Primary and Secondary Outcome MeasuresVarious outcome measures relating to illness expectations were captured including: symptom severity, symptom duration, quality of life, personal control, treatment control and illness coherence. ResultsWe ran a series of 2 x 2 x 2 ANOVAs on the outcome variables. We found a main effect of illness description: individuals reported longer symptom duration and less illness coherence when the illness was described as Long COVID (compared to ongoing COVID-19 recovery). There was a main effect of illness uncertainty: when uncertainty was emphasised, participants reported longer expected symptom duration, less treatment control, and less illness coherence than when uncertainty was not emphasised. There was also a main effect of efficacy of support: participants reported higher personal control and higher treatment control when support was enhanced (compared to basic support). We also found an interaction between illness description and efficacy of support: when support was enhanced, participants reported less illness coherence for Long COVID (compared to ongoing COVID-19 recovery). ConclusionsCommunications around Long COVID should not emphasise symptom uncertainty and should provide people with information on how they can facilitate their recovery and where they can access additional support. The findings also suggest that use of the term ongoing COVID-19 recovery, where possible, may reduce negative expectations associated with the illness. Strengths and Limitations of this studyO_LIThis is one of the first experimental designed studies to assess the impact of different types of communication about Long COVID. C_LIO_LIParticipants were a UK representative sample, although these findings are not necessarily applicable to all population groups (i.e., ethnic minorities). C_LIO_LIThis study is one of the first applications of the IPQ-R in a hypothetical, online experiment, with high reliability. C_LIO_LIThis was an online experiment, with hypothetical scenarios and participants with no experience of COVID-19 or Long COVID, therefore outcomes may be different in a real-world context. C_LI
RESUMEN
BackgroundThe COVID-19 pandemic generated a surge of critically ill patients greater than the NHS capacity. Additionally, there have been multiple well-documented impacts associated with the national COVID-19 pandemic surge on ICU workers, including an increased prevalence of mental health disorders on a scale potentially sufficient to impair high-quality care delivery. AimTo identify prevalence of probable mental health disorders and functional impairment. As well as establish demographic and professional predictors of probable mental health disorders and functional impairment in ICU staff between November 2020 to April 2021. MethodsEnglish ICU staff were surveyed before, during and after the winter 2020/2021 surge using a survey which comprised of validated measures of mental health. Results6080 surveys were completed, by nurses (57.5%), doctors (27.9%), and other healthcare staff (14.5%). Reporting probable mental health disorders increased from 51% (prior to), to 64% (during) and then dropped to 46% (after). Younger, less experienced and nursing staff were most likely to report probable mental health disorders. Additionally, during and after the winter, over 50% of participants met threshold criteria for functional impairment. Staff who reported probable post-traumatic stress disorder, anxiety or depression were more likely to meet threshold criteria for functional impairment. ConclusionsThe winter of 2020/2021 was associated with an increase in poor mental health outcomes and functional impairment during a period of peak caseload. These effects are likely to impact on patient care outcomes and the longer-term resilience of the healthcare workforce.
RESUMEN
ObjectivesIndividuals who receive a negative lateral flow coronavirus (Covid-19) test result may misunderstand it as meaning no risk of infectiousness, giving false reassurance. This experiment tested the impact of adding information to negative test result messages about (a) residual risk and (b) need to continue protective behaviours. Design4 (residual risk) x 2 (post-test result behaviours) between-subjects design. SettingOnline. Participants1200 adults from a representative UK sample recruited via Prolific (12-15 March 2021). InterventionsParticipants were randomly allocated to one of eight messages. Residual risk messages were: 1) Your coronavirus test result is negative (control); 2) Message 1 plus Its likely you were not infectious when the test was done (Current NHS Test & Trace); 3) Message 2 plus But there is still a chance you may be infectious (Elaborated NHS T&T); 4) Message 3 plus infographic depicting residual risk (Elaborated NHS T&T + infographic). Each message contained either no additional information or information about behaviour, i.e. the need to continue following guidelines and protective behaviours. Outcome measures(i) proportion understanding residual risk of infectiousness and (ii) likelihood of engaging in protective behaviours (score range 0-7). ResultsThe control message decreased understanding relative to the current NHS T&T message: 54% vs 71% (AOR=0.37 95% CI [0.22, 0.61], p<.001). Understanding increased with the elaborated NHS T&T (89%; AOR=3.27 95% CI [1.78, 6.02], p<.001) and elaborated NHS T&T + infographic (91%; AOR=4.03 95% CI [2.14, 7.58], p<.001) compared to current NHS T&T message. Likelihood of engaging in protective behaviours was unaffected by information (F(1,1192)=0.43, p=.513), being high (M=6.4, SD=0.9) across the sample. ConclusionsThe addition of a single sentence ( But there is still a chance you may be infectious) to current NHS Test & Trace wording increased understanding of the residual risk of infection. Trial registrationOpen Science Framework: https://osf.io/byfz3/
RESUMEN
Mathematical modelling is an important public health tool for aiding understanding the spread of respiratory infectious diseases, such as influenza or COVID-19, and for quantifying the effects of behavioural interventions. However, such models rarely explicitly appeals to theories of human behaviour to justify model assumptions. Here we propose a novel mathematical model of disease transmission via fomites (luggage trays) at airport security screening during an outbreak. Our model incorporates the self-protective behaviour of using hand sanitiser gel in line with the extended parallel processing model (EPPM) of behaviour. We find that changing model assumptions of human behaviour in line with the EPPM gives qualitatively different results on the optimal placement of hand sanitiser gels within an airport compared to the model with naive behavioural assumptions. Specifically, that it is preferable to place hand sanitiser gels after luggage screening in most scenarios, however in situations where individuals perceive high threat and low efficacy this strategy may need to be reviewed. This model demonstrates how existing behavioural theories can be incorporated into mathematical models of infectious disease.
RESUMEN
ObjectivesTo understand the experiences of those who underwent supported isolation as part of the response to the COVID-19 pandemic, after returning to the UK from Wuhan, China. DesignWe used semi-structured interviews to capture participants experiences and perceptions of supported isolation. SettingTelephone interviews carried out within approximately one month of an individual leaving supported isolation. Participants26 people who underwent supported isolation at either Arrowe Park Hospital (n = 18) or Kents Hill Park Conference Centre (n = 8) after being repatriated from Wuhan in January - February 2020. ResultsParticipants were willing to undergo supported isolation because they understood that it would protect themselves and others. Positive treatment by staff was fundamental to participants willingness to comply with isolation procedures. Despite the high level of compliance, participants expressed some uncertainty about what the process would involve. ConclusionsAs hotel quarantine is introduced across the UK for international arrivals, our findings suggest that those in charge should: communicate effectively before, during and after quarantine, emphasising why quarantine is important and how it will protect others; avoid enforcement and focus on supporting and promoting voluntary compliance; facilitate shared social experiences for those in quarantine; and ensure all necessary supplies are provided. Doing so will increase adherence and reduce any negative effects on wellbeing.
RESUMEN
BackgroundIntensive Care Unit (ICU), anaesthetic and theatres staff have faced significant challenges during the COVID-19 pandemic which have the potential to adversely affect their mental health AimsTo identify the rates of probable mental health disorder in ICU and anaesthetic staff in six English hospitals during June and July 2020 MethodsAn anonymised brief web-based survey comprising standardised questionnaires examining depression, anxiety symptoms, symptoms of Post Traumatic Stress Disorder (PTSD), wellbeing and alcohol use was administered to staff. Results709 participants completed the surveys comprising 291 (41%) doctors, 344 (48.5%) nurses, and 74 (10.4%) other healthcare staff. Over half (58.8%) reported good wellbeing, however 45.4% met the threshold for probable clinical significance on at least one of the following measures: severe depression (6.3%), PTSD (39.5%), severe anxiety (11.3%) or problem drinking (7.2%). 13.4% of respondents reported frequent thoughts of being better off dead, or of hurting themselves in the past two weeks. We found that doctors consistently reported better mental health than nurses. ConclusionsWe found substantial rates of probable mental health disorders, and thoughts of self-harm, amongst ICU staff; these difficulties were especially prevalent in nurses. These results indicate the need for a national strategy to protect the mental health, and decrease the risk of functional impairment, of ICU staff whilst they carry out their essential work during COVID-19. Occ Med Statements: article should contain 3 statements (each max of 3 bullets of max 50 words each)O_ST_ABSWhat is already known about this subjectC_ST_ABSO_LIIntensive care unit (ICU) staff are regularly exposed to traumatic situations as part of their job C_LIO_LIPrevious studies have shown them to be at risk of psychological and moral distress C_LIO_LILittle is known about the mental health of ICU staff during the current pandemic C_LI What this study addsO_LIAlmost half of ICU staff report symptoms consistent with a probable diagnosis of post traumatic stress disorder, severe depression or anxiety or problem drinking C_LIO_LIAround 1 in 7 ICU staff report recent thoughts of self-harm or of wanting to be better off dead C_LIO_LINursing staff are more likely to report higher levels of distress than doctors or other clinical staff C_LI What impact this may have on practice or policyO_LIHealthcare managers need to prioritise staff mental health support and timely access to evidence based treatments for ICU staff C_LIO_LISupervisors and managers should be aware that a substantial proportion of ICU staff may perform less well because of their current poor state of mental health C_LIO_LIMore work is needed to understand whether the high levels of mental health symptoms identified in this study are truly indicative of high levels of clinical need for mental healthcare C_LI
RESUMEN
Healthcare workers (HCWs) are frontline responders to emergency infectious disease outbreaks such as COVID-19. We investigated factors associated with adherence to personal protective behaviours in UK HCWs during the COVID-19 pandemic using an online cross-sectional survey of 1035 healthcare professionals in the UK. Data were collected between 12th and 16th June 2020. Adjusted logistic regressions were used to separately investigate factors associated with adherence to use of personal protective equipment, maintaining good hand hygiene, and physical distancing from colleagues. Adherence to personal protective measures was suboptimal (PPE use: 80.0%, 95% CI [77.3 to 82.8], hand hygiene: 67.8%, 95% CI [64.6 to 71.0], coming into close contact with colleagues: 74.7%, 95% CI [71.7 to 77.7]). Adherence to PPE use was associated with having adequate PPE resources, receiving training during the pandemic, lower perceived fatalism from COVID-19, higher perceived social norms and higher perceived effectiveness of PPE. Adherence to physical distancing was associated with ones workplace being designed, using markings to facilitate physical distancing and receiving training during the pandemic. There were few associations with adherence to hand hygiene. Findings indicate HCWs should receive training on personal protective behaviours to decrease fatalism over contracting COVID-19 and increase perceived effectiveness of protective measures.
RESUMEN
Infectious disease outbreaks can be distressing for everyone, especially so for those deemed to be particularly vulnerable, such as pregnant women who have been named a high-risk group in the current COVID-19 pandemic. This rapid review aimed to summarise existing literature on the psychological impact of infectious disease outbreaks on women who were pregnant at the time of the outbreak. In April 2020 five databases were searched for relevant literature and main findings were extracted. Thirteen papers were included in the review. The following themes were identified: negative emotional states; living with uncertainty; concerns about infection; concerns about and uptake of prophylaxis or treatment; disrupted routines; non-pharmaceutical protective behaviours; social support; demands from others; financial and occupational concerns; disrupted expectations of birth, prenatal care and postnatal care, and; sources of information. Results showed that pregnant women have unique needs during infectious disease outbreaks and could benefit from: up-to-date, consistent information and guidance; appropriate support and advice from healthcare professionals, particularly with regards to the risks and benefits of prophylaxis and treatment; virtual support groups, and; designating locations or staff specifically for pregnant women.