RESUMEN
BACKGROUND: Hesitancy towards the coronavirus disease 2019 (COVID-19) vaccine has been a topic of considerable concern in recent months. Studies have reported hesitancy within the general population and specific facets of the health care system. Little evidence has been published about vaccine hesitancy among Emergency Medical Services (EMS) providers despite them having played a frontline role throughout the pandemic. METHODS: A 27-question survey examining vaccination decisions and potential influencing factors among EMS providers was created and disseminated. Responses from providers who declined a COVID-19 vaccine were compared with responses from providers who did not decline a COVID-19 vaccine. RESULTS: Across 166 respondents, 16% reported declining a COVID-19 vaccine. Providers who self-identified as men, providers who reported conservative or conservative-leaning beliefs, and providers surrounded by environments where the vaccine was discussed negatively or not encouraged are significantly more likely to decline a vaccine (P <.01). Providers who have declined a vaccine reported significantly greater levels of concern about its safety, effectiveness, and development (P <.01). CONCLUSION: This study answers key questions about why some EMS providers might be declining COVID-19 vaccinations. Initiatives to improve vaccination among EMS providers should focus on the areas highlighted, and further studies should continue to examine vaccine hesitancy among EMS providers as well as in other populations.
Asunto(s)
COVID-19 , Servicios Médicos de Urgencia , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/uso terapéutico , Humanos , Masculino , Motivación , SARS-CoV-2 , Estados Unidos/epidemiología , Vacunación , Vacilación a la VacunaciónRESUMEN
BACKGROUND: Palliative care is typically performed in-hospital. However, Emergency Medical Service (EMS) providers are uniquely positioned to deliver early palliative care as they are often the first point of medical contact. The aim of this study was to gather the perspectives of advanced life support (ALS) providers within the South African private EMS sector regarding pre-hospital palliative care in terms of its importance, feasibility and barriers to its practice. METHODS: A qualitative study design employing semi-structured one-on-one interviews was used. Six interviews with experienced, higher education qualified, South African ALS providers were conducted. Content analysis, with an inductive-dominant approach, was performed to identify categories within verbatim transcripts of the interview audio-recordings. RESULTS: Four categories arose from analysis of six interviews: 1) need for pre-hospital palliative care, 2) function of pre-hospital healthcare providers concerning palliative care, 3) challenges to pre-hospital palliative care and 4) ideas for implementing pre-hospital palliative care. According to the interviewees of this study, pre-hospital palliative care in South Africa is needed and EMS providers can play a valuable role, however, many challenges such as a lack of education and EMS system and mindset barriers exist. CONCLUSION: Challenges to pre-hospital palliative care may be overcome by development of guidelines, training, and a multi-disciplinary approach to pre-hospital palliative care.
Asunto(s)
Técnicos Medios en Salud/psicología , Cuidados Paliativos/métodos , Femenino , Humanos , Masculino , Investigación Cualitativa , SudáfricaRESUMEN
BACKGROUND: Emergency medical service (EMS) providers may face sexual harassment (SH) from citizens. No studies have assessed SH prevalence and its association with depressive symptoms among EMS providers in South Korea. METHODS: We conducted a nationwide cross-sectional survey of 1346 EMS providers in South Korea. SH experience was assessed by asking, "During the past 12 months, have you ever experienced sexual harassment on duty by civil citizens?" Depressive symptoms during the preceding week were assessed using the Centers for Epidemiologic Studies Depression Scale. Modified Poisson regression was applied to examine association between SH and depressive symptoms. RESULTS: Among EMS providers, 28.1% of females and 5.6% of males reported sexual harassment. In the gender-stratified analysis, EMS providers those who experienced SH were more likely to have depressive symptoms among females (PR: 2.97, 95% CI: 1.99, 4.44) and males (PR: 2.01, 95% CI: 1.41, 2.86). CONCLUSIONS: Female EMS providers were about five times more likely to experience SH than males.
Asunto(s)
Depresión/epidemiología , Depresión/psicología , Auxiliares de Urgencia/psicología , Acoso Sexual/psicología , Acoso Sexual/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , República de Corea/epidemiología , Distribución por Sexo , Adulto JovenRESUMEN
BACKGROUND: Growing numbers of emergency medical services (EMS) providers respond to patients who receive hospice care. The objective of this investigation was to assess the knowledge, attitudes, and experiences of EMS providers in the care of patients enrolled in hospice care. METHODS: We conducted a survey study of EMS providers regarding hospice care. We collected quantitative and qualitative data on EMS provider's knowledge, attitudes, and experiences in responding to the care needs of patients in hospice care. We used Chi-squared tests to compare EMS provider's responses by credential (Emergency Medical Technician [EMT] vs. Paramedic) and years of experience (0-5 vs. 5+). We conducted a thematic analysis to examine open-ended responses to qualitative questions. RESULTS: Of the 182 EMS providers who completed the survey (100% response rate), 84.1% had cared for a hospice patient one or more times. Respondents included 86 (47.3%) EMTs with Intermediate and Advanced training and 96 (52.7%) Paramedics. Respondent's years of experience ranged from 0-10+ years, with 99 (54.3%) providers having 0-5 years of experience and 83 (45.7%) providers having 5+ years of experience. There were no significant differences between EMTs and Paramedics in their knowledge of the care of these patients, nor were there significant differences (p < 0.05) between those with 0-5 and 5+ years of experience. Furthermore, 53 (29.1%) EMS providers reported receiving formal education on the care of hospice patients. A total of 36% respondents felt that patients in hospice care required a DNR order. In EMS providers' open-ended responses on challenges in responding to the care needs of hospice patients, common themes were family-related challenges, and the need for more education. CONCLUSION: While the majority of EMS providers have responded to patients enrolled in hospice care, few providers received formal training on how to care for this population. EMS providers have expressed a need for a formal curriculum on the care of the patient receiving hospice.
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Auxiliares de Urgencia/psicología , Conocimientos, Actitudes y Práctica en Salud , Cuidados Paliativos al Final de la Vida , Adulto , Estudios Transversales , Curriculum , Servicios Médicos de Urgencia , Auxiliares de Urgencia/educación , Femenino , Georgia , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
The purpose of this study was to evaluate the attitudes and opinions of a broad population of EMS providers on enrolling patients in research without consent. A survey was conducted in 2010 of all EMS providers who participated in the National Registry of Emergency Medical Technicians (NREMT) reregistration process, which included half of all registered providers. Each reregistration packet included our optional survey, which had nine 6-point Likert scale questions concerning their opinion of research studies without consent as well as 8 demographic questions. Responses were collapsed to agree and disagree and then analyzed using descriptive statistics with 99% confidence intervals. A total of 65,993 EMS providers received the survey and 23,832 (36%) participated. Most respondents agreed (98.4%, 99%CI: 98.2-98.6) that EMS research is important, but only 30.9% (99%CI: 30.1-31.6) agreed with enrolling patients without their consent when it is important to learn about a new treatment. Only 46.6% (99%Cl: 45.7-47.4) were personally willing to be enrolled in a study without their consent. A majority (68.5% [99%Cl: 67.7-69.3]) of respondents believed that EMS providers should have the individual right to refuse to enroll patients in EMS research. While the majority of respondents agreed that EMS research is important, considerably less agree with enrolling patients without consent and less than half would be willing to be enrolled in a study without their consent. Prior to starting an Exception from Informed Consent (EFIC) study, researchers should discuss with EMS providers their perceptions of enrolling patients without consent and address their concerns.
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Actitud del Personal de Salud , Investigación Biomédica/ética , Auxiliares de Urgencia/ética , Consentimiento Informado , Sujetos de Investigación , Adulto , Femenino , Humanos , Masculino , Sistema de Registros , Encuestas y Cuestionarios , Estados UnidosRESUMEN
BACKGROUND: Prospective studies have improved knowledge of prehospital spinal immobilization. The opinion of Emergency Medical Services (EMS) providers regarding spinal immobilization is unknown, as is their knowledge of recent research advances. STUDY OBJECTIVES: To examine the attitudes, knowledge, and comfort of prehospital and Emergency Department (ED) EMS providers regarding spinal immobilization performed under a non-selective protocol. METHODS: An online survey was conducted from May to July of 2011. Participants were drawn from the Howard County Department of Fire and Rescue Services and the Howard County General Hospital ED. The survey included multiple choice questions and responses on a modified Likert scale. Correlation analysis and descriptive data were used to analyze results. RESULTS: Comfort using the Kendrick Extrication Device was low among ED providers. Experienced providers were more likely to indicate comfort using this device. Respondents often believed that spinal immobilization is appropriate in the management of penetrating trauma to the chest and abdomen. Reported use of padding decreased along with the frequency with which providers practice and encounter immobilized patients. Respondents often indicated that they perform spinal immobilization due solely to mechanism of injury. Providers who feel as if spinal immobilization is often performed unnecessarily were more likely to agree that immobilization causes an unnecessary delay in patient care. CONCLUSIONS: The results demonstrate the need for improved EMS education in the use of the Kendrick Extrication Device, backboard padding, and spinal immobilization in the management of penetrating trauma. The attitudes highlighted in this study are relevant to the implementation of a selective spinal immobilization protocol.