Research

15 pages, 1073 KiB

Open AccessArticle

An Importance-Performance Analysis of Korean Middle School Students’ Health Management Awareness during the Post-COVID-19 Era Depending on Sex

by Chul-Min Kim, Yi-Hang Huang, Tong Zhou, Min-Jun Kim and Hyun-Su Youn

Healthcare 2024, 12(7), 763; https://doi.org/10.3390/healthcare12070763 - 31 Mar 2024

Viewed by 605

Abstract

This study aimed to conduct importance-performance analyses (IPAs) based on Korean middle school students’ health management awareness during the post-coronavirus disease 2019 (COVID-19) era. Data were collected from 867 Korean middle school students (13–15 years old) via online and offline surveys between May [...] Read more.

This study aimed to conduct importance-performance analyses (IPAs) based on Korean middle school students’ health management awareness during the post-coronavirus disease 2019 (COVID-19) era. Data were collected from 867 Korean middle school students (13–15 years old) via online and offline surveys between May and June 2023. Frequency analysis, reliability analysis, IPA based on the entire student group, and IPA depending on sex were carried out with the collected data, which revealed the following. First, regardless of sex, the IPA results indicated that four factors of mental health were located in the third quadrant, with one factor of the same variable in the fourth quadrant. The three factors of disease management were located in the third quadrant. Regarding physical activity, two factors were located in the first quadrant, one in the second quadrant, and one in the third quadrant. Regarding sleep management, two factors were located in the second quadrant, one in the third quadrant, and one in the first quadrant. Regarding eating management, two factors were located in the third quadrant and one in the fourth quadrant. Regarding the social distancing variable, all four factors were located in the third quadrant. Regarding hygiene management, two factors were located in the first quadrant, one in the third quadrant, and one in the fourth quadrant. Furthermore, the IPA results indicated sex differences in regular sports and vigorous movement activities associated with physical activity. Additionally, a sex difference was observed in regular diet associated with eating management. This study proposed possible measures for encouraging middle school students to recognize the importance of health and increase their health-related performance during the COVID-19 endemic phase. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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13 pages, 970 KiB

Open AccessArticle

Post-Pandemic Burden of COVID-19-Related Restrictions in the Management of Digestive Tract Cancers: A Single Center Study

by Andreea-Luiza Palamaru, Gheorghe G. Balan, Gabriela Stefanescu, Diana Dumitrascu and Elena Toader

Healthcare 2024, 12(6), 691; https://doi.org/10.3390/healthcare12060691 - 19 Mar 2024

Viewed by 591

Abstract

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has required a complete change in the management of patients with gastrointestinal disease who needed to undergo endoscopic procedures. In the second year of the COVID-19 pandemic, due to restrictions [...] Read more.

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has required a complete change in the management of patients with gastrointestinal disease who needed to undergo endoscopic procedures. In the second year of the COVID-19 pandemic, due to restrictions for elective endoscopic procedures, a large number of cancer patients were prevented from early diagnosis of several digestive cancers, which has led to a serious burden in the health system that now needs to be dealt with. We designed a prospective study that included patients in whom access to elective endoscopic examinations during the COVID-19 pandemic had been delayed. Our aim was to investigate the impact of the COVID-19 pandemic on the diagnosis rate of digestive tract malignancies in the context of health crisis management that generates an ethical dilemma regarding the balance of utilitarianism versus deontology. Our study shows that the decrease in the number of newly diagnosed gastrointestinal cancers by endoscopy and biopsy during the pandemic restrictions and the delay in diagnosis have had a clear impact on stage migration due to disease progression. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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12 pages, 239 KiB

Open AccessArticle

Mental Health Status of New Police Trainees before and during the COVID-19 Pandemic

by Joungsue Kim, Jiyoung Yoon, Inah Kim and Jeehee Min

Healthcare 2024, 12(6), 645; https://doi.org/10.3390/healthcare12060645 - 13 Mar 2024

Viewed by 624

Abstract

This study aimed to investigate the mental health of new police trainees during the coronavirus disease 2019 (COVID-19) pandemic in Korea. Two groups of police trainees were surveyed considering the distribution of gender, age, and education level: those who joined the school before [...] Read more.

This study aimed to investigate the mental health of new police trainees during the coronavirus disease 2019 (COVID-19) pandemic in Korea. Two groups of police trainees were surveyed considering the distribution of gender, age, and education level: those who joined the school before COVID-19 and those who joined during the outbreak. Mental health indicators, including insomnia, depression, and anxiety, were compared between the two groups. The prevalence of insomnia, depression, and anxiety significantly varied in the group that joined during COVID-19 compared with the group that joined before. Specifically, insomnia showed a significant change in women, with a higher rate of 2.6%. Although the prevalence of depression was initially low, it increased from 0.4% to 1.3% during the pandemic. Anxiety rates also showed notable differences, particularly among women, with a higher rate of 4.7%. The highest differences in prevalence were observed in the low-income group, with a rate of 7.7% for anxiety. The findings highlight the vulnerability of police officers to psychosocial effects during disasters such as pandemics. Disaster preparedness programs or education can be integrated into new police officer training institutions to help manage mental health changes and promote overall well-being. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

12 pages, 625 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on the Diagnosis and Management of Non-Melanoma Skin Cancer in the Head and Neck Region: A Retrospective Cohort Study

by Simone Benedetti, Andrea Frosolini, Lisa Catarzi, Agnese Marsiglio, Paolo Gennaro and Guido Gabriele

Healthcare 2024, 12(4), 501; https://doi.org/10.3390/healthcare12040501 - 19 Feb 2024

Viewed by 749

Abstract

The present study investigates the impact of the COVID-19 pandemic on the management of Non-Melanoma Skin Cancer (NMSC) in the head and neck region. Conducted at the University Hospital “Le Scotte” in Siena, Italy, the research includes 111 patients treated from 2018 to [...] Read more.

The present study investigates the impact of the COVID-19 pandemic on the management of Non-Melanoma Skin Cancer (NMSC) in the head and neck region. Conducted at the University Hospital “Le Scotte” in Siena, Italy, the research includes 111 patients treated from 2018 to 2021. The study aims to understand how pandemic-related healthcare changes affected NMSC treatment, focusing on differences in diagnosis and management before and during the pandemic. Methods involved retrospective analysis of patient demographics, clinical characteristics, lesion details, and treatment modalities, using Jamovi software (version 1.6) for statistical analysis. Results revealed the scalp as the most common NMSC site, with Squamous Cell Carcinoma (SCC) being the predominant histotype. A significant rise in Basal Cell Carcinoma (BCC) cases and a reduction in surgery duration were noted during the pandemic. The shift to local anesthesia was more pronounced, reflecting the necessity to adapt to healthcare limitations. Despite the disruptions caused by the pandemic, there was no significant drop in NMSC cases, which is attributed to the noticeable nature of head and neck lesions. In conclusion, this study highlights that the COVID-19 pandemic significantly influenced surgical practices in NMSC management, emphasizing the need for effective healthcare strategies that balance quality patient care with public health safety measures. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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13 pages, 274 KiB

Open AccessArticle

Gender Differences Regarding Self-Perceived Physical and Mental Health in Spanish University Sports and Physical Therapy Students after Termination of the COVID-19 Lockdown Period

by Ismael García-Campanario, María Jesús Viñolo Gil, Luc E. Vanlinthout, Carlos Pérez Pérez and Cristina O’Ferrall González

Healthcare 2024, 12(2), 191; https://doi.org/10.3390/healthcare12020191 - 12 Jan 2024

Viewed by 859

Abstract

The COVID-19 pandemic was an unprecedented situation that raised concerns about the physical and mental health of adolescents. Several surveys demonstrated that post-lockdown, women reported more complaints and lower perceived quality of life compared to men. The aim of this study was to [...] Read more.

The COVID-19 pandemic was an unprecedented situation that raised concerns about the physical and mental health of adolescents. Several surveys demonstrated that post-lockdown, women reported more complaints and lower perceived quality of life compared to men. The aim of this study was to analyze gender differences in self-reported physical and mental health immediately after the second lock-down restrictions (July 2020 to December 2020) were suspended and physical exercise classes resumed after a break of several months. This was achieved using a comparative cross-sectional survey of over-18-year-old students from the faculties of Sports Science and Physical Therapy at the University of Cadiz (UCA) in Spain. Quality of life was assessed using two types of questionnaires. The first covered quality of nutrition (PREDIMED), and the second assessed emotional impact (SF12). Physical activity level was estimated using the International Physical Activity Questionnaire (IPAQ). Of the 166 participants in this study, about two-thirds were men. Men had a better perception of their overall health quality than women. In addition, men had significantly fewer limitations in performing activities of daily living than their female counterparts. In contrast, female university students had better coping strategies, that is, they were better able to handle the problems of daily life and did so with more composure, attention, and concentration. These findings highlight the differences in post-release recovery between men and women and can be used to develop programs to promote better living standards and services to reduce gender disparities, which can ultimately improve quality of life. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

11 pages, 909 KiB

Open AccessArticle

Asymptomatic Autonomic Dysregulation after Recovery from Mild COVID-19 Infection Revealed by Analysis of Heart Rate Variability Responses to Task Load

by Toshikazu Shinba, Yujiro Shinba and Shuntaro Shinba

Healthcare 2024, 12(1), 43; https://doi.org/10.3390/healthcare12010043 - 24 Dec 2023

Viewed by 962

Abstract

(1) Background: The coronavirus disease 2019 (COVID-19) infection is often followed by various complications, which can cause disturbances in daily life after recovery from the infectious state, although etiological mechanisms are not fully elucidated. Previous studies have indicated that autonomic dysregulation is an [...] Read more.

(1) Background: The coronavirus disease 2019 (COVID-19) infection is often followed by various complications, which can cause disturbances in daily life after recovery from the infectious state, although etiological mechanisms are not fully elucidated. Previous studies have indicated that autonomic dysregulation is an underlying factor, and it is of interest to clarify whether autonomic dysregulation is also present in the asymptomatic subjects after COVID-19 infection (post-COVID-19) for early detection of post-COVID-19 complications. (2) Methods: In the present study, autonomic activity was assessed using heart rate variability (HRV) analysis in the workers who recovered from mild COVID-19 infection (n = 39). They took a leave of absence for an average of 11.9 days and returned to the original work without complications. HRV was measured after an average of 9.3 days from return. High-frequency (HF) and low-frequency (LF) HRV parameters and heart rate (HR) were recorded during a three-behavioral-state paradigm of approximately 5 min length composed of initial rest, task load, and post-task rest periods and were compared with the data of the workers without the history of COVID-19 infection (normal, n = 38). (3) Results: The HRV and HR scores at the initial rest in the post-COVID-19 subjects showed no difference from those in the control. It is found that the post-COVID-19 subjects exhibited an attenuation of LF/HF increment during the task load and an excessive increase of HF together with a decrease of LF, LF/HF and HR during the post-task rest period in comparison with the initial rest scores. (4) Conclusions: These abnormalities are evaluated as asymptomatic autonomic dysregulation in response to task load, are frequently present after COVID-19 infection, and could be related to the generation of complications. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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14 pages, 239 KiB

Open AccessArticle

Severe Loneliness and Isolation in Nursing Students during COVID-19 Lockdown: A Phenomenological Study

by Pingting Zhu, Wen Wang, Meiyan Qian, Guanghui Shi, Qianqian Zhang, Ting Xu, Huiwen Xu, Hui Zhang, Xinyue Gu, Yinwen Ding, Amanda Lee and Mark Hayter

Healthcare 2024, 12(1), 19; https://doi.org/10.3390/healthcare12010019 (registering DOI) - 21 Dec 2023

Viewed by 965

Abstract

In 2022, COVID-19 continued to spread across the globe, and to stop the spread of the virus and protect people’s health, universities across China continued to remain in a lockdown state. Loneliness is an important topic among college students, and the coronavirus pandemic [...] Read more.

In 2022, COVID-19 continued to spread across the globe, and to stop the spread of the virus and protect people’s health, universities across China continued to remain in a lockdown state. Loneliness is an important topic among college students, and the coronavirus pandemic has exacerbated loneliness. This prolonged school lockdown was unprecedented and it caused severe social isolation and emotional loneliness for students. Few people know how nursing students experience loneliness and find a way through their experience. This qualitative phenomenological study was conducted to reveal the lived experiences of nursing students who indicated COVID-19 lockdown-related loneliness in a previous quantitative survey. We performed 20 semi-structured interviews with nursing students aged 19–23 yrs during their lockdown (April 2022 to June 2022). Our research applied Colaizzi’s seven-step data analysis processes to reveal shared patterns in terms of how nursing students experienced lockdown and found the following four themes: emotional challenges associated with loneliness; causes of loneliness; positive and negative motivation to learn; and accepting solitude and reconstructing real life. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

20 pages, 4900 KiB

Open AccessArticle

Impacts of Complete Unemployment Rates Disaggregated by Reason and Duration on Suicide Mortality from 2009–2022 in Japan

by Ryusuke Matsumoto, Eishi Motomura and Motohiro Okada

Healthcare 2023, 11(20), 2806; https://doi.org/10.3390/healthcare11202806 - 23 Oct 2023

Cited by 2 | Viewed by 866

Abstract

In Japan, suicides had consistently decreased before the COVID-19 pandemic (from 2009–2019), but conversely increased after the pandemic outbreak (from 2020–2022). To identify the features of fluctuations of suicides in Japan, the standardized suicide mortality rates per 100,000 population (SMRP) disaggregated by gender [...] Read more.

In Japan, suicides had consistently decreased before the COVID-19 pandemic (from 2009–2019), but conversely increased after the pandemic outbreak (from 2020–2022). To identify the features of fluctuations of suicides in Japan, the standardized suicide mortality rates per 100,000 population (SMRP) disaggregated by gender (males/females) and age (10-year cohorts) from 2009–2022 were analyzed using interrupted time-series and joinpoint regression analyses. Temporal causalities from unemployment rate (CUR) disaggregated by unemployment duration and reasons for seeking work to SMRP were analyzed using vector autoregressive modelling with Granger causality analysis. SMRP fluctuations from 2009–2022 were composed of three patterns, such as positive discontinuity (increasing) synchronized with the pandemic outbreak, attenuations of decreasing trends before the pandemic, turning from decreasing before the pandemic to increasing/unchanging after the pandemic outbreak. Dismissal CUR positively related to SMRP of working-age generations, whereas voluntary CUR negatively related to SMRP of younger population (<30 years), which turned to persistently increasing before the pandemic (approximately 2016–2017). CUR shorter than 3 months positively related to SMRP of working-age females, which displayed promptly increasing synchronization with the pandemic outbreak. CUR longer than 12 months positively related to SMRP of working-age males, which contributed to persistently increasing SMRPs during the pandemic. These results suggest that increasing SMRP during 2020–2022 in Japan has been probably at-tributed to interactions among the pandemic-related factors, continuous vulnerabilities from before the pandemic and newly developing risk factors for suicides during the pandemic. Unexpectedly, increasing SMRPs of working-age males in 2022 suggest that either prolongation of the pandemic or the ending of the pandemic might positively affect suicides in Japan. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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10 pages, 1097 KiB

Open AccessArticle

Investigating COVID-19 Pandemic Effects on Acute Pancreatitis Development—From the Perspective of Alcohol Sales (Consumption) in a Japanese Regional Hospital

by Fumi Sakuma, Akira Yamamiya, Yoko Abe, Kazunori Nagashima, Takahito Minaguchi, Ken Kashima, Yasuhito Kunogi, Koh Fukushi, Yasunori Inaba, Takeshi Sugaya, Keiichi Tominaga, Kenichi Goda and Atsushi Irisawa

Healthcare 2023, 11(20), 2769; https://doi.org/10.3390/healthcare11202769 - 19 Oct 2023

Viewed by 747

Abstract

[Aim and Background] People’s lifestyles changed considerably due to the coronavirus disease 2019 (COVID-19) pandemic. The number of patients with acute pancreatitis (AP) can be expected to decrease as alcohol consumption decreases. This study was conducted to assess COVID-19 pandemic effects on AP [...] Read more.

[Aim and Background] People’s lifestyles changed considerably due to the coronavirus disease 2019 (COVID-19) pandemic. The number of patients with acute pancreatitis (AP) can be expected to decrease as alcohol consumption decreases. This study was conducted to assess COVID-19 pandemic effects on AP patients in a Japanese regional hospital. [Methods] Based on the first and second states of emergency declarations in Tochigi Prefecture, the survey periods were set as follows: period A, 16 April–14 May; period B, 15 May–13 January; period C, 14 January–7 February; and period D, 8 February–15 April. Using data acquired in 2017, 2018, 2019, and 2020, we retrospectively reviewed the number of patients admitted to our hospital with a diagnosis of AP, and their clinical characteristics. [Results] According to a National Tax Agency survey, the average alcohol sales per adult in Tochigi Prefecture were 71.3 L in 2017 before the pandemic, and 64.0 L in 2021 under the pandemic. The number of AP patients in 2020 was 38% lower than in 2017. Comparing 2017 with 2020, the number of alcoholic AP patients was lower in 2020 (p = 0.007). [Conclusions] The findings suggest that COVID-19-pandemic-related lifestyle changes contributed to the decrease in AP patients. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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15 pages, 3578 KiB

Open AccessArticle

Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic

by Velizar Shivarov, Denitsa Grigorova and Angel Yordanov

Healthcare 2023, 11(18), 2594; https://doi.org/10.3390/healthcare11182594 - 20 Sep 2023

Viewed by 1377

Abstract

Background: The COVID-19 pandemic has led to millions of documented deaths worldwide, with diverse distribution among countries. Surprisingly, Bulgaria, a middle-income European Union member state, ranked highest in COVID-19 mortality. This study aims to assess whether Bulgarian cancer patients experienced a higher relative [...] Read more.

Background: The COVID-19 pandemic has led to millions of documented deaths worldwide, with diverse distribution among countries. Surprisingly, Bulgaria, a middle-income European Union member state, ranked highest in COVID-19 mortality. This study aims to assess whether Bulgarian cancer patients experienced a higher relative risk (RR) of death compared to the general Bulgarian population during the pandemic. Materials and Methods: Data from the Bulgarian National Statistical Institute and the Bulgarian National Cancer Registry were analyzed to estimate monthly RR of death in cancer patients compared to the general population before and during the first two years of the pandemic. The impact of the COVID-19 waves and predominant SARS-CoV-2 variants on RR was evaluated on various cancer types and age groups using a multiple linear regression approach. Results: During the COVID-19 waves, both the general population and cancer patients experienced a significant increase in mortality rates. Surprisingly, the RR of death in cancer patients was lower during pandemic waves. The results from the statistical modeling revealed a significant association between the COVID-19 waves and reduced RR for all cancer patients. Notably, the effect was more pronounced during waves associated with the Alpha and Delta variants. The results also showed varying impacts of the COVID-19 waves on RR when we analyzed subsamples of data grouped depending on the cancer type, age and sex. Conclusions: Despite increased overall mortality in Bulgarian cancer patients during the pandemic, the RR of death was lower compared to the Bulgarian general population, indicating that protective measures were relatively effective in this vulnerable group. This study underscores the importance of implementing and encouraging preventive measures, especially in cancer patients, to mitigate the impact of future viral pandemics and reduce excess mortality. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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19 pages, 6793 KiB

Open AccessArticle

Impact of COVID-19 on Quality of Life in Long-Term Advanced Rectal Cancer Survivors

by Daniel Blasko, Claudia Schweizer, Tim Fitz, Christoph Schröter, Christopher Sörgel, Annett Kallies, Rainer Fietkau and Luitpold Valentin Distel

Healthcare 2023, 11(14), 1981; https://doi.org/10.3390/healthcare11141981 - 08 Jul 2023

Viewed by 1023

Abstract

Colorectal cancer remains one of the most commonly diagnosed cancers. Advanced rectal cancer patients receive neoadjuvant radiochemotherapy as well as surgery and suffer from reduced health-related quality of life due to various side effects. We were interested in the role of the COVID-19 [...] Read more.

Colorectal cancer remains one of the most commonly diagnosed cancers. Advanced rectal cancer patients receive neoadjuvant radiochemotherapy as well as surgery and suffer from reduced health-related quality of life due to various side effects. We were interested in the role of the COVID-19 pandemic and how it affected those patients’ quality of life. A total of 489 advanced rectal cancer patients from the University Hospital Erlangen in Germany were surveyed between May 2010 and March 2022 and asked to fill out the EORTC QLQ-C30 and QLQ-CR38 questionnaires over eight different time points: at the beginning, during and after radiochemotherapy, right before surgery, and in yearly intervals after surgery for up to four years. Answers were converted to scores to compare the COVID-19 period to the time before March 2020, focusing on the follow-ups, the developments over time—including by sex and age—and the influence of the TNM cT-stage. Overall, a trend of impaired functional and symptom scores was found across all surveys with few significances (body image −10.6 percentage points (pp) after one year; defecation problems +13.5 pp, insomnia +10.2 pp and weight loss +9.8 pp after three years; defecation problems +11.3 pp after four years). cT4-stage patients lost significantly more weight than their cT1-3-stage counterparts (+10.7 to 13.7 pp). Further studies should be conducted to find possible causes and develop countermeasures for future major infectious diseases. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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14 pages, 1301 KiB

Open AccessArticle

A Cross-Sectional Assessment of Parental Concerns in the Pediatric Surgery Department during the COVID-19 Pandemic

by Ada Claudia Silvana Gruescu, Calin Popoiu, Mihaela Codrina Levai, Raluca Tudor, Roxana Manuela Fericean and Mircea Rivis

Healthcare 2023, 11(9), 1330; https://doi.org/10.3390/healthcare11091330 - 05 May 2023

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Abstract

The COVID-19 pandemic has impacted various aspects of healthcare, including pediatric surgery. This study aimed to assess parental concerns and stress levels in pediatric surgery during the COVID-19 pandemic, identify factors associated with increased parental anxiety or concern, and provide recommendations for healthcare [...] Read more.

The COVID-19 pandemic has impacted various aspects of healthcare, including pediatric surgery. This study aimed to assess parental concerns and stress levels in pediatric surgery during the COVID-19 pandemic, identify factors associated with increased parental anxiety or concern, and provide recommendations for healthcare providers. A cross-sectional study was conducted in a tertiary pediatric hospital in Timisoara, Romania, involving 174 parents of pediatric patients requiring elective or emergency surgery, with a mean age of 37.6 (25–47) years, out of which 89.1% of respondents were women. Parental concerns were assessed using the Parental Concerns Questionnaire (PCQ), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS-10). Parents of children undergoing emergency surgery (n = 108) reported higher levels on the practical impact domain of the PCQ scale (3.4 vs. 2.2, p < 0.001), emotional impact (2.7 vs. 2.2, p = 0.002), and total PCQ score (9.5 vs. 7.7, p < 0.001) compared to parents of children undergoing elective surgery (n = 66). Parents in the emergent surgery group also reported higher anxiety scores on the HADS questionnaire (7.9 vs. 6.5, p = 0.009) and higher perceived stress and total score on the PSS-10 survey (7.8 vs. 5.6, p = 0.046) (10.5 vs. 9.1, p = 0.047), respectively. A significantly higher proportion of parents in the emergent surgery group were concerned about restricted visitation policies (p = 0.013) and reported delaying or considering delaying their child’s surgery due to the pandemic (p = 0.036). The results demonstrate heightened concerns, anxiety, and stress among parents of children undergoing emergency surgery during the COVID-19 pandemic. Healthcare providers should address parental concerns, provide clear communication, and ensure adequate support for families. Recommendations include enhancing information about COVID-19 precautions, reassuring parents about personal protective equipment availability, and facilitating family support within visitation restrictions. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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15 pages, 1534 KiB

Open AccessArticle

Successive Waves of the COVID-19 Pandemic Had an Increasing Impact on Chronic Cardiovascular Patients in a Western Region of Romania

by Adelina Tudora, Diana Lungeanu, Adina Pop-Moldovan, Maria Puschita and Radu I. Lala

Healthcare 2023, 11(8), 1183; https://doi.org/10.3390/healthcare11081183 - 20 Apr 2023

Cited by 1 | Viewed by 1797

Abstract

Three years since the COVID-19 pandemic started, there is still little information about patients with chronic medical conditions, such as cardiovascular diseases (CVDs), who become infected with SARS-CoV-2. A retrospective analysis was performed to evaluate the impact of the COVID-19 pandemic on patients [...] Read more.

Three years since the COVID-19 pandemic started, there is still little information about patients with chronic medical conditions, such as cardiovascular diseases (CVDs), who become infected with SARS-CoV-2. A retrospective analysis was performed to evaluate the impact of the COVID-19 pandemic on patients with cardiovascular comorbidities hospitalized with positive RT-PCR results for SARS-CoV-2 during the highest peaks of the first three pandemic waves: April 2020, October 2020, and November 2021. The primary outcome was in-hospital mortality; the secondary outcomes were length of hospitalization and required mechanical ventilation to assess the disease severity. Data were extracted from the hospital electronic database system: 680 eligible cases were identified out of 2919 patients. Mortality was the highest in wave 3 (31.9%) compared to the previous waves (13.6% and 25.8%). Hospitalization was also significantly longer in wave 3 (11.58 ± 5.34 vs. 8.94 ± 4.74 and 10.19 ± 5.06; p < 0.001), and so was the need for mechanical ventilation (21.7% vs. 8.2% and 9%; p < 0.001). Older age and male gender were confirmed as highly significant predictors of unfavorable outcomes. Ischemic heart disease worsened the odds of patients’ survival irrespective of the three pandemic waves (Breslow–Day test, p = 0.387), with a marginally significant Mantel–Haenszel common estimate for risk: OR = 1.604, 95% (0.996; 2.586). The significantly worse outcomes in wave 3 could have been influenced by a combination of factors: the low percentage of vaccinations in Romanian population, the more virulent delta strain, and pandemic attrition in the care provided to these patients with chronic CVDs. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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10 pages, 2137 KiB

Open AccessArticle

Child and Adolescent Mental Health during the COVID-19 Pandemic: Challenges of Psychiatric Outpatient Clinics

by Mariela Mosheva, Yael Barzilai, Nimrod Hertz-Palmor, Ehud Mekori-Domachevsky, Asia Avinir, Galit Erez, Noa Vardi, Gila Schoen, Tal Lahav, Hadar Sadeh, Michal Rapaport, Chen Dror, Alex Gizunterman, Shlomit Tsafrir, Doron Gothelf and Yuval Bloch

Healthcare 2023, 11(5), 765; https://doi.org/10.3390/healthcare11050765 - 06 Mar 2023

Cited by 2 | Viewed by 1803

Abstract

Background: Worldwide national surveys show a rising mental health burden among children and adolescents (C&A) during COVID-19. The objective of the current study is to verify the expected rise in visits to psychiatric outpatient clinics of C&A, especially of new patients. Methods: a [...] Read more.

Background: Worldwide national surveys show a rising mental health burden among children and adolescents (C&A) during COVID-19. The objective of the current study is to verify the expected rise in visits to psychiatric outpatient clinics of C&A, especially of new patients. Methods: a cross-sectional study focusing on visits as recorded in electronic medical records of eight heterogeneous C&A psychiatric outpatient clinics. The assessment was based on visits held from March to December of 2019 (before the pandemic) in comparison to visits held in 2020 (during the pandemic). Results: The number of visits was similar for both periods. However, in 2020, 17% of the visits used telepsychiatry (N = 9885). Excluding telepsychiatry reveals a monthly decrease in traditional in-person activities between 2020 and 2019 (691.6 ± 370.8 in 2020 vs. 809.1 ± 422.8 in 2019, mean difference = −117.5, t (69) = −4.07, p = 0.0002, Cohen’s d = −0.30). Acceptation of new patients declined during 2020, compared to 2019 (50.0 ± 38.2 in 2020 vs. 62.8 ± 42.9 in 2019; Z = −3.12, p = 0.002, r = 0.44). Telepsychiatry was not used for new patients. Conclusions: The activity of C&A psychiatric outpatient clinics did not rise but was guarded due to the use of telepsychiatry. The decline in visits of new patients was explained by the lack of use of telepsychiatry for these patients. This calls for expanding the use of telepsychiatry, especially for new patients. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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13 pages, 1257 KiB

Open AccessArticle

Toward a Positive Life beyond COVID-19: Problem-Solving Appraisal as a Resistance Resource in the Relationship between Stress and Well-Being in Students

by Tyrone B. Pretorius and Anita Padmanabhanunni

Healthcare 2023, 11(3), 350; https://doi.org/10.3390/healthcare11030350 - 25 Jan 2023

Cited by 4 | Viewed by 1144

Abstract

The COVID-19 pandemic is a major global stressor that has been associated with elevated risk of negative mental health symptoms. As a helping profession, our main task should be identifying factors that may shield individuals from the negative consequences of stress, rather than [...] Read more.

The COVID-19 pandemic is a major global stressor that has been associated with elevated risk of negative mental health symptoms. As a helping profession, our main task should be identifying factors that may shield individuals from the negative consequences of stress, rather than only focusing on the causes and symptoms of stress. One such factor, identified in the literature, is an individual’s perception of their problem-solving skills. In this study we investigate the role of problem-solving appraisal in the association between perceived stress and psychological well-being. Participants were students (n = 322) who completed the Problem Solving Inventory, the Perceived Stress Scale, the short forms of the trait scale of the State-Trait Anxiety Inventory, and the Beck Hopelessness Scale. The results demonstrate the health-sustaining benefits of problem-solving appraisal, as all dimensions of problem-solving appraisal (problem-solving confidence, approach-avoidance style, and problem-solving control) were directly associated with hopelessness and anxiety. The stress-buffering role of problem-solving appraisal with respect to hopelessness was demonstrated through the interaction between perceived stress and problem-solving appraisal. However, problem-solving appraisal did not buffer the effects of stress on anxiety. The findings indicate that problem-solving appraisal may be an important protective resource that could be beneficial for coping with other negative events and experiences beyond COVID-19. The implications of these findings for interventions are discussed. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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14 pages, 567 KiB

Open AccessArticle

Clinical Characteristics in the Acute Phase of COVID-19 That Predict Long COVID: Tachycardia, Myalgias, Severity, and Use of Antibiotics as Main Risk Factors, While Education and Blood Group B Are Protective

by Jose Guzman-Esquivel, Martha A. Mendoza-Hernandez, Hannah P. Guzman-Solorzano, Karla A. Sarmiento-Hernandez, Iram P. Rodriguez-Sanchez, Margarita L. Martinez-Fierro, Brenda A. Paz-Michel, Efren Murillo-Zamora, Fabian Rojas-Larios, Angel Lugo-Trampe, Jorge E. Plata-Florenzano, Marina Delgado-Machuca and Ivan Delgado-Enciso

Healthcare 2023, 11(2), 197; https://doi.org/10.3390/healthcare11020197 - 09 Jan 2023

Cited by 7 | Viewed by 2698

Abstract

Background: Risk factors for developing long COVID are not clearly established. The present study was designed to determine if any sign, symptom, or treatment of the acute phase, or personal characteristics of the patient, is associated with the development of long COVID. Methods: [...] Read more.

Background: Risk factors for developing long COVID are not clearly established. The present study was designed to determine if any sign, symptom, or treatment of the acute phase, or personal characteristics of the patient, is associated with the development of long COVID. Methods: A cohort study was carried out, randomly selecting symptomatic COVID-19 patients and not vaccinated. The severity of the acute illness was assessed through the number of compatible COVID-19 symptoms, hospitalizations, and the symptom severity score using a 10-point visual analog scale. Results: After multivariate analysis, a severity score ≥8 (RR 2.0, 95%CI 1.1–3.5, p = 0.022), hospitalization (RR 2.1, 95%CI 1.0–4.4, p = 0.039), myalgia (RR 1.9, 95%CI 1.08–3.6, p = 0.027), tachycardia (RR 10.4, 95%CI 2.2–47.7, p = 0.003), and use of antibiotics (RR 2.0, 95%CI 1.1–3.5, p = 0.022), was positively associated with the risk of having long COVID. Higher levels of education (RR 0.6, 95%CI 0.4–0.9, p = 0.029) and type positive B blood group (B + AB, RR 0.44, 95%CI 0.2–0.9, p = 0.044) were protective factors. The most important population attributable fractions (PAFs) for long COVID were myalgia (37%), severity score ≥8 (31%), and use of antibiotics (27%). Conclusions: Further studies in diverse populations over time are needed to expand the knowledge that could lead us to prevent and/or treat long COVID. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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21 pages, 1352 KiB

Open AccessArticle

Exploration of COVID-19 Pandemic Prevention Behaviors among Healthcare Workers

by Hui-Ting Huang, Chung-Hung Tsai, Chia-Fen Wang, Tzu-Chao Chien and Shu-Hao Chang

Healthcare 2023, 11(2), 153; https://doi.org/10.3390/healthcare11020153 - 04 Jan 2023

Viewed by 1936

Abstract

Since the outbreak of COVID-19, the pandemic has become an important topic of global public health. To reduce the rapid spread of the pandemic, compliance with preventive behaviors has become one of the important guidelines from the World Health Organization (WHO). Healthcare workers [...] Read more.

Since the outbreak of COVID-19, the pandemic has become an important topic of global public health. To reduce the rapid spread of the pandemic, compliance with preventive behaviors has become one of the important guidelines from the World Health Organization (WHO). Healthcare workers stand on the frontline for pandemic prevention, and preventive behaviors are essential measures to protect their health and safety. The purpose of this study was to propose an integrative model that explained and predicted COVID-19 preventive behaviors among healthcare workers. The study integrated workplace safety climate and the health belief model (HBM) to verify the impact of workplace safety climate and health belief factors on the safety attitude, safety compliance, and safety satisfaction of healthcare workers performing COVID-19 pandemic prevention behaviors. A cross-sectional study was conducted from March to August 2021 with a self-administered online questionnaire. The sample of the study was drawn from healthcare workers of a famous medical institution in Taipei City as research subjects. After collecting 273 valid questionnaires and verifying them through the analysis of structural equation modeling (SEM), the findings revealed that workplace safety climate had an impact on health belief factors, and then health belief factors had impacts on safety attitudes. In addition, safety attitude affected safety compliance, while safety compliance further affected safety satisfaction. The study showed that workplace safety climate can strengthen healthcare workers’ health beliefs and further affect their safety attitudes, safety compliance, and safety satisfaction. The study attempted to propose a model of healthcare workers’ pandemic prevention behaviors as a reference for medical facility administrators in real practice. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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13 pages, 2129 KiB

Open AccessArticle

The Risk of SARS-CoV-2 Infection in Pregnant Women: An Observational Cohort Study Using the BIFAP Database

by Mercedes Mota, Consuelo Huerta-Álvarez, Ana Llorente and Lucia Cea-Soriano

Healthcare 2022, 10(12), 2429; https://doi.org/10.3390/healthcare10122429 - 02 Dec 2022

Cited by 2 | Viewed by 1634

Abstract

Background: It has been suggested that women experiencing during pregnancy several physiological and immunological changes that might increase the risk of any infection including the SARS-CoV-2. Objective: We aimed to quantify the risk of SARS-CoV-2 infection during pregnancy compared with women with no [...] Read more.

Background: It has been suggested that women experiencing during pregnancy several physiological and immunological changes that might increase the risk of any infection including the SARS-CoV-2. Objective: We aimed to quantify the risk of SARS-CoV-2 infection during pregnancy compared with women with no pregnancies. Methods: We used data from the BIFAP database and a published algorithm to identify all pregnancies during 2020. Pregnancies were matched (1:4) by age region, and length of pregnancy with a cohort of women of childbearing age. All women with SARS-CoV-2 infection before entering the study were discarded. We estimated incidence rates of SARS-CoV-2 with 95% confidence intervals (CIs) expressed by 1000 person-months as well as Kaplan–Meier figures overall and also stratified according to pregnancy period: during pregnancy, at puerperium (from end of pregnancy up to 42 days) and after pregnancy. (from 43 days after pregnancy up to end pf study period (i.e., June 2021). We conducted a Cox regression to assess risk factors for SARS-COV infection. The incidence rate of SARS-CoV-2 infection expressed by 1000 person-months were. Results: There was a total of 103,185 pregnancies and 412,740 matched women at childbearing, with a mean age of 32.3 years. The corresponding incidence rates of SARS-CoV-2 infection according to cohorts were: 2.44 cases per 1000 person-months (confidence interval (CI) 95%: 2.40–2.50) and 4.29 (95% CI: 4.15–4.43) for comparison cohort. The incidence rate ratio (IRR) of SARS-CoV-2 was 1.76 (95% CI: 1.69–1.83). When analyzing according to pregnancy period, the IRRs were 1.30 (95% CI: 11.20–1.41) during the puerperium and 1.19 (95% CI: 41.15–1.23) after pregnancy. In addition to pregnancy itself, other important risk factors were obesity (1.33 (95% CI: 1.23–1.44)) and diabetes (1.23 (95% CI: 11.00–1.50). Conclusion: Pregnant women are at increased risk of SARS-CoV-2 infection compared with women of childbearing age not pregnant. Nevertheless, there is a trend towards reverting during puerperium and after pregnancy. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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Review

Jump to: Research, Other

14 pages, 295 KiB

Open AccessReview

Impact of the COVID-19 Pandemic on the Lifestyle and Psychosocial Behavior of Patients with Inflammatory Bowel Diseases: A Narrative Review

by Yu Nishida, Shuhei Hosomi, Yumie Kobayashi, Rieko Nakata, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Noriko Kamata and Yasuhiro Fujiwara

Healthcare 2023, 11(19), 2642; https://doi.org/10.3390/healthcare11192642 - 28 Sep 2023

Cited by 1 | Viewed by 744

Abstract

The coronavirus disease (COVID-19) pandemic has had a considerable impact on the global healthcare system and potentially the clinical course of patients with inflammatory bowel disease (IBD). Although IBD is a chronic disease, its therapy (except steroid therapy) does not increase the risk [...] Read more.

The coronavirus disease (COVID-19) pandemic has had a considerable impact on the global healthcare system and potentially the clinical course of patients with inflammatory bowel disease (IBD). Although IBD is a chronic disease, its therapy (except steroid therapy) does not increase the risk of contracting or aggravating COVID-19. However, the clinical course of patients is significantly influenced by environmental factors. Social restrictions due to the pandemic or the fear of contracting the virus have influenced lifestyle and psychosocial behaviors that may worsen the clinical course of patients with IBD. This narrative literature review summarizes the current evidence on the impact of the COVID-19 pandemic on the lifestyle and psychosocial behaviors of patients with IBD. The COVID-19 pandemic negatively affected the lifestyle and psychosocial behaviors of patients with IBD. Furthermore, patients with IBD failed to maintain medication adherence, thus affecting the clinical course of their condition. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

Other

Jump to: Research, Review

26 pages, 1236 KiB

Open AccessSystematic Review

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review

by Mehri Karimi-Dehkordi, Heather M. Hanson, James Silvius and Adrian Wagg

Healthcare 2024, 12(7), 807; https://doi.org/10.3390/healthcare12070807 - 08 Apr 2024

Viewed by 581

Abstract

This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities (LTCFs). A systematic review was conducted to summarize and synthesize empirical studies using a multi-level analysis approach to address the identified influential factors. [...] Read more.

This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities (LTCFs). A systematic review was conducted to summarize and synthesize empirical studies using a multi-level analysis approach to address the identified influential factors. Five databases were searched on 23 May 2023. To be included in the review, studies had to be published in peer-reviewed journals or as grey literature containing relevant statistical data. The Joanna Briggs Institute critical appraisal tool was employed to assess the methodological quality of each article included in this study. Of 2137 citations identified after exclusions, 99 records met the inclusion criteria. The predominant individual, organizational, and environmental factors that were most frequently found associated with the COVID-19 outbreak comprised older age, higher dependency level; lower staffing levels and lower star and subset domain ratings for the facility; and occupancy metrics and co-occurrences of outbreaks in counties and communities where the LTCFs were located, respectively. The primary individual, organizational, and environmental factors frequently linked to COVID-19-related deaths comprised age, and male sex; higher percentages of racial and ethnic minorities in LTCFs, as well as ownership types (including private, for-profit, and chain membership); and higher occupancy metrics and LTCF’s size and bed capacity, respectively. Unfolding the risk factors collectively may mitigate the risk of outbreaks and pandemic-related mortality in LTCFs during future endemic and pandemics through developing and improving interventions that address those significant factors. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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12 pages, 572 KiB

Open AccessStudy Protocol

A Prospective Multicenter Longitudinal Analysis of Suicidal Ideation among Long-COVID-19 Patients

by Alessandra Costanza, Andrea Amerio, Andrea Aguglia, Luca Magnani, Jacques Alexander, Alessandra Maiorano, Hélène Richard-Lepouriel, Elena Portacolone, Isabella Berardelli, Maurizio Pompili, Gianluca Serafini, Mario Amore and Khoa D. Nguyen

Healthcare 2024, 12(3), 290; https://doi.org/10.3390/healthcare12030290 - 23 Jan 2024

Viewed by 941

Abstract

Long coronavirus disease 19 (COVID-19) is an emerging multifaceted illness with the pathological hallmarks of chronic inflammation and neuropsychiatric symptoms. These pathologies have also been implicated in developing suicidal behaviors and suicidal ideation (SI). However, research addressing suicide risk in long COVID-19 is [...] Read more.

Long coronavirus disease 19 (COVID-19) is an emerging multifaceted illness with the pathological hallmarks of chronic inflammation and neuropsychiatric symptoms. These pathologies have also been implicated in developing suicidal behaviors and suicidal ideation (SI). However, research addressing suicide risk in long COVID-19 is limited. In this prospective study, we aim to characterize SI development among long-COVID-19 patients and to determine the predictive power of inflammatory markers and long-COVID-19 symptoms—including those of psychiatric origin—for SI. During this prospective, longitudinal, multicenter study, healthy subjects and long-COVID-19 patients will be recruited from the University Hospital of Geneva, Switzerland, the University of Genova, the University of Rome “La Sapienza”, and the University of San Francisco. Study participants will undergo a series of clinic visits over a follow-up period of 1 year for SI assessment. Baseline and SI-onset levels of inflammatory mediators in plasma samples, along with 12 long-COVID-19 features (post-exertional malaise, fatigue, brain fog, dizziness, gastrointestinal disturbance, palpitations, changes in sexual desire/capacity, loss/change of smell/taste, thirst, chronic cough, chest pain, and abnormal movements) will be collected for SI risk analysis. The proposed enrollment period is from 15 January 2024 to 15 January 2026 with targeted recruitment of 100 participants for each study group. The anticipated findings of this study are expected to provide important insights into suicide risk among long-COVID-19 patients and determine whether inflammation and psychiatric comorbidities are involved in the development of SI in these subjects. This could pave the way to more effective evidence-based suicide prevention approaches to address this emerging public health concern. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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