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Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between...
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Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 18142

Special Issue Editors

Dr. Stinne Glasdam

E-Mail Website
Guest Editor
Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1 B, S-222 41 Lund, Sweden
Interests: COVID-19; antimicrobial resistance; cancer; older adults; healthcare professionals; sociological medicine
Dr. Frode F. Jacobsen

E-Mail Website
Guest Editor
1. Centre of Care Research (West), Western Norway University of Applied Sciences (HVL), 5009 Bergen, Norway
2. Faculty of Health Studies, VID Specialized University, N-5009 Bergen, Norway
Interests: older adults; organisations; healthcare professionals; anthropology
Dr. Sigrid Stjernswärd

E-Mail Website
Guest Editor
Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1 B, S-222 41 Lund, Sweden
Interests: COVID-19; healthcare professionals; mental health; social media; e-Health; mindfullnes

Special Issue Information

Dear Colleagues,

During the current coronavirus pandemic, frontline health professionals stand on precarious grounds in an unknown situation and with continuous news feeds. Health professionals’ work situation is affected by the pandemic in multiple ways, for instance through an increased workload because of the relocation of colleagues to other units and related task shifts, the absence of relatives to support and care for patients, safety issues, and novel and constantly updated work routines. In addition, health professionals have difficulties navigating the contradictory needs for both closeness to and distance from patients, and to find time for catering to increased need for information and follow-up of close family of patients. Health professionals can, as with all others, be affected by an unpredictable future, including experiences of work-related stress, feelings of distress, worry, insecurity, etc. A crisis, such as the pandemic, places several constraints on the common practices of frontline healthprofessionals, both in hospitals and in the primary health care sector. However, such sudden limitations also often open the door to creativity and new solutions. Other solutions, which are right up our street, are not used, they are not even recognised as possibilities. This Special Issue will focus on how health professionals work between these limitations and opportunities through the COVID-19 pandemic; this to handle the pandemic and with the potential to develop healthcare and health professionals' practices in the future. This Special Issue of Healthcare seeks original research, case studies, debate articles, reflections, and reviews on practices and strategies of health professionals created or exacerbated by the COVID-19 pandemic. This can relate to: the development and adaptation of clinical guidelines; seeking new ways of working due to and related to the pandemic; clinical work with patients affected by COVID-19, relatives, and colleagues, etc.; experienced limitations in terms of existing knowledge and clinical routines, with more. These are only suggestions, which the current Special Issue is not limited to. All kind of studies about creative and innovative suggestions in line with the topic at stake are welcome.

Dr. Stinne Glasdam
Dr. Frode F. Jacobsen
Dr. Sigrid Stjernswärd
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • healthcare professionals
  • encounters with patients
  • strategies
  • practices
  • creativity
  • innovation
  • limitations
  • collegial relationships

Published Papers (10 papers)

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Editorial

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3 pages, 198 KiB  
Editorial
Practices and Strategies of Health Professionals during the COVID-19 Pandemic—Between Limitations and Opportunities
by Stinne Glasdam, Frode F. Jacobsen and Sigrid Stjernswärd
Healthcare 2022, 10(10), 1817; https://doi.org/10.3390/healthcare10101817 - 21 Sep 2022
Viewed by 1005
Abstract
The COVID-19 pandemic was declared as such in March 2020 [...] Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)

Research

Jump to: Editorial

24 pages, 11135 KiB  
Article
The Patient Flow Effect of Pandemic Policies: A Hybrid Simulation Study in a Norwegian Emergency Department
by Gaute Terning, Eric Christian Brun and Idriss El-Thalji
Healthcare 2023, 11(1), 1; https://doi.org/10.3390/healthcare11010001 - 20 Dec 2022
Cited by 1 | Viewed by 1554
Abstract
The COVID-19 pandemic required several interventions within emergency departments, complicating the patient flow. This study explores the effect of intervention policies on patient flow in emergency departments under pandemic conditions. The patient flow interventions under evaluation here are the addition of extra treatment [...] Read more.
The COVID-19 pandemic required several interventions within emergency departments, complicating the patient flow. This study explores the effect of intervention policies on patient flow in emergency departments under pandemic conditions. The patient flow interventions under evaluation here are the addition of extra treatment rooms and the addition of a waiting zone. A predeveloped hybrid simulation model was used to conduct five scenarios: (1) pre-pandemic patient flow, (2) patient flow with a 20% contamination rate, (3) adding extra treatment rooms to patient flow, (4) adding a waiting zone to the patient flow, (5) adding extra treatment rooms and a waiting zone to the patient flow. Experiments were examined based on multiple patient flow metrics incorporated into the model. Running the scenarios showed that introducing the extra treatment rooms improved all the patient flow parameters. Adding the waiting zone further improved only the contaminated patient flow parameters. Still, the benefit of achieving this must be weighed against the disadvantage for ordinary patients. Introducing the waiting zone in addition to the extra treatment room has one positive effect, decreasing time that the treatment rooms are blocked for contaminated patients entering the treatment room. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
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12 pages, 261 KiB  
Article
Coping and Social Resilience during the COVID-19 Pandemic: A Qualitative Follow-Up Study among Healthcare Workers in Norwegian Public In-Home Services
by Aud Johannessen, Anne-Sofie Helvik, Kjerstin Elisabeth Tevik and Kirsten Thorsen
Healthcare 2022, 10(12), 2518; https://doi.org/10.3390/healthcare10122518 - 13 Dec 2022
Viewed by 1444
Abstract
Background: Healthcare workers (HCWs) are central and serve in the frontlines when epidemics threaten public health. Thus, certain communities may be hardest hit by these challenges. Interventions supporting HCWs are important, and to develop these, understanding their experiences is essential. Aim: To explore [...] Read more.
Background: Healthcare workers (HCWs) are central and serve in the frontlines when epidemics threaten public health. Thus, certain communities may be hardest hit by these challenges. Interventions supporting HCWs are important, and to develop these, understanding their experiences is essential. Aim: To explore how HCWs in Norwegian public in-home services experienced work during the COVID-19 pandemic over time. Method: A longitudinal qualitative study with two data collections approximately one year apart (2021 and 2022) was performed. Individual interviews were conducted with HCWs. Results: The analysis resulted in six main themes: Changing everything, Redefining ‘necessary tasks’, Distancing and loneliness, Cooperation and coordination, More infections and fewer worries and Lessons for the future. These indicate capabilities and processes, how they are evolving over time, and outcomes. The first two themes focus on the first period of the pandemic, the next two on the ongoing intermediate period, and the final two cover the last period. Conclusion: The HCWs’ narratives have demonstrated their collective coping based on adaptive and transformative capacities. Further, they have enlisted experienced social resilience in their strategies for coping with the COVID-19 challenges. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
22 pages, 5178 KiB  
Article
Blockchain in Healthcare: A Decentralized Platform for Digital Health Passport of COVID-19 Based on Vaccination and Immunity Certificates
by Abdul Razzaq, Syed Agha Hassnain Mohsan, Shahbaz Ahmed Khan Ghayyur, Nouf Al-Kahtani, Hend Khalid Alkahtani and Samih M. Mostafa
Healthcare 2022, 10(12), 2453; https://doi.org/10.3390/healthcare10122453 - 05 Dec 2022
Cited by 5 | Viewed by 2682
Abstract
COVID-19 has become a very transmissible disease that has had a worldwide impact, resulting in a huge number of infections and fatalities. Testing is critical to the pandemic’s successful response because it helps detect illnesses and so attenuate (isolate/cure) them and now vaccination [...] Read more.
COVID-19 has become a very transmissible disease that has had a worldwide impact, resulting in a huge number of infections and fatalities. Testing is critical to the pandemic’s successful response because it helps detect illnesses and so attenuate (isolate/cure) them and now vaccination is a life-safer innovation against the pandemic which helps to make the immunity system stronger and fight against this infection. Patient-sensitive information, on the other hand, is now held in a centralized or third-party storage paradigm, according to COVID-19. One of the most difficult aspects of using a centralized storage strategy is maintaining patient privacy and system transparency. The application of blockchain technology to support health initiatives that can minimize the spread of COVID-19 infections in the context of accessibility of the system and for verification of digital passports. Only by combining blockchain technology with advanced cryptographic algorithms can a secure and privacy-preserving solution to COVID-19 be provided. In this article, we investigate the issue and propose a blockchain-based solution incorporating conscience identity, encryption, and decentralized storage via interplanetary file systems (IPFS). For COVID-19 test takers and vaccination takers, our solution includes digital health passports (DHP) as a certification of test or vaccination. We explain smart contracts constructed and tested with Ethereum to preserve a DHP for test and vaccine takers, allowing for a prompt and trustworthy response from the necessary medical authorities. We use an immutable trustworthy blockchain to minimize medical facility response times, relieve the transmission of incorrect information, and stop the illness from spreading via DHP. We give a detailed explanation of the proposed solution’s system model, development, and assessment in terms of cost and security. Finally, we put the suggested framework to the test by deploying a smart contract prototype on the Ethereum TESTNET network in a Windows environment. The study’s findings revealed that the suggested method is effective and feasible. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
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14 pages, 296 KiB  
Article
“Talking on the Phone Is Very Cold”—Primary Health Care Nurses’ Approach to Enabling Patient Participation in the Context of Chronic Diseases during the COVID-19 Pandemic
by Marcus Heumann, Edurne Zabaleta-del-Olmo, Gundula Röhnsch and Kerstin Hämel
Healthcare 2022, 10(12), 2436; https://doi.org/10.3390/healthcare10122436 - 02 Dec 2022
Cited by 1 | Viewed by 1570
Abstract
Strengthening patient participation is considered a crucial element of primary health care (PHC) nurses’ practice when working with chronically ill patients. The COVID-19 pandemic had extraordinary effects on PHC nursing routines and how chronically ill patients’ could be involved in their own care. [...] Read more.
Strengthening patient participation is considered a crucial element of primary health care (PHC) nurses’ practice when working with chronically ill patients. The COVID-19 pandemic had extraordinary effects on PHC nursing routines and how chronically ill patients’ could be involved in their own care. This study investigates the adaptation of Spanish PHC nurses’ approaches to supporting the participation of patients living with chronic illness during the COVID-19 pandemic. To reach this goal, we interviewed 13 PHC nurses who practiced in PHC centers in Spain. The interviews were analyzed using thematic coding. Three themes emerged from the descriptions of the nurses: (1) High COVID-19-related workload, decreasing health promotion, and chronic care, (2) Emphasis on patients’ and families’ self-responsibility, (3) Expanded digital and telephone communication with fewer in-person consultations. Nurses felt especially challenged to uphold the support for vulnerable groups, such as older people or patients without family support. Future research should focus on how the participation of the most vulnerable chronic patients can be supported in the context of the growing relevance of remote care. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
12 pages, 543 KiB  
Article
Exploring the Feasibility of an Online Diabetes Wellness Programme among Periodontitis Patients with Type II Diabetes Mellitus during the COVID-19 Pandemic
by Nur Fadzlin Syahira Rusly, Nor Aini Jamil, Tuti Ningseh Mohd-Dom, Haslina Rani, Shahida Mohd-Said, Nur Adila Mohd-Norwir and Afendi Hamat
Healthcare 2022, 10(11), 2129; https://doi.org/10.3390/healthcare10112129 - 26 Oct 2022
Cited by 1 | Viewed by 1222
Abstract
There were massive interruptions, including patient visits for dietary advice and dental services, during the COVID-19 outbreak. This study assessed the feasibility of an online diabetes wellness programme among periodontitis patients with type II diabetes mellitus. Patients were grouped into the intervention group [...] Read more.
There were massive interruptions, including patient visits for dietary advice and dental services, during the COVID-19 outbreak. This study assessed the feasibility of an online diabetes wellness programme among periodontitis patients with type II diabetes mellitus. Patients were grouped into the intervention group (IG) and control group (CG). At baseline and week 12, all patients answered online questionnaires on diabetes-related knowledge, physical activity, and oral impacts on daily performances (OIDP). Body weight and waist circumference were self-measured with guided instructions. Diet recalls were used to estimate dietary and added sugar intake. All patients received a weekly educational video, but the IG attended three e-consultation sessions with a dietitian (weeks 1, 3, and 8) and a dentist (week 8) via video call. A semi-structured interview was conducted to collate qualitative feedback among the IG participants at the end of the programme. A total of 24 periodontitis patients (14 IG and 10 CG) participated in this study. Among the IG patients, significant improvements in diabetes knowledge, body weight, BMI, calories, carbohydrates, fat, and added sugar intakes were observed at week 12. The CG patients only had a significant reduction in carbohydrate intake post intervention. No changes were reported in physical activity level and OIDP for both groups. Feedback received from the IG participants included convenience, practical, preferred approach during the pandemic, increased awareness and knowledge, and favourable lifestyle changes. This study demonstrates that an online diabetes wellness programme with healthcare professionals is feasible and can facilitate knowledge and lifestyle improvements that can be adapted during the crisis situation. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
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20 pages, 6185 KiB  
Article
An International Federal Hyperledger Fabric Verification Framework for Digital COVID-19 Vaccine Passport
by Dong-Her Shih, Pai-Ling Shih, Ting-Wei Wu, Shu-Huai Liang and Ming-Hung Shih
Healthcare 2022, 10(10), 1950; https://doi.org/10.3390/healthcare10101950 - 06 Oct 2022
Cited by 4 | Viewed by 1654
Abstract
The COVID-19 virus has been spreading worldwide on a large scale since 2019, and the most effective way to prevent COVID-19 is to vaccinate. In order to prove that vaccination has been administered to allow access to different areas, paper vaccine passports are [...] Read more.
The COVID-19 virus has been spreading worldwide on a large scale since 2019, and the most effective way to prevent COVID-19 is to vaccinate. In order to prove that vaccination has been administered to allow access to different areas, paper vaccine passports are produced. However, paper vaccine passport records are vulnerable to counterfeiting or abuse. Previous research has suggested that issuing certificates digitally is an easier way to verify them. This study used the consortium blockchain based on Hyperledger Fabric to upload the digital vaccine passport (DVP) to the blockchain network. In order to enable collaboration across multiple systems, networks, and organizations in different trust realms. Federated Identity Management is considered a promising approach to facilitate secure resource sharing between collaborating partners. Therefore, the international federal identity management architecture proposed in this study enables inspectors in any country to verify the authenticity of the DVP of incoming passengers using the consortium blockchain. Through practical construction, the international federal Hyperledger verification framework for the DVP proposed in this study has shown the feasibility of issuing a global DVP in safety analysis and efficacy testing. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
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12 pages, 1358 KiB  
Article
A Pilot Study Conducting Online Think Aloud Qualitative Method during Social Distancing: Benefits and Challenges
by Asim Alhejaili, Heather Wharrad and Richard Windle
Healthcare 2022, 10(9), 1700; https://doi.org/10.3390/healthcare10091700 - 05 Sep 2022
Cited by 4 | Viewed by 2403
Abstract
COVID-19 social distancing restrictions provided unprecedented insights into online research methodologies and approaches for both participants and researchers. Field research traditionally conducted face-to-face had to be transferred online, highlighting the great strides made in communication technologies (particularly live video streaming) over the last [...] Read more.
COVID-19 social distancing restrictions provided unprecedented insights into online research methodologies and approaches for both participants and researchers. Field research traditionally conducted face-to-face had to be transferred online, highlighting the great strides made in communication technologies (particularly live video streaming) over the last two decades for online qualitative research. However, dedicated research on these phenomena is tentative, including with regard to specific methods such as Think Aloud. This paper contributes to literature on online Think Aloud in qualitative research, evaluating new insights on its adoption online. It draws on findings from an online piloting study of Think Aloud tasks to explore the implications of using real-time internet video calls via SoIP applications by MS Teams. To assess the online Think Aloud process, this review called upon some of the comments made by participants during the semi-structured interview or comments made during the Think Aloud process, when they were relevant to the online process itself. It focuses on different dimensions of benefits, rapport in the session’s encounter, challenges, and ethical concerns. Overall, the findings indicate that online Think Aloud sessions cannot completely replace in-person sessions for some particular and highly in-depth research areas, but they can greatly facilitate qualitative data collection in most conventional contexts. It is necessary to carry out further studies exploring the use of this and other online approaches and instructions. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
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10 pages, 262 KiB  
Article
The Stressful Memory Assessment Checklist for the Intensive Care Unit (SMAC-ICU): Development and Testing
by Karin Samuelson
Healthcare 2022, 10(7), 1321; https://doi.org/10.3390/healthcare10071321 - 16 Jul 2022
Cited by 1 | Viewed by 1284
Abstract
Stressful or traumatic memories of an intensive care stay may lead to long-term psychological morbidity. Memory assessment is therefore essential to aid in the patients’ recovery process. Acknowledging the large cohort of post ICU patients during the SARS-CoV-2 pandemic, a simple tool for [...] Read more.
Stressful or traumatic memories of an intensive care stay may lead to long-term psychological morbidity. Memory assessment is therefore essential to aid in the patients’ recovery process. Acknowledging the large cohort of post ICU patients during the SARS-CoV-2 pandemic, a simple tool for the evaluation of ICU memories is needed. The aim of this study was, therefore, to develop and test the validity and reliability of a short stressful memory assessment checklist, including a distress intensity rating scale, for intensive care survivors. The consecutive sample consisted of 309 patients attending an intensive care follow-up consultation in Sweden. A methodological design was used consisting of four phases. The first three concerned construct and content validity and resulted in a 15-item checklist of potential stressful memories with a Likert-type scale including five response categories for distress intensity rating. To fill out the checklist, a median of 3 (2–3) minutes was needed. A test–retest approach yielded weighted kappa values between 0.419 and 0.821 for 12 of the single items and just below 0.4 for the remaining three. In conclusion, the stressful memory assessment checklist seems to be valid and reliable and can be used as a simple tool to evaluate the impact of stressful ICU memories. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
19 pages, 319 KiB  
Article
Scandinavian Nurses’ Use of Social Media during the COVID-19 Pandemic—A Berger and Luckman Inspired Analysis of a Qualitative Interview Study
by Stinne Glasdam, Frode F. Jacobsen, Lisbeth Hybholt and Sigrid Stjernswärd
Healthcare 2022, 10(7), 1254; https://doi.org/10.3390/healthcare10071254 - 05 Jul 2022
Cited by 3 | Viewed by 2275
Abstract
There is a knowledge gap about nurses’ use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to explore how nurses in [...] Read more.
There is a knowledge gap about nurses’ use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to explore how nurses in the Scandinavian countries used social media for professional purposes in relation to the first 15 months of the COVID-19 pandemic. Qualitative, semi-structured interviews with 30 nurses in three Scandinavian countries (Denmark, Norway, and Sweden) were conducted. Thematic analyses were made, methodically inspired by Braun and Clarke, and theoretically inspired by Berger and Luckmann’s theory about the construction of social reality. The Standards for Reporting Qualitative Research (SRQR) checklist was used. The results showed that social media was a socialisation tool for establishing new routines in clinical practice. Virtual meeting places supported collective understandings of a specific COVID-19 ‘reality’ and ‘knowledge’ amongst nurses, with the pandemic bringing to the fore the issue of e-professionalism among nurses relating to their clinical practice. However, social media and virtual education were not commonly used in patient contacts. Further, nurses attempted a re-socialisation of the public to proper COVID-19 behaviour through social media. Moreover, blurred boundaries between acting as a private individual and a professional nurse were identified, where ethics of the nursing profession extended to nurses’ private lives. Full article
(This article belongs to the Special Issue Practices and Strategies of Health Professionals during the COVID-19 Pandemic—between Limitations and Opportunities)
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