bluuebunny/crossref_metadata_2025 huggingface dataset:
Health literacy, consciousness, and locus of control in relation to vaccine hesitancy and refusal
Authors: Kouvari K , Hadjikou A , Heraclidou I , Heraclides A
Published: October 2022

Background

About 35% of adult Europeans remain not fully vaccinated against COVID-19. Health literacy (HL), health consciousness (HC), and health locus of control (HLC) have been linked to different health behaviors, yet their role in COVID-19 vaccination uptake remains unclear. Here, we report preliminary findings from a cross-sectional survey conducted in Greece and Cyprus, aiming to elucidate the aforementioned associations.

Methods

Participant recruitment for the current analysis took place from January to June 2022, following proportional quota sampling. The current sample comprises 190 participants, with full information on COVID-19 vaccine hesitancy (composite scale outcome) and refusal (binary outcome), as well as HL (European Health Literacy Survey Questionnaire-Q16), HC (Health Consciousness Scale-G), and HLC (Multidimensional Health Locus of Control Form B). Linear and logistic regression analyses were used to determine associations between the aforementioned factors, using the standardized versions of the independent variables.

Results

After adjusting for sociodemographic factors and other predictors of vaccination status, HL (β, 95% CI: -2.56, -3.76; -1.36), ‘internal’ HLC (-2.76, -3.79; -1.73) and ‘health professionals’ HLC (-2.64, -3.66; -1.63) were strongly and negatively associated with vaccine hesitancy, while HC showed a weaker association in the same direction (-1.46, -2.58; -0.35). In contrast, ‘chance’ HLC was strongly and positively associated with vaccine hesitancy (4.40, 3.37; 5.43). Similar results were detected when vaccine refusal was used as a binary outcome.

Conclusions

Health literacy and locus of control and to a lesser extent health consciousness, are independent predictors of COVID-19 vaccine hesitancy and refusal. Increasing vaccination uptake via programs aiming at enhancing health literacy and shifting health locus of control, can have a significant impact on COVID-19 pandemic management internationally.

Key messages

• Health literacy, locus of control and to a lesser extent consciousness, are novel predictors of vaccine hesitancy and refusal in two Eastern Mediterranean European populations.

• Increasing health literacy and shifting health locus of control could render programs aiming to increase COVID-19 vaccine uptake more targeted and effective, internationally.
Infodemic management for public health practitioners: landscape analysis and practical tools
Authors: Ishizumi A , Purnat T , Ludolph R , Cecchini S , Yau B , Bertrand-Ferrandis C , Briand S , Nguyen T
Published: October 2022

Issue

Infodemics (i.e., overflow of information in physical and digital spaces that makes it difficult for people to make good health decisions) can undermine emergency response, but capacity for infodemic management has been limited in countries thus far. Specifically, there is a need to build capacities in the field with practical and scalable tools.

Description of the problem

WHO has developed tools and trainings to quickly build and enhance infodemic management (IM) capacity at the country-level, such as tools for rapid generation of IM insights and a framework for conducting landscape analyses to establish sustainable IM capacities. These were developed in collaboration with multidisciplinary experts who provided feedback. We sought to create tools that can be a basis for introducing evidence-generation in health information systems to inform emergency preparedness and response, and mainstream methods into routine infodemic diagnostics activities.

Results

The tools and trainings provide a comprehensive framework for diagnosing and addressing infodemics, such as a public health taxonomy to guide digital intelligence analysis and integrated analysis methods for generation of actionable insights. Additionally, the landscape analysis framework outlines steps for assessing strategic needs and assets for routinizing IM functions as part of existing public health systems and programs.

Lessons

The tools and trainings will be deployed in the field to evaluate utility. Feedback from users in the global WHO infodemic manager community will be systematically captured.

Key messages

• Field responders need practical tools and trainings that guide quick infodemic response during health emergencies.

• These tools and trainings can be used to diagnose and intervene on infodemics, even in settings where infodemic insights units are not yet established.
Beliefs about vaccines and information about coronavirus, COVID-19 and the pandemic. Findings from Italy
Authors: Lorini C , Velasco V , Zanobini P , Vecchio L , Bonaccorsi G
Published: October 2022

Introduction

In Italy, COVID-19 vaccination campaign for school personnel started in February 2021 and began mandatory from 15th December 2021 to all the people who work within schools. Here we described Italian school principals’ beliefs about vaccines and its association with feelings about information regarding coronavirus, COVID-19 and the pandemic.

Methods

Data collection started in October 2021 and is ongoing. Beliefs about vaccines were investigated both for COVID-19 vaccination and for vaccination in general.

Results

A total of 726 questionnaires were analyzed so far. The majority feels to be well informed about the coronavirus or the pandemic (75%) and not at all nor a little confused about COVID-19 information (89%). Only 2% disagree/strongly disagree with the statement “vaccination is compatible with my attitudes or religious beliefs”. Beliefs regarding vaccines in general are correlated with those regarding COVID-19 vaccines. When different beliefs are described, we observed a trend towards considering COVID-19 vaccines less safe and effective, but more important to protect themselves and their family than other vaccines. Moreover, beliefs about vaccination in general and regarding COVID-19 are associated with how well they feel informed about the coronavirus or the pandemic, and whether they feel confused about COVID-19 information. In particular: the better they feel informed about the coronavirus and the related pandemic, the higher the perception of vaccines in general and COVID-19 vaccine as important, safe, and effective; the less they feel confused about COVID-19 information.

Conclusions

School principals showed a high level of confidence on vaccines. The association between beliefs in vaccinations and the characteristics of information about COVID-19 supported the effectiveness of Italian vaccination policy and information campaigns.
Development of a strategy to control COVID-19 in hard-to-reach migrant communities
Authors: Rosso A , Rinaldi A , Coluzzi D , Perrelli F , Napoli PA , Villari P
Published: October 2022

Issue/Problem

The risk of SARS-Cov-2 infection and its adverse health effects proved to be higher among socially disadvantaged groups, including migants and ethnic minorities. Hard-to-reach (HTR) migrants, such as undocumented people, those living in informal settelments (e.g squats) or roma people have experienced severe barries to access COVID-19 information, testing and vaccination services.

Description of the problem

During 2020 and 2021, the Migrants'Health Unit of Roma 2 Local Health Unit (ASL) developed different strategies to control the COVID-19 epidemics in HTR communities, addressing both the containment of clusters in informal settelments and access to COVID-19 vaccination for these population.

Methods

A multicomponent and multidisciplinary strategy was implemented, based on a strong collaboration of different services across the ASL and with Non Governmental Organizations (NGOs). Starting from a mapping of the settlements and the identification of the main critical issues for the control of the epidemic in the target populations, interventions were carried out that included the involvement of NGOS in active surveillance, reporting of suspected cases of COVID-19 to the ASL and information to the communities, and the reorganization of health interventions (eg, swabs, epidemiological investigations, COVID-19 vaccinations) directly in HTR communities’ life places.

Results

In the period from April 2020 to February 2021, 15 outbreaks were controlled, for a total of over 4500 persons reached, and 265 COVID-19 cases identified. From July to November 2021, vaccinations were offered in outreach or with dedicated vaccination sessions, which reached 1664 people. The intervention model, based on a deep context analysis, strong multisectoral collaboration, community involvement, lays the foundations for the design of public health strategies, not only aimed at HTR populations.

Key messages

• Controlling COVID-19 in Hard- to- reach migrant populations was possible thanks to a strong collaboration between public health services and NGOs.

• Public health interventions addressed complex groups should envisage intersectoral collaborations, reorientation of services in order to meet target groups’ need and community involvement.
Impact of COVID-19 vaccination on risk perception: a cross- sectional study on vaccinated people
Authors: De Nicolò V , Villari P , De Vito C
Published: October 2022

Background

High risk perception and perceived threat of COVID-19 had played an important role on public attitudes toward vaccination and protective countermeasures acting as motivational factors to perform behaviors that facilitated disease prevention. To explore COVID-19 vaccination influence we conducted a cross-sectional study on vaccinated people (18-80 years old).

Methods

Partecipants, randomly selected, were recruited during the vaccination campaign in the Hub of Cosenza, Calabria Region, Italy, at the end of the 2nd wave of pandemic (Jul-Aug 2021). A multivariable logistic regression model was built to calculate odds ratios (OR) and 95% confidence intervals (95% CI) comparing risk perception and preventive measures confidence pre vs. post vaccination.

Results

Globally 625 partecipants fully responded; 51.4% women, mean age 40.5 years (SD +/-15.36). Infection risk perception and protective measures adherence significantly decreased after the vaccination even if a significant gender gap was present; women were always more worried and respectful than men. More prudent partecipants had a significantly higher mean age. 64.2% of participants believed that compliance with social distancing was yet absolutely necessary after the immunization and about half of them believed that also the use of masks was yet necessary. Results of multivariable analysis confirmed that risk perception decreases after vaccination in different contexts: workplace (0.65; 95% CI 0.44-0.94); sport activities (0.60; 95% CI 0.39-0.95); bars and restaurants (0.51; 95% CI 0.33-0.80); means of transport (0.32; 95% CI 0.19-0.50) as well as handwashing practice (2.23 95% CI 1.20-4.12).

Conclusions

The research shows that COVID-19 vaccination significantly decreases self-perceived risk and adherence to preventive measures. Public Health communication strategies could underline that COVID-19 vaccination is indispensabile but not sufficient to protect the World against this devastating catastrophe.

Key messages

• Public Health should promote consciousness and strengthen the importance of health-protective measures in order to further reduce risk of human-to-human transmission after immunization.

• Even after vaccination, extra precautions are still required and necessary to do not nullify vaccination protective effect, mostly in more exposed and less careful groups like young people.
How to deal with COVID-19 vaccine hesitancy in pregnant and breastfeeding women? A meta-analysis
Authors: Bianchi FP , Stefanizzi P , Di Gioia MC , Brescia N , Lattanzio S , Tafuri S
Published: October 2022

Background

Pregnant and breastfeeding women are at an increased risk of severe illness from COVID-19 compared to people who are not pregnant. Therefore, the CDC recommends COVID-19 vaccination for women who are pregnant, breastfeeding, and trying to become pregnant or who may become pregnant in the future. Despite this, low vaccination coverages are reported in this population sub-group. The purpose of this study is to estimate the proportion of pregnant and breastfeeding women expressing hesitation to the COVID-19 vaccine worldwide. Determinants of vaccine compliance and options suggestedto address vaccine hesitancy were also analyzed.

Methods

Forty-six studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar, and Scopus databases between January 1, 2020 and February 6, 2022. The following terms were used for the search strategy: (adherence OR hesitancy OR compliance OR attitude) AND (covid* OR SARS*) AND (vaccin* OR immun*) AND (pregnan* OR post-partum OR breastfeeding OR lactating).

Results

The vaccine hesitation rate was 48.4% (95%CI=43.4-53.4%). In a sub analysis by study period, the pooled prevalence of vaccine hesitation was 40.0% (95%CI=31.6-46.6%) considering surveys administered in 2020, 58.0% (95%CI=48.9-66.9%) considering surveys administered in the first semester of 2021, and 38.1% (95%CI=25.9-51.2%) considering surveys administered in the second semester of 2021. The main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events for both mother and fetus/child.

Conclusions

In order to achieve high vaccination coverage, a multifactorial approach is needed, requiring major social, scientific, and health efforts. The success of the vaccination campaign in this population depends on the capillarity and consistency of the interventions implemented.

Key messages

• Vaccine hesitancy can be a determining factor in the success (or otherwise) of the anti-COVID-19 immunization campaign.

• Vaccine hesitancy in pregnant and breastfeeding women is a genuine public health concern worldwide.
Smoking during pregnancy and children’s emotional and behavioural trajectories
Authors: Fekom M , Bonello K , Gomajee R , Ibanez G , Martin S , Keyes K , Nakamura A , Lepeule J , Strandberg-Larsen K , Melchior M
Published: October 2022

Background

The nature of the relationship between maternal tobacco smoking during pregnancy and the occurrence of children's behavioural problems is still a matter of controversy. We tested this association using data collected among a sample of children followed from pregnancy to early adolescence (age 11.5 years), accounting for multiple parents’, children's and family characteristics.

Methods

Data come from 1424 mother-child pairs participating in the EDEN mother-child cohort set up in France. Using repeated measures (3, 5.5, 8 and 11.5 years) of the mother-reported Strengths and Difficulties Questionnaire, we estimated trajectories of children's emotional and behavioural difficulties. Two aspects of maternal smoking were studied: the timing and the level of use (cigarettes/day) during the first trimester of pregnancy. Multinomial regression models controlled for confounding factors including maternal mental health and socioeconomic characteristics using propensity scores with the overlap weighting technique.

Results

Contrary to bivariate analyses, in propensity score-controlled regression models, maternal smoking throughout pregnancy was no longer significantly associated with offspring emotional or behavioural difficulties. Maternal heavy smoking (≥10cigarettes/day) remained significantly associated with intermediate levels of overall emotional and behavioural difficulties (OR 1.64, 95%CI 1.04-2.58) and conduct problems (OR 3.05 95%CI 1.22-7.61), as well as with high levels of conduct problems symptoms (OR 2.82 95%CI 0.88-9.06) - although the latter did not reach statistical significance.

Conclusions

The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties appears to be largely explained by women's other characteristics. However, maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics.

Key messages

• The association between maternal smoking in pregnancy and offspring emotional and behavioural difficulties seem largely explained by the family's socio-demographic and behavioural characteristics.

• Maternal heavy smoking appears to be related to offspring behavioural difficulties beyond the role of confounding characteristics.
Socioeconomic factors affecting psychotherapy use rates
Authors: Selinheimo S , Gluschkoff K , Turunen J , Kausto J , Väänänen A
Published: October 2022

Objectives

Previous studies indicate socioeconomic inequalities in psychotherapy utilization. The aim of this study was to assess the associations of individual annual incomes with the utilization of long-term rehabilitative psychotherapy during nine-year follow-up in men and women. As secondary analyses we assessed the association of main activity with the utilization of psychotherapy.

Methods

For this study, we selected those from a random sample of the working-age population (18-55 years) with information about income at each time point during the follow-up from 2011 to 2019 (N = 736 613). Psychotherapy usa during the follow-up period served as dependent variable and sosiodemographic variables, annual incomes and main activity (employed, unemployed, studying, other) were used as independent variables. To examine change in the psychotherapy use rates over time, we used sex-stratified generalized estimating equations logistic regression models with predicted marginal probabilities.

Results

Psychotherapy use rate was constantly higher among women than in men (in 2011 0.8% and 0.2%) and increased from 2011 to 2019 among both genders and income quartiles (among women 174% - 231% and among men 213% - 248% increase between quartiles). Among men, psychotherapy use rate was highest among lowest income quartile throughout the study interval. Among women such difference was not observed. Among women, studentś psychotherapy use increased significantly when compared to other groups from 2011 to 2019 (299% increase vs 89% - 210% increase among other groups). A similar pattern was seen among studying men versus other groups.

Conclusions

Between 2011 and 2019 the probability of having psychotherapy increased among both genders. Unexpectedly, pro-rich psychotherapy use rate was not observed. The highest probability to use psychotherapy in lowest income quartile might be linked with differences in health care systems for students and for other.
Occupational class, gender, mental distress and use of psychotherapy
Authors: Kokkinen L , Gluschkoff K , Kausto J , Selinheimo S , Väänänen A
Published: October 2022

Introduction

Previous studies have shown the effects of occupational class and gender on mental distress and use of psychotherapy. However, less is known about the mental distress-based use of psychotherapy in different occupational classes.

Objectives

The aim of our study is to show how the prevalence of mental distress and the use of long-term psychotherapy correlates in different occupational classes by gender.

Methods

Data were drawn from the Rise of Mental Vulnerability Study (psychotherapy) and FinHealth 2017 Study (mental distress). Adjusting for age, we calculated GHQ caseness, psychotherapy use rate, and the ratio between GHQ caseness and psychotherapy use rate in three occupational classes (upper non-manual employees, lower non-manual employees, and manual workers) separately for men and women. Age-adjustment was performed through regression analysis by using model generated predicted values of GHQ caseness and psychotherapy use rate at the average sample age of 40.

Results

In the group of upper non-manual men there were 10 persons with severe mental distress for every single person having used psychotherapy. For lower non-manual men and manual male workers the numbers were 14 and 31, respectively. In the group of upper non-manual women there were six persons with severe mental distress for every person having used psychotherapy. For lower non-manual women and manual female workers these numbers were nine and 18, respectively.

Conclusions

We found differences in the mental distress-based use of state-subsidized long-term psychotherapy between occupational classes. For upper non-manual workers, the use of therapy best meets their mental distress. The opposite is true for manual workers. We also found differences between men and women, but these findings should be confirmed with larger datasets.
Depression, diabetes and change in cognitive functioning: results from the Canadian Longitudinal study on Aging
Authors: Shojaa M , Deschenes S , McLeish J , Schmitz N
Published: October 2022

Background

Individuals who ultimately receive a diagnosis of dementia typically have an observable accelerated cognitive decline (ACD) many years prior to diagnosis. Depression in combination with diabetes is an emerging risk factor that is associated with cognitive problems. Using data from the Canadian Longitudinal Study on Aging, the objective of the present study was to investigate the longitudinal association between depression, diabetes, and cognitive decline in an elderly cohort.

Methods

Baseline and follow-up data from a population-based study in Canada were used. The sample consisted of 18161 adults between 45 and 85 years of age without diabetes. Cognitive functioning was assessed at baseline and after 4 years using six measures: the Rey Auditory Verbal Learning Test (RAVLT), the Mental Alternation Test (MAT), the Animal Fluency Test (AF), the Controlled Oral Word Association Test (COWAT), the Stroop Test, and the Prospective Memory Test. Depression was assessed using the CES-D10. Regression analysis was conducted to evaluate interactions between depression, diabetes and cognitive decline.

Results

The mean age of participants was 61 years. Participants with a comorbidity of depression and diabetes had an accelerated cognitive decline (g-factor) compared to those with depression without diabetes and those with diabetes without depression (regression coefficients ß=-0.145 (0.036), ß=-0.076 (0.011), and ß=-0.053 (0.021), respectively).

Conclusions

This study suggests that depression and diabetes might increase the risk of cognitive decline in a synergistic way.
How breaks in nature can affect the users’ wellbeing: an experience based survey during the lockdown
Authors: Gola M , Botta M , D’Aniello AL , Capolongo S
Published: October 2022

Background

In the occasion of COVID-19 pandemic in Italy, the life of citizens was greatly disrupted - from healthcare professionals to the smart workers - and consequently also the state of mood. On the basis of the scientific evidences in relation to the relationship between the built environment and health, a research group has promoted an investigation on the benefits that greenery can have on the psychophysical state of the users, especially healthcare staff and users at home.

Objectives

The methodology adopted is the Profile of Mood States, which provides experiential activity in nature - without any technological distraction- to evaluate the benefits on mood. The methodology adopted refer to the shorter version (34 items) designed by prof. Grove at the University of Western Australia. In relation to the COVID-19 pandemic, the experience based questionnaire is differentiated for healthcare staff and general users. The questionnaire is composed of a few questions, to be completed before and after an experience in nature of 20/30 minutes. The investigation requires to be carried out in private gardens, balcony and/or terrace with greenery, public green areas, etc.

Results

300 participants (subdivided into 225 general users and 75 healthcare professionals) took part in the investigations. Data analysis highlighted the higher performances in anxiety, depression, anger, force, fatigue and confusion, in particular for users who had the experience in garden (-50/70%), and among the healthcare staff the best outcomes are related to who did the investigation during or after the workshift (-60/-90%).

Conclusions

Although it is well-known the benefits that nature affects positively on well-being and stress level of users, the investigation underlines that brief breaks in the nature - especially in period of great stress such as pandemic - can influence the well-being and mental health of users.
Digital health literacy and well-being of health sciences students from MU-Sofia during the pandemic
Authors: Leventi N , Vodenicharova A , Popova K
Published: October 2022

Background

The aim of the study is to demonstrate the Digital health literacy and the well-being of the students from different faculties in Medical University - Sofia during the pandemic.

Methods

To achieve the purpose of the study a web-based questionnaire was distributed among health sciences students from the Faculty of Public Health and the Medical College -Sofia, as well as medical students from the Faculty of Medicine all from Medical University -Sofia in Bulgaria. Data was collected between February and April 2022, and all respondents participated anonymously and voluntarily. Established statistical methods were used in data analysis.

Results

Completed questionnaires were received from 239 students. Data collected show that among participants the majority (81,4%) were females, and 73,3% were studying in a Bachelor's programme. Among the respondents 87.7% found it easy, or very easy to use the proper words or search query to find the information they were looking for about coronavirus or related topics. Finally 29,3% of health sciences students expressed low to very low well-being during the last two weeks and the rest 70,7% expressed high well-being.

Conclusions

The presented results draw attention to the fact that during the pandemic health sciences students demonstrate the appropriate skills in searching and acquiring the information about coronavirus or related topics. In addition, translating and applying the information could contribute to benefit the psychological well-being of the students. In a digitally transformed health sector it is significant for future health professionals to obtain competencies including digital health literacy to promote health and well-being of the patients and provide better outcomes for them. The necessity of digital competences was underlined and thus we need further more, and in depth education in ICT, and digital technologies to all students, starting from the beginning of their studies.
Relevance and limits of patient surveys within humanitarian primary health care in Germany
Authors: Dieterich A
Published: October 2022

Background

In Germany, distinct parts of the population, such as undocumented persons, uninsured German nationals, EU citizens without employment and asylum seekers, do not have adequate access to health care. Civil society organisations provide humanitarian medical aid for these individuals. However, the offered care is not comprehensive, but depends on volunteers and is restricted to acute conditions. The local initiatives are often underfinanced. To receive funding, they experience increasing pressure to provide evidence of the impact of their work.

Methods

The applied research project was conducted in cooperation with a German medical Non-Government Organization. A routine patient survey, including items on patient satisfaction and patient reported outcomes, was developed and implemented. The NGO aimed to use it as an instrument for patient participation as well as to strengthen their impact assessment.

Results

Survey results show high satisfaction levels and a reported increase in health status and system competence. They provide valuable answers for organisational development and fundraising but do not correlate with the extent of care provided.

Conclusions

Patient surveys are particularly helpful in humanitarian care to legitimatize the efforts of compensatory initiatives. Since the affected persons still suffer from undersupply, results are not a valid measure of care standards but rather demonstrate appreciation for the mere existence of volunteer help. For an effective participation, one should not confound involvement in surveys with access to care. To illuminate existing barriers, alternative methodical approaches such as qualitative multilevel case studies are promising, as they allow data on local support settings to be linked with individual care histories and underlying institutional frameworks.
Participation in vulnerable old age? Barriers and opportunities in nursing homes in Germany
Authors: Kuempers S , Hahn D , von Köppen M
Published: October 2022

Background

Nursing homes in Germany are still often associated with the idea of a daily routine determined by the institution, linked to losses of self-determination and participation. Residents, as well as carers and caregivers, perceive chances for co-determination and co-creation as limited.

Methods

The research project PaStA (Participation in Inpatient Care for Older People) examined and analyzed opportunities and limits of improved participation in nursing homes in Germany with the help of a participatory action research design. Experiences and findings with participatory research processes in two nursing homes are presented.

Results

Access to people both living and working in nursing homes is demanding and time-consuming. Building a trusting cooperation requires commitment and resources. However, if a research team - including residents - is successfully installed, the participatory process enables all those involved to explore, try out and shape participation possibilities. The reflection that takes place in the process leads to learning processes that (can) result in empowerment.

Discussion

However, there is a danger that participatory research may primarily reach people better provided with resources for participation based on life-long circumstances (participation dilemma), highlighting the need for responsibly designed access. Likewise, the question of impact must be critically discussed. Sustainability must be considered from the beginning.

Conclusions

Participatory action research is a worthwhile endeavor, even in settings that are rather unfamiliar with participation, such as residential care for older people. However, researchers should not underestimate the time and commitment required, because preconditions and resistance of people and structures can compromise progress.
Participation and chronic illness: Nurses’ perceptions in primary care in Brazil, Germany, and Spain
Authors: Heumann M , Röhnsch G , Zabaleta-del-Olmo E , Rosana Gonçalves de Oliveira Toso B , Giovanella L , Hämel K
Published: October 2022

Background

Many chronically ill persons are challenged by integrating the illness in everyday life and making ‘competent’ decisions on their life and care. In multiprofessional primary care, promoting clients’ self-management and strengthening their abilities to participate in everyday life is increasingly recognized as a nursing task. This study investigates facilitating and inhibiting conditions that nurses experience when exercising this task.

Methods

Drawing upon a phenomenological approach, we conducted guided interviews with 34 practicing nurses and 23 key informants with advanced knowledge of primary health care nursing practice in Brazil, Germany, and Spain. The interviews were analysed using structuring content analysis.

Results

The interviewees see competencies of nurses to establish trusting relationships with chronically ill clients as key to greater client participation. Nurses, however, state that bonding with clients can be time-consuming and exhausting. They consider it fundamental that physicians and other professionals value nurses’ efforts towards stronger client participation as a way forward to reach for person-oriented primary care. They criticize that especially physicians value biomedical tasks more than enabling participation. Referring to primary health care organisation, nurses experience that pressure of time through a growing number of routine and administrative tasks inhibits their efforts to strengthen clients’ participation.

Conclusions

To promote the participation of clients with chronic illnesses in their everyday life and in care, relationship building with clients and self-management support needs to be acknowledged as an important scope of practice approached by nurses. To be able to unfold the potentials nurses need to be equipped with sufficient time and skills.
Health literacy time trends in Germany
Authors: Schaeffer D , Klinger J , Berens E-M , Hurrelmann K
Published: October 2022

Background

Health literacy (HL) is becoming increasingly important in the European public health sector. Since the Health information landscape is changing constantly there is a need for monitoring HL regularly in order to observe the influence of these changes, to enable trend statements and to obtain precise information on the societal and individual factors. For the first time, this has been done for the population in Germany.

Methods

Cross-sectional data collected in the adult population in Germany in 2014 (n = 1.940) and 2020 (n = 504) was used. The instrument HLS-EU-Q47 was used to measure HL in the domains of health care, disease prevention and health promotion. Changes between time points were analysed on the population level as well as in several population groups.

Results

The HL of the German population has become lower within the observed six years. This is evident in all three domains but is most pronounced in health promotion literacy. This trend is particularly visible among people with low social status and financial deprivation. Single health information tasks that are precepted as more difficult involve the evaluation of information and handling information from the media.

Conclusions

Over time, dealing with health and disease-related information has become more difficult. As this development is mainly driven by socioeconomically disadvantaged population groups, it has apparently increased social inequality in the health sector. Due to more complex and demanding health information, which lately result in an ‘infodemic’, it seems that these groups in particular are overburdened and cannot raise the resources and skills to adequately engage with health information.

Key messages

• HL interventions should focus on socioeconomically disadvantaged population groups to counteract the increasing health inequality.

• Monitoring HL should be included in public health surveillance to determine needs and challenges for health policies as well as achievements of interventions.
Evaluation of pediatric dentists’ approaches to oral health literacy
Authors: Karamüftüoğlu N , Atabek D , Uğraş Dikmen A , Semanur Korkmaz Öner F , Özkan S
Published: October 2022

Aim

In the study;it is aimed to determine the knowledge,attitudes,behaviors and educational needs of pediatric dentists about oral health literacy(OHL).

Methods

The study was carried out with 100 pediatric dentists across Turkey between 20/06/2021-20/07/2021 on the online platform.In the questionnaire form;there are 14 descriptive,25 approaches to OHL in a 5-point Likert format and 8 questions about communication barriers in individuals with insufficient OHL.

Results

The mean age of the participants was 34.4±7.9 years.92.0%(n = 92) of the participants did not receive OHL training.63%(n = 63) of the participants stated that it is necessary to carry out studies to improve OHL and to develop programs.The mean OHL approach scores of the participants were 3.81±0.61;the mean score of evaluating communication barriers in individuals with insufficient OHL level was 4.06±0.62.60%(n = 54) of the participants think that the health information in the media is very effective in misleading patients.As the age of the participants increased,the OHL approach score increased(r = 0.204;p=0.042).As the number of daily outpatient clinics of the individuals participating in the research increases,the evaluation scores of communication barriers decrease(r=-0.304;p=0.004).Among the participants,those who work in private institutions,those who know their rights while providing oral health services and those who are satisfied with the profession have higher scores for evaluating the OHL approach,the difference is statistically significant(p < 0.05).

Conclusions

As a result,positive benefits will be provided to the professional satisfaction of pediatric dentists and the quality of oral health services with in-service trainings to be organized before and after graduation on the evaluation of communication barriers in individuals with inadequate OHL approach and level.

Key messages

• Oral health literacy is a new concept and is becoming increasingly important in dentistry.

• The importance of oral health literacy in pediatric dentistry is that both children and parents are affected.
Racially discriminatory experiences among older chronically ill people of Turkish origin in Germany
Authors: Tezcan-Güntekin H
Published: October 2022

Background

Racism in health care is rarely clearly identified as such in Germany. Barriers to access are more often addressed, but people's experiences of discrimination rarely receive attention (Schellenberg & Tusch 2021, Kristiansen 2016). Internationally, racism is recognized as a determinant of health and there is a discourse that it must be addressed in order to achieve health equity (Weil 2022). This qualitative secondary data analysis focuses on racially discriminatory experiences among older chronically ill people of Turkish origin in the context of medical and drug care in Germany.

Methods

11 expert interviews and 11 problem-centred interviews with chronically ill people of Turkish origin and their relatives in Germany were conducted in the MedikaMig-Project with regard to care practices, continuity of drug care and polypharmacy and analysed with structuring qualitative content analysis (Mayring 2015).

Results

The analysis yielded 7 superordinate categories and 27 subcategories, identifying racial discrimination in access to care, the treatment situation and communication, and in the consideration of transnational lifestyles. Patients are often helpless, sometimes trying to put their experiences into perspective or to be treated by Turkish doctors in order to avoid these discriminatory experiences.

Conclusions

Racial discrimination is pervasive in health care and should not be hidden behind other terms that mask discrimination. An intersectional approach allows us to understand which individuals are particularly affected and what they need to be protected from racism in health care.

Key messages

• Structural racism in health care needs to be clearly named and examined from an intersectional perspective in further research projects.

• Elderly patients with Turkish origin need empowerment and contact persons after racist experiences to find ways to deal with discriminating experiences that are sometimes perceived as traumatic.
Does it matter who addresses whom in vaccination promotion campaign?
Authors: Cvjetkovic S , Jeremic- Stojkovic V , Mandic-Rajcevic S , Jankovic J
Published: October 2022

Background

A vaccine promotion campaign is primarily grounded on the selected message features, namely, a carefully chosen information source. People holding diverse views towards vaccination could experience the same information source differently, and it is the comprehension of these diversities that is important to tailor effective interventions. The aim of this study was to determine differences in perceived source credibility between the vaccinated and unvaccinated.

Methods

Overall 172 adults aged 18 and older from Western Balkans both vaccinated and unvaccinated, voluntarily after obtaining informed consent, were randomly assigned to one of four message interventions. The messages were developed combining two prototypical COVID-19 vaccine decision narratives (determined vs. hesitant) with two communication sources (physician vs. lay peer), resulting in four conditions: determined physician, hesitant physician, determined peer, hesitant peer. After the message exposure, participants evaluated three components of source credibility - expertise, trustworthiness and, goodwill. Two-way ANOVA was applied.

Results

Compared to the vaccinated, the unvaccinated judged the source as less trustworthy (p < 0.01), regardless of the message they have been exposed to. Although not statistically significant (p = 0.064), the unvaccinated evaluated all sources with the exception of hesitant physician as having a lower level of good intentions. Vaccinated perceived the determined physician as a source with most expertise, while unvaccinated attributed highest expertise to the hesitant physician (without significant difference (p = 0.719)).

Conclusions

The unvaccinated are generally less likely to experience the information sources as goodwill and trustworthy. In order to perceive the source as more competent the focus should be on the objective characteristics of the communicator, as well as on the congruency in attitudes between the communicator and the audience.
The effects of the Covid-19 pandemic on the stress and depression levels of new mothers
Authors: Florea C , Preiß J , Angerer M , Schabus M
Published: October 2022

Background

New mothers are a particularly vulnerable group during the COVID-19 pandemic, due both to the higher depression and stress levels associated with early child care and to the risk of a COVID-19 infection. We investigated the effects of the pandemic on the childbirth experience, stress and depression levels in this population.

Methods

This cross-sectional, explorative study included 1964 Austrian and German mothers who gave birth between 16.03.2020 and 01.07.2021 and completed an online survey between 18.05.2021 and 01.07.2021. This contained the Childbirth Experience Questionnaire (CEQ2), the Edinburgh Postnatal Depression Scale (EPDS), and the Perceived Stress Scale (PSS), as well as three custom-made scales: a birth risk score (risk factors for a poor birth outcome), a pandemic repercussions score (perceived effects on different aspects of personal life), and a social support score (how emotionally supported they feel). We computed post-hoc multilinear regression models to evaluate which factors can predict the CEQ2, PSS and EPDS scores.

Results

Mothers had a worse birth experience, perceived less stress and had more depressive symptoms during the pandemic than previously reported cohorts. The CEQ2 was predicted by the birth risk (negatively), the access to a midwife (positively) and the perception of sufficient access of the visitors in the hospital (positively) (adjusted R2 = 0.26, F(4, 1738) = 155.64, p < 0.001). The PSS was predicted by the pandemic repercussions (positively), the social support (negatively), and the presence of a coping mechanism (negatively) (adjusted R2 = 0.28, F(4, 1959) = 195.1, p < 0.001). The EPDS was similarly predicted by the same factors as the PSS (adjusted R2 = 0.28, F(4, 1959) = 189.59, p < 0.001).

Conclusions

Social support and strong coping mechanisms can lower the stress and depression scores. Instructing the population about how to improve these factors might be a target for future social policies.

Key messages

• Compared to historical cohorts, mothers who gave birth during the pandemic had a worse birth experience, and, postnatally, perceived less stress but had more depressive symptoms.

• The visitors’ access to the hospital and the mother’s access to a midwife impacted the birth experience, while the social support and the coping mechanisms affected the stress and depression scores.
Self-reported anxiety and depression among COVID-19 patients: A prospective cohort study from Turkey
Authors: Şiyve N , Emecen AN , Keskin S , Başoğlu E , Turunç Ö , Süner AF , Cimilli C , Ünal B
Published: October 2022

Background

It has been shown that COVID-19 can cause symptoms and diseases such as insomnia, depression, and anxiety. This study aimed to describe prevalence of feeling anxious or depressive among COVID-19 patients in six months of follow-up time and its association with baseline independent factors.

Methods

This prospective cohort study included patients aged ≥18 years who tested positive for SARS-CoV-2 at Dokuz Eylul University Hospital, Turkey between November 1, 2020 and May 31, 2021. Participants were interviewed by telephone calls on the 1st, 3rd and 6th months after diagnosis. The dependent variable of the study was self-reported moderate or severe anxiety or depression based on EQ-5D-3L general quality of life scale. Generalized estimating equations were used to identify the factors associated with feeling anxious and depressive after SARS-CoV-2 infection.

Results

In total 5446 patients agreed to participate in the study. Frequency of feeling anxious or depressive at the 1st, 3rd and 6th months after diagnosis were 18.5%, 17.9% and 15.4%, respectively. Older age (≥65 years; odds ratio-OR:1.17, 95% confidence interval-CI: 0.95-1.44), female gender (OR:1.76 (1.58-1.96)), bad economic status (OR: 1.62 (1.34-1.97)), having more symptoms (4-5, OR:1.48 (1.21-1.81); ≥5, OR:1.65 (1.35-2.01)), having more underlying health conditions (1-2, OR:1.35 (1.19-1.54); ≥3: OR:1.50 (1.13-1.99)), intensive care unit admission (OR: 2.58 (1.70-3.90)) were associated with self-reported anxiety and depression.

Conclusions

Feelings of anxiety and depression are common in COVID-19 patients and may persist in the long term. Anxiety and depression were associated with gender, economic status and disease severity. Determination of vulnerable groups for anxiety and depression after COVID-19 can be helpful for early diagnosis and initiation of mental care services.

Key messages

• As a consequence of Covid-19, anxiety and depression in Covid-19 survivors are common generally. It shouldn't be overlooked or underestimated for the public mental well-being.

• Covid-19 mental effects on the population have a correlation with social determinants of health. Therefore, determining vulnerable groups is a key to planning mental care services.
Policies to reduce availability of tobacco products in the retail environment
Authors: Kunst AE , van den Putte B , Veldhuizen EM , Kuipers MAG
Published: October 2022

Background

After implementation of a tobacco vending machine ban in 2022 and a supermarket sales ban in 2024, the Dutch government intends to further phase out tobacco sales after 2030 by prohibiting sales in petrol stations and small outlets. This study aims to understand 1) the impact of these policies on tobacco outlet availability, and 2) differences in tobacco outlet availability by area socioeconomic status (SES) in the Netherlands.

Methods

Between September 2019 and June 2020, all potential tobacco retailers in four Dutch cities (Amsterdam, Eindhoven, Haarlem, and Zwolle) were visited and mapped using Global Positioning System (GPS). Expected reductions in tobacco outlet availability were calculated per policy measure. Tobacco outlet density was calculated using ESRI ArcMap version 10.4.1. The association between neighbourhood SES and tobacco outlet availability was estimated with linear and logistic regression model.

Results

We identified 870 tobacco outlets and an outlet density of 6.2/10.000 capita. The potential sales bans in petrol stations and small outlets would reduce the number of outlets (resp. -7% and -43%) and the outlet density (resp. -0.4 and -2.7). In Eindhoven, Haarlem, and Zwolle, neighbourhoods with high-SES compared to low-SES were less likely to contain a tobacco outlet (OR:0.71, 95%CI:0.59-0.85) and had a lower outlet density (ß:-1.20, 95%CI:-2.20;-0.20). In Amsterdam, the associations were inverse (OR:1.22, 95%CI:1.05-1.40; ß:3.50, 95%CI:0.81;6.20).

Conclusions

The availability of tobacco outlets varies within and between cities depending on the distribution of the built environment. Future tobacco control policies targeting the retail environment should focus on limiting the overall number tobacco outlets and especially small outlets, which may benefit low SES neighbourhoods in mid-sized cities most.