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End-of-Life Issues in the Era of the COVID-19 Pandemic
Deyashinee Ghosh,Bhavna Gupta 한국호스피스완화의료학회 2020 한국호스피스.완화의료학회지 Vol.23 No.3
Purpose: The coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill and has exposed the lack of preparedness of most nations’ health care systems. Even in usual times, palliative care has not received its fair share of recognition as an important component of patient care; instead, the emphasis is often placed on aggressive patient management. Now, with the entire medical community and decision-making committees focussed on intensive patient care, end-of-life care has taken a backseat. Methods: This article is a brief communication. Results: COVID 19 infection has been shown to lead to greater mortality and morbidity in patients with pre-existing illnesses such as hypertension, diabetes, renal failure, and cancer. Patients typically in need of end-of-life care, such as those with late-stage cancer or heart failure, are therefore at a higher risk of both contracting COVID-19 and suffering a more severe disease course. The strict nationwide lockdowns being imposed in most countries have deterred patients from seeking medical attention or hospice care. Every day new research is coming to light regarding COVID 19. This has helped significantly in creating awareness and limiting the spread of disease. However, misinformation is also rampant, leading to discrimination and mistreatment of infected patients. Conclusion: This pandemic has been a terrifying ordeal for all and has exposed our entire population physically, psychologically, emotionally, and financially to unimaginable stresses. In the present scenario, EOL care is as much a necessity as intensive care and should be given at least a fraction of its importance.
Gaurav Jain,Bhavna Gupta,Priyanka Gupta,Sagarika Panda,Sameer Sharma,Shalinee Rao 대한중환자의학회 2021 Acute and Critical Care Vol.36 No.1
Background: Due to the risk of viral transmission during in-person training, a shift towardonline platforms is imperative in the current pandemic. Therefore, we compared the effectivenessof an in-person interactive course with a structurally similar online course designedto improve cognitive skills among clinical health professionals in arterial blood gas analysis,management of electrolyte imbalances, and approaches to mechanical ventilation in criticallyill patients. Methods: In an observational, outcome assessor-blinded, cohort trial, group A included participantsenrolled prospectively in an online course, while group B included those who tookpart in an in-person course (retrospective arm). The primary objective was comparison ofcognitive skills through a pre and post-test questionnaire. Statistical analysis was performedusing Student t-test. Results: In total, 435 participants were analyzed in group A, while 99 participants were evaluatedin group B. The mean pre-test score was 9.48±2.75 and 10.76±2.42, while the meanpost-test score was 11.94±1.90 (passing rate, 64.6%) and 12.53±1.63 (passing rate, 73.3%)in groups A and B, respectively. Group B scored significantly higher in both pre-test (P=0.001)and post-test evaluations (P=0.004). The improvement in post-test score was significantlygreater (P=0.001) in group A (2.46±2.22) compared to group B (1.77±1.76). The medicalspecialties fared better in group B, while surgical specialties scored higher in group A. Thepre-test vs. post-test scores exhibited a moderate correlation in both groups (P<0.001). Thefeedback survey showed a Likert score >3.5 for most points in both groups. Conclusions: The online teaching module exhibited a significant benefit in terms of participantsensitization and knowledge sharing.