We were very pleased to see your study (Sreeram et al., 2023) exploring mental health nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient units by observing the interactions between consumers and nurses. We found your publication timely to provide more supporting research evidence that mental health nurses are confident to use recovery-focused care in acute inpatient units. Specifically, we were delighted to see that the findings of your study echoed that of our previous study (Lim et al., 2021), that mental health nurses are using recovery-focused care in acute inpatient units. While there seems to be a ‘natural fit’ for mental health nurses to use recovery-focused care given to their continuous presence in the consumers' recovery process (Caldwell et al., 2010; Santangelo et al., 2018), previous studies that have used traditional research methods and explored mental health nurses' beliefs, attitudes, knowledge and skills grappled with the evidence that they generated on how mental health nurses used recovery-focused care in acute mental health (Cleary et al., 2013; Hardy et al., 2022; Kidd et al., 2015; McKenna et al., 2014). This may be due to the uniqueness of every consumers' phases of mental illness when admitted to acute mental health units that required mental health nurses to use different approaches to contribute positively to the individual's recovery and to be actively engaged in the management of their illness (Lim et al., 2021). As such, there is a need for nursing researchers to consider novel research methods to examine this phenomenon of interest (Lim et al., 2021). Your choice of using non-participation observation method is novel in mental health nursing research to capture the micro-affirmations (Topor et al., 2018) when meeting the consumer's personal needs. The use of micro-affirmations in acute inpatient settings are important for supporting the consumers to experience more meaningful conversations that foster strengths, hope, optimisms and regain their confidence to assume control of own lives after experiencing a mental health crisis (Jacob et al., 2015; Xie et al., 2015). The use of micro-affirmation is also important for supporting consumers to experience self-determination, shared-decision making and be empowered to participate actively in co-production of their care and treatment (Laitila et al., 2018; Park et al., 2014; Slade et al., 2014; Wyder et al., 2017). These nurse-consumer interactions are moments where mental health nurses may be using recovery-focused care but could easily be overshadowed by their conflicting and competing roles of working in acute mental health settings (Lim et al., 2019). Indeed, the mental health nursing profession has been blamed or scapegoated for the organizational failure to achieve a recovery-oriented culture in acute mental health settings (McKeown et al., 2019). As such, the caveat is placed on improving the attitudes, knowledge and skills of mental health nurses to use recovery-focused care. This may have inevitably led to mental health nurses being stereotyped as being unskilled and unknowledgeable to use recovery-focused care (Sercu et al., 2015). Consequently, there is a lack of organizational investment to support mental health nurses with adequate staffing and time (McKeown et al., 2019), and support consumers to achieve self-management of their psychiatric symptoms and risks (Lim et al., 2021). For this reason, mental health nurses are spending most of their clinical time on risk management as an integral part of mental health nursing in acute mental health settings (Paradis-Gagné et al., 2021). Yet, this should not reflect mental health nurses' attitudes towards the use of recovery-focused care, even though they may in some situations use restrictive practices as ‘the last resort’ to manage the person's level of risk or potential for aggression (Wilson et al., 2017). As highlighted in the results of your observations in the intensive care area, recovery-focused care can be used by maintaining dignity and respect, non-judgmental communication and facilitating choices for consumers in all aspects of care (Sreeram et al., 2023). With the increasing research evidence that mental health nurses are using recovery-focused care in acute mental health settings, we believed that there is a need to advocate for more systemic-level changes in acute mental health care. For example, the current policies and procedures may need to adopt a more recovery-focused perspective towards consumers with an acute mental illness, and move away from the traditional risk-averse perspective to promote a safe and therapeutic environment (Fletcher et al., 2018). Ashcraft and Anthony (2008) highlighted that the consumers' inherent strengths and resources to self-regulate continue to be overlooked or underutilized when hospitalized when the dominating model of care is driven by the reduction of psychiatric symptoms. As such, consumers were often considered to be incapable of achieving self-management of their mental illnesses and subjected to strict regimes prescribed by the treating team in acute mental health settings (Serin et al., 2016). If all healthcare professionals adopt a more recovery-focused perspective towards consumers with an acute mental illness, this will significantly help to drive clinical practice and initiatives in acute mental health settings to support mental health nurses to use recovery-focused care. Secondly, there may be a need to incorporate relationship-building and supporting the consumer's personal recovery is as a key performance indicator of mental health nursing in acute mental health settings (Santangelo et al., 2018). The Australian College of Mental Health Nurses (2010) affirmed that mental health nurses are registered nurses who have specialist knowledge in mental health nursing to provide holistic care and can work collaboratively with the service users towards recovery as defined by the individual. Yet, the communications between mental health nurses and the interdisciplinary team continues to be centred on consumers' clinical recovery. The lack of communications regarding the importance of consumers' personal recovery can significantly discount the importance of mental health nurses using recovery-focused care in acute mental health settings. Lastly, with the integration of mental health nursing curriculum into the comprehensive nursing programs, there is a reduction in clinical placements for nursing students to acquire the clinical experience to care for consumers that are acutely unwell (Happell et al., 2015). Hardy et al. (2022) examined the factors affecting knowledge of recovery-oriented practice amongst mental health nursing and medical staff working on acute mental health settings highlighted that their total mental health experiences was an important predictor of higher recovery knowledge and attitudes. Similarly, your observations in the intensive care area identified that junior nursing staff are more likely to experience some level of anxiety when compared to senior staff to use recovery-focused care (Sreeram et al., 2023). As such, the responsibility may now lie with the respective mental health services to support junior nursing staff to develop specialist mental health knowledge and skills, for example through mandatory clinical supervision and acquisition of professional nursing qualifications that allows them to be credentialing as a mental health nurse with The Australian College of Mental Health Nurses to practice confidently in acute mental health settings. This is important for the mental health service to build mental health nursing workforce that can consistently use recovery-focused care to care for consumers in all areas of mental health delivery. Contributions to conception and writing: Eric Lim. Writing of the article, reviewing and revising for improving intellectual content: Dianne Wynaden, Karen Heslop. None. Open access publishing facilitated by Curtin University, as part of the Wiley - Curtin University agreement via the Council of Australian University Librarians. There is no funding. Emeritus Professor Dianne Wynaden is an Editorial Board Member of International Journal of Mental Health Nursing. Dr Eric Lim and Associate Professor Karen Heslop declare that there is no conflict of interest or funding. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
Back to table of contents Previous article Next article CommentaryFull AccessMental Health Response to the COVID-19 Outbreak in ChinaJunying Zhou, M.D., Ph.D., Liu Liu, M.D., Pei Xue, M.D., Xiaorong Yang, B.N., Xiangdong Tang, M.D., Ph.D.Junying Zhou, M.D., Ph.D., Liu Liu, M.D., Pei Xue, M.D., Xiaorong Yang, B.N., Xiangdong Tang, M.D., Ph.D.Published Online:7 May 2020https://doi.org/10.1176/appi.ajp.2020.20030304AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Transmission of the 2019 novel coronavirus (COVID-19) (1) has now widely and rapidly spread around the world. On March 11, 2020, the World Health Organization announced that COVID-19 is a pandemic (2). The rapid transmission and mortality risk of the COVID-19 infection may increase the risk of mental health problems among healthy individuals in the general public and worsen preexisting psychiatric problems in psychiatric patients, although data are still being gathered. A constellation of difficult feelings and psychological distress, including panic, worries, and depression, could be triggered by the fear of possible infection, being quarantined at hospitals and home, social isolation, and even the shortage of protective gear.A number of mental health surveys associated with the COVID-19 outbreak are being conducted in different vulnerable populations, which include infected patients, medical staff, students, and the general population. Liu et al. have reported results from a multicenter survey conducted among 1,563 medical staff members and found that the prevalence of depression and anxiety was 51% and 45%, respectively (3). So far, data on the mental health repercussions of the COVID-19 pandemic in outpatient populations have not been available. Thus, we conducted a questionnaire survey, from February 25 to March 9, 2020, among outpatients who sought care in the Departments of Psychiatry, Neurology, and Sleep Medicine in West China Hospital of Sichuan University (Chengdu, China). A self-report questionnaire was completed by outpatients, who provided consent, via the WeChat-based survey program Questionnaire Star. A total of 2,065 out of 3,441 patients completed the survey, including 589 new patients and 1,476 existing patients. The prevalence rates of mental health problems related to the COVID-19 outbreak, including anxiety (defined as a total score ≥5 on the Generalized Anxiety Disorder 7-item scale), depression (defined as a total score ≥5 on the Patient Health Questionnaire 9-item scale), and insomnia (defined as a total score ≥8 on the Insomnia Severity Index), were 25.5%, 16.9%, and 26.2%, respectively. Furthermore, 20.9% of patients (N=300) with preexisting psychiatric disorders (N=1,434) reported a deterioration of their mental health condition related to the pandemic. In particular, transportation restrictions, isolation at home, and fear of cross-infection in hospitals have inevitably become major concerns and barriers to treatment for these patients during the outbreak. Our survey also showed that 24.5% of new patients, including those with anxiety (N=46), depression (N=37), insomnia (N=79), and psychosis (N=21), could not receive timely diagnoses and treatment. Similarly, 22.0% of existing patients with diagnosed mental disorders, including depression, bipolar disorders, and schizophrenia (N=315), could not receive routine psychiatric care because of suspended hospital visits. Consequently, 18.1% of patients (N=259) have self-reduced medication dosages, and 17.2% of patients (N=247) stopped taking their medication because they could not gain access to prescriptions from physicians during the outbreak. As the lifetime prevalence of mental disorders is 16.6% among adults in China (4), millions of psychiatric patients may face barriers to help seeking for timely management of their mental health condition. The long-term repercussions of the viral pandemic on the management of psychiatric patients warrant further investigation. Nonetheless, our data reiterate the importance of implementing appropriate mental health care measures in the face of the COVID-19 pandemic.In response to the COVID-19 outbreak, there have been ongoing measures and concerted efforts in China that emphasize the importance of dealing with the potentially concurrent mental health crisis. On January 26, 2020, the National Health Commission of China released principles for emergency psychological crisis intervention for the COVID-19 pandemic (5). Mental health hotlines were quickly established across China and provided the public with counseling and psychological services. The telephone and Internet have been widely used to deliver mental health care services, and social media platforms (e.g., WeChat, Weibo) have been used to share strategies, guidelines, and education programs for managing potential mental distress. In addition, a series of self-help handbooks for psychological care associated with COVID-19 have been published by the China Association for Mental Health, medical institutions, and universities.Furthermore, a number of hospitals in China have initiated telemedicine services for patients in need during the outbreak of COVID-19. On January 26, 2020, West China Hospital of Sichuan University, as one of the leading hospitals in China, opened a free online outpatient service involving more than 100 medical doctors across specialties. This online outpatient service was created mainly to provide prescriptions to existing patients and to offer consultation to new patients. Our hospital collaborated with commercial courier services to deliver medication to patients' homes at no cost. To date, thousands of patients have received health care provided by this online outpatient service. Interestingly, only 7.4% of patients with mental disorders (N=136) in our survey have sought online help for medical care. Thus, there is a need to promote online mental health care services across China to manage mental health problems during the pandemic.The long-term outcomes of the mental health interventions in both community and hospital settings need further evaluation to determine how we can ameliorate the negative effects of viral outbreaks in the general public, especially among vulnerable patients with mental health problems.Sleep Medicine Center (Zhou, Xue, Tang), Department of Anesthesiology, Translational Neuroscience Center (Liu), and Outpatient Department (Yang), West China Hospital, Sichuan University, Chengdu, China.Send correspondence to Dr. Zhou ([email protected]).The authors report no financial relationships with commercial interests.The authors thank the clinic nurses in the Departments of Psychiatry, Neurology, and Sleep Medicine, West China Hospital, Sichuan University.References1 Lu R, Zhao X, Li J, et al.: Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395:565–574Crossref, Medline, Google Scholar2 World Health Organization (WHO): WHO director-general's opening remarks at the media briefing on COVID-19: 11 March 2020 (https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020)Google Scholar3 Liu S, Yang L, Zhang C, et al.: Online mental health services in China during the COVID-19 outbreak. Lancet Psychiatry 2020; 7:e17–e18Crossref, Medline, Google Scholar4 Huang Y, Wang Y, Wang H, et al.: Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry 2019; 6:211–224Crossref, Medline, Google Scholar5 National Health Commission of China: [Principles for emergency psychological crisis intervention for the new coronavirus pneumonia.] http://www.nhc.gov.cn/jkj/s3577/202001/6adc08b966594253b2b791be5c3b9467.shtml (Chinese)Google Scholar FiguresReferencesCited byDetailsCited byRelationship between depression and burnout among nurses in Intensive Care units at the late stage of COVID-19: a network analysis1 April 2024 | BMC Nursing, Vol. 23, No. 1Effects of Long COVID on Psycho-Physical Conditions in the Italian Population: A Statistical and Large Language Model Combined Description27 April 2024 | European Journal of Investigation in Health, Psychology and Education, Vol. 14, No. 5The efficacy of internet-delivered cognitive-behavioral therapy for posttraumatic stress disorder according to the mean age of patients: a systematic review and meta-analysis11 December 2023 | Psychology, Health & Medicine, Vol. 29, No. 4Descripción de un Programa de Telesalud Mental en el Marco de la Pandemia de COVID-19 en ColombiaRevista Colombiana de Psiquiatría, Vol. 53, No. 2Longitudinal trajectories of anxiety and depression in subjects with different mental disorders after one year in the COVID-19 pandemicPsychiatry Research, Vol. 334The Impact of the COVID-19 Pandemic on the Mental Health of Families16 April 2024Effect of anxiety and depression on self-reported adverse reactions to COVID-19 vaccine: a cross-sectional study in Shanghai, China3 March 2023 | BMC Public Health, Vol. 23, No. 1Evaluation of cognitive functions in a group of Egyptian recovered COVID-19 patients22 May 2023 | Middle East Current Psychiatry, Vol. 30, No. 1Trends in telemedicine utilization for mental illness during the COVID-19 pandemic: an analysis of a nationwide database in Korea24 October 2023 | BMC Psychiatry, Vol. 23, No. 1Investigating the dynamic relationship between stigma of fear, discrimination and employees performance among healthcare workers during Covid-19 pandemic31 July 2023 | Cognition, Technology & Work, Vol. 25, No. 4"I Can't See an End in Sight." How the COVID-19 Pandemic May Influence Suicide RiskCrisis, Vol. 44, No. 6Mental Distress Among Norwegian Adults During the COVID-19 Pandemic: Predictors in Initial Response and Subsequent Trajectories25 October 2023 | International Journal of Public Health, Vol. 68The mediating effect of family health on the relationship between health literacy and mental health: A national cross-sectional survey in China24 April 2023 | International Journal of Social Psychiatry, Vol. 69, No. 6Coronavirus anxiety, fear level, and awareness of nursing students starting face-to-face education28 August 2023 | Journal of Public Health, Vol. 20Unleashing the link between the relaxation of the COVID-19 control policy and residents' mental health in China: the mediating role of family tourism consumption22 August 2023 | Frontiers in Public Health, Vol. 11Impact of the first wave of COVID-19 pandemic on the Hungarian university students' social and health behaviour28 October 2021 | Journal of Public Health, Vol. 31, No. 7Is psychologically vulnerable rural-to-urban migrants' mental health further at stake under China's tightened COVID-19 measures: how should the government respond?5 May 2023 | Frontiers in Sociology, Vol. 8The impact of the COVID-19 pandemic and earthquake on mental health of persons with severe mental illness: A survey study among people receiving community mental health care versus treatment as usual in Croatia1 November 2022 | International Journal of Social Psychiatry, Vol. 69, No. 3Prosocial behavior predicts meaning in life during the COVID-19 pandemic: The longitudinal mediating role of perceived social support16 March 2023 | Frontiers in Public Health, Vol. 11Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspectiveJournal of Affective Disorders, Vol. 324The Racial Differences in Impact and Knowledge of COVID-19 Among Patients with Psychiatric IllnessesCurrent Psychiatry Research and Reviews, Vol. 19, No. 1Codesign of a digital health tool for suicide prevention: protocol for a scoping review10 March 2023 | BMJ Open, Vol. 13, No. 3Chinese adolescents' depression, anxiety, and family mutuality before and after COVID ‐19 lockdowns: Longitudinal cross‐lagged relations2 September 2022 | Family Relations, Vol. 72, No. 1Public psychological crisis reports: an investigation during the remission of COVID-19 in China21 January 2022 | Chinese Management Studies, Vol. 17, No. 1"Nice You Share in Return": Informational Sharing, Reciprocal Sharing, and Life Satisfaction Amid COVID-19 Pandemic29 October 2022 | Social Indicators Research, Vol. 165, No. 2Psychological Distress of Healthcare Workers in 4 Hospitals Compared to General Population During the First Italian Wave of COVID-19 Pandemic27 January 2023 | INQUIRY: The Journal of Health Care Organization, Provision, and Financing, Vol. 60Effect of the COVID-19 Lockdown and Post-lockdown on Mental Health Among Diploma in Pharmacy Students27 July 2023Evaluation and Application of Cloud Computing in Mental Health Service PlatformProcedia Computer Science, Vol. 228A mathematical model of coronavirus transmission by using the heuristic computing neural networksEngineering Analysis with Boundary Elements, Vol. 146Complicaciones neuropsiquiátricas por COVID-1931 December 2022 | Salud, Ciencia y Tecnología, Vol. 2, No. S1Network analysis of depressive and anxiety symptoms in adolescents during the later stage of the COVID-19 pandemic10 March 2022 | Translational Psychiatry, Vol. 12, No. 1Impact of housing conditions on changes in youth's mental health following the initial national COVID-19 lockdown: a cohort study4 February 2022 | Scientific Reports, Vol. 12, No. 1COVID-19 behavioral health and quality of life19 January 2022 | Scientific Reports, Vol. 12, No. 1RETRACTED ARTICLE: Type 1 diabetes and the challenges of emotional support in crisis situations: results from a randomized clinical trial of a multidisciplinary teleintervention23 February 2022 | Scientific Reports, Vol. 12, No. 1Type 1 diabetes and the challenges of emotional support in crisis situations: results from a feasibility study of a multidisciplinary teleintervention20 May 2022 | Scientific Reports, Vol. 12, No. 1Prevalence of post-traumatic stress disorder symptoms among patients with mental disorder during the COVID-19 pandemic1 March 2022 | BMC Psychiatry, Vol. 22, No. 1COVID-19 and substance use disorders: a review of international guidelines for frontline healthcare workers of addiction services31 March 2022 | BMC Psychiatry, Vol. 22, No. 1Anxiety and depression in the post-pandemic era: concerns about viral mutation and re-outbreak3 November 2022 | BMC Psychiatry, Vol. 22, No. 1Gender differences in psychiatric outpatients: a before and during COVID-19 pandemic study in general hospitals from China7 September 2022 | Annals of General Psychiatry, Vol. 21, No. 1Public wellbeing analytics framework using social media chatter data3 November 2022 | Social Network Analysis and Mining, Vol. 12, No. 1Association between sedentary time and metabolic syndrome: A cross-sectional study among Chinese Garze Tibetans17 November 2022 | Frontiers in Public Health, Vol. 10COVID-19 pandemic and adolescent mental health in China: Micro evidence and socioeconomic mechanisms14 November 2022 | Frontiers in Psychology, Vol. 13A deep learning-based model for detecting depression in senior population7 November 2022 | Frontiers in Psychiatry, Vol. 13Einfluss der COVID-19-Pandemie auf die ambulante psychotherapeutische Versorgung von Kindern und Jugendlichen27 June 2022 | Die Psychotherapie, Vol. 67, No. 6Family Resilience, Media Exposure, and Children's Mental Health in China During COVID-196 December 2021 | The Family Journal, Vol. 30, No. 4The associations among the stress symptoms, depressive symptoms, anxiety symptoms and insomnia symptoms in depressed patients after the first COVID-19 outbreak was initially controlled in China: A prospective cohort studyJournal of Affective Disorders, Vol. 314Minority and low-SES families' experiences during the early phases of the COVID-19 pandemic crisis: A qualitative studyChildren and Youth Services Review, Vol. 140Network analysis of depression, anxiety, insomnia and quality of life among Macau residents during the COVID-19 pandemicJournal of Affective Disorders, Vol. 311Prevalence of problematic Internet use during the coronavirus disease 2019 pandemicCurrent Opinion in Behavioral Sciences, Vol. 46Prevalence of anxiety symptoms among Chinese university students amid the COVID-19 pandemic: A systematic review and meta-analysisHeliyon, Vol. 8, No. 8Machine learning approach for anxiety and sleep disorders analysis during COVID-19 lockdown30 May 2022 | Health and Technology, Vol. 12, No. 4Mental health of patients with mental illness during the COVID-19 pandemic lockdown: a questionnaire-based survey weighted for attrition17 September 2021 | Nordic Journal of Psychiatry, Vol. 76, No. 5Proposal of a Model for the Analysis of the State of the Use of ICT in Education Applied to Technological Institutes of Higher Education8 July 2022 | Computers, Vol. 11, No. Mental and COVID-19 A in the June 2022 | Frontiers in Public Health, Vol. of Psychiatric in Patients in Hospitals to COVID-19 Outbreak in A Center Longitudinal April 2022 | Vol. No. Use and Mental Health During the COVID-19 Health Vol. No. for During the COVID-19 Pandemic: A April 2022 | Frontiers in Psychiatry, Vol. post-traumatic in the general a cross-sectional study from August 2021 | Psychology, Health & Medicine, Vol. No. as in a with A Reports, Vol. 17, No. of symptoms in Internet and depression among adolescents in A network of Affective Disorders, Vol. March 2022 | University Journal of and of Social Media in for the of the Pandemic among Students27 February 2022 | International Journal of Research and Public Health, Vol. 19, No. of the during the COVID-19 Lockdown by the Mental Health by the of Psychology of March 2022 | International Journal of Research and Public Health, Vol. 19, No. symptoms during the early and late of the COVID-19 pandemic in China: a systematic review and Medicine, Vol. and Sleep of Patients with Sleep February 2022 | Journal of Sleep Medicine, Vol. 9, No. of and psychiatric symptoms in patients with psychiatric disorders during the Covid-19 May 2021 | European of Psychiatry and Vol. No. the Care and Anxiety of Patients with COVID-19 in November 2021 | Journal of and Health, Vol. No. impact of the pandemic on in the with preexisting mental health A longitudinal October 2021 | Journal of Vol. No. of Psychiatric and Psychiatric Among for During the Initial of COVID-19 Pandemic in Vol. 19, No. of the COVID-19 September to the Prevalence of of Mental in the During the COVID-19 Pandemic: December 2022 | Research, Vol. No. in the of the COVID-19 Pandemic in January 2022 | Journal of Science, Vol. No. 6Mental Health and among University during the COVID-19 Pandemic in January 2022 | Journal of Sciences, Vol. No. in the and COVID-19 among patients with psychiatric illness A study from of Psychiatry, Vol. No. on Impact of COVID-19 Pandemic on with their and with Social Psychiatry, Vol. No. and of to Department during COVID-19 Pandemic of December 2021 | Journal of Care Medicine, Vol. 25, No. impact of the COVID-19 pandemic on depression in a prospective cohort December 2021 | Medicine, Vol. impact in patients with mental disorders after of COVID-19 Vol. to the COVID-19 Pandemic Among the General February 2021 | Journal of and Studies, Vol. No. 8The impact of COVID-19 pandemic on symptoms and among patients with medication a cross-sectional May 2021 | The Journal of and Vol. 22, No. reactions and insomnia in adults with mental health disorders during the COVID-19 January 2021 | BMC Psychiatry, Vol. 21, No. and anxiety symptoms in adults before and during the COVID-19 pandemic: evidence from a September 2021 | Annals of General Psychiatry, Vol. No. 1Prevalence of psychiatric and related symptoms among patients with COVID-19 during the wave of the April 2021 | and Health, Vol. 17, No. anxiety, and post-traumatic stress symptoms and COVID-19 patients: a cross-sectional study4 May 2021 | Middle East Current Psychiatry, Vol. No. of a of patients with disorders during the first COVID-19 December 2021 | Scientific Reports, Vol. 11, No. 1Effects of COVID ‐19 pandemic on mental health outcomes in a cohort of early psychosis January 2021 | in Psychiatry, Vol. No. the psychological therapy treatment outcomes for adults who are not in of and be to November 2021 | Medicine, Vol. Health to Social During the COVID-19 Pandemic in a November 2021 | Frontiers in Public Health, Vol. between the COVID-19 and and symptoms in people with November 2021 | impact of and mental health on health during of Psychiatric Research, Vol. and of public health on public new A systematic March 2021 | International Journal of Social Psychiatry, Vol. 67, No. and disorders associated with COVID-19. disorders and Vol. of mental disorders on COVID-19 October 2021 | Neurology, Vol. 13, No. of COVID-19 pandemic on emergency community Psychiatry, Vol. and psychological impact of COVID-19 pandemic in a cohort study Vol. mental health and need for care among psychiatric outpatients during the COVID-19 pandemic: from an in Research, Vol. pandemic in January 2021 | Journal of Social and Vol. 23, No. Psychiatric and the of Mental during the COVID-19 Pandemic: A et la de la COVID-19: January 2021 | The Journal of Psychiatry, Vol. No. Media and Analysis during the Covid-19 September 2021 | Vol. 13, No. Distress During the COVID-19 Pandemic in Patients Mental August 2021 | Frontiers in Psychology, Vol. to Analysis of the of July 2021 | Vol. 13, No. of COVID-19: of and July 2021 | No. 29, of Health for the of July 2021 | Frontiers in Health, Vol. of the Patients in Hospital to the COVID-19 A July 2021 | Frontiers in Psychology, Vol. during the COVID-19 pandemic social July 2021 | Vol. No. COVID-19 in Chinese July 2021 | Frontiers in Medicine, Vol. experiences of and mental health services during the first Covid-19 of Health Vol. 9, No. Health and during the Pandemic in A Questionnaire of Mental Health and Psychiatric July 2021 | International Journal of Research and Public Health, Vol. No. of the COVID-19 pandemic on mental health service use among psychiatric outpatients in a of Affective Disorders, Vol. and Association of Life Among of Patients Psychiatric Services During the COVID-19 June 2021 | Frontiers in Psychiatry, Vol. of Anxiety to the COVID-19 Ph.D., Yang, Ph.D., Ph.D., Ph.D., Ph.D., Yang, Ph.D., Ph.D., Ph.D., Ph.D., Ph.D., Ph.D., Ph.D., Ph.D., Ph.D., Ph.D., Ph.D., M.D., Ph.D., April 2021 | Journal of Psychiatry, Vol. No. in depression & anxiety among mental health service during the COVID-19 pandemicJournal of Affective Disorders, Vol. symptoms and seeking during the Covid-19 May 2021 | Translational Psychiatry, Vol. 11, No. und und February 2021 | der Vol. No. prevalence of depressive and anxiety symptoms and their associations with quality of life among patients with psychiatric disorders during the COVID-19 January 2021 | Translational Psychiatry, Vol. 11, No. COVID-19 pandemic and mental of The Vol. of COVID-19 pandemic on the mental health of May 2021 | Journal of associated with mental health and quality of life during the COVID-19 pandemic in May 2021 | Open, Vol. No. and risk of psychiatric symptoms and diagnoses before and during the COVID-19 pandemic: from the COVID-19 mental health April 2021 | Medicine, Vol. in The impact of protective and on and Medicine in Psychiatry, Vol. COVID-19 the of March 2021 | Current Psychiatry Reports, Vol. 23, No. Medicine in Psychiatry in the COVID-19 era: the impact of the pandemic on mental Medicine in Psychiatry, Vol. and in the age of October 2020 | Psychology & Vol. No. in mental health problems related to COVID-19 in Hospital Psychiatry, Vol. mental health and novel coronavirus: The risk of the Journal of Psychiatry, Vol. for and Mental On the of COVID-19 February 2021 | Frontiers in Vol. of during COVID-19: a an January 2021 | Vol. 44, No. and psychological of students during the early stage of COVID-19 outbreak in China: a cross-sectional February 2021 | BMJ Open, Vol. 11, No. an to Mental Health, and among Youth and February 2021 | International Journal of Research and Public Health, Vol. No. in the and of Mental Health November from July Disorders, and and mental illness: A systematic review and & Health, Vol. and in pandemic: the in mental health October 2020 | International Journal of Vol. No. 1Prevalence and with Insomnia Among the Chinese General Public the 2019 June 2021 | and of Vol. the of December 2021 | and of Vol. Health for to Patients in a of Pandemic: and of Patient July 2021 | Mental Health, Vol. 8, No. impact of COVID-19 pandemic on the of depression among health care cross-sectional May 2021 | Vol. Mental Health the of in the April 2021 | Journal of Education in the Health Vol. No. from November to the Mental Health of by COVID-19 in China: A December 2020 | Frontiers in Psychiatry, Vol. of in 100 Patients Disorder During the COVID-19 Pandemic in December 2020 | Frontiers in Psychiatry, Vol. in of November 2020 | Current Psychiatry Reports, Vol. 22, No. adverse with during COVID-19 Journal of Psychiatry, Vol. of patients with Journal of Psychiatry, Vol. health response for and adolescents during the COVID-19 outbreak in Research, Vol. to COVID-19 to in and from a for Sleep in December 2020 | International Journal of Research and Public Health, Vol. 17, No. awareness of suicide during the October 2020 | Reports, Vol. No. of and health anxiety during COVID pandemic among of a psychiatric an Journal of impact of COVID ‐19 on individuals with disorders: A survey of individuals in the and the July 2020 | International Journal of Disorders, Vol. 53, No. and Distress COVID-19 Among University in the October 2020 | Frontiers in Psychiatry, Vol. pandemic and mental health review of the and Vol. and to the COVID-19 crisis in the of Psychiatric Research, Vol. of COVID-19 on Youth Mental Health, and A of and de la COVID-19 la de et adolescents un et July 2020 | The Journal of Psychiatry, Vol. No. Network Analysis of During the COVID-19 October 2020 | Frontiers in Psychology, Vol. of suicide during and after the COVID ‐19 September 2020 | World Psychiatry, Vol. 19, No. psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public A systematic review and Research, Vol. changes during COVID-19 and the potential A June 2020 | Journal of Health Psychology, Vol. 25, No. and July 2020 | Journal of Psychiatry, Vol. No. COVID-19-Pandemie die und Psychotherapie, Vol. No. 2019 (COVID-19) and Psychiatric in Anxiety and Journal of Medicine, Vol. 2, No. of COVID-19 on Mental Health in the September 2020 | Journal of Internet Research, Vol. 22, No. an Outpatient Psychiatric to During the COVID-19 Pandemic: A October 2020 | Journal of Internet Research, Vol. 22, No. disorders in people infected with the coronavirus September 2020 | Journal of Public Health, Vol. No. 4 July authors thank the clinic nurses in the Departments of Psychiatry, Neurology, and Sleep Medicine, West China Hospital, Sichuan April 2020 online May 2020 in 1 July 2020
•The National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity calls for a series of policy reforms to unleash the potential of nurses to play greater roles in advancing health equity.•The report recommends that the systems that educate, pay and employ nurses: 1) permanently remove barriers to care; 2) value their contributions; 3) prepare nurses to tackle health equity; and 4) diversify the workforce. The need to fully support nurses is interwoven throughout the report.•All nurses should work in partnership with others to advance the nine major report recommendations. The National Academy of Medicine's long-anticipated report, The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity, offers an aspirational vision: the achievement of health equity in the United States built on strengthened nursing capacity, diversity, and expertise (Wakefield, 2021Wakefield M. Federally qualified health centers and related primary care workforce issues.Jama. 2021; 325: 1145-1146Crossref PubMed Scopus (10) Google Scholar). Released in May 2021, the report arrives at a critical moment for the profession. Many nurses are burned out, exhausted, and have experienced moral injury from caring for an unrelenting stream of patients with COVID-19. The pandemic has laid bare and further exacerbated long-existing health inequities. School closings during the pandemic similarly exacerbated educational disparities, and poor treatment of Black, Indigenous, and other people of color by police spotlighted inequities in law enforcement. Collectively, these inequities have resulted in renewed calls to dismantle structural, cultural, and interpersonal racism, including within nursing. This new report provides a roadmap for how the nursing profession can contribute its expertise to create a fairer, more just and healthier world. The report is the second collaboration between the Robert Wood Johnson Foundation (RWJF) and the National Academy of Medicine (NAM) on the future of nursing. The first report, released in 2010, re-conceptualized the role of nurses in transforming the healthcare system (Shalala et al., 2011Shalala D. Bolton L.B. Bleich M.R. Brennan T. Campbell R. Devlin L. The future of nursing: Leading change, advancing health. 10. The National Academy Press, Washington DC2011: 12956https://www.nap.edu/catalog/12956/the-future-of-nursing-leading-change-advancing-healthGoogle Scholar). RWJF and AARP formed The Future of Nursing: Campaign for Action, a nationwide initiative to advance the report recommendations. Over the past decade, the nursing field strengthened nursing education, advanced practice, promoted leadership, and increased workforce diversity. In doing so, the nursing field has built – and is continuing to build – its capacity to provide high-quality care to more Americans. As nursing built its capacity and as the evidence increasingly linked inequities to poorer health status, it became clear that nurses could do more to build healthier communities and advance equity. Nurses are the most trusted profession and the first point of contact for most people seeking health care. They are bridge builders and collaborators who engage and connect with people, communities, and organizations to promote health and well-being (Pittman, 2019Pittman, P. (2019,. March 12). Activating nursing to address the unmet needs of the 21st century: Background paper for the NAM Committee on Nursing 2030.Robert Wood Johnson Foundation. Available at: https://publichealth.gwu.edu/sites/default/files/downloads/HPM/Activating%20Nursing %20To%20Address%20Unmet%20Needs%20In%20The %2021st%20Century.pdfGoogle Scholar). Their expertise could be better used to combat the many shortcomings of the U.S. health system. The United States spends $3.5 trillion each year on health care (CMS, 2020) more than any other country in the world but ranks last compared with other high-income countries on equity, access to care, health care outcomes, and administrative efficiency (Schneider et al., 2021Schneider, E. et al.,(2021, August)) Mirror, Mirror 2021 — Reflecting Poorly: Health Care in the U.S. compared to other high-income countries (Commonwealth Fund). https://doi.org/10.26099/01dv-h208.Google Scholar). Life expectancy, infant mortality and maternal mortality are worse in the United States compared with other high-income nations. Disparities in health care access and outcomes related to race, income, geography and other social and environmental factors are also common. RWJF has long believed that nurses have enormous potential for tackling the shortcomings of health and health care in the United States and in 2019 asked the NAM to form a committee tasked with charting a path for the nursing profession to create a culture of health, reduce health disparities, and improve the health and well-being of the nation. As the committee was well into the process of reviewing evidence and preparing to write the report, the pandemic took hold across the country and shined a light on the nation's rampant health inequities. The committee delayed the report to incorporate the major lessons from the pandemic: its disproportionate and devastating toll on poor and marginalized populations that could largely be attributed to persistent health disparities; the need to fully support nurses; and better prepare the workforce for future disasters. Released in May 2021, the report called for a series of policy reforms to unleash the potential of nurses to play greater roles in advancing health equity. The report recommends that the systems that educate, pay, and employ nurses: (1) permanently remove barriers to care; (2) value their contributions; (3) prepare nurses to tackle health equity; and (4) diversify the workforce. The report underscores that prioritizing nurse well-being is paramount to advancing the recommendations. In addition, the report calls on national nursing organizations to develop a shared agenda for addressing the social determinants of health and achieving health equity. Finally, the committee prioritized research needs to build the evidence base to support nurses in advancing health equity. Each of these areas is discussed below. Far too often in the United States, people do not see a health care provider when they need one. Nearly 30 million people are uninsured in the United States, and roughly 40 million have health plans that leave them potentially underinsured (Collins et al., August 2020Collins, Sara R., Gunja, Munira Z., & Aboulafia, Gabriella N. (2020). U.S. Health insurance coverage in 2020: A looming crisis in affordability — findings from the Commonwealth Fund Biennial Health Insurance Survey, 2020.Commonwealth Fund. https://doi.org/10.26099/6aj3-n655.Google Scholar). In addition, timely access to health care is undermined due to the inability to pay; geographic inaccessibility to services and providers, particularly in rural and underserved urban areas; lack of health literacy; and fundamental mistrust of the health care system and providers. Research demonstrates that delays in obtaining care can lead people to experience worse symptoms and disease progression (Man et al., 2018Man R.X.G. Lack D.A. Wyatt C.E. Murray V. The effect of natural disasters on cancer care: A systematic review.The Lancet Oncology. 2018; 19: e482-e499https://doi.org/10.1016/S1470-2045(18)30412-1Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar). Nurses can help to explicitly address these gaps in access to care. For example, about 70% to 80% of advanced-practice nurses work in primary care, including in pediatrics, adult practice, gerontology, and nurse midwifery. While the primary care nurse practitioner field has grown, the number of physicians entering primary care has stagnated or declined (Barnes et al., 2018Barnes H. Richards M.R. McHugh M.D. Martsolf G. Rural and nonrural primary care physician practices increasingly rely on nurse practitioners.Health Affairs. 2018; 37: 908-914https://doi.org/10.1377/hlthaff.2017.1158Crossref PubMed Scopus (127) Google Scholar; Barnes et al., 2018Xue Y. Ye Y. Brewer C. Spetz J. Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review.Nursing outlook. 2016; 64: 71-85https://doi.org/10.1377/hlthaff.2017.1158Crossref PubMed Scopus (117) Google Scholar). Care provided by nurse practitioners has been found to be comparable to the care provided by physicians, according to numerous studies (Perloff et al., 2019Perloff J. Clarke S. DesRoches C.M. O'Reilly-Jacob M. Buerhaus P. Association of state-level restrictions in nurse practitioner scope of practice with the quality of primary care provided to Medicare beneficiaries.Medical Care Research and Review. 2019; 76: 597-626Crossref PubMed Scopus (24) Google Scholar; Yang et al., 2020Yang B.K. Johantgen M.E. Trinkoff A.M. Idzik S.R. Wince J. Tomlinson C. State Nurse Practitioner practice regulations and US health care delivery outcomes: A systematic review.Medical Care Research and Review. 2021; 78: 183-196https://doi.org/10.1177/1077558719901216Crossref PubMed Scopus (32) Google Scholar). They are less expensive to employ than physicians and are more likely to care for vulnerable populations, including those in rural areas (Perloff et al., 2016Perloff J. DesRoches C.M. Buerhaus P. Comparing the cost of care provided to Medicare beneficiaries assigned to primary care nurse practitioners and physicians.Health Services Research. 2016; 51: 1407-1423Crossref PubMed Scopus (83) Google Scholar). However, the ability of nurses to expand access to care is limited by state and federal laws, institutional barriers, and restrictive health systems policies that prohibit them from working to the full extent of their education and training (Wakefield et al., 2021Wakefield M.K. Williams D.R. Le Menestrel S. Flaubert J.L. The future of nursing 2020-2030: Charting a path to health equity. National Press, Google Scholar). The report calls for and organizations to remove these and as well as restrictive policies and In during the and provided full practice to nurse is just about the effect of the to expand scope of practice during the pandemic et al., R. Impact of pandemic on from a national 2021; Full Text Full Text PDF PubMed Scopus Google Scholar; et al., 19: for nurse practitioners to healthcare and for full practice 2021; PubMed Scopus (24) Google in the found that with to from The of nurse practitioner to reduce from the and Scholar). The report calls for these restrictions on scope of practice to be This to remove practice barriers the work of the first report, but it in more the need to barriers that and nurses from to the of their education and training to access to care and help to reduce health care inequities for populations to see a provider when they need one. that the care that and nurses provide restrictions on services and policies that nurses from care. nurses to practice to the full extent of their education and training is an policy to gaps in access to care. As the report the and systems do to reduce health inequities. This has been by the has its to health equity a in policy & E. M. D. et at the for Medicare and a for the 2021; Google Scholar). health care that health equity can a in The U.S. systems the care that nurses provide and the critical role that they can play in addressing to health equity. 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School nurses are to for services that they but the process is that do M. Available Scholar). that and diversify the nursing workforce help to advance health equity. to the nursing the report calls for and to provide for nursing that address social needs and the social determinants of health in nursing practice and systems can nurses to to care and outcomes for patients by and that can reduce health inequities. the of nursing to improve care limited the organizations that employ nurses are not for these care and for nursing to advance health The future of nursing NAM 2021; Scholar). The report recommends that and systems be to support and health care and health organizations to nurses to these the United States spends of for health care with health outcomes that in to countries that and are to policy that better health Nursing in these is as is policy that the nurses can to advancing health equity. The of nurses needs to be well to promote health equity and improve the health and well-being of nurses need to and the social and environmental factors that health, care for an and more engage in new new with other and health equity and to a policy and collaboration with across the health care and health systems as well as of health care with organizations on social and be paramount during the the nursing field an in preparing the as an million nurses during the by This in an May as nursing education to nurses well to on and roles and to advance the NAM report recommendations. to prepare nurses to tackle health equity related to the social determinants of health, health and health are not into and nursing that nurses are to address the social determinants of health and advance health and healthcare equity. and should be throughout including need to the extent to they provide education in that provide with and from who with an of social needs as well as with communities with the social determinants of health (Wakefield et al., 2021Wakefield M.K. Williams D.R. Le Menestrel S. Flaubert J.L. The future of nursing 2020-2030: Charting a path to health equity. National Press, Google Scholar). across the including in policy by on as are of can provided health as health care, qualified health health and for educational should incorporate to and work with other health and to address the social determinants of health. need in that prepare them to on a in health equity, care for populations with and and them to build the and to advance health equity. 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Journal of Palliative MedicineVol. 3, No. 1 Innovations in End-of-Life CareTaking a Spiritual History Allows Clinicians to Understand Patients More FullyDr. Christina Puchalski and Anna L. RomerDr. Christina Puchalski and Anna L. RomerPublished Online:19 Apr 2005https://doi.org/10.1089/jpm.2000.3.129AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byVerbalizing spiritual needs in palliative care: a qualitative interview study on verbal and non-verbal communication in two Danish hospices4 January 2022 | BMC Palliative Care, Vol. 21, No. 1Implementation of an Educational Toolkit to Increase Nurse Competence in Spirituality and Spiritual Care of Oncology Patients8 November 2022 | Journal of Holistic Nursing, Vol. 5Posicionamento sobre a Saúde Cardiovascular nas Mulheres – 2022Arquivos Brasileiros de Cardiologia, Vol. 119, No. 5Experiences of German health care professionals with spiritual history taking in primary care: a mixed-methods process evaluation of the HoPES3 intervention15 October 2022 | Family Practice, Vol. 29Religious and spiritual journeys of LGBT older adults in rural Southern Appalachia25 October 2021 | Journal of Religion, Spirituality & Aging, Vol. 34, No. 4The CASH assessment tool: A window into existential suffering19 May 2021 | Journal of Health Care Chaplaincy, Vol. 28, No. 4Integrating religion/spirituality into professional social work practice27 July 2022 | Journal of Religion & Spirituality in Social Work: Social Thought, Vol. 41, No. 4The Concept of Spirituality in the Health Sector: Contributions from the Study of Religion27 September 2022 | International Journal of Latin American Religions, Vol. 12Systematic review: The relationship between religion, spirituality and mental health in adolescents who identify as transgender13 September 2022 | Journal of Gay & Lesbian Mental Health, Vol. 26„Des Lebens Ruf an uns wird niemals enden“ – Sinnzentrierte Interventionen im Überblick30 August 2022 | Zeitschrift für Palliativmedizin, Vol. 23, No. 05Case discussion: The critically ill older adult in spiritual distressGeriatric Nursing, Vol. 47Australian Patient Preferences for the Introduction of Spirituality into their Healthcare Journey: A Mixed Methods Study3 August 2022 | Journal of Religion and Health, Vol. 27Religion, Spirituality, and Ethics in Psychiatric Practice30 March 2022 | Journal of Nervous & Mental Disease, Vol. 210, No. 8Spiritual distress in dialysis: A case report21 July 2022 | Progress in Palliative Care, Vol. 211Interprofessional communication training to address spiritual aspects of cancer care19 July 2022 | Journal of Health Care Chaplaincy, Vol. 29Spirituality in Serious Illness and HealthJAMA, Vol. 328, No. 2What is the role of spiritual care specialists in teaching generalist spiritual care? 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April 2020 | Cognitive, Affective, & Behavioral Neuroscience, Vol. 20, No. 3Patterns of Religiosity, Death Anxiety, and Hope in a Population of Community-Dwelling Palliative Care Patients in New Zealand—What Gives Hope If Religion Can’t?9 December 2019 | American Journal of Hospice and Palliative Medicine®, Vol. 37, No. 5Pain Management in Patients with Serious IllnessMedical Clinics of North America, Vol. 104, No. 3Varieties of Religious (Non)AffiliationJournal of Nervous & Mental Disease, Vol. 208, No. 5Cuidados paliativos31 August 2020 | PAJAR - Pan American Journal of Aging Research, Vol. 8, No. 1The Invisibility of Spiritual Nursing Care in Clinical Practice28 November 2019 | Journal of Holistic Nursing, Vol. 38, No. 1Spirituality in heart failure: a review of the literature from 2014 to 2019 to identify spiritual care needs and spiritual interventionsCurrent Opinion in Supportive & Palliative Care, Vol. 14, No. 1Plädoyer für einen (berufs-) alltagstauglichen Begriff von 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and Spiritual SufferingSurgical Clinics of North America, Vol. 99, No. 5Spirituality and Religion-Relevance and Assessment in the Clinical SettingCurrent Psychiatry Research and Reviews, Vol. 15, No. 2Religion, Belief, and Spirituality in Health Care2 August 2019Faith-Health Collaboration to Improve Community and Population Health12 August 2019 | NAM PerspectivesBrazilian Physicians’ Beliefs and Attitudes Toward Patients’ Spirituality: Implications for Clinical Practice29 September 2018 | Journal of Religion and Health, Vol. 58, No. 4Recent Advances in Cognitive Behavioral Therapy For Digestive Disorders and the Role of Applied Positive Psychology Across the Spectrum of GI CareJournal of Clinical Gastroenterology, Vol. 53, No. 7Preferences, use of and satisfaction with mental health services among a sample of Puerto Rican cancer patients18 July 2019 | PLOS ONE, Vol. 14, No. 7Spirituality as agency and restoration in existential recovery11 April 2018 | Journal of Spirituality in Mental 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Maiko, Steven Ivy, Beth Newton Watson, Kianna Montz, and Alexia M. Torke27 March 2019 | Journal of Palliative Medicine, Vol. 22, No. 4Time to follow the evidence – Spiritual care in health careEthics, Medicine and Public Health, Vol. 9How and When Is Role Modeling Effective? The Influence of Mentee Professional Identity on Mentoring Dynamics and Personal Learning Outcomes18 April 2019 | Group & Organization Management, Vol. 44, No. 2Teenagers and Cannabis Use: Why It's a Problem and What Can Be Done About ItJournal of Psychosocial Nursing and Mental Health Services, Vol. 57, No. 3Haken und Ösen: Spiritualität in der klinischen PalliativversorgungWege zum Menschen, Vol. 71, No. 2Approaching Spirituality Using the Patient-Centered Clinical Method27 January 2018 | Journal of Religion and Health, Vol. 58, No. 1Medical Students’ (Dis)comfort with Assessing Religious and Spiritual Needs in a Standardized Patient Encounter10 October 2018 | Journal of Religion and Health, Vol. 58, No. 1Spirituality and Religiosity of Pharmacy Students1 February 2019 | American Journal of Pharmaceutical Education, Vol. 83, No. 1Interprofessional spiritual care in oncology: a literature review16 February 2019 | ESMO Open, Vol. 4, No. 1Physical, Psychological/Psychiatric, Social, and Spiritual Problems and Symptoms13 April 2019Spiritual Assessment in Healthcare: An Overview of Comprehensive, Sensitive Approaches to Spiritual Assessment for Use Within the Interdisciplinary Healthcare Team18 May 2019The Role of the Nurse in Providing Spiritual Care: A Case Study Approach to Exploring Specific Care Provision by Healthcare Workers in the Context of an Interdisciplinary Healthcare Team18 May 2019Teaching and Learning About Spirituality in Healthcare Practice Settings18 May 2019Religion and Spirituality Among Medical Students5 June 2019Spiritual Care: The Role of Health Care Chaplaincy4 September 2019End-of-life milieu of critically sick children admitted to a pediatric hospital: A comparative study of survivors versus nonsurvivorsIndian Journal of Palliative Care, Vol. 25, No. 4Incorporating and Teaching Spirituality into Medical Education: An Overview of the Field and Possible Educational Strategies4 September 2019Religion, Spirituality, and Stress6 March 2019Toward Comprehensive Medicine: Listening to Spiritual and Religious Needs of Patients26 April 2019 | Gerontology and Geriatric Medicine, Vol. 5Din ve Psikoloji Arasındaki Uçurum Gerçekten Ne Kadar Derin? Psikoterapilerdeki Dini İzler15 December 2018 | Cumhuriyet İlahiyat Dergisi, Vol. 22, No. 3Women's Perceptions of Using Short Films to Integrate Spirituality in TherapyJournal of Systemic Therapies, Vol. 37, No. 4Content Validation of Advanced Illness Criteria of a Palliative Care Screening Tool Lauren C. DiLello, Karen Mulvihill, Jennifer Delli Carpini, Riddhi Shah, Julia Hermanowski, and Damanjeet Chaubey29 October 2018 | Journal of Palliative Medicine, Vol. 21, No. 11Understanding, assessing, and in the spiritual of medical and October 2018 | Theology, Vol. 11, No. and of in Living with October 2018 | Journal of & Social Services, Vol. No. for the spirituality as October 2018 | Revista de Vol. 71, No. An of an aged psychiatry March 2018 | Psychiatry, Vol. 26, No. de de vida de de Vol. 25, No. support and with in Care in the Care A Narrative June | Journal of Care Medicine, Vol. No. Care in Cancer: in the of of Clinical Oncology Educational Vol. 3, No. religion/spirituality in clinical practice: A among social and and October | Journal of Clinical Psychology, Vol. 74, No. Spirituality in Care December | Journal of Religion and Health, Vol. 57, No. of to spiritual care at the of a phenomenological exploration from the of palliative care February 2018 | Journal for the Study of Spirituality, Vol. 8, No. Existential Distress in Pediatric Cancer December and Patient Spiritual in the through October of Spirituality in November Psychological/Psychiatric, Social, and Spiritual Problems and July and End-of-Life Care in Cancer in Oncology Nursing, Vol. No. Care in Hospice and Palliative Journal of Hospice and Palliative Care, Vol. 20, No. and Spirituality: Literature review and Journal of Counseling, Vol. 18, No. of the tool existential communication between and cancer August | European Journal of General Practice, Vol. 23, No. Education and of Christian Nursing, Vol. 34, No. Care Interventions in to and Therapy C. and D. September | Journal of Palliative Medicine, Vol. 20, No. in Patients with A Qualitative September | Journal of Research in Nursing and Vol. 14, No. theory on the and in an exploratory case study September | Vol. 69, No. of the of Spirituality and Palliative Care Research and of Pain and Symptom Management, Vol. No. of a spiritual care training program for staff on November | Palliative and Supportive Care, Vol. 15, No. 4Spiritual distress and spiritual care in advanced heart July | Reviews, Vol. and Spiritual Patient Simulation in Nursing, Vol. No. Vol. 42, No. 4The impact of a spiritual in patients with and and their support December | Vol. 26, No. 3The Importance of a Spiritual History in Healthcare Vol. No. About Substance Use DisordersJournal of Psychosocial Nursing and Mental Health Services, Vol. No. and Spiritual Beliefs of April | Journal of Religion and Health, Vol. No. Care Perceptions of and With of Hospice & Palliative Nursing, Vol. 19, No. in Substance Use What to Know to Practice30 November | in Mental Health Nursing, Vol. 38, No. End-of-Life Care to Religious and Vol. No. of Social Education, Vol. 53, No. Nursing Care and of Christian Nursing, Vol. 34, No. 1The of taking a religious and spiritual July | Psychiatry, Vol. 24, No. religion and spirituality in Vol. No. the role of religious in the at the of of Vol. No. care spiritual March | Supportive Care in Cancer, Vol. 24, No. Spiritual Care and the Role of An Review of Literature and April | Journal of Religion and Health, Vol. No. of the Spiritual Needs of of with Is in the June | Journal of Palliative Medicine, Vol. 19, No. Impact of a Tool for Comprehensive Assessment of Palliative Care on Assessment at and of Pain and Symptom Management, Vol. No. from Healthcare Students to Understand Spiritual Assessment in Clinical Practice29 October | Journal of Religion and Health, Vol. No. Spirituality in January | Journal of Religion and Health, Vol. No. 3Development and of to Assess Nurse Provision of Spiritual August 2014 | Journal of Holistic Nursing, Vol. 34, No. and Validation of the Practice Assessment September 2014 | Research on Social Practice, Vol. 26, No. and the Medical A of July | Journal of Health Care Chaplaincy, Vol. 22, No. history taking in palliative care: A controlled September | Palliative Medicine, Vol. 30, No. Is Is Using A and the Life With American in Spiritual March | Journal of in Mental Health, Vol. 11, No. and spiritual in September | International Journal of and Mental Health, Vol. No. 1The of Hospital to and Patients’ Spiritual A May | Journal for the Study of Spirituality, Vol. No. 1The and to March End-of-Life Spiritual March in Holistic Patient Journal of Nursing, Vol. No. of spiritual assessment for older September 2014 | and Vol. No. und der der Care, Vol. No. Spirituality and A for Holistic January | Journal of Religion and Health, Vol. No. and Belief, in Care spiritual history tool by C. M. Puchalski as an for an interdisciplinary in January | Journal for of and Social Vol. 21, No. the of Spiritual A Pain and Palliative Care Service Quality of Pain and Symptom Management, Vol. No. of Spiritual Assessment in September | Vol. No. the of Christian Nursing, Vol. 32, No. 4Spiritual care: is the assessment tool for palliative Journal of Palliative Nursing, Vol. 21, No. und Spiritualität in der September | Vol. 60, No. of September of spirituality assessment in palliative care patients in November 2014 | Progress in Palliative Care, Vol. 23, No. 4The for Spiritual A Mixed-Methods July | Oncology Nursing Vol. 42, No. 4The Integration of Religion and Spirituality in Social Practice: A May | Social Vol. 60, No. 3The and Educational of a Spiritual Life Review for Patients with and June 2014 | Journal of Cancer Education, Vol. 30, No. in Geriatric Palliative in Geriatric Medicine, Vol. No. An for Spiritual Well-Being May | Journal of Religion & Spirituality in Social Work: Social Thought, Vol. 34, No. Spiritual Assessment March | Journal of Health Care Chaplaincy, Vol. 21, No. American on Mental Health, and Help April | and Vol. 60, No. of Christian Nursing, Vol. 32, No. the Spiritual Needs and of Oncology Patients in Nursing Practice, Vol. 29, No. Care Training to Healthcare Professionals: A Systematic April | Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications, Vol. 69, No. analysis of spiritual
No AccessWorld Development Report1 Feb 2013World Development Report 1993Investing in Health, Volume1Authors/Editors: World BankWorld Bankhttps://doi.org/10.1596/0-1952-0890-0AboutView ChaptersPDF (6.2 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In Abstract:This is the sixteenth in the annual series and examines the interplay between human health, health policy and economic development. Because good health increases the economic productivity of individuals and the economic growth rate of countries, investing in health is one means of accelerating development. More important, good health is a goal in itself. During the past forty years life expectancy in the developing world has risen and child mortality has decreased, sometimes dramatically. But progress is only one side of the picture. The toll from childhood and tropical diseases remains high even as new problems - including AIDS and the diseases of aging populations - appear on the scene. And all countries are struggling with the problems of controlling health expenditures and making health care accessible to the broad population. This report examines the controversial questions surrounding health care and health policy. Its findings are based in large part on innovative research, including estimation of the global burden of disease and the cost-effectiveness of interventions. These assessments can help in setting priorities for health spending. The report advocates a threefold approach to health policy for governments in developing countries and in the formerly socialist countries. First, to foster an economic environment that will enable households to improve their own health. Policies for economic growth that ensure income gains for the poor are essential. So, too, is expanded investment in schooling, particulary for girls. Second, redirect government spending away from specialized care and toward such low-cost and highly effective activities such as immunization, programs to combat micronutrient deficiencies, and control and treatment of infectious diseases. By adopting the packages of public health measures and essential clinical care dsecribed in the report, developing countries could reduce their burden of disease by 25 percent. Third, encourage greater diversity and competition in the provision of health services by decentralizing government services, promoting competitive procurement practices, fostering greater involvement by nongovernmental and other private organizations, and regulating insurance markets. These reforms could translate into longer, healthier, and more productive lives for people around the world, and especially for the more than 1 billion poor. As in previous editions, this report includes the World Development Indicators, which give comprehensive, current data on social and economic development in more than 200 countries and territories. Previous bookNext book FiguresreferencesRecommendeddetailsCited byLatin America at the margins? Implications of the geographic and epistemic narrowing of 'global' healthGlobal Public Health, Vol.19, No.126 December 2023Pay-for-performance in healthcare provision: the role of discretion in policy implementation in TurkeyInternational Journal of Public Sector Management, Vol.36, No.6/78 August 2023Questioning global health in the times of COVID-19: Re-imagining primary health care through the lens of politics of knowledgeHumanities and Social Sciences Communications, Vol.10, No.121 May 2023Cost-Effectiveness Analysis of a Regional Program for Identifying and Treating Children with Correctable Refractive Error in IndonesiaOphthalmic Epidemiology, Vol.165 October 2023Primary Health-Care Financing and Resource Mobilization8 September 2023Knowledge politics in global governance: philanthropists' knowledge-making practices in global healthReview of International Political Economy, Vol.130 August 2023From health inequalities to health justice in 50 yearsCommunity Dentistry and Oral Epidemiology, Vol.51, No.417 May 2023Cause of death certificates in nursing homes: Does quality matter? A retrospective review from two counties in NorwayScandinavian Journal of Public Health, Vol.726 July 2023Geographic Mythology and Global HealthAnnals of the American Association of Geographers, Vol.113, No.625 April 2023Women's employment trajectories in a low-income setting: Stratification and change in NepalDemographic Research, Vol.499 August 2023From Imperialism to the "Golden Age" to the Great Lockdown: The Politics of Global Health GovernanceAnnual Review of Political Science, Vol.26, No.1Examining the computation of the underlying components of DALYsHealth Policy and Planning, Vol.38, No.515 March 2023Repackaging growth at Davos: the World Economic Forum's inclusive growth and development approachReview of International Political Economy, Vol.30, No.326 May 2022NotesThe Sensible MediumMedia Theory (in a Pandemic)The Multispecies KinestheticBibliographyThe Epidemic EpistemeEpidemic MediaThe -Morphic ImageExperiences of implementing hospital management information system (HMIS) at a tertiary care hospital, IndiaVilakshan - XIMB Journal of Management, Vol.20, No.119 November 2021On the genealogy of the global health justice movementGlobal Public Health, Vol.18, No.16 December 2023Financing Development Through PPPs: What Does This Mean for Inequalities22 April 2023Definition, Principles, and Evolution of Global Health8 September 2023Uma História Global e Brasileira da Aids, 1986-20211 January 2023Unfair Wealth-Transfer Effects of the Palm Oil Trade in Nigeria 1868–1959: Illustrative Partial Estimates18 January 2024Why cost-effectiveness thresholds for global health donors differ from thresholds for Ministries of Health (and why it matters)F1000Research, Vol.1227 February 2023Understanding the Global Health ArchitectureMethodological considerations in injury burden of disease studies across Europe: a systematic literature reviewBMC Public Health, Vol.22, No.117 August 2022Out-of-pocket Health Spending and Its Impact on Household Well-being in MaharashtraJournal of Health Management, Vol.24, No.431 October 2021Reflexões sobre o resgate da economia política na análise do setor saúde no Brasil e na América Latina no século XXI22 November 2022Decolonising the global to local movement: Time for a new paradigmGlobal Public Health, Vol.17, No.1117 November 2021Time‐resolved dynamic disability adjusted life‐years estimationIndoor Air, Vol.32, No.1118 November 2022The impact of the social adaptability of different groups on the human capital level in an uncertain environment: Panel data analysis based on 35 urban life satisfactionFrontiers in Psychology, Vol.1326 October 2022Philosophy of sustainable development: understanding public healthEnvironment, Development and Sustainability, Vol.24, No.1011 November 2021Establishing political priority for global mental health: a qualitative policy analysisHealth Policy and Planning, Vol.37, No.813 June 2022IntroductionThe National University EscuelaClinical Social MedicineReligion and Caring in a Medical SettingHospital Budgets before and after NeoliberalismViolence and ResistanceRemaining amid DestructionLearning and Practicing Medicine in a For-Profit SystemFinal RemarksNotesReferencesBurden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choicesEuropean Journal of Public Health, Vol.32, No.27 January 2022Seasonal quality of water sources indicated by Escherichia coli: a case of Elobied, North Kordofan state, SudanApplied Water Science, Vol.12, No.311 February 2022The Social Construction of Global Health Priorities: An Empirical Analysis of Contagion in Bilateral Health AidInternational Studies Quarterly, Vol.66, No.121 December 2021IntroductionEmbodied Value TheoryRelative ValueNever EnoughMaking a DifferencePharmaceutical Citizenship, Marketing, and the Global Monoculture of HealthWhat Drugs Do in Different SpacesActing through Other (Prescribing) HabitsCulture, Context, and ConsensusGenericSame Ills, Same PillsFailed BiocommensurationsReferencesGlobal Sanitation Crisis: Challenges and Responses11 June 2022Epidemiology and Economics of Deworming2 August 2022Air Pollution and Health: Economic Implications13 October 2022Health29 October 2021Sustaining Development Process: Set of New Targets25 August 2022Impact of COVID-19 on Sustainable Development Goals25 August 2022Conclusion and Way Forward25 August 2022Non-Governmental Organizations as Partners for Sustainable Local Development: Ghana's Experiences15 November 2022Comprehensive Assessment of Health System Performance in Odisha, IndiaHealth Systems & Reform, Vol.8, No.119 October 2022Complex Humanitarian Emergencies: Concepts and Issues4 January 2023Predicted Effects and Cost-Effectiveness of Wheat Flour Fortification for Reducing Micronutrient Deficiencies, Maternal Anemia, and Neural Tube Defects in Yaoundé and Douala, CameroonFood and Nutrition Bulletin, Vol.42, No.45 August 2021Recruitment, training and supervision of nurses and nurse assistants for a task-shifting depression intervention in two RCTs in Brazil and PeruHuman Resources for Health, Vol.19, No.15 February 2021Good soil management can reduce dietary zinc deficiency in ZimbabweCABI Agriculture and Bioscience, Vol.2, No.126 September 2021Approaches to Defining Scientific Priorities in Healthcare and Medicine: The Experience of the Soviet UnionScientific and Technical Information Processing, Vol.48, No.617 March 2022Introducing the Adequate Housing Index (AHI): A New Approach to Estimate the Adequate Housing Deficit within and across Emerging Economies17 November 2021Convergence theory and conditional income convergence among sub‐Saharan African countriesAgricultural Economics, Vol.52, No.69 August 2021Global estimated Disability-Adjusted Life-Years (DALYs) of diarrheal diseases: A systematic analysis of data from 28 years of the global burden of disease studyPLOS ONE, Vol.16, No.1027 October 2021The 'noncommunicable disease space': ethnographies of conferences, advocacy and outrageCritical Public Health, Vol.31, No.56 July 2020Retail pharmacy prescription medicines' availability, prices and affordability in EswatiniAfrican Journal of Primary Health Care & Family Medicine, Vol.13, No.115 September 2021Do health infrastructure and services, aging, and environmental quality influence public health expenditures? Empirical evidence from PakistanSocial Work in Public Health, Vol.36, No.625 August 2021The burden of skin disease and eye disease due to onchocerciasis in countries formerly under the African Programme for Onchocerciasis Control mandate for 1990, 2020, and 2030PLOS Neglected Tropical Diseases, Vol.15, No.726 July 2021Valuing health outcomes: developing better defaults based on health opportunity costsExpert Review of Pharmacoeconomics & Outcomes Research, Vol.21, No.420 September 2020Making Health Insurance Pro-poor: Lessons from 20 Developing CountriesHealth Systems & Reform, Vol.7, No.217 August 2021Midwives providing maternal health services to poor women in the private sector: is it a financially feasible model?Health Policy and Planning, Vol.36, No.63 May 2021The Breathing Catastrophe: COVID-19 and Global Health GovernanceDevelopment, Vol.64, No.1-213 July 2021Filtering Inequality: Screening and Knowledge in Senegal's Topography of Hepatitis B CareFrontiers in Pharmacology, Vol.1112 April 2021The advice they give: Knowledge transfer of international organisations in countries of the former Soviet UnionGlobal Social Policy, Vol.21, No.14 December 2020How Do Metrics Shape Polities? From Analogue to Digital Measurement Regimes in International Health PoliticsInternational Political Sociology, Vol.15, No.17 September 2020Scaling Up Delivery of Biofortified Staple Food Crops Globally: Paths to Nourishing MillionsFood and Nutrition Bulletin, Vol.42, No.117 February 2021Integrated Management of Childhood Health in the Eastern Mediterranean Region11 August 2021Transforming Health Financing Systems in the Arab World Toward Universal Health Coverage11 August 2021Violence Against Women in the Arab World: Eyes Shut Wide Open11 August 2021Transforming Health Financing Systems in the Arab World Toward Universal Health Coverage10 February 2021Health Status and Economic Growth8 November 2020Necessity of Big Data Analytics in Social Media for Questioning the Existence and Survival of Women and the Marginalized People11 October 2021Review of the inclusion of SRHR interventions in essential packages of health services in low- and lower-middle income countriesSexual and Reproductive Health Matters, Vol.29, No.115 November 2021OUP accepted manuscriptThe Journal of Infectious Diseases1 January 2021United Nations and Global Health21 December 2020United Nations and Global Health12 May 2021Admission platelet count and indices as predictors of outcome in children with severe Sepsis: a prospective hospital-based studyBMC Pediatrics, Vol.20, No.119 August 2020History of global burden of disease assessment at the World Health OrganizationArchives of Public Health, Vol.78, No.124 August 2020SAĞLIK RİSK FAKTÖRLERİNE GÖRE ÜLKELERİN KÜMELENMESİ VE ÇOK KRİTERLİ KARAR VERME TEKNİKLERİYLE SAĞLIK DURUMU GÖSTERGELERİNİN ANALİZİSosyal Guvence30 November 2020Mother's Nutritional Knowledge and Practice: A study on Slum Area of Khulna CityEuropean Journal of Medical and Health Sciences, Vol.2, No.629 November 2020Is Gender-Based Violence a Social Norm? Rethinking Power in a Popular Development InterventionFeminist Review, Vol.126, No.122 October 2020Global Common Goods for Health: Towards a New Framework for Global FinancingGlobal Policy, Vol.11, No.522 November 2020The Devils in the DALY: Prevailing Evaluative AssumptionsPublic Health Ethics, Vol.1629 October 2020Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017Injury Prevention, Vol.26, No.Suppl 228 February 2020An Accidental NutritionistAnnual Review of Nutrition, Vol.40, No.1What Happened to the Global Forum for Health Research?Global Public Health, Vol.15, No.815 April 2020Estimating the Health and Economic Benefits of Universal Salt Iodization Programs to Correct Iodine Deficiency DisordersThyroid17 July 2020Incidence and Trends of Breast and Cervical Cancers: A Joinpoint Regression AnalysisIndian Journal of Medical and Paediatric Oncology, Vol.41, No.0517 May 2021Mapping crimes against women: spatio-temporal analysis of braid chopping incidents in Kashmir Valley, IndiaGeoJournal, Vol.85, No.213 February 2019Eliciting and Utilizing Willingness to Pay: Evidence from Field Trials in Northern GhanaJournal of Political Economy, Vol.128, No.4The strengths and limitations of using hospital records to assess environmental health in Karonga, MalawiEnvironment and Urbanization, Vol.32, No.118 July 2019African Conceptions of Age‐Based Moral Standing: Anchoring Values to Regional RealitiesHastings Center Report, Vol.50, No.220 April 2020If You Build It Nearby and Keep the Price Low, Will They Come? Large‐Scale Evidence on the Relative Roles of Access and Quality in Use of Healthcare in Low‐and Middle‐Income CountriesSouth African Journal of Economics, Vol.88, No.13 February 2020Limited alignment of publicly competitive disease funding with disease burden in JapanPLOS ONE, Vol.15, No.210 February 2020Using mHealth to improve health care delivery in India: A qualitative examination of the perspectives of community health workers and beneficiariesPLOS ONE, Vol.15, No.115 January 2020Disability-Adjusted Life Years (DALYs)20 October 2020The Path for Introducing Diagnosis Related Groups (DRGs) in Albanian Health care28 April 2020Inter-Sectoral Allocation Choices3 November 2020Health Status and Economic Growth1 June 2020Service and Knowledge: The Emergence of Disability Studies Extension3 April 2020Alternative Destinies and Solidarities for Health and Medicine in Latin America Before and During the Cold WarUnder SurveillanceNational Politics and Scientific PursuitsCold War Mexico in a Time of "Wonder Drugs"The Puerto Rico Family Life Study and the Cold War Politics of Fertility SurveysParasitology and CommunismRevolutionizing Cuban PsychiatryFrom Cold War Pressures to State Policy to People's Health"Psychotherapy of the Oppressed"South-South Cooperation as a Cold War TonicA Lingering Cold (War)?BibliographyTraffic in Asian WomenAsian Women as Method?Traffic in WomenSexual SlaveryViolence against WomenTruth DisclosureJust CompensationEnduring MemorialsNotesBibliographyVom Sehen zum Leben – die Stiftung Sight and Life7 August 2020From Washington DC to Washington State: The Global Burden of Diseases Data Basis and the Political Economy of Global Health30 June 2020Gaps and barriers in interventions for the control of soil-transmitted helminthiasis among school-age children in an endemic area of the Philippines: a school-based point-of-viewJournal of Public Health Policy, Vol.40, No.47 August 2019Reaching the last mile: main challenges relating to and recommendations to accelerate onchocerciasis elimination in AfricaInfectious Diseases of Poverty, Vol.8, No.14 July 2019Into the Machine: Economic Tools, Sovereignty, and Joy in a Global Health InstitutionMedical Anthropology Quarterly, Vol.33, No.416 July 2019A Review of Economic Consequences and Costs of Male Violence Against WomenIndian Journal of Gender Studies, Vol.26, No.324 October 2019Projecting burden of hypertension and its management in Turkey, 2015-2030PLOS ONE, Vol.14, No.911 September 2019Can Basic Maternal Literacy Skills Improve Infant Health Outcomes? Evidence from the Education Act in NepalJournal of Human Capital, Vol.13, No.3Deconstructing the Financialization of HealthcareDevelopment and Change, Vol.50, No.56 June 2019What Explains Uneven Female Labor Force Participation Levels and Trends in Developing Countries?World Bank Research Observer, Vol.34, No.210 September 2019Effectiveness, Cost-Effectiveness, and Economic Impact of a Multi-Specialty Charitable Surgical Center in HondurasInternational Journal of Surgery OpenChallenges in the implementation of primary health care reforms: a qualitative analysis of stakeholders' views in TurkeyBMJ Open, Vol.9, No.719 July 2019Regional Disparities in Social Development: Evidence from States and Union Territories of IndiaSouth Asian Survey, Vol.26, No.123 April 2019Integrated Management of Childhood Health in the Eastern Mediterranean Region14 March 2019Violence Against Women in the Arab World: Eyes Shut Wide Open5 June 2019A semi-endogenous growth with public capital and for developing of Economics, Vol.22, June of Economic Studies, of Vol.33, Global Burden of to From Journal of Public Health, National Burden of from Evidence to of Medical Science, Vol.34, No.Suppl January of rate on and services Evidence from a large Journal of International Trade & Economic December after Primary Health Care and Health for to Global Health, No.Suppl December the quality of life of women: a systematic reviewBMC and Vol.18, No.123 November of of death on child in a African Public Health, Vol.18, No.16 November health for all to health is and Health, Vol.14, No.13 July of a systematic review and & Vol.11, February can improve priority and Resource Vol.16, November and in and and health and Public Health, Vol.13, November the of the global burden of disease for and for low- and Research, of diseases in low-income to countries international Global Health, October of the of in the Journal of & Vol.29, June global and the of for and and Vol.38, No.45 October politics and of a of of Vol.29, March from an health information system implementation in No.56 August Health Status of in Research, No.121 August of disease studies in the European Journal of Public Health, April in with at a Research, Vol.40, No.726 March against the economic growth and in Studies, Vol.14, April of in India: An International Journal of Health and Management, Vol.33, No.220 October Policy and March development and health in the Journal of Social Economics, in Health: A of and Economic No.15 March of death in the global burden of of Medical Ethics, October mortality to in a assessment by Open, Vol.8, February Allocation for in the National Health An Analysis of the of Health Policy and Violence and October World August and the Value of December October Healthcare Policy from to November Public Health, Vol.13, of with for control in a and cost-effectiveness study Global Health, January National Burden of from Evidence to of Medical Science, Vol.33, January health and through in Research, September Health and for January for Public Health January Global Health: A analysis of a Vol.12, June and barriers to evidence based in the health system in of health Health Research, Vol.17, February health and a case study of of in Journal for in Health, Vol.16, No.115 September disability for a Health Vol.15, No.14 March of human lives due to tropical diseases in AfricaInfectious Diseases of Poverty, No.118 December of and global health to Sustainable Development in Health Vol.10, May and Health and Development: Neglected December Infectious from Control December December 2017Injury and Health: from Control December and of maternal and care economic analysisHealth Policy and Planning, Vol.32, October Political in Health Delivery in Journal of Health August Organizations in to Healthcare Access for the and in and Sector Quarterly, June of a intervention to the system in Public Health, Vol.12, February Journal of Development Studies Vol.38, April for Health from the Relative Social Vol.37, July of in and Vol.21, November and The Experience of Women in Journal of Gender Studies, Vol.24, February and treatment of mental in primary of a systematic review and of the New of Sciences, October Health Systems in Eastern and North African CountriesHealth Systems & Reform, January Health and in November of and November for to as The of Economic in the from International to Global Health March Organizations and to March February Policy and Planning, Vol.32, and between health and global health why a Global Health, Vol.2, January Health in the and of Economic The of and the of Public Health Evidence from and impact of human development on health: a analysis through and March of priority setting in health and health No.16 October Cost-Effectiveness, and January the of of of A During Health in and Nutrition Bulletin, Vol.37, No.420 September of global mental December for health: an study with case studies from Public Health, Vol.16, September priority setting for health 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Journal of Women's HealthVol. 29, No. 4 CommentaryFree AccessSex and Gender Disparities in the COVID-19 PandemicJewel Gausman and Ana LangerJewel GausmanWomen & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.Search for more papers by this author and Ana LangerAddress correspondence to: Ana Langer, MD, Women & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 651 Huntington Avenue, FXB Building 6th Floor Office 643B, Boston, MA 02115 E-mail Address: [email protected]Women & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.Search for more papers by this authorPublished Online:17 Apr 2020https://doi.org/10.1089/jwh.2020.8472AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail In the case of the ongoing COVID-19 pandemic, sex-disaggregated data suggest that fewer women are dying from the disease than men.1 However, taking this observation at face value oversimplifies the biological, behavioral, and social and systemic factors that may cause differences to emerge with regard to how women and men experience both the disease and its consequences. As governments react with swift and severe measures in their ongoing fight to control the pandemic's spread, it is important to understand how these actions may disproportionately increase the risks for women both directly and indirectly with regard to sex and gender.Pregnant women are often among the most vulnerable groups during public health emergencies. In some cases, pregnant women face increased biological susceptibility to adverse health outcomes, as in the case of some respiratory infections. With other emergent coronaviruses, such as those responsible for severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS), pregnant women who became infected were found to be more likely than nonpregnant women to experience severe complications.2 It is still too early to tell whether this will be the case with COVID-19.In the ongoing pandemic, other factors may have a ripple effect that put women at increased risk even if the disease itself does not. As made clear during the 2014 Ebola outbreak, the consequences of large-scale infectious disease outbreaks on uninfected pregnant women can be dire. Routine prenatal care appointments, if not interrupted or discontinued, may put women at increased risk of exposure to the virus. Overwhelmed hospitals struggling to function with staff and supply shortages may not be able to provide the high quality of care that all pregnant women and their newborns deserve, let alone respond to emergency obstetric complications. Furthermore, there is also a risk that life-saving treatments or vaccines will be denied to pregnant women over concern for fetal safety or a lack of data.3,4The fear of infection, concern for the well-being of friends and loved ones, uncertainty, disruption, and social isolation that have become part and parcel of daily life for many around the world will undoubtedly have profound effects on mental health on the population at large, but being pregnant during a global pandemic is likely to be even more frightening for many women. Although containment strategies, such as those that require women to deliver without a companion present, including partners and doulas, that have already been put into place in some cities in the United States,5 or those that separate newborns from their mothers immediately after birth if the mother is infected with COVID-196 may be clinically important to reduce transmission, they may also have profound short- and long-term mental health implications for women. Among women who have young children, previous research in Ethiopia, India, and Vietnam found that women who experience family-related stressful life events, such as illness or death within the household and financial uncertainty, are more likely to experience episodes of severe mental distress.7 With the ongoing need to social distance, family and community networks may struggle and pregnant and postpartum women may feel even more vulnerable and isolated over a lack of social support.The adverse effects of the pandemic in relation to women's reproductive health are not limited to pregnancy or motherhood. As movement restrictions are put into place, supply chains are disrupted, and businesses are shuttered, some women may be at increased risk of unintended pregnancy should it become difficult to obtain their regular contraceptive method or emergency contraceptives, if needed. Furthermore, some states within the United States have begun to impose restrictions on certain medical procedures that they deem to be elective, including abortion, suggesting they must be delayed until after the pandemic is over.8 Spikes in domestic violence during times of crisis are another area of grave concern for women's health, and as governments continue to put into place more extreme measures to enforce social distancing, for some women, more time at home may mean more time spent with an abusive partner. Fewer social interactions may also mean less accountability for perpetrators and fewer opportunities for others to intervene.Gender-related factors may also increase the impact of the COVID-19 pandemic on women globally. Women constitute a disproportionately high percentage of caregivers in both the formal and informal sectors.9 A large proportion of frontline health care professionals (nurses, community health workers, health technicians, etc.) is women who face a higher risk of infection, morbidity, and death as a result of their profession.9 At the same time, women more frequently serve as the primary caregivers within a household, which may further increase their risk of exposure. In the United States, 65% of unpaid family caregivers are estimated to be women and 80% of them care for someone aged 50 years or older.10 Outside of their caregiving role, women are overrepresented in the informal employment sector. In low-and middle-income countries, two-thirds of women who work do so as part of the informal economy with limited access to health care for themselves and their families.9 Containment and mitigation policies that limit women's ability to perform their duties without offering effective alternatives, such as closing of daycare facilities for their children or not providing paid sick leave, may result in unnecessary exposure to disease and increased family vulnerability.It is urgent that we adopt a gender lens to study the pandemic and its effects, including the policies and actions that are put into place at the global, country, and local levels. This may be especially important in disadvantaged populations and resource-poor communities, where women are especially vulnerable. The public health community must ensure that existing health and social services meant to support women in the face of their unique needs do not disappear in lieu of the all-encompassing focus on stopping the pandemic. Furthermore, we argue that special attention needs to be paid to ensure that informal caregivers are supported, informed, and protected. To avoid making existing gender disparities larger as a result of the pandemic, a special body at the U.S. Centers of Disease Control and Prevention is urgently needed to track sex disaggregated data and analyze policies related to COVID-19 using a gender lens.Author Disclosure StatementNo competing financial interests exist.Funding InformationNo funding was received for this article.References1. Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med 2020;pii: S2213-2600(20)30117-X. Medline, Google Scholar2. Favre G, Pomar L, Musso D, Baud D. 2019-nCoV epidemic: What about pregnancies? Lancet 2020;395:e40. Crossref, Medline, Google Scholar3. Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: What obstetricians need to know. Am J Obstet Gynecol 2020;pii: S0002-9378(20)30197-6. Medline, Google Scholar4. Weigel G. Novel coronavirus "COVID-19": Special considerations for pregnant women. Available at: https://www.kff.org/womens-health-policy/issue-brief/novel-coronavirus-covid-19-special-considerations-for-pregnant-women/?utm_source=Global+Health+NOW+Main+List Accessed March 17, 2020. Google Scholar5. Caron C, Syckle KV. Laboring alone: Some hospitals bar partners because of virus fears. The New York Times. 2020. Google Scholar6. American College of Obstetricians and Gynecologists. Practice advisory: Novel coronavirus 2019 (COVID-19). Available at: https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Advisories/Practice-Advisory-Novel-Coronavirus2019?IsMobileSet=false Accessed March 13, 2020. Google Scholar7. Gausman J, Austin SB, Subramanian S, Langer A. Adversity, social capital, and mental distress among mothers of small children: A cross-sectional study in three low and middle-income countries. PLoS One 2020;15:e0228435. Crossref, Medline, Google Scholar8. Tavernise S. Texas and Ohio include abortion as medical procedures that must be delayed. The New York Times. 2020. Google Scholar9. Langer A, Meleis A, Knaul FM, et al. Women and health: The key for sustainable development. Lancet 2015;386:1165–1210. Crossref, Medline, Google Scholar10. Feinberg L, Reinhard SC, Houser A, Choula R. Valuing the invaluable: 2011 update, the growing contributions and costs of family caregiving. Washington, DC: AARP Public Policy Institute, 2011:32. Google ScholarFiguresReferencesRelatedDetailsCited byMachine learning-based prediction of COVID-19 mortality using immunological and metabolic biomarkers3 February 2023 | BMC Digital Health, Vol. 1, No. 1No fear: Willingness of smartphone activated first responders to assist with cardiac arrest during the COVID-19 pandemicResuscitation Plus, Vol. 13Overlooked sex and gender aspects of emerging infectious disease outbreaks: Lessons learned from COVID-19 to move towards health equity in pandemic response20 February 2023 | Frontiers in Global Women's Health, Vol. 4Anxiety, depression, and stress in youth during lockdown: differences between clinical and community samples13 February 2023 | CES Psicología, Vol. 16, No. 1Correlates of long-COVID-19: the role of demographics, chronic illness, and psychiatric diagnosis in an urban sample8 February 2023 | Psychology, Health & Medicine, Vol. 11Perception of COVID‐19 pandemic restrictions on dental researchers21 September 2022 | Journal of Dental Education, Vol. 87, No. 2Penicillin Allergy Evaluation and Health Equity: A Call to ActionThe Journal of Allergy and Clinical Immunology: In Practice, Vol. 11, No. 2Covid-19 Effects on Psychological Outcomes: How Do Gender Responses Differ?23 August 2021 | Psychological Reports, Vol. 126, No. 1Gendered Consequences of COVID-19 Among Professional Tennis Players24 August 2022 | Journal of Sports Economics, Vol. 24, No. 2Nursing Students' Perception about Gender Inequalities Presented on Social Networks: A Qualitative Study20 January 2023 | International Journal of Environmental Research and Public Health, Vol. 20, No. 3Laboring Alone: Perinatal Outcomes during Childbirth without a Birth Partner or Other Companion during the COVID-19 Pandemic1 February 2023 | International Journal of Environmental Research and Public Health, Vol. 20, No. 3Psychological Adjustment Profiles of LGBTQ+ Young Adults Residing with Their Parents during the COVID-19 Pandemic: An International Study11 February 2023 | International Journal of Environmental Research and Public Health, Vol. 20, No. 4The Ups and Downs of Feminist Activist Research: Positional Reflections1 March 2023Freiheit und Autonomie von Frauen in Zeiten der Coronakrise3 March 2023COVID-19 Concerns, Perceived Stress, and Increased Alcohol Use Among Adult Women in the United States18 November 2022 | Clinical Nursing Research, Vol. 32, No. 1"Life is hard": How the COVID-19 pandemic affected daily stressors of womenDialogues in Health, Vol. 1Laboratory predictors for COVID-19 Intensive Care Unit admissions in Trinidad and TobagoDialogues in Health, Vol. 1Sex-related disparities in students' disaster responses in the post-COVID-19 eraInternational Journal of Disaster Risk Reduction, Vol. 83Public perceptions during the first wave of the COVID-19 pandemic in Canada: a demographic analysis of self-reported beliefs, behaviors, and information acquisition9 April 2022 | BMC Public Health, Vol. 22, No. 1Implication of single nucleotide polymorphisms in Interleukin-10 gene (rs1800896 and rs1800872) with severity of COVID-191 October 2022 | Egyptian Journal of Medical Human Genetics, Vol. 23, No. 1Population Perspectives on Impact of the COVID-19 Pandemic on Essential Health Services—Behavioral Insights from the Federation of Bosnia and Herzegovina3 December 2022 | Behavioral Sciences, Vol. 12, No. 12Gender and age structure of mortality caused by COVID-1923 November 2022 | Innovative Medicine of Kuban, No. 4Using trajectory modeling of spatio-temporal trends to illustrate disparities in COVID-19 death in flint and Genesee County, MichiganSpatial and Spatio-temporal Epidemiology, Vol. 43Neonatologist staffing models: urgent change is needed7 October 2022 | Journal of Perinatology, Vol. 42, No. 11The Structure of the Relationship between Physical Activity and Psychosocial Functioning of Women and Men during the COVID-19 Epidemic in Poland20 September 2022 | International Journal of Environmental Research and Public Health, Vol. 19, No. 19Syndemic aspects between COVID-19 pandemic and social inequalitiesWorld Journal of Methodology, Vol. 12, No. 5Impact of Social and Personal Factors on Psychological Distress in the Spanish Population in the COVID-19 Crisis9 September 2022 | The British Journal of Social Work, Vol. 28(Suppl 1)Levels of Depression and Anxiety Among Informal Caregivers During the COVID-19 Pandemic: A Study Based on the Canadian Longitudinal Study on Aging12 February 2022 | The Journals of Gerontology: Series B, Vol. 77, No. 9Knowledge, attitudes, and practices [KAP] toward COVID-19: A cross-sectional study in the New York Metropolitan Area and California Bay Area10 August 2022 | PLOS ONE, Vol. 17, No. 8Examining the impact of sex differences and the COVID-19 pandemic on health and health care: findings from a national cross-sectional study28 September 2022 | JAMIA Open, Vol. 5, No. 3Combination of cycle threshold time, absolute lymphocyte count and neutrophil:lymphocyte ratio is predictive of hypoxia in patients with SARS-CoV-2 infection11 December 2021 | Transactions of The Royal Society of Tropical Medicine and Hygiene, Vol. 116, No. 7Conflicto trabajo-familia de mujeres en situación de teletrabajo a partir de la contingencia sanitaria por COVID-19 en Chile15 June 2022 | Investigaciones Feministas, Vol. 13, No. 1Impact of COVID-19 restrictions on mental health and physical activity among LGBQAP and heterosexual adults21 December 2021 | Journal of Gay & Lesbian Mental Health, Vol. 26, No. 3Women's Use and Abuse of the News Media during the COVID-19 Pandemic on Mumsnet2 September 2021 | Digital Journalism, Vol. 10, No. 6COVID-19 effects on women's home and work life, family violence and mental health from the Women's Health Expert Panel of the American Academy of NursingNursing Outlook, Vol. 70, No. 4Perceived risk, political polarization, and the willingness to follow COVID-19 mitigation guidelinesSocial Science & Medicine, Vol. 305Racial and Ethnic Disparities in Postpartum Care in the Greater Boston Area During the COVID-19 Pandemic23 June 2022 | JAMA Network Open, Vol. 5, No. 6Access to contraception during the Covid-19 pandemic: barriers and perspectives1 June 2022 | Cadernos Saúde Coletiva, Vol. 30, No. 2Disparities by Sex in COVID-19 Risk and Related Harms Among People with Opioid Use Disorder Caitlin E. Martin, Bhushan Thakkar, DaShaunda D.H. Taylor, and Derek A. Chapman16 May 2022 | Journal of Women's Health, Vol. 31, No. 5Vision 2020: How and for E. A. E. S. and May 2022 | Journal of Women's Health, Vol. 31, No. of women in clinical A for and Clinical Vol. and urban towards pandemic May 2022 | Vol. the The of during a January 2022 | & Psychology, Vol. 32, No. and During the and of the COVID-19 Pandemic in April 2022 | Frontiers in Vol. to Greater With the COVID-19 and to Journal of Health Psychology, Vol. 29, No. of to the of SARS-CoV-2 With Anxiety and A Study of March 2022 | International Journal of Public Health, Vol. in the Impact of COVID-19 Pandemic in in The Gender in Vol. No. 3Women's health and access COVID-19 Outlook, Vol. 70, No. of to COVID-19 Outcomes in a Longitudinal of February 2022 | Vol. No. as March 2022 | Saúde Vol. No. COVID-19 wave in during the of and its with higher February 2022 | PLOS ONE, Vol. 17, No. well-being and during the COVID-19 pandemic in the United A February 2022 | The Social Science Vol. to and February 2022 | Psychology, Vol. women's during the COVID-19 pandemic in June 2021 | and An International Vol. No. an and at the same in work and during the coronavirus April 2021 | International Journal of Psychology, Vol. No. and local A in the time of November 2021 | International Journal of Psychology, Vol. No. and the During June 2021 | & Vol. 26, No. of Medical Care among in the United States during the COVID-19 May 2022 | Journal of Public Health Research, Vol. 11, No. the Gender Disparities in COVID-19 and January 2022 | & Vol. with public health for COVID-19: a study of mothers with young children in the United February 2022 | Journal of in Vol. No. Perspectives on January and Among Adults During the to COVID-191 February in and and during the COVID-19 pandemic health and and Vol. in the COVID‐19 Effects of on December 2021 | British Journal of Vol. No. effects of the on for an emerging January 2022 | & Vol. No. Distress among Dental during the COVID-19 December 2021 | International Journal of Environmental Research and Public Health, Vol. 19, No. physical and social of health during the COVID-19 lockdown: a for of depression, and stress in the population during social isolation to the COVID-19 a cross-sectional study28 April 2021 | BMC Vol. No. and but same mortality of severe disease in March 2021 | BMC Medicine, Vol. No. Factors with and among community October 2021 | and Health, Vol. 17, No. differences in a of COVID-19 patients during the first and pandemic August 2021 | of Sex Vol. 12, No. in December 2021 | Journal of Clinical Medicine, Vol. 10, No. November 2021 | of Coronavirus Anxiety in Women on and Birth One of Coronavirus October 2021 | Journal of and Research, Vol. No. in and among Young Adults During Social to March 2021 | The Journal of Sex Research, Vol. No. of COVID-19 short- and long-term Disparities in and October 2021 | PLOS ONE, Vol. 16, No. analysis of on 2021 | Journal of in Medicine, Vol. No. of and Among COVID-19 by States in Women An September 2021 | and Vol. No. of COVID-19 using Public Gender and COVID-19: a Social Media of 2021 | Journal of Research, Vol. 5, No. for COVID-19 and its impact on in the Research on and Economics, Vol. No. differences in mental health of Canadian during the COVID-19 of and Health, Vol. No. Use and Relationship to Stress, and Perceived During the COVID-19 Pandemic in August 2021 | Frontiers in Public Health, Vol. and Lessons for August 2021 | PLOS ONE, Vol. 16, No. in How women in the United States in of of during the pandemic of March 2021 | Journal of Psychology, Vol. No. of in severe COVID-19 and Vol. No. the gender June 2021 | Journal of Perinatal Medicine, Vol. No. and the Related Factors in for COVID-19 at 2021 | International Journal of Health and Sciences, Vol. No. Gender Disparities and A Vol. No. impact of COVID‐19 on women to A of December | & Vol. No. of the and During the Covid-19 2021 | Frontiers in Psychology, Vol. in a January 2021 | Vol. No. responses to COVID-19 to Abuse & Vol. in and Practice During Social Among Young Adults in the May 2021 | Medicine, Vol. No. SARS-CoV-2 pandemic: A Health, Vol. and and after the pandemic April 2021 | Clinical and Research, Vol. No. on in August | Vol. 13, No. An to COVID-19 February 2022 | Journal of Women and Social Vol. No. in the and Outcomes of With May 2021 | Journal of Medicine, Vol. 16, No. of COVID-19: and May 2021 | Frontiers in Public Health, Vol. in the of February 2022 | Journal of Human Vol. No. and of the COVID-19 pandemic from the of in May 2021 | Journal of Social Work, Vol. No. the Pandemic: December April health disparities in vulnerable populations of psychiatric patients during the COVID-19 Journal of Vol. 11, No. 4The Gender of to in March 2021 | Feminist Economics, Vol. No. in Risk Factors and Mental Health During the of the COVID-19 Pandemic: A of U.S. Women A. E. E. and April 2021 | Journal of Women's Health, Vol. 30, No. and of and in March 2021 | Medicine, Vol. No. impact of COVID-19 on the mental health of and Science & Medicine, Vol. of and with in April 2021 | Vol. 12, No. health and well-being of staff during the coronavirus disease 2019 4 and in an March 2021 | Journal of Vol. of Gender in the and of Coronavirus Disease 2019 An of Health and and March 2021 | Journal of Women's Health, Vol. 30, No. of the COVID-19 pandemic on and Vol. of COVID-19 and of and Public Health, Vol. No. cross-sectional study of the of and with perceptions of to March 2021 | Open, Vol. 11, No. research and social of health: at the of of impact on and of Clinical Medicine, Vol. 17, No. differences in responses to SARS-CoV-2 in patients with January 2021 | Reports, Vol. No. and to COVID-19 in and January 2021 | Policy and Practice, Vol. impact of COVID-19 among and of November | & Health, Vol. 26, No. in case and mortality of coronavirus disease 2019 (COVID-19) among states in the United November | of Medicine, Vol. No. and pandemic risk and fear among September 2021 | Health and Behavioral Medicine, Vol. No. June 2021 | Vol. No. of and with of Coronavirus Related September 2021 | Vol. a January 2021 | Cadernos de Saúde Vol. No. and Among Vol. of Psychological Distress and Factors among During the COVID-19 Pandemic at in March 2021 | Disease and Vol. and on During the COVID-19 Pandemic in of Social Media October 2021 | Journal of Medical Research, Vol. 23, No. and and attitudes, and practices toward COVID-19 among birth of and Health Vol. 10, No. the of in COVID-19 October | Health Vol. No. in the of COVID-19 and political Vol. services in times of in of quality care for pregnant women and their October | Health Care for Women Vol. No. social support in the face of the December | Journal of & Vol. 12, No. with fear and during the COVID-19 pandemic in October | and Health, Vol. 16, No. and of People from by December | Journal of in Health, and Education, Vol. 10, No. is in gender and age for COVID-19 A December | Journal of and Vol. No. of SARS-CoV-2 Among Nursing and in September | Journal of Medicine, Vol. No. role of in the severity of learned from Vol. on gender disparities in the impact of the U.S. COVID-19 Research, Vol. Gender Women's Health and October | Frontiers in Global Women's Health, Vol. and the risk to and women during Journal of Vol. No. With Disparities in COVID-19 Outcomes in an Health Care October | JAMA Network Open, Vol. No. in the time of in August | Vol. 17, No. de la en en por September | Vol. No. de la COVID-19 en la de September | Vol. No. Perspectives to Health Research and Prevention During the COVID-19 | and Health Vol. 24, No. and Disease Disparities in the United in Vol. No. for a to | Global Public Health, Vol. No. and of in September | Vol. 11, No. and What is the Vol. No. we in Covid-19 women and men Vol. in of COVID-19: Insights a Vol. No. will The need to for the research on and the role of and and Vol. Impact and Factors During the of the Coronavirus (COVID-19) Pandemic Among the Population in June | Frontiers in Psychology, Vol. and of and the in SARS-CoV-2 to the in May | International Journal of Sciences, Vol. No. Coronavirus Disease 2019 the of August | Vol. Gender of to in January | Vol. Social of Vol. of of and Digital Vol. this Gausman and Ana and Gender Disparities in the COVID-19 of Women's in April 17,
Cyberpsychology, Behavior, and Social NetworkingVol. 23, No. 7 EditorialConnecting Through Technology During the Coronavirus Disease 2019 Pandemic: Avoiding “Zoom Fatigue”Brenda K. WiederholdBrenda K. WiederholdBrenda K. Wiederhold, Editor-in-Chief Search for more papers by this authorPublished Online:10 Jul 2020https://doi.org/10.1089/cyber.2020.29188.bkwAboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail View article"Connecting Through Technology During the Coronavirus Disease 2019 Pandemic: Avoiding “Zoom Fatigue”." 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June 2022 | Cyberpsychology, Behavior, and Social Networking, Vol. 25, No. learning Review of Education, Vol. May 2022 | Vol. 12, No. in the experiences and to and reflections the year of January 2022 | The Clinical Vol. 36, No. Psychological and Academic M. and May 2022 | Cyberpsychology, Behavior, and Social Networking, Vol. 25, No. of via videoconference on fatigue and Implications for the March 2022 | Healthcare Management Vol. No. Policy of Technology April 2022 | Education Sciences, Vol. 12, No. under A July 2021 | Journal of Family Vol. 44, No. Strategies During the COVID-19 Pandemic: Virtual Learning for Public Health and Cancer Health April 2022 | Frontiers in Public Health, Vol. during How a to online interaction and social April 2022 | Journal of Research on Vol. 16, No. a Roadmap for Technology in Social Training the of Social February 2022 | in Social Vol. No. Psychological for with Learning during the Pandemic: The Experiences of in the March 2022 | Journal of Mental Health Research in Vol. 15, No. to education and communication the and intensive community during the COVID-19 Vol. No. to education and communication the and intensive community during the COVID-19 Vol. No. and implementation of a virtual pain management programme to COVID-19: a September 2021 | British Journal of Vol. 16, No. Video Conference Fatigue of in the on Video Conference Social and April 2022 | International Journal of Environmental Research and Public Health, Vol. 19, No. of in during the COVID‐19 pandemic: the and of and challenges and the of mental health and in December 2021 | Journal of Research in Educational Vol. 22, No. New with COVID-19 and A Qualitative Study on Zoom Fatigue30 March 2022 | Vol. 19, No. distance une No. Social in Remote Social A for of When the Social of Interactions via Videoconferencing March 2022 | Frontiers in Psychology, Vol. the stress of and of Zoom December 2021 | Electronic Vol. 32, No. social as of A study under in Human Behavior, Vol. the of to an online in to February 2022 | Sciences Education, Vol. 15, No. changes in social during COVID pandemic in the United December 2021 | Vol. 29, No. in Journal of and Vol. 13, No. or How online February 2022 | PLOS Vol. No. in Zoom Fatigue B. and February 2022 | Cyberpsychology, Behavior, and Social Networking, Vol. 25, No. of on mental August 2021 | Vol. 19, No. 1Videoconference Fatigue: A February 2022 | International Journal of Environmental Research and Public Health, Vol. 19, No. 4The Use of Videoconferencing in Higher January and digital communication in Australian December 2021 | Journal of the International for Business, Vol. No. and in Industry August Zoom Learning February and in During Coronavirus January of Leadership on June Online Social a from a of February An Approach to Social During Online June Virtual Reality August in a Mediated July – und February Teaching as an for Vol. 22, No. Video During the COVID-19 Pandemic and Effects on May 2021 | and Vol. No. During Remote Teaching in through a pandemic: impact of on and of Clinical Medicine, Vol. 18, No. during the pandemic A Systematic Review using April 2022 | Information Science, Vol. 6, No. Hybrid Learning Challenges and February de de de December 2022 | Vol. 4, No. of COVID‐19 with and variables in An analysis of September 2021 | The International Journal of Health and Management, Vol. 37, No. Design With Research for the Development of a Digital for and August 2022 | Journal of Research Vol. No. to Equity, and in Science and December 2021 | Frontiers in Science, Vol. December 2021 | Vol. 25, No. reality during the COVID-19 pandemic: A and and Vol. for study for a randomized controlled September 2021 | Pilot and Studies, Vol. 7, No. and A Design December in social of and mothers during the COVID-19 Vol. “Zoom A November 2021 | Applied Psychology, Vol. The from to of Human - and Psychology of the Pandemic November Through the October 2021 | Education, Vol. No. Practice During COVID-19 to and of November 2021 | Vol. 36, No. as the of Exploring and Perspectives of of Telehealth by a Australian Service during COVID-19 October 2021 | International Journal of Environmental Research and Public Health, Vol. 18, No. with The of technology and consumer July 2021 | International Journal of Consumer Studies, Vol. 45, No. of June 2021 | Annals of Surgery, Vol. No. and of Virtual in Video and Effects on of the ACM on Human-Computer Interaction, Vol. 5, No. How a Virtual Network during the COVID-19 of the ACM on Human-Computer Interaction, Vol. 5, No. May 2021 | American Journal of Clinical Vol. No. to and Education in the of December 2021 | Journal of Education, Vol. No. between social communication and during the early of September 2021 | Journal of Social and Vol. No. September 2021 | Vol. 11, No. Bir September 2021 | Vol. 5, No. of During the COVID-19 Pandemic by the of Medical of A Survey September 2021 | Frontiers in Medicine, Vol. student under remote learning using digital A June 2021 | Education and Information Vol. No. of the COVID-19 Pandemic on Higher Education: the
No AccessEducationJul 2010Design Thinking for Social InnovationAuthors/Editors: Tim Brown, Jocelyn WyattTim BrownSearch for more papers by this author, Jocelyn WyattSearch for more papers by this authorhttps://doi.org/10.1596/1020-797X_12_1_29SectionsAboutView ChaptersPDF (0.2 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In Designers have traditionally focused on enchancing the look and functionality of products. 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A Socially Responsible 3D Printed One-Handed RecorderInternational Journal of Environmental Research and Public Health, Vol.18, No.2220 November 2021Higher Perceived Design Thinking Traits and Active Learning in Design Courses Motivate Engineering Students to Tackle Energy Sustainability in Their CareersSustainability, Vol.13, No.2214 November 2021On-Site Construction Quality Inspection Using Blockchain and Smart ContractsJournal of Management in Engineering, Vol.37, No.6A co-design study to develop supportive interventions to improve psychological and social adaptation among adults with new-onset type 1 diabetes in Denmark and the UKBMJ Open, Vol.11, No.112 November 2021Design and development of Air to Water Generator for the Village in Kerala, IndiaMaking sense of design thinking: A primer for medical teachersMedical Teacher, Vol.43, No.1026 January 2021Innovating at the nexus of world languages and cultures and design thinkingPedagogies: An International Journal, Vol.16, No.48 March 2021Knowledge interoperability and re-use in Empathy Mapping: an ontological approachExpert Systems with Applications, Vol.180Outcomes of Community-Based Youth Empowerment Programs Adopting Design Thinking: A Quasi-Experimental StudyResearch on Social Work Practice, Vol.31, No.722 March 2021De candidato a pós-graduando em Design no Brasil: mapeamento da jornada do usuário1 October 2021Sustainable solution to address waste management and energy challenges in rural IndiaAddressing Sanitation and Health challenges in rural India through socio-technological interventions: A Case Study in OdishaGuest editorialEuropean Journal of Marketing, Vol.55, No.920 September 2021Designing food experiences for well-being: a framework advancing design thinking research from a customer experience perspectiveEuropean Journal of Marketing, Vol.55, No.927 May 2021An innovation intermediary for Nairobi, Kenya: Designing student-centric services for university-industry Journal of Science, Technology, Innovation and Development, Vol.13, August the of service in tourism and Vol.31, August Research A Design Thinking Approach to on Journal of Environmental Research and Public Health, Vol.18, September Innovation Design and Sustainability of in Vol.13, No.173 September of in the design thinking of a Skills and Creativity, Sosyal August 2021Design thinking and innovation: the of Business July 2020Design thinking approach to for the Journal of August Uygulamaları Bilimler August 2021Innovating for through collaborative innovation of Cleaner Production, OF DESIGN AND OF AND of the Design Society, July of Social Innovation through The Case of in Vol.13, August COVID-19 as a for public and The need for robust governance to turbulent Management Review, Vol.23, September and practice of Design Thinking: of and business Journal of Design Creativity and Innovation, Vol.9, May Learning to Support Decision-Making and Creative in Instructional Design Vol.65, No.46 April in Learning through the of Design Thinking in a Vol.13, July methodology design: participatory processes for of Research, a approach to food as in Student case of using a to support Technology as an The and of in Regional Open Innovation Vol.13, June Services during the in of Design, December 2022Supporting and Living through Journal of Environmental Research and Public Health, Vol.18, April de Vol.26, the new on the in public & a April of Design Thinking to in a Vol.13, April Courses of Design on the Light on to Social and Vol.13, April 2021Using human-centred design to develop an female Vol.7, January case study of an of Business No.214 May Innovation in Education and Social Service and Approaches to Social in Education, March Design Thinking Approach for March to the of energy in Research & Social Science, A Conceptual Framework for the and of Youth of and Health, Vol.18, evaluation of innovation: A case of for in Journal of Science, Technology, Innovation and Development, Vol.13, July Novel for Digital Assessment Using A Human-Centered Design Approach (Preprint)JMIR February mental health and in and mental framework for in of Cleaner Production, to Design Thinking to Creative and in Journal of & Design Education, August Theory in An Journal, March 2021Designing and for with January with design thinking: a case study from Journal of Environmental Education, Vol.52, January and the of Design: of Design and Design in No.122 May to Design with A for Design and July Case and the of Design Thinking in Public Education in August to Co-Created Digital to Support Activities for Socially Youth in February Innovation and Exchange a Lessons Learned from a Design Thinking Challenge in May October Sustainable Business and January Analysis of Agile Development Methodology Through Design June Sustainable Design to Environmental of Design November Case for Design May Learning in Design Thinking to April 2021Design Thinking as a Strategy to Learning in Education Across South April Inspection Management with October design methodology for A to community health and health in the Health of and Science, Vol.5, February 2021Using Design Thinking to the Educational of August factors of service design methodology for manufacturing Business & Management, Vol.8, February 2021Design and of an app for September 2021Design Innovation Methodology – Design in Journal, of the Health Mental Health Intervention for in and for a Research Vol.10, June Design Approach to Social a of Public and October Design Thinking in an Interdisciplinary Learning December Design Thinking to Design Thinking to Food Innovation for January of Design Thinking and to Food and January 2021Design Thinking to Engage in Food The January 2021Systemic and Design Towards Participatory The Journal of Design, and Innovation, Vol.7, Design Thinking October Research and Design Thinking for the Health and Social A para de de Vol.16,
Telemedicine and e-HealthVol. 26, No. 9 OpinionFree AccessTechnology Literacy as a Barrier to Telehealth During COVID-19Austin J. Triana, Roman E. Gusdorf, Kaustav P. Shah, and Sara N. HorstAustin J. TrianaVanderbilt University School of Medicine, Nashville, Tennessee, USA.Search for more papers by this author, Roman E. GusdorfVanderbilt University School of Medicine, Nashville, Tennessee, USA.Search for more papers by this author, Kaustav P. ShahVanderbilt University School of Medicine, Nashville, Tennessee, USA.Search for more papers by this author, and Sara N. HorstAddress correspondence to: Sara N. Horst, MD, MPH, Department of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, 1211 21st Avenue South, Medical Arts Building Suite 220, Nashville, TN 37232, USA E-mail Address: [email protected]Department of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA.Search for more papers by this authorPublished Online:10 Sep 2020https://doi.org/10.1089/tmj.2020.0155AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail During the ongoing COVID-19 pandemic, there have been many fundamental changes to the health care system, one of which has been the rapid adoption of telehealth.1 Despite technological capability for widespread implementation before the pandemic, telehealth remained limited in many areas of the United States due to state regulations and poor insurance reimbursement.2 When these policies changed in March 2020 with national widespread coverage for telemedicine, traditional clinical workflows attempted to rapidly shift to a virtual format to increase social distancing and protect vulnerable patients. At our institution alone, the number of telehealth visits increased from ∼15 per day to >2,000 per day in a matter of weeks.As the health care system rapidly reorganized and trained physicians on how to host videoconference visits, some patients have struggled to keep up. During these changes, providers reported that many patients were struggling to access their telemedicine appointments. Patients may have difficulty navigating their devices and entering the health care system virtually. Others simply do not have devices or a stable Wi-Fi to connect with providers from home. Technology literacy and access should be viewed as a major driver of health and needs to be on a large scale.As an example, Ms. P is a 70-year-old woman with diabetes and hypertension who knows she is high risk for complications from COVID-19. Taking extra precautions, she cancelled her in-person appointments and scheduled a telehealth visit with one of her providers. She spent an entire afternoon preparing her technology for the visit, but she could not connect to the virtual appointment. Despite a proactive mindset, she had difficulty downloading the necessary software. Recognizing this barrier to care Ms. P and other patients face, we started a medical student-led volunteer initiative to help patients set up and test devices for their telemedicine appointments. We rapidly created systematic processes for recruitment, volunteer training, clinic coverage, and operational support. A standardized phone script helped students guide patients as they downloaded the proper software and understood what to expect at the time of the visit.Within a month, we have had 135 medical student volunteers commit 1,300 h and assist >5,000 patients in preparing for upcoming telehealth visits. Along the way, we have seen a wide range of patient comfort with technology that has advanced our understanding of technology literacy. One patient, a computer programmer, initially scoffed when asked whether he needed help. However, he still appreciated the tip that he received about which web browser to use to access his visit, avoiding a glitch that kept some patients from connecting. For patients low self-reported technology literacy, our impact can be great. Many patients had never downloaded a smartphone application or used videoconferencing software before their first virtual appointment. Wary of hackers and scammers, another patient was strongly opposed to telehealth and wanted to cancel his visit, but after talking about the safety of the process with a student, he downloaded the software and had a successful telemedicine visit with his provider.If a patient cannot connect to the videoconference, the provider is forced to call the patient to troubleshoot over the phone, reschedule the appointment, or simply proceed without video. Prior work has shown that the video component significantly contributes to quality and satisfaction of the visit.3 In addition to the technology itself, patients need to know what to expect for their telehealth appointments. Ideally, a patient will have a medication list and be in a quiet and private location at the time of the visit. Therefore, it is important to communicate these expectations beforehand to avoid a visit that takes place from the grocery store or in the car.With the ability to see patients in their own environments, we also gain insight into their lives. Using videoconferencing, it is possible to see a patient's home, to contextualize their experiences, and to better utilize the biopsychosocial model of health. One patient was blind but wanted to use videoconferencing so that the provider could see him. A volunteer helped the patient and his able-sighted daughter navigate the telehealth process using accessibility features for blindness. As medical students who grew up immersed in technology, we have been humbled by the complexity of teaching others to navigate smartphones, web browsers, and applications, and we have seen the tremendous technology gaps in various patient populations.Outside the context of direct patient care, widespread adoption of telehealth has the potential to improve quality of life and health outcomes through additional synergies. Although many older adults perceive benefits from technology, common barriers include self-efficacy, cost, and privacy concerns.4 Prior research has shown that technology adoption can be improved through education and increasing perceived self-efficacy.5 If patients can better navigate their web browsers and applications, they may feel empowered to message their providers through the patient portal or look up healthy recipes online.Among the drastic changes in health care, we hope that updated regulations and improved insurance coverage will be permanent, improving access for patients by addressing issues related to distance, mobility, or health concerns. Licensure across state lines remains a big question that could drastically impact access for many patients. In addition, it is imperative to further understand and address how to help our patients access and use technology. The transition to telehealth requires time, patience, and resources—an investment that is crucial for patients who are at risk of being left behind.AcknowledgmentsWe thank Drs. Michelle Griffith and Eiman Jahangir for organizational support of this project as well as reviewing and editing drafts.Disclosure StatementNo competing financial interests exist.Funding InformationNo funding was received for this article.References1. Smith A, Thomas E, Snoswell C, Haydon H, Mehrotra A, Clemensen J, Caffery Lj. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020. Available at: https://doi.org/10.1177/1357633X20916567 (last accessed May 15, 2020). Google Scholar2. Dorsey ER, Topol EJ. State of telehealth. N Engl J Med 2016;375:154–161. Crossref, Medline, Google Scholar3. McLendon SF. Interactive video telehealth models to improve access to diabetes specialty care and education in the rural setting: A systematic review. Diabetes Spectr 2017;30:124–136. Crossref, Medline, Google Scholar4. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare 2018;24:4–12. Crossref, Medline, Google Scholar5. Gatti FM, Brivio E, Galimberti C. "The future is ours too": A training process to enable the learning perception and increase self-efficacy in the use of tablets in the elderly. Educ Gerontol 2017;43:209–224. Crossref, Google ScholarFiguresReferencesRelatedDetailsCited bySatisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review10 January 2024 | Libyan Journal of Medicine, Vol. 19, No. 1How COVID-19 impacts telehealth: an empirical study of telehealth services, users and the use of metaverse1 February 2024 | Connection Science, Vol. 36, No. 1Experiences of telehealth among people receiving alcohol and other drug treatment during the COVID ‐19 pandemic: Implications for future telehealth delivery28 December 2023 | Drug and Alcohol Review, Vol. 43, No. 3The effect of patient positioning on the accuracy and reliability of assessment of knee range of motion over a telemedicine platform9 October 2021 | Journal of Telemedicine and Telecare, Vol. 30, No. 2Delivering COVID-19 Vaccine via Trusted Social Services: Program Evaluation Results from the Chicagoland CEAL Program12 July 2023 | Journal of Community Health, Vol. 49, No. 1The psychometric properties and feasibility of the Alberta infant motor scale used in telehealth: A scoping reviewEarly Human Development, Vol. 189Age-related smartphone use patterns among individuals with moderate-to-severe traumatic brain injury20 December 2023 | Brain Injury, Vol. 38, No. 1Reliability of Visual Field Testing in a Telehealth Setting Using a Head-Mounted Device: A Pilot Study14 August 2023 | Journal of Glaucoma, Vol. 33, No. 1Open Dialogue Through TelehealthTranslation, cultural adaptation and validity assessment of the Dutch version of the eHealth Literacy Questionnaire: a mixed-method approach30 May 2023 | BMC Public Health, Vol. 23, No. 1Digital health and acute kidney injury: consensus report of the 27th Acute Disease Quality Initiative workgroup14 August 2023 | Nature Reviews Nephrology, Vol. 19, No. 12Standardising the role of a digital navigator in behavioural health: a systematic reviewThe Lancet Digital Health, Vol. 5, No. 12Teleophthalmology and retina: a review of current tools, pathways and services5 December 2023 | International Journal of Retina and Vitreous, Vol. 9, No. 1Comparison of Delivery of Care Before and During COVID-19 Within an Academic Outpatient Psychiatry Practice Kelly C. 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Triana, Roman E. Gusdorf, Kaustav P. Shah, and Sara N. Horst.Technology Literacy as a Barrier to Telehealth During COVID-19.Telemedicine and e-Health.Sep 2020.1118-1119.http://doi.org/10.1089/tmj.2020.0155Published in Volume: 26 Issue 9: September 10, 2020Online Ahead of Print:May 19, 2020 TopicsCOVID-19e-health and telehealth careTelehealth devices PDF download
The Journal of Alternative and Complementary MedicineVol. 26, No. 5 CommentariesPublic Health Approach of Ayurveda and Yoga for COVID-19 ProphylaxisGirish Tillu, Sarika Chaturvedi, Arvind Chopra, and Bhushan PatwardhanGirish TilluAYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India.Search for more papers by this author, Sarika ChaturvediDr. D.Y. Patil Vidyapeeth (DPU), Pune, India.Search for more papers by this author, Arvind ChopraCenter for Rheumatic Diseases, Pune, India.Search for more papers by this author, and Bhushan PatwardhanAddress correspondence to: Bhushan Patwardhan, AYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India E-mail Address: [email protected]AYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India.Search for more papers by this authorPublished Online:11 May 2020https://doi.org/10.1089/acm.2020.0129AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited byDNA metabarcoding uncovers fungal communities in Zingiberis RhizomaChinese Herbal Medicines, Vol. 6"We are adapting to it because it is within us": The co‐becoming of COVID‐19 in Malawi20 December 2023 | World Medical & Health Policy, Vol. 5COVID-19 Cases and Comorbidities: Complementary and Alternative Medicinal Systems (CAM) for Integrated Management of the PandemicJournal of Herbal Medicine, Vol. 42Traditional Formulations for Managing COVID-19: A Systematic Review Rudra B. 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A Narrative Review2 October 2022 | Healthcare, Vol. 10, No. 10Online Yoga and Ayurveda Intervention as Tertiary Prevention of Psychological Comorbidities in COVID-19 Survivors: A Randomized Controlled Trial18 August 2022 | Annals of Neurosciences, Vol. 29, No. 4An exhaustive comprehension of the role of herbal medicines in Pre- and Post-COVID manifestationsJournal of Ethnopharmacology, Vol. 296Modeling the relationship between perceived service quality, tourist satisfaction, and tourists' behavioral intentions amid COVID-19 pandemic: Evidence of yoga tourists' perspectives23 September 2022 | Frontiers in Psychology, Vol. 13Antiviral potential of anthraquinones from Polygonaceae, Rubiaceae and Asphodelaceae: potent candidates in the treatment of SARS-COVID-19, A comprehensive reviewSouth African Journal of Botany, Vol. 35A randomized, controlled, blinded, parallel group, clinical trial to study the role of Ayurcov (AyurCoro3), one day regimen as an adjuvant therapy for COVID-19 disease management, at dedicated Covid Hospital (DCH) in IndiaComplementary Therapies in Medicine, Vol. 67Efficacy of add-on Ayurveda and Yoga intervention in health care workers of tertiary care hospital during COVID-19: Randomized controlled trialComplementary Therapies in Clinical Practice, Vol. 48The Role of Complementary and Alternative Medicines in the Treatment and Management of COVID-196 July 2022Ayurveda research-are we on the right track?Journal of Ayurveda and Integrative Medicine, Vol. 13, No. 3COVID-19 patient with B cell lymphoma co-morbidity managed with co-administration of ayurvedic formulationJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 3Electro-Homeopathy based COVID-19 Safe-home Medical Management Study19 April 2022 | Journal of Natural Remedies, Vol. 22, No. 2Combating the psychological impact of COVID-19 pandemic through yoga: Recommendation from an overviewJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 2Role of medicinal plants in inhibiting SARS-CoV-2 and in the management of post-COVID-19 complicationsPhytomedicine, Vol. 98COVID-19 Adaptive Interventions: Implications for Wellbeing and Quality-of-Life17 March 2022 | Frontiers in Psychology, Vol. 13THE ROLE OF HERBAL IMMUNOMODULATORS AS ADJUVANT THERAPY FOR ASYMPTOMATIC AND MILDLY SYMPTOMATIC COVID-19: AN EXPLORATORY CLINICAL STUDY9 February 2022 | Asian Journal of Pharmaceutical and Clinical ResearchRespiratory Infectious Disease and the COVID-19 Pandemic : A Review of Medieval Unani Medical Literature14 February 2022 | Journal of Natural Remedies, Vol. 22, No. 1Emerging Technological Trends and Advancements in Respiratory Medicine24 March 2022Herbal Immunomodulators and COVID-1918 June 2022COVID-19 pandemic: A pragmatic plan for ayurveda interventionJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 1Influenza like illness related clinical trial on AYUSH-64 requires cautious interpretationJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 1A prospective clinical study of an Ayurveda regimen in COVID 19 patientsJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 1Pathophysiology of Covid-19 and host centric approaches in AyurvedaJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 1Time when a physician turned out to be a patient: A case study on how an Ayurvedic physician cured himself from COVID-19Journal of Ayurveda and Integrative Medicine, Vol. 13, No. 1Modulation of neutrophil (dys)function by Ayurvedic herbs and its potential influence on SARS-CoV-2 infectionJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 1Role of Ayurveda and Yoga-Based lifestyle in the COVID-19 pandemic – A narrative reviewJournal of Ayurveda and Integrative Medicine, Vol. 13, No. 1Welche Behandlungsoptionen wurden von COVID-19-infizierten Yogaübenden als hilfreich empfunden? Ergebnisse einer Querschnittsanalyse29 March 2022 | Complementary Medicine Research, Vol. 29, No. 4Understanding COVID-19 Situation in Nepal and Implications for SARS-CoV-2 Transmission and Management7 June 2022 | Environmental Health Insights, Vol. 16The effects of yoga-based breathing techniques and meditation on outpatients' symptoms of COVID-19 and anxiety scoresJournal of Nursing and Midwifery Sciences, Vol. 9, No. 3Effect of yoga mudras in improving the health of users: A precautionary measure practice in daily life for resisting the deadly COVID-19 diseaseCOVID-19 and its impact on cancer, HIV, and mentally ill patientsSiddha Medicine and Computer Modeling: A Treasure for SARS-CoV-2 Treatment2 November 2021Theoretical effectiveness of steam inhalation against SARS-CoV-2 infection: updates on clinical trials, mechanism of actions, and traditional approachesHeliyon, Vol. 8, No. 1The Effect on the Immune System in the Human Body Due to COVID-19: An Insight on Traditional to Modern Approach as a Preventive MeasureJournal of Pharmacopuncture, Vol. 24, No. 4Preventive aspect of ayurveda and yoga towards newly emerging disease COVID-1927 January 2021 | Journal of Complementary and Integrative Medicine, Vol. 18, No. 4AYURVEDIC UNDERSTANDING & PREVENTIVE MEASURES OF COVID-19: AN OVERVIEW15 December 2021 | GLOBAL JOURNAL FOR RESEARCH ANALYSISThe Future of Medicine: Frontiers in Integrative Health and Medicine28 November 2021 | Medicina, Vol. 57, No. 12The use of integrative therapy based on Yoga and Ayurveda in the treatment of a high-risk case of COVID-19/SARS-CoV-2 with multiple comorbidities: a case report24 February 2021 | Journal of Medical Case Reports, Vol. 15, No. 1A Comprehensive Overview of the Newly Emerged COVID-19 Pandemic: Features, Origin, Genomics, Epidemiology, Treatment, and Prevention25 October 2021 | Biologics, Vol. 1, No. 3Ayurveda approaches to COVID-19 in 2 wave: Lessons learned from practice15 November 2021 | Journal of Preventive Medicine and Holistic Health, Vol. 7, No. 2Yoga for Improving Mental Health during COVID-19 Pandemic: A Review15 November 2021 | Eastern Journal of Psychiatry, Vol. 23, No. 1Withania somnifera as a safer option to hydroxychloroquine in the chemoprophylaxis of COVID-19: Results of interim analysisComplementary Therapies in Medicine, Vol. 62Withania somnifera attenuates Tilapia lake virus (TiLV)‐induced mortality by inhibiting stress and strengthening the innate antioxidant defence system24 June 2021 | Aquaculture Research, Vol. 52, No. 11EFFECTS OF THE EASTERN MIND-BODY PRACTICES ON MENTAL HEALTH DURING THE COVID-19 PANDEMIC: WHEN EAST MEETS WEST1 January 2021 | Wiadomości Lekarskie, Vol. 74, No. 11Therapeutic approaches for SARS-CoV-2 infectionMethods, Vol. 195Some Igbo Indigenous Plants with Anti-COVID-19 Properties27 October 2021In-silico investigation of phytochemicals from Asparagus racemosus as plausible antiviral agent in COVID-1924 June 2020 | Journal of Biomolecular Structure and Dynamics, Vol. 39, No. 14A RANDOMIZED CONTROL STUDY TO EVALUATE THE ROLE OF HERBAL IMMUNOMODULATORS IN BOOSTING THE IMMUNITY AND OVERALL HEALTH OF HEALTHCARE WORKERS IN COVID-19 WARDS: AN EXPLORATORY, FEEDBACK CLINICAL STUDY7 August 2021 | Asian Journal of Pharmaceutical and Clinical ResearchAssociation Between Physical Exercise and Mental Health During the COVID-19 Outbreak in China: A Nationwide Cross-Sectional Study16 August 2021 | Frontiers in Psychiatry, Vol. 12Sars-cov-2 host entry and replication inhibitors from Indian ginseng: an in-silico approach22 June 2020 | Journal of Biomolecular Structure and Dynamics, Vol. 39, No. 12AN APPROACH TOWARDS THE DIAGNOSIS AND MANAGEMENT OF COVID 19 AS PER AYURVEDA15 July 2021 | International Ayurvedic Medical Journal, Vol. 9, No. 7Novel corona virus (COVID-19); Global efforts and effective investigational medicines: A reviewJournal of Infection and Public Health, Vol. 14, No. 7Candidate Anti-COVID-19 Medicinal Plants from Ethiopia: A Review of Plants Traditionally Used to Treat Viral DiseasesEvidence-Based Complementary and Alternative Medicine, Vol. 2021The Plausible Role of Indian Traditional Medicine in Combating Corona Virus (SARS-CoV 2): A Mini-ReviewCurrent Pharmaceutical Biotechnology, Vol. 22, No. 7Significance of AYUSH: India's first line of defence against COVID-19Journal of Ayurveda and Integrative Medicine, Vol. 12, No. 2Matrix metalloproteinase inhibitors identified from Camellia sinensis for COVID-19 prophylaxis: an in silico approach6 October 2020 | Advances in Traditional Medicine, Vol. 21, No. 1Integrative Medicine Treatment in Times of Pandemic Coronavirus Disease? Juan Yang, Dietlind L. Wahner-Roedler, Tony Y. Chon, and Brent A. Bauer16 February 2021 | Medical Acupuncture, Vol. 33, No. 1COVID-19 vaccine: A recent update in pipeline vaccines, their design and development strategiesEuropean Journal of Pharmacology, Vol. 892Safety and efficacy of ozone therapy in mild to moderate COVID-19 patients: A phase 1/11 randomized control trial (SEOT study)International Immunopharmacology, Vol. 91A comprehensive review on potential therapeutics interventions for COVID-19European Journal of Pharmacology, Vol. 890Randomized controlled trials of traditional, complementary, and integrative medicine-based interventions for coronavirus disease 2019 (COVID-19): A bibliometric analysis and review of study designsIntegrative Medicine Research, Vol. 10Traditional medicine is the valuable resource for global healthJournal of Traditional Chinese Medical Sciences, Vol. 8, No. 1SARS CoV-2: Progression and treatment protocols – An overviewMaterials Today: Proceedings, Vol. 46Association Between Yogic Breathing Practice With Perceived Impact of COVID-19: A Cross-Sectional Study From India30 November 2020 | Asia Pacific Journal of Public Health, Vol. 33, No. 120-Week Study of Clinical Outcomes of Over-the-Counter COVID-19 Prophylaxis and Treatment6 July 2021 | Journal of Evidence-Based Integrative Medicine, Vol. 26Emergence of Ethnomedical COVID-19 Treatment: A Literature Review1 October 2021 | Infection and Drug Resistance, Vol. Volume 14Balancing Healthcare and Economy Amidst the COVID-19 Pandemic: An Indian Experience1 February 2021 | Risk Management and Healthcare Policy, Vol. Volume 14Yoga-based lifestyle intervention as a potential adjuvant in addressing anxiety, fear, depression, and perceived health in mild-to-moderate COVID-19 patients. A pilot studyAYUHOM, Vol. 8, No. 1A holistic care approach to combat the COVID-19 diseaseJournal of Family Medicine and Primary Care, Vol. 10, No. 2Clinical evaluation of Chyawanprash as a preventive measure during the COVID-19 pandemic: An open-label, multicentric, randomized, comparative, prospective, and interventional community-based clinical study on healthy individualsJournal of Indian System of Medicine, Vol. 9, No. 2Effect of Meditation and Breathing Exercises on the Well-being of Patients with SARS-CoV-2 Infection under Institutional Isolation: A Randomized Control Trial26 November 2021 | Indian Journal of Palliative Care, Vol. 27The Relevance of Complementary and Integrative Medicine in the COVID-19 Pandemic: A Qualitative Review of the Literature11 December 2020 | Frontiers in Medicine, Vol. 7The COVID-19 Pandemic and the Relevance of Ayurveda's Whole Systems Approach to Health and Disease Management Unnikrishnan Payyappallimana, Kishor Patwardhan, Prasad Mangalath, Christian S. Kessler, Rama Jayasundar, Anupama Kizhakkeveettil, Antonio Morandi, and Rammanohar Puthiyedath9 December 2020 | The Journal of Alternative and Complementary Medicine, Vol. 26, No. 12A review on coronavirus survivability on material's surfaces: present research scenarios, technologies and future directions19 October 2020 | Surface Engineering, Vol. 36, No. 12Pipeline Pharmacological Therapies in Clinical Trial for COVID-19 Pandemic: a Recent Update18 July 2020 | Current Pharmacology Reports, Vol. 6, No. 5The role of Yoga in working from home during the COVID-19 global lockdownWork, Vol. 66, No. 4In the Turkish News: Coronavirus and "Alternative & complementary" medicine methodsComplementary Therapies in Medicine, Vol. 53Blessings in Disguise: Yoga and Meditation during Corona Lockdown31 August 2020 | Journal of Evolution of Medical and Dental Sciences, Vol. 9, No. 35Role of Complementary and Alternative Medicine in Prevention and Treatment of COVID-19: An Overhyped Hope5 August 2020 | Chinese Journal of Integrative Medicine, Vol. 26, No. 8हठयौगिक ग्रंथों में कफ संबंधी दोषों को दूर करने के लिये वर्णित यौगिक विधिया : कोविड-19 महामारी के विशेष संदर्भ में31 July 2020 | Dev Sanskriti Interdisciplinary International Journal, Vol. 16Meditation and Yoga Practices as Potential Adjunctive Treatment of SARS-CoV-2 Infection and COVID-19: A Brief Overview of Key Subjects William Bushell, Ryan Castle, Michelle A. Williams, Kimberly C. Brouwer, Rudolph E. Tanzi, Deepak Chopra, and Paul J. Mills14 July 2020 | The Journal of Alternative and Complementary Medicine, Vol. 26, No. 7AYUSH for COVID-19 managementJournal of Ayurveda and Integrative Medicine, Vol. 11, No. 2Indians vs.COVID-19: The scenario of mental healthSensors International, Vol. 1Preventive strategies to combat infections–a review of traditional practices and Ayurveda concepts1 January 2020 | International Journal of Complementary and Alternative Medicine, Vol. 13, No. 3COVID-19: A new horizon for ayurvedaAYUHOM, Vol. 7, No. 2Ayurveda: The promising shelter for the mankind in the wake of COVID-19 pandemicJournal of Ayurveda Case Reports, Vol. 3, No. 1Epidemic containment measures in Unani medicine and their contemporary relevanceJournal of Indian System of Medicine, Vol. 8, No. 2COVID 19 in ayurvedic perspectiveInternational Journal of Health & Allied Sciences, Vol. 9, No. 5 Volume 26Issue 5May 2020 InformationCopyright 2020, Mary Ann Liebert, Inc., publishersTo cite this article:Girish Tillu, Sarika Chaturvedi, Arvind Chopra, and Bhushan Patwardhan.Public Health Approach of Ayurveda and Yoga for COVID-19 Prophylaxis.The Journal of Alternative and Complementary Medicine.May 2020.360-364.http://doi.org/10.1089/acm.2020.0129Published in Volume: 26 Issue 5: May 11, 2020Online Ahead of Print:April 20, 2020 TopicsCOVID-19Yoga PDF download
No AccessStand Alone Books1 Feb 2013Curbing the epidemicGovernments and the economics of tobacco controlAuthors/Editors: World BankWorld Bankhttps://doi.org/10.1596/0-8213-4519-2SectionsAboutPDF (0.6 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In Abstract:Besides the often asked questions on smokers ' health related risks, and cost-bearing of their consumption choices, the report examines basically, the economic questions that policymakers should address when contemplating tobacco control, and, explores options for governments, in light of justified intervention decisions. Following a careful analysis in the global trends of tobacco use, the report assesses the consequences of tobacco control for health, economies, and individuals. It further demonstrates how the economic fears, deterring policymakers from taking action, are largely unfounded: policies reducing tobacco demand, such as the increase in tobacco taxes, would not only, not cause long-term job losses, nor, would it reduce tax revenues, but rather, bring unprecedented health benefits without harming economies. Finally, an agenda for action is provided, on how to overcome the political barriers against change, with suggestions for research into the causes, consequences, and costs of smoking at national and regional levels. The report makes two recommendations: strategic action should be taken in a variety of aspects to curb the tobacco epidemic; and, international organizations should review existing programs/policies, to ensure due prominence in tobacco control. FiguresreferencesRecommendeddetailsCited bySocioeconomic differences in the impact of prices and taxes on tobacco use in low- and middle-income countries–A systematic reviewPLOS Global Public Health, Vol.3, No.927 September 2023Recent trends of tobacco use in IndiaJournal of Public Health, Vol.29, No.120 June 2019Introduction: Supporting tobacco cessation – from health policy to health system reorientation and patient careGovernment intervention in the market for electronic nicotine delivery systems (ENDS). The known, the unknown and challengesDrugs and Alcohol Today, Vol.20, No.3ESR/ERS statement paper on lung cancer screeningEuropean Radiology, Vol.30, No.612 February 2020Factors associated with maintenance of smoking cessation in adolescents after implementation of tobacco pricing policy in South Korea: Evidence from the 11th Youth Health Behavior SurveyResearch in Nursing & Health, Vol.43, No.11 December 2019Política de controle do tabaco no Brasil1 January 2020Willingness to Stop Growing Tobacco in UgandaJournal of Global Oncology, No.5Economics of tobacco control (part 3): evidence from the ITC ProjectTobacco Control, Vol.28, No.Suppl 117 April 2019Anti-tobacco control industry strategies in TurkeyBMC Public Health, Vol.18, No.126 February 2018Determinants of cigarette smoking and smoking intensity among adult males in GhanaBMC Public Health, Vol.18, No.131 July 2018The Impact of Prices and Taxes on the Use of Tobacco Products in Latin America and the CaribbeanAmerican Journal of Public Health, Vol.108, No.S6El impacto de los precios e impuestos sobre el consumo de productos de tabaco en América Latina y el CaribeAmerican Journal of Public Health, Vol.108, No.S6Are global taxes feasible?International Tax and Public Finance, Vol.25, No.512 March 2018Global Health5 September 2018Lung cancer prevention14 August 2018Alcohol taxes' contribution to prices in high and middle‐income countries: Data from the International Alcohol Control StudyDrug and Alcohol Review, Vol.37, No.S222 November 2017Long-Run Impacts of Increasing Tobacco Taxes: Evidence from South Africa11 April 2018Dutch Tobacco Control Policy from the 1950s to the Present1 May 2018The International Context: EU and WHO1 May 2018Scientific Evidence and Policy Learning1 May 2018Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in TanzaniaPLOS ONE, Vol.12, No.82 August 2017Tobacco packaging design for reducing tobacco useCochrane Database of Systematic Reviews, Vol.2017, No.427 April 2017Are Tobacco Taxes Really Regressive? Evidence from Chile4 April 2017Does Life in the United States Take a Toll on Health? Duration of Residence and Birthweight among Six Decades of ImmigrantsInternational Migration Review, Vol.51, No.119 July 2018The Prevention of Smoking and Restrictive Policies11 November 2016Economic Remedies to Reduce Smoking11 November 2016Are Global Taxes Feasible?SSRN Electronic JournalOf neoliberalism and global health: human capital, market failure and sin/social taxesCritical Public Health, Vol.26, No.513 June 2016Time trend of smoking scenes in Iranian movies during the past three decades (1982?2011): a historical analysisTobacco Control, Vol.25, No.514 July 2015The impact of an increase in excise tax on the retail price of tobacco in New ZealandTobacco Control, Vol.25, No.42 July 2015Tobacco packaging design for preventing tobacco uptake26 February 2016Can demand-side policies stop the tobacco industry's damage? Lessons from TurkeyGlobal Public Health, Vol.10, No.72 February 2015World No Tobacco Day reminds us of the desolating effects of smoking on healthMedical Journal of Australia, Vol.202, No.918 May 2015Tobacco tax and the illicit trade in tobacco products in New ZealandAustralian and New Zealand Journal of Public Health, Vol.39, No.231 March 2015Understanding increases in smoking prevalence: case study from France in comparison with England 2000-10Addiction, Vol.110, No.320 January 2015The Impact of Prices and Taxes on the Use of Tobacco Products in Latin America and the CaribbeanAmerican Journal of Public Health, Vol.105, No.3Contesting Tobacco-Control Policy in IndonesiaCritical Asian Studies, Vol.47, No.123 February 2015Heavy metal hazards of Nigerian smokeless tobaccoTobacco Control, Vol.23, No.621 June 2013Tobacco packaging design for reducing tobacco use4 August 2014Politique d'augmentation des taxes sur les cigarettes au Cameroun: Comment réaliser à la fois les objectifs de santé publique et de recettes fiscalesAfrican Development Review, Vol.26, No.215 July 2014Change in tobacco excise policy in Bulgaria: the role of tobacco industry lobbying and smugglingTobacco Control, Vol.23, No.e110 November 2012Understanding the Influence of Evidence in Public Health Policy: What Can We Learn from the 'Tobacco Wars'?13 December 2013A cross-country study of cigarette prices and affordability: evidence from the Global Adult Tobacco SurveyTobacco Control, Vol.23, No.125 August 2012Disparities in health care utilization by smoking status in CanadaInternational Journal of Public Health, Vol.58, No.624 February 2013Smoking, mental illness and socioeconomic disadvantage: analysis of the Australian National Survey of Mental Health and WellbeingBMC Public Health, Vol.13, No.111 May 2013Tobacco control in the Russian Federation- a policy analysisBMC Public Health, Vol.13, No.123 January 2013The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 studyBMC Health Services Research, Vol.13, No.117 July 2013What price quitting? The price of cigarettes at which smokers say they would seriously consider trying to quitBMC Public Health, Vol.13, No.113 July 2013Nationwide Survey of Fifth–Year Dental Students' Perceptions About Tobacco Prevention, Control, and Curriculum in IndiaJournal of Dental Education, Vol.77, No.101 October 2013Impacto do apelo ao medo nas embalagens do cigarro: a percepção de fumantes em relação às mensagens de advertência antitabagismoRevista Eletrônica de Ciência Administrativa, Vol.12, No.231 August 2013Understanding the Influence of Evidence in Public Health Policy: What Can We Learn from the 'Tobacco Wars'?Social Policy & Administration, Vol.47, No.47 June 2013Smoking and absence from work: systematic review and meta‐analysis of occupational studiesAddiction, Vol.108, No.219 November 2012The Limits of Corporate Social Responsibility: Techniques of Neutralization, Stakeholder Management and Political CSRJournal of Business Ethics, Vol.112, No.22 March 2012Screening for Smoking in a General Hospital: Scale Validation, Indicators of Prevalence, and ComorbidityPerspectives in Psychiatric Care, Vol.49, No.114 March 2012Critical Interventions in Global Health: Governmentality, Risk, and AssemblageAnnals of the Association of American Geographers, Vol.102, No.5Special Health Issues in Less Developed Countries20 May 2011REVERSING THE TAXES APPROACH FOR A WIN-WIN TOBACCO CONTROL POLICYAddiction, Vol.106, No.116 October 2011Impact of tobacco advertising and promotion on increasing adolescent smoking behavioursCochrane Database of Systematic Reviews, Vol.125 October 2011Cross-National Sources of Health Inequality: Education and Tobacco Use in the World Health SurveyDemography, Vol.48, No.214 April 2011Effectiveness of a Mobile Smoking Cessation Service in Reaching Elderly Smokers and Predictors of Quitting17 October 2012Commentary on Lund et al. (2011): Consolidating the evidence on effectiveness of snus for smoking cessation - implications for public healthAddiction, Vol.106, No.110 December 2010The impact of smuggled cigarettes to national economics in Taiwan-A CGE model analysisJournal of Statistics and Management Systems, Vol.14, No.1Public policy action and CCC implementation: benefits and hurdlesCancer Causes & Control, Vol.21, No.1218 November 2010"Immortal but frightened"-smoking adolescents' perceptions on smoking uptake and preventionBMC Public Health, Vol.10, No.121 December 2010Factors associated with commencing smoking in 12-year-old students in Catalonia (Spain): a cross-sectional population-based studyBMC Public Health, Vol.10, No.12 November 2010Berlin's medical students' smoking habits, knowledge about smoking and attitudes toward smoking cessation counselingJournal of Occupational Medicine and Toxicology, Vol.5, No.116 April 2010Knowledge and Beliefs about Smoking and Cancer among Women in Five European CountriesCancer Epidemiology, Biomarkers & Prevention, Vol.19, No.118 November 2010Reduction of Tobacco Smoking Health Risk Through an Appropriate Media Based Communication Strategy in UgandaChinese Journal of Population Resources and Environment, Vol.8, No.3Predictors of Women's Attitudes Toward World Health Organization Framework Convention on Tobacco Control Policies in Urban ChinaJournal of Women's Health, Vol.19, No.5Tobacco Industry, Advertising and Advertising Bans21 July 2009Recent Progress in the Development of a Protocol on the Illicit Trade in Tobacco ProductsSSRN Electronic JournalTABADO: "Evaluation of a smoking cessation program among Adolescents in Vocational Training Centers": Study protocolBMC Public Health, Vol.9, No.113 November 2009Prevalence and correlates of smoking among urban adult men in Bangladesh: slum versus non-slum comparisonBMC Public Health, Vol.9, No.122 May 2009Corporate Power and Social PolicyGlobal Social Policy, Vol.9, No.317 November 2009[Commentary] TIME FOR THE MIDDLE AGED TO OWN UP TO THE PROBLEMAddiction, Vol.104, No.93 August 2009Demand for cigarettes in the United States: effects of prices in bordering states and contiguity with Mexico and CanadaApplied Economics, Vol.41, No.18Exports to Smuggle and Smuggling Technologies*Review of International Economics, Vol.17, No.313 July 2009Psychosocial Mediators of a School-Based Tobacco Prevention Program in India: Results from the First Year of Project MYTRIPrevention Science, Vol.10, No.221 November 2008Tobacco dependence treatment and the Framework Convention on Tobacco ControlAddiction, Vol.104, No.417 March 2009Tobacco Use: Prevention18 March 2011Tobacco Abuse: Treatment and Management18 March 2011Challenges in Reducing the Disease Burden of Tobacco Smoking18 March 2011An international survey of training programs for treating tobacco dependenceAddiction, Vol.104, No.2Smoking patterns and sociodemographic factors associated with tobacco use among Chinese rural male residents: a descriptive analysisBMC Public Health, Vol.8, No.121 July 2008Effectiveness of a mobile smoking cessation service in reaching elderly smokers and predictors of quittingBMC Geriatrics, Vol.8, No.16 October 2008Tobacco industry issues management organizations: Creating a global corporate network to undermine public healthGlobalization and Health, Vol.4, No.117 January 2008Gender Differences in Smoking Behaviors in an Asian PopulationJournal of Women's Health, Vol.17, No.6Changes in Youth Smoking, 1976–2002Youth & Society, Vol.39, No.49 August 2007An Assessment of the Relationship between Condom Labels and HIV-Related Beliefs and IntentionsAIDS and Behavior, Vol.12, No.329 January 2008Analysis of Willingness-to-Quit Cigarette Price among Korean Male AdultsJournal of Preventive Medicine and Public Health, Vol.41, No.3Smoking in Germany: Stylized Facts, Behavioral Models, and Health PolicySSRN Electronic JournalStimulerende middelen: tabakTobacco ConsumptionThe synergistic effect of cigarette taxes on the consumption of cigarettes, alcohol and betel nutsBMC Public Health, Vol.7, No.125 June 2007Five‐year outcomes for a smoking cessation clinicRespirology, Vol.12, No.622 October 2007Addressing tobacco‐related health disparitiesAddiction, Vol.102, No.s210 September 2007Cell proliferation kinetics and genotoxicity in lymphocytes of smokers living in mexico cityHuman & Experimental Toxicology, Vol.26, No.92 July 2016Alcohol, Drug, and Tobacco Study Group Takes a Stand: The WHO Framework Convention on Tobacco Control: An Urgent Call for U.S. RatificationMedical Anthropology Quarterly, Vol.21, No.3Tobacco and Cardiovascular Disease28 February 2013Buying and Selling "Loosies" in Baltimore: The Informal Exchange of Cigarettes in the Community ContextJournal of Urban Health, Vol.84, No.413 April 2007Prevention and Control of Diseases Associated with Tobacco use through Law and PolicyNicotine2 March 2007Global Patterns and Determinants of Sex Differences in SmokingInternational Journal of Comparative Sociology, Vol.47, No.626 July 2016Smoking trends among adolescents from 1990 to 2002 in ten European countries and CanadaBMC Public Health, Vol.6, No.110 November 2006Civil society-a leader in HIV prevention and tobacco controlDrug and Alcohol Review, Vol.25, No.629 May 2009Globalization and TobaccoBack Matter26 October 2017Growing Up Healthy26 October 2017The Fourth Pillar of the Framework Convention on Tobacco Control: Harm Reduction and the International Human Right to HealthPublic Health Reports, Vol.121, No.52 August 2016INDUSTRY RESPONSES TO THE TOBACCO EXCISE TAX INCREASES IN SOUTH AFRICAThe South African Journal of Economics, Vol.74, No.1"SIN" TAXES AND POOR HOUSEHOLDS: UNANTICIPATED EFFECTSThe South African Journal of Economics, Vol.74, No.1Nicotine psychopharmacology research: advancing science, public health, and global policyPsychopharmacology, Vol.184, No.3-47 February 2006Improving the health of EuropeansDrugs: Education, Prevention and Policy, Vol.13, No.610 July 2009Not another smoking survey! Healthy public policy and the need for local informationInternational Journal of Health Promotion and Education, Vol.44, No.3Are non-responders in a quitline evaluation more likely to be smokers?BMC Public Health, Vol.5, No.123 May 2005Tobacco outlet density and smoking prevalence: Does racial concentration matter?Drugs: Education, Prevention and Policy, Vol.12, No.310 July 2009Globalisation and Noncommunicable DiseasesTobacco: The Global Challenge for Health PromotionSmoking in Adults in Sri Lanka: Prevalence and AttitudesAsia Pacific Journal of Public Health, Vol.17, No.130 June 2016Preventing Tobacco Use and Harm: What is Evidence Based Policy?24 December 2009Changed market access in the north and the farm prices in the south: some lessons from the war on drugsDe Economist, Vol.152, No.4Culture Change and Ethnic-Minority Health Behavior: An Operant Theory of AcculturationJournal of Behavioral Medicine, Vol.27, No.6Tobacco initiation, cessation, and change: evidence from VietnamHealth Economics, Vol.13, No.121 January 2004Tobacco is a "weapon of mass destruction". Should western countries be invaded for that?Postgraduate Medical Journal, Vol.80, No.9465 August 2004Smoking is an occupational hazardAmerican Journal of Industrial Medicine, Vol.46, No.21 January 2004Workplace policy considerations for curbing the tobacco epidemicAmerican Journal of Industrial Medicine, Vol.46, No.21 January 2004Effects of stage-matched repeated individual counseling on smoking cessation: A randomized controlled trial for the high-risk strategy by lifestyle modification (HISLIM) studyEnvironmental Health and Preventive Medicine, Vol.9, No.4The Syrian Center for Tobacco Studies: A Model of International Partnership for the Creation of Sustainable Research Capacity in Developing CountriesPromotion & Education, Vol.11, No.24 June 2018Advances in pharmacotherapy for tobacco dependenceExpert Opinion on Emerging Drugs, Vol.9, No.12 March 2005How can we increase the involvement of primary health care in the treatment of tobacco dependence? A meta‐analysisAddiction, Vol.99, No.318 February 2004Public Health in GermanyChildhood smoking: the research, clinical and theoretical imperative for nursing actionInternational Nursing Review, Vol.50, No.47 November 2003Women and the global tobacco epidemic: nurses call to actionInternational Nursing Review, Vol.50, No.47 November 2003Redirecting the Diet Transition: What Can Food Policy Do?Development Policy Review, Vol.21, No.5-626 January 2004Reducing toxicity exposure for the nicotine‐dependentAddiction, Vol.98, No.927 August 2003Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours21 July 2003Tobacco: public perceptions and the role of the industryJournal of the Royal Statistical Society: Series A (Statistics in Society), Vol.166, No.2The effects of tobacco smoke on the homocysteine level?a risk factor of atherosclerosisAddiction Biology, Vol.8, No.2Women and tobaccoRespirology, Vol.8, No.29 May 2003A qualitative study on the determinants of smoking behaviour among adolescents in South AfricaScandinavian Journal of Public Health, Vol.31, No.35 September 2016You've come a long way baby: women and the tobacco epidemicAddiction, Vol.98, No.57 May 2003Smoking among adolescents in muenster, germany: increase in prevalence (1995–2000) and relation to tobacco advertising☆☆There was no conflict of interest.Preventive Medicine, Vol.36, No.2Tobacco Industry, Advertising and Advertising BansSmoking and young women in Vietnam: the influence of normative gender rolesSocial Science & Medicine, Vol.55, No.4Public-private partnerships to reduce tobacco dependenceAddiction, Vol.97, No.828 July 2002Roles of the Private Sector in Tobacco Cessation ProgrammesAddiction, Vol.97, No.828 July 2002Can Capitalism Advance the Goals of Tobacco Control?Addiction, Vol.97, No.828 July 2002The Distributional Impact of Tobacco Excise Increases* (1)South African Journal of Economics, Vol.70, No.318 August 2005Excise Taxation and Tobacco Consumption in South Africa: A NoteSouth African Journal of Economics, Vol.70, No.318 August 2005Active Ageing: A Policy FrameworkThe Aging Male, Vol.5, No.16 July 2009Nurses' Initiatives in Smoking Cessation in Hong KongProgress in Cardiovascular Nursing, Vol.17, No.115 June 2007The challenge of effectively addressing tobacco control within a health promoting NHS TrustPatient Education and Counseling, Vol.45, No.4Prospects for tobacco control in Zimbabwe: a historical perspectiveHealth Policy, Vol.57, No.3Framework Convention on Tobacco Control: The Way OutTropical Doctor, Vol.31, No.325 June 2016What Lessons Have Been Learned From Other Attempts to Guide Social Change?Nutrition Reviews, Vol.59, No.327 April 2009Tobacco warsCancer, Vol.91, No.S11 January 2001Adolescent lifestyleFighting tobacco dependence in EuropeNature Medicine, Vol.7, No.11 January 2001Struggle over Tobacco Control in Serbia: Transnational Tobacco Companies vs. Public Health"Enjoy Smoking" — Die Zigarettenindustrie und ihre AbwehrschlachtenNicotine Psychopharmacology: Policy and RegulatoryPharmacotherapy for Tobacco DependenceTabakindustrie, Werbung und Werbeverbote View Published: May 1999 ISBN: 978-0-8213-4519-1 Copyright & Permissions Related Regions Africa East Asia & Pacific Europe and Central Asia Related Countries China South Africa Related Topics Health Nutrition and Population KeywordsTOBACCO RESEARCHTOBACCO TAXESSMOKINGHAZARDS OF POLLUTANTSNUTRITION & HEALTH CARETOXIC SUBSTANCESDECISION MAKINGECONOMIC IMPACTPOLICY MAKINGTAX REVENUESHEALTH IMPROVEMENTADDICTIVE NATUREADDICTIVE NATURE OF TOBACCOECONOMICS OF TOBACCO CONTROLEDUCATIONAL CLASSROOM USESMOKERSTOBACCOTOBACCO SMOKINGTOBACCO USEUPTAKE OF SMOKING PDF DownloadLoading ...
Myths and misunderstandings about mental health nursing are damaging not only to the discipline but also affect the quality of services experienced by people needing mental health support. Contextually, these myths and misunderstandings abound due to stigmatising attitudes towards mental health, the dominance of generalist nursing in countries such as Australia and the United Kingdom, and generic undergraduate nurse education. They are perpetuated through a lack of awareness of the history of this specialty discipline, including its professional registration, education pathways and specialist knowledge, and a loss of graduate specialist skills required for safe and effective mental health nursing practice. It is important to analyse and correct these myths and address controversies as they have ramifications for the mental health nursing profession and mental health care. A commonly repeated myth is that all nurses are mental health nurses, including those who work in a mental health setting. While perhaps not intended, this is a damaging and inaccurate myth. It comes from a misguided, albeit well-intended, effort to acknowledge that all nurses need fundamental mental health knowledge and skills to provide care to meet patients' needs. Indeed, they do. That does not make them mental health nurses with specialist nursing knowledge and skills. Mental health (or psychiatric) nursing is a specialty field that ‘provides holistic care to promote the physical and psychosocial well-being of individuals at risk for or experiencing mental health conditions and/or substance misuse disorders or behaviour problems’ (International Council of Nurses 2024, 24). The mental health nurse role requires specialist qualifications in mental health. Other nurses in the field without specialist qualifications are nurses working in mental health. This damaging myth serves to undermine and invalidate the specialty knowledge and skills of mental health nursing, as it implies any nurse can provide safe, skilled and effective mental health care, including for people with complex and severe mental health problems. This also strikes at the very identity of being a mental health nurse, an identity, knowledge and skill-base that differentiates this field from all other forms of nursing. This includes an intricate enactment of technical clinical skills such as talk-based therapies, risk reduction and holistic assessments. These skills are combined with non-technical capabilities of emotional intelligence, utilising self as a therapeutic tool and holding values and practices reflective of recovery and trauma-informed care (Hurley et al. 2022). This myth has other implications, including nurses without specialist mental health qualifications and experience being considered fit to teach mental health to students in undergraduate nursing programs, or nurses forgoing undertaking specialist postgraduate mental health nursing education, as ‘all nurses are mental health nurses’. They are not. In the same way that a General Practitioner with some mental health training who provides primary mental health care is not a specialist Psychiatrist with extensive postgraduate training who provides specialist mental health care and treatment, a comprehensively trained nurse, even one with clinical experience in the field, is not a mental health nurse. They are both valuable, but distinct, roles. In the rise of comprehensive undergraduate education across several countries, mental health nursing has been increasingly subsumed into the wider field of nursing where it is commonly viewed and treated as one of its subspecialty areas. There is a prevailing myth that mental health nursing is simply one of many subspecialties in generalist nursing, like critical care nursing. Mental health nursing is not and never has been a subspecialty within general nursing. It is a parallel and separate specialty field in nursing and health care with its own history. In Australia, for instance, until the early 1990s there were three separate fields that nurses could gain registration in: general, mental health and intellectual disability nursing. Each registration field had its own specialty education and preparation for registered practice—its own identity. There were multiple pathways of education where some trained directly into their specialty, or where nurses did general nursing training, then a specialist mental health nursing (or psychiatric nursing), and/or a disability course and clinical experience. They consequently earnt their specialist nurse qualifications and registration in these fields. In 1993 the registrations were combined into a single register, with removal of specialty registration and recognition in mental health and disability (Happell 2009). Importantly, mental health/psychiatry has also had a distinct health service provision from generalist health services. Mental health nurses worked within these parallel and separate health services including psychiatric hospitals, originating from the convict era (Raeburn et al. 2018). While there has been some integration of mental and general health settings and services since then, separate mental health services continue to this day, as do the mental health nurses working within them. Another prevailing and damaging myth that is perpetuated in many undergraduate programs is that nursing graduates need to consolidate their general nursing skills in the first year of graduate practice. They are often actively discouraged from going into mental health. This myth is based on stigmatising attitudes and ignorance towards mental health nursing skills and is indicative of the dominance of generalist nursing that is positioned as superior in undergraduate programs and clinical practice. This is incorrect and harmful to recruitment of the future mental health nursing workforce. New graduate identity as a registered nurse is formed in the first few years of clinical practice, typically where nurses receive peer recognition of growing expertise within clinical environments. Being entrenched within a generalist setting over this professionally formative period adds yet another barrier to new graduates undertaking mental health nursing and has a substantial effect on the number of nurses recruited into the mental health nursing workforce. Perpetuating these myths is damaging to the status, specialty knowledge, and skills of the mental health nursing profession. They reflect stigma and lack of respect for the field, are a major contributor to difficulty recruiting nurses into the mental health workforce, and of most significance, affect the quality and provision of nursing care to people with mental health conditions including complex and severe mental health problems requiring advanced nursing skills and specialist treatment and management. Indeed, it is this population that mental health nurses are frequently the only nursing discipline offering specialist clinical services to (Hurley et al. 2022). We have raised and debated these myths and controversies to highlight damaging attitudes, behaviours and outcomes for the field of mental health nursing and for mental health care. There is much at stake here. It is imperative these myths stop being repeated. The field of mental health nursing should be accorded respect and autonomy. The future of the profession is at stake. The well-being of, and quality of care for, people with mental health conditions depends on it. Kim Foster is an Editor of the International Journal of Mental Health Nursing.
HomeCirculationVol. 83, No. 1An updated coronary risk profile. A statement for health professionals. Free AccessAbstractPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessAbstractPDF/EPUBAn updated coronary risk profile. A statement for health professionals. K M Anderson, P W Wilson, P M Odell and W B Kannel K M AndersonK M Anderson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P W WilsonP W Wilson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P M OdellP M Odell Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. and W B KannelW B Kannel Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. Originally published1 Jan 1991https://doi.org/10.1161/01.CIR.83.1.356Circulation. 1991;83:356–362 Previous Back to top Next FiguresReferencesRelatedDetailsCited By Hespe C, Giskes K, Harris M and Peiris D (2022) Findings and lessons learnt implementing a cardiovascular disease quality improvement program in Australian primary care: a mixed method evaluation, BMC Health Services Research, 10.1186/s12913-021-07310-6, 22:1, Online publication date: 1-Dec-2022. Lemke E, Vetter V, Berger N, Banszerus V, König M and Demuth I (2022) Cardiovascular health is associated with the epigenetic clock in the Berlin Aging Study II (BASE-II), Mechanisms of Ageing and Development, 10.1016/j.mad.2021.111616, 201, (111616), Online publication date: 1-Jan-2022. Wong N, Budoff M, Ferdinand K, Graham I, Michos E, Reddy T, Shapiro M and Toth P (2022) Atherosclerotic cardiovascular disease risk assessment: An American Society for Preventive Cardiology clinical practice statement, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2022.100335, 10, (100335), Online publication date: 1-Jun-2022. Coller J, Gong F, McGrady M, Shiel L, Liew D, Stewart S, Owen A, Krum H, Reid C, Prior D and Campbell D (2021) Risk factors for asymptomatic echocardiographic abnormalities that predict symptomatic heart failure, ESC Heart Failure, 10.1002/ehf2.13695, 9:1, (196-212), Online publication date: 1-Feb-2022. Mittal M, McEniery C, Supramaniam P, Cardozo L, Savvas M, Panay N and Hamoda H (2022) Impact of micronised progesterone and medroxyprogesterone acetate in combination with transdermal oestradiol on cardiovascular markers in women diagnosed with premature ovarian insufficiency or an early menopause: a randomised pilot trial, Maturitas, 10.1016/j.maturitas.2022.01.012, 161, (18-26), Online publication date: 1-Jul-2022. Adikari D, Gharleghi R, Zhang S, Jorm L, Sowmya A, Moses D, Ooi S and Beier S (2022) A new and automated risk prediction of coronary artery disease using clinical endpoints and medical imaging-derived patient-specific insights: protocol for the retrospective GeoCAD cohort study, BMJ Open, 10.1136/bmjopen-2021-054881, 12:6, (e054881), Online publication date: 1-Jun-2022. Disouza J, Patil K, Kakade P and Patravale V (2022) Dietary Fibers and Nutraceuticals in Prevention of Hypertension Research Anthology on Recent Advancements in Ethnopharmacology and Nutraceuticals, 10.4018/978-1-6684-3546-5.ch040, (778-809) Barton T, Low D, Bakker E, Janssen T, de Groot S, van der Woude L and Thijssen D (2021) Traditional Cardiovascular Risk Factors Strongly Underestimate the 5-Year Occurrence of Cardiovascular Morbidity and Mortality in Spinal Cord Injured Individuals, Archives of Physical Medicine and Rehabilitation, 10.1016/j.apmr.2020.07.013, 102:1, (27-34), Online publication date: 1-Jan-2021. Sadat Halder M and Kumar De S (2021) A RETROSPECTIVE COHORT STUDY TO UNDERSTAND THE AGE, GENDER AND RISK FACTORS PATTERN IN PATIENTS ATTENDING FOR CARDIAC REHABILITATION (CR) AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) SURGERY, INDIAN JOURNAL OF APPLIED RESEARCH, 10.36106/ijar/5702089, (57-60), Online publication date: 1-Jul-2021. Black J, Campbell J, Parker S, Sharman J, Nelson M, Otahal P, Hamilton G and Marwick T (2021) Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic, Medical Journal of Australia, 10.5694/mja2.50960, 214:6, (266-271), Online publication date: 1-Apr-2021. Wen J (2021) Stem Cell Therapies for Cardiac Disease: Which Cell Types Are the Best ICBBS 2021: 2021 10th International Conference on Bioinformatics and Biomedical Science, 10.1145/3498731.3498762, 9781450384308, (196-203), Online publication date: 29-Oct-2021. Mishra P, Mishra B, Lyytikäinen L, Hilvo M, Juonala M, Kähönen M, Hutri-Kähönen N, Fotiadis D, Raitakari O, Laaksonen R and Lehtimäki T (2021) Assessment of plasma ceramides as predictor for subclinical atherosclerosis, Atherosclerosis Plus, 10.1016/j.athplu.2021.09.005, 45, (25-31), Online publication date: 1-Nov-2021. Okami Y, Ueshima H, Nakamura Y, Kondo K, Kadota A, Okuda N, Ohkubo T, Miyamatsu N, Okamura T, Miura K and Okayama A (2021) Risk Factors That Most Accurately Predict Coronary Artery Disease Based on the Duration of Follow-up ― NIPPON DATA80 ―, Circulation Journal, 10.1253/circj.CJ-20-0739, 85:6, (908-913), Online publication date: 25-May-2021. Wilson R, Aminian A and Tahrani A (2021) Metabolic surgery: A clinical update, Diabetes, Obesity and Metabolism, 10.1111/dom.14235, 23:S1, (63-83), Online publication date: 1-Feb-2021. Steger A, Dommasch M, Müller A, Sinnecker D, Huster K, Gotzler T, Gotzler O, Hapfelmeier A, Ulm K, Barthel P, Hnatkova K, Laugwitz K, Malik M and Schmidt G (2020) Polyscore of autonomic parameters for risk stratification of the elderly general population: the Polyscore study, EP Europace, 10.1093/europace/euaa359, 23:5, (789-796), Online publication date: 21-May-2021. Li Y, Sperrin M, Ashcroft D and van Staa T (2021) Consistency of ranking was evaluated as new measure for prediction model stability: longitudinal cohort study, Journal of Clinical Epidemiology, 10.1016/j.jclinepi.2021.06.026, 138, (168-177), Online publication date: 1-Oct-2021. Albaugh V, Kindel T, Nissen S and Aminian A (2021) Cardiovascular Risk Reduction Following Metabolic and Bariatric Surgery, Surgical Clinics of North America, 10.1016/j.suc.2020.12.012, 101:2, (269-294), Online publication date: 1-Apr-2021. Eftychidis I, Sakellari I, Anagnostopoulos A and Gavriilaki E (2021) Endothelial dysfunction and vascular complications after allogeneic hematopoietic cell transplantation: an expert analysis, Expert Review of Hematology, 10.1080/17474086.2021.1968823, 14:9, (831-840), Online publication date: 2-Sep-2021. Vaes B, Indestege P, Serneels T, Hegendörfer E, van Peet P, Poortvliet R, Wallemacq P, Gussekloo J and Degryse J (2020) Biomarkers versus traditional risk factors to predict cardiovascular events in very old adults: cross-validated prospective cohort study, BMJ Open, 10.1136/bmjopen-2019-035809, 10:6, (e035809), Online publication date: 1-Jun-2020. Wong N (2020) Cardiovascular risk assessment: The foundation of preventive cardiology, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2020.100008, 1, (100008), Online publication date: 1-Mar-2020. Anžič Drofenik A, Vrtovec M, Božič Mijovski M, Sever M, Preložnik Zupan I, Kejžar N and Blinc A (2020) Progression of coronary calcium burden and carotid stiffness in patients with essential thrombocythemia associated with JAK2 V617F mutation, Atherosclerosis, 10.1016/j.atherosclerosis.2020.01.001, 296, (25-31), Online publication date: 1-Mar-2020. van Bussel E, Hoevenaar-Blom M, Poortvliet R, Gussekloo J, van Dalen J, van Gool W, Richard E and Moll van Charante E (2020) Predictive value of traditional risk factors for cardiovascular disease in older people: A systematic review, Preventive Medicine, 10.1016/j.ypmed.2020.105986, 132, (105986), Online publication date: 1-Mar-2020. Kim Y, Noh K, Byun S, Lee S, Kim T, Sunwoo L, Lee K, Kang S, Park K and Park S (2020) Effects of Hypertension, Diabetes, and Smoking on Age and Sex Prediction from Retinal Fundus Images, Scientific Reports, 10.1038/s41598-020-61519-9, 10:1, Online publication date: 1-Dec-2020. Palazón-Bru A, Ferri-Rufete D, Mares-García E, Durazo-Arvizu R, Divisón-Garrote J, Carbayo-Herencia J, Artigao-Rodenas L, Simarro-Rueda M, Molina-Escribano F, Ponce-García I, Gil-Guillén V and Pérez-Sempere Á (2020) Clusters of Cardiovascular Risk Factors and Their Impact on the 20-Year Cardiovascular Risk in a General Population, Journal of Cardiovascular Nursing, 10.1097/JCN.0000000000000637, 35:2, (210-216), Online publication date: 1-Mar-2020. Jamthikar A, Gupta D, Saba L, Khanna N, Viskovic K, Mavrogeni S, Laird J, Sattar N, Johri A, Pareek G, Miner M, Sfikakis P, Protogerou A, Viswanathan V, Sharma A, Kitas G, Nicolaides A, Kolluri R and Suri J (2020) Artificial intelligence framework for predictive cardiovascular and stroke risk assessment models: A narrative review of integrated approaches using carotid ultrasound, Computers in Biology and Medicine, 10.1016/j.compbiomed.2020.104043, 126, (104043), Online publication date: 1-Nov-2020. Torralbas-Ortega J, Paños-Martínez M, Patró-Moncunill E, Santiago-Barragán A, Cobo J, Escayola-Maranges A, Granero-Lázaro A and Marti-Mestre M (2020) Efficacy of a Short Psychoeducational Group Intervention for the Prevention of Cardiovascular Risk in Patients With Severe Mental Disorder, Journal of Nervous & Mental Disease, 10.1097/NMD.0000000000001081, 208:3, (222-229), Online publication date: 1-Mar-2020. Wang J, Smail-Crevier R, Nannarone M, Manuel D, MacQueen G, Patten S, Lashewicz B and Schmitz N (2020) The accuracy of depression risk perception in high risk Canadians, Journal of Affective Disorders, 10.1016/j.jad.2020.01.099, 265, (410-415), Online publication date: 1-Mar-2020. Vuksan V, Sievenpiper J, Jovanovski E, Jenkins A, Komishon A, Au-Yeung F, Zurbau A, Ho H, Li D and Smircic-Duvnjak L (2020) Effect of soluble-viscous dietary fibre on coronary heart disease risk score across 3 population health categories: data from randomized, double-blind, placebo-controlled trials, Applied Physiology, Nutrition, and Metabolism, 10.1139/apnm-2019-0728, 45:7, (801-804), Online publication date: 1-Jul-2020. Warner E, Nannarone M, Smail-Crevier R, Manuel D, Lashewicz B, Patten S, Schmitz N, MacQueen G and Wang J (2020) The relationship between depression risk perception and self-help behaviours in high risk Canadians: a cross-sectional study, BMC Public Health, 10.1186/s12889-020-08983-0, 20:1, Online publication date: 1-Dec-2020. Wallisch C, Heinze G, Rinner C, Mundigler G, Winkelmayer W and Dunkler D (2020) Re-estimation improved the performance of two Framingham cardiovascular risk equations and the Pooled Cohort equations: A nationwide registry analysis, Scientific Reports, 10.1038/s41598-020-64629-6, 10:1, Online publication date: 1-Dec-2020. Kim J, Yu M, Kim Y, Min S, Ha J, Lee J, Kim D, Oh K, Joo K, Ahn C, Kim Y and Lee H (2019) Ratio of triglyceride to high-density lipoprotein cholesterol and risk of major cardiovascular events in kidney transplant recipients, Clinical and Experimental Nephrology, 10.1007/s10157-019-01776-9, 23:12, (1407-1417), Online publication date: 1-Dec-2019. Gomez-Sanchez L, Gomez-Marcos M, Patino-Alonso M, Recio-Rodriguez J, Gomez-Sanchez M, González-Sánchez J, Alonso-Domínguez R, Sánchez-Aguadero N, Maderuelo-Fernandez J, Ramos R, Garcia-Ortiz L and Rodriguez-Sanchez E (2019) Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study, Medicina Clínica (English Edition), 10.1016/j.medcle.2019.01.035, 153:9, (351-356), Online publication date: 1-Nov-2019. Lee K, Yong H, Lee J, Kang E and Na J (2018) Is the epicardial adipose tissue area on non-ECG gated low-dose chest CT useful for predicting coronary atherosclerosis in an asymptomatic population considered for lung cancer screening?, European Radiology, 10.1007/s00330-018-5562-4, 29:2, (932-940), Online publication date: 1-Feb-2019. Gibson C, Kerneis M, Yee M, Daaboul Y, Korjian S, Mehr A, Tricoci P, Alexander J, Kastelein J, Mehran R, Bode C, Lewis B, Mehta R, Duffy D, Feaster J, Halabi M, Angiolillo D, Duerschmied D, Ophuis T and Merkely B (2019) The CSL112-2001 trial: Safety and tolerability of multiple doses of CSL112 (apolipoprotein A-I [human]), an intravenous formulation of plasma-derived apolipoprotein A-I, among subjects with moderate renal impairment after acute myocardial infarction, American Heart Journal, 10.1016/j.ahj.2018.11.008, 208, (81-90), Online publication date: 1-Feb-2019. ter Wee M and Lissenberg-Witte B (2019) To Predict or not to Predict? A Quick Guide on How to Conduct Medical Research, 10.1007/978-90-368-2248-0_7, (189-227), . Wang J, MacQueen G, Patten S, Manuel D, Lashewicz B and Schmitz N (2019) A randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of developing major depression: a research protocol, BMC Psychiatry, 10.1186/s12888-019-2270-9, 19:1, Online publication date: 1-Dec-2019. Gavriilaki E, Gkaliagkousi E, Sakellari I, Anyfanti P, Douma S and Anagnostopoulos A (2019) Early Prediction of Cardiovascular Risk after Hematopoietic Cell Transplantation: Are We There Yet?, Biology of Blood and Marrow Transplantation, 10.1016/j.bbmt.2019.07.012, 25:10, (e310-e316), Online publication date: 1-Oct-2019. Sarfo F, Nichols M, Gebregziabher M, Tagge R, Asibey S, Jenkins C and Ovbiagele B (2019) Evaluation of Vascular Event Risk while on Long-term Anti-retroviral Suppressive Therapy [EVERLAST]: Protocol for a prospective observational study, eNeurologicalSci, 10.1016/j.ensci.2019.100189, 15, (100189), Online publication date: 1-Jun-2019. van Bronswijk S, Lemmens L, Keefe J, Huibers M, DeRubeis R and Peeters F (2018) A prognostic index for long-term outcome after successful acute phase cognitive therapy and interpersonal psychotherapy for major depressive disorder, Depression and Anxiety, 10.1002/da.22868, 36:3, (252-261), Online publication date: 1-Mar-2019. Dimberg L, Eriksson B and Hashem M (2019) Myocardial infarction and death findings from a 22-year follow-up of a cohort of 980 employed Swedish men, Public Health, 10.1016/j.puhe.2019.07.006, 175, (148-155), Online publication date: 1-Oct-2019. Cifkova R (2019) Arterial Hypertension and Cardiovascular Risk Management of Hypertension, 10.1007/978-3-319-92946-0_3, (57-74), . Rojas C, Ramírez H, Salazar L, Kalergis A, Gálvez A and Escobar‐Vera J (2019) Characterization of LDLR rs5925 and PCSK9 rs505151 genetic variants frequencies in healthy subjects from northern Chile: Influence on plasma lipid levels , Journal of Clinical Laboratory Analysis, 10.1002/jcla.23001, 33:9, Online publication date: 1-Nov-2019. Kotalik A, Eaton A, Lian Q, Serrano C, Connett J and Neaton J (2019) A win ratio approach to the re-analysis of Multiple Risk Factor Intervention Trial, Clinical Trials, 10.1177/1740774519868233, 16:6, (626-634), Online publication date: 1-Dec-2019. An Y, Yun S, Yang I, Kim D and Yang D (2019) Predictive Performance of Ultrasound-Determined Non-Alcoholic Fatty Pancreas Disease Severity for Intermediate and High Risk of Coronary Heart Disease, Journal of the Korean Society of Radiology, 10.3348/jksr.2019.80.6.1190, 80:6, (1190), . Sakaki J, Melough M, Lee S, Pounis G and Chun O (2019) Polyphenol-Rich Diets in Cardiovascular Disease Prevention Analysis in Nutrition Research, 10.1016/B978-0-12-814556-2.00010-5, (259-298), . Gomez-Sanchez L, Gomez-Marcos M, Patino-Alonso M, Recio-Rodriguez J, Gomez-Sanchez M, González-Sánchez J, Alonso-Domínguez R, Sánchez-Aguadero N, Maderuelo-Fernandez J, Ramos R, Garcia-Ortiz L and Rodriguez-Sanchez E (2019) Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study, Medicina Clínica, 10.1016/j.medcli.2019.01.033, 153:9, (351-356), Online publication date: 1-Nov-2019. Chen G, Gao L and Li X (2019) Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis, Renal Failure, 10.1080/0886022X.2019.1611602, 41:1, (408-418), Online publication date: 1-Jan-2019. Rosenblit P (2019) Extreme Atherosclerotic Cardiovascular Disease (ASCVD) Risk Recognition, Current Diabetes Reports, 10.1007/s11892-019-1178-6, 19:8, Online publication date: 1-Aug-2019. Disouza J, Patil K, Kakade P and Patravale V (2019) Dietary Fibers and Nutraceuticals in Prevention of Hypertension Nutraceutical and Functional Foods in Disease Prevention, 10.4018/978-1-5225-3267-5.ch007, (192-232) Charles‐Schoeman C, DeMasi R, Valdez H, Soma K, Hwang L, Boy M, Biswas P and McInnes I (2019) Risk Factors for Major Adverse Cardiovascular Events in Phase III and Long‐Term Extension Studies of Tofacitinib in Patients With Rheumatoid Arthritis , Arthritis & Rheumatology, 10.1002/art.40911, 71:9, (1450-1459), Online publication date: 1-Sep-2019. Sánchez-Acevedo M, Acosta-Chí Z, Sabino-Moxo B, Márquez-Domínguez J and Canton-Croda R (2019) Big Data Analysis for Cardiovascular Diseases Coronary and Cardiothoracic Critical Care, 10.4018/978-1-5225-8185-7.ch004, (60-77) Plante T, Juraschek S, Zakai N, Tracy R and Cushman M (2019) Comparison of Frequency of Atherosclerotic Cardiovascular Disease Events Among Primary and Secondary Prevention Subgroups of the Systolic Blood Pressure Intervention Trial, The American Journal of Cardiology, 10.1016/j.amjcard.2019.08.028, 124:11, (1701-1706), Online publication date: 1-Dec-2019. Nakas G, Bechlioulis A, Marini A, Vakalis K, Bougiakli M, Giannitsi S, Nikolaou K, Antoniadou E, Kotsia A, Gartzonika K, Chasiotis G, Bairaktari E, Katsouras C, Triantis G, Sionis D, Michalis L and Naka K (2019) The importance of characteristics of angina symptoms for the prediction of coronary artery disease in a cohort of stable patients in the modern era, Hellenic Journal of Cardiology, 10.1016/j.hjc.2018.06.003, 60:4, (241-246), Online publication date: 1-Jul-2019. Buettner R and Schunter M (2019) Efficient machine learning based detection of heart disease 2019 IEEE International Conference on E-health Networking, Application & Services (HealthCom), 10.1109/HealthCom46333.2019.9009429, 978-1-7281-0402-7, (1-6) Albarqouni L, Doust J, Magliano D, Barr E, Shaw J and Glasziou P (2019) External validation and comparison of four cardiovascular risk prediction models with data from the Australian Diabetes, Obesity and Lifestyle study, Medical Journal of Australia, 10.5694/mja2.12061, 210:4, (161-167), Online publication date: 1-Mar-2019. Liu Y, Li Q, Chen S, Wang X, Zhou Y, Tan N and Chen J (2018) A Simple Modified Framingham Scoring System to Predict Obstructive Coronary Artery Disease, Journal of Cardiovascular Translational Research, 10.1007/s12265-018-9837-6, 11:6, (495-502), Online publication date: 1-Dec-2018. Hermansson J and Kahan T (2017) Systematic Review of Validity Assessments of Framingham Risk Score Results in Health of Therapies in Online publication date: M, V, J, E, C, G, L and A (2018) levels in and as markers of and adipose tissue BMC Online publication date: 1-Dec-2018. H, T, D and E (2018) Risk Factors for Heart Disease International on Medical and (1-6) J, B, Wang J, S, S, C, S, C and MacQueen G (2018) for of the study, BMC Psychiatry, Online publication date: 1-Dec-2018. A, M, and M (2017) of in research the review of the of the Framingham Journal of Medical Online publication date: C, J, J, C, J, E, J, D and F (2018) Online publication date: T, G and E (2018) The of in for Primary Prevention of Cardiovascular Diseases in Current Cardiovascular Risk Reports, Online publication date: M, D, M, M and M (2018) a review of and Biomedical Online publication date: R and L (2018) The of Cardiovascular Disease Risk is the Best Risk for the Journal of and in Medical and Online publication date: H (2018) Risk Prediction in Biomedical . L, S, T, C, A, S, D, H, J, Jenkins D, C and Sievenpiper J (2018) Dietary and Cardiovascular Disease: A Systematic Review and of Trials, in Cardiovascular Online publication date: H (2018) Risk Prediction of Cardiovascular Research and Medicine, . Most J, L, S, H, E and L (2018) improvement in health in healthy individuals and American Journal of and Metabolism, Online publication date: J, B, F, I, M, M, M, E, N, A, M, L, T, D, J and Neaton J (2018) Which with high from of A of the trial, The Online publication date: J, C, E, N, E and N (2018) Risk Factors in Cardiovascular Disease Risk Online publication date: R, K, R, W and L (2018) The of the model for prognostic in health a review, and Research, Online publication date: 1-Dec-2018. S and I (2018) Clínica Online publication date: M, I and D (2017) The cardiovascular of of and International Journal of and Nutrition, Online publication date: T and S (2018) assessment of to health in patients with cardiovascular disease in BMC Health Services Research, Online publication date: 1-Dec-2018. C, L, A, A, M, M, V, A, M, N, A and A (2018) Is With a Risk of Atherosclerosis in Patients on Journal of Online publication date: Sánchez-Acevedo M, Acosta-Chí Z, Sabino-Moxo B, Márquez-Domínguez J and Canton-Croda R (2018) Big Data Analysis for Cardiovascular Diseases Big Data Management and the of for Health V, J, S, J, J, S and R (2018) Cardiovascular Risk Prediction Underestimate Risk in Online publication date: X, Wang X, Y, Chen S, Zhang R, Li L, Yu B and J (2017) Impact of Smoking and Smoking on as by The American Journal of Cardiology, Online publication date: S, J and R (2017) Cardiovascular Disease and Blood Pressure & Online publication date: J, I, M, D, B, R and de A (2017) of in a general population Clínica Online publication date: Marini A, Naka K, Vakalis K, Bechlioulis A, Bougiakli M, Giannitsi S, Nikolaou K, Antoniadou E, Gartzonika C, Chasiotis G, Bairaktari E, Katsouras C, Triantis G, Sionis D and Michalis L (2017) of coronary artery disease in patients for stable or acute coronary Hellenic Journal of Cardiology, Online publication date: V, A, P, R and S (2017) of a in Fibers and at Low in in and Nutrition . M, K, D and M (2017) E de Medicina Online publication date: E, R, C, T, S, W and N and of that and the risk of cardiovascular Diabetes, Obesity and Metabolism, 19:1, Online publication date: Jenkins D, B, F, M, P, A, A, W, M, de R, C, N, Jenkins A, S and N (2017) Effect of Current Dietary on and Cardiovascular Risk Journal of the American of Cardiology, Online publication date: S, L, Y, F, Zhang S, Li D, W, Zhang X, D and X (2017) of and traditional risk factors the performance of coronary heart disease Online publication date: O, D and G Efficacy of on for Cardiovascular Disease Risk Reduction among a Review of the Journal of and Health Online publication date: Most J, V, L and L (2017) in An update, Ageing Research Online publication date: J, K, E, C, T, B, N, T, Li Q, A and Peiris D (2017) of for with cardiovascular Australian Journal of Primary Health, 23:5, . Lee S, Yun S, Kim D, H and Park Y (2017) Severity of disease on and risk of coronary heart Journal of Clinical 45:7, Online publication date: H and L (2017) An early risk of coronary heart using model International Conference on of Data and Online publication date: J The and Medical Online publication date: E, N and A (2017) for of Research
In her excellent editorial, “Rising from the ashes: affirming the spirit of courage, community resilience, compassion and caring,” Professor Alison Kitson raised several pertinent issues around caring in and for the world that we live in, set against the devastation caused by the Australian bushfires (Kitson, 2020). Whilst watching the horrendous television footage of the Australian disaster unfolding at the beginning of the year, another news item was beginning to gain momentum, the emergence of an unknown coronavirus disease in Mainland China. Once more, we witnessed dreadful humanitarian images that looked like footage from a science fiction movie, sick people being heralded into makeshift camps by individuals in protective suits. However, once again it was not a movie, it was very real. Living in Hong Kong, the emergence COVID-19 immediately drew parallels with the 2003 severe acute respiratory syndrome (SARS) outbreak, which brought devastation to the region. The profound impact that SARS had upon the people of Hong Kong can still be clearly seen seventeen years later; people habitually wearing protective facemasks, communally touched surfaces in public places being regularly disinfected, antibacterial hand gel dispensers located throughout all shopping centres, and public toilets that are amongst the cleanest in the world. The intent to prevent another SARS-like infection in Hong Kong is clear for all to see; however, that all changed at the end of last year with the emergence of novel coronavirus in Mainland China, Quickly, cases were confirmed in Hong Kong and the fear of another pandemic lead rapidly to a pandemic of fear. People were panic buying, prices were rising, and supermarket shelves were very quickly stripped of essential food items and basic cleansing products. It was impossible to turn on the television without being told about the importance wearing surgical masks, how to wear surgical masks, the surgical masks celebrities were wearing and the danger of wearing “fake” surgical masks. Interestingly, limited attention was being given to the effectiveness of wearing a surgical facemask in the face of viral infection. Surgical masks were, and still are, in very short supply and retail prices have increased sharply. One enduring television image of recent weeks has been the sight of older people standing in line overnight in cold weather to get a small package of surgical masks hoping to protect themselves from the virus. Perhaps, all of these activities mask the truly important public health message that good personal hygiene and effective handwashing is the most effective way to curb the spread of the virus. As clinical nurses, we all know that engaging in these actions will outweigh the benefits of wearing any surgical mask. SARS generated a lot of very influential nursing research, particularly in the field of infection control nursing. The Journal of Clinical Nursing published several significant papers that highlighted the emotional impact of caring at the time of SARS and dealt with some of the other lessons that could be learnt from the outbreak, in terms of evaluating systems of care delivery and use of nursing care models (Watson, 2009). It was hoped that research generated during this period would help the international nursing community be in a better position to deal more effectively with any subsequent viral outbreaks. With the emergence of COVID-19, that was about to be tested. Would healthcare managers and hospital administrators understand what is really needed to support nursing practice and ensure the provision of high quality of care? Would they deliver this time? It was clear that amidst a worsening humanitarian crisis in Wuhan and the surrounding regions of China that uncertainty was rife. Despite widespread efforts in the Chinese mainland to combat the control and spread of COVID-19, including the very quick construction of purpose-built hospitals; at the time of writing, many large cities remain in complete “lock down,” with an ongoing massive quarantine of over 50 million people. COVID-19 was about to show no respect for geographical borders and to test whether the world was ready to deal effectively with a health risk of such high magnitude. Reflecting on this situation at the beginning of the year, it was possible to see that there were parallels in relation to issues of caring, compassion, courage and resilience between the struggle with the COVID-19 and those of the Australian disaster, as outlined by Alison Kitson (2020). This editorial sets out to examine some of these issues that are closely associated with the nursing profession. Historically, nurses have always played an important role in infection prevention, infection control, isolation, containment and public health, as initially advocated by Florence Nightingale. Providing these aspects of care at this capricious time, our clinical nursing colleagues in China and around the world are working under enormous pressure to battle this life-threatening viral infection. Worryingly, it is clear that many of these nurses and healthcare professionals are not only fighting the virus, they are also fighting the humanitarian crisis with limited protective supplies, putting their own lives on the line. Howard Catton (ICN CEO) commended the courage and compassion that has been shown by Chinese nurses, stressing the importance of them having access to the correct safety equipment and clothing at this time. However, there have been numerous reports of shortages of even the basic personal protective equipment, such as masks and protective suits (ICN, 2020). It has even been reported that in some rural Chinese hospitals, clinical staff have resorted to wearing their raincoats and using plastic bags as a source of protection (Buckley, Wee, & Qin, 2020). World Health Organization Director-General Mr Tedros hailed healthcare workers as “the glue that holds the health system and the outbreak response together” (WHO, 2020). Indeed, the WHO provides very comprehensive guidelines for the protection of front-line healthcare workers when faced with such an epidemic. The question is how can nurses adhere to such guidance when they are starved of even the most basic personal protective equipment? How adhesive can “the glue” be in the face of such adversity? One third of all fatalities during the 2003 SARS outbreak in China were healthcare professionals (Hung, 2003); at the time of writing, COVID-19 has already accounted for the lives of eight healthcare professionals (Griffiths, 2020). Healthcare-associated amplification of transmission of emerging viral infections is always a concern; surely, lessons should have been learnt about the importance of occupational protection during previous epidemics, including the Middle East respiratory syndrome (MERS) outbreak in 2012. Clearly, some lessons have not been learnt, as clinical nurses in China who are battling the virus are working around the clock and some are not eating food so as to avoid the need for toilet breaks (Thiagarajan, 2020). Nursing staff need to change their protective gear if they take a toilet break; therefore, some have resorted to wearing diapers and there are even stories of nurses shaving their heads to reduce spread of infection and to allow them to be able to change their protective gear more quickly (Farber, 2020). Stories of nursing courage and compassion are bounteous; however, the narrative of Nurse Yao, captured by the BBC, is one which is particularly touching. Her day-to-day job was in a fever clinic, she decided not to celebrate Chinese Lunar New Year with her family and chose to volunteer to work in a hospital in the epicentre of the virus. In a moving narrative, she expressed her strong devotion to care for those with the virus, reporting long working shifts “at the end of the shift, when we take off our suits, we find our clothes are completely wet with sweat” and exhaustion “nursing staff would collapse at the end of their shift and they were too tired to walk home.” Despite working in such adversity, Nurse Yao chose to highlight the positive aspects of her work with her nursing colleagues “the virus brings us all together, it unites us.” (BBC, 2020a). The word resilience is used a lot these days, and it has become something of a buzzword in nursing, leading to criticism from within and out with our profession. However, if we view resilience as “the ability of an individual to withstand adversity” (Jackson, Firtko, & Edenborough, 2007 p3), then Nurse Yao embodies what it is to have resilience in nursing. During the last few weeks, there have been unprecedented levels of misinformation, conspiracy theories, fake news and rumours related to COVID-19, these can only be counterproductive in the fight against the current epidemic. Perhaps, this is the first major disease outbreak that poses a global threat in the age of social media. Accounts vary, but it is clear that social media and sensationalist reporting of the outbreak have generated panic and mistrust in the general public, not only diverting attention away from the response to outbreak but also impeding the activities of already stretched healthcare professionals. Hopefully, we and the general public can gain some reassurance because the WHO are using their Information Network for Epidemics platform to track for false information in numerous languages and are working with social media providers, including Facebook, Twitter and Weibo (a Chinese blog platform) to help filter out such misinformation. Conceivably, COVID-19 will provide an opportunity to put into practice some of the lessons we learn from studies of social media during this outbreak, specifically in relation to the dynamics of online heroisation and blame. However, it does remain difficult to know what to believe with the current media coverage of COVID-19. Remarkably, the WHO have deemed it necessary to circulate a statement indicating several measures, that have been touted online and in social media, which are not effective in the treatment of COVID-19 including taking excessive vitamin C, smoking (yes seriously!), wearing multiple surgical masks and self-medicating with antibiotics. The WHO also provides “Open WHO,” which offers free and reliable health-related information to the world. In China, medical advertisers have not missed the opportunity to capitalise on the outbreak of COVID-19, reporting that one traditional Chinese herbal remedy may be effective in the prevention and treatment of the COVID-19 (Heymann & Shindo, 2020). This remedy has now sold out across China, despite the fact that there is presently very limited evidence to support the claims; indeed due to the nature of the illness, it may actually produce counterproductive effects. It is also somewhat ironic that the most likely crossover of the virus took place at a wet market, selling the very foods and remedies that are used in traditional health practices to promote immunity and longevity. The scientific community certainly needs more high-quality rigorous research into the issues surrounding the combined use of Western and Chinese medicine in the prevention and treatment of disease. As well as stories of courage and strength, times of crisis have been known to bring out the darker side of human nature. Historically, the response to new diseases and other catastrophic events have been known to evoke feelings of mistrust, hatred, fear and outright racism. It has been shocking to hear the nature and the extent of anti-Chinese racism and stereotyping that has been reported around the world (BBC, 2020c). From “coronavirus student parties” to the outright ban of people of Chinese ethnicity from many restaurants, it would appear once again that the fear of pandemic has further stoked a pandemic of fear. Healthcare professionals have not been exempt from such expression of hatred and racism, the BBC reported one Filipino cardiac nurse in England being asked to “stop spreading the virus” whilst on public transportation (BBC, 2020b). Such levels of xenophobia and racial profiling are utterly abhorrent and have no place in a modern civilised society. Unfortunately, racism in the face of humanitarian disasters has a much longer history than that of the current COVID-19 outbreak. Human catastrophes are not just the result of natural phenomenon; they are linked to political, social and economic factors that create vulnerability to risk. Any response to a major disease outbreak is always deeply political. Racist fear mongering and pointing the finger of blame towards Chinese and Asian nationals may have contributed to the development of the current disaster. Several nurses and doctors have lost their lives to COVID-19, including Dr Li Wenliang who was one of the first medical doctors to express concern about the emergence of a new SARS-like illness in the Hubei province (Green, 2020). Another important lesson that should have been learnt from previous experience, such as the SARS outbreak, is the need for appropriate psychological support for the healthcare professionals. Clinical nurses, especially those working in hospitals providing front-line care for those with COVID-19, are not only vulnerable to a higher risk of infection but also mental health problems. The Journal of Clinical Nursing reported increased levels of post-traumatic stress disorders, anxiety and depression in nurses after the SARS outbreak (Thompson, Lopez, Lee, & Twinn, 2004). They may experience fears of contagion and spreading the virus to others, including loved ones. We cannot ignore the need for timely psychological support and care specialised for those affected, psychiatric treatments and appropriate mental health services need to be provided. COVID-19 presents a vast public health challenge, not only to China, but also around the world. As outlined in this editorial, it has already posed many challenges to our profession and international research community. It was only through high-quality nursing research that some of the questions raised by the SARS outbreak were answered and lessons were learned. In some ways, COVID-19 may act as a wake-up call to the world to revisit those lessons and to re-examine public health priorities. We live in a very different world from that of 2003, it is a constantly changing and very unpredictable world. Hopefully, this outbreak will provide scope and impetus for nurse researchers to address some of the key questions that have been thrown up by the current epidemic and we need to do this in a collaborative way and from an international perspective. We, as nurse researchers, should be mindful of the benefits of conducting this research with healthcare colleagues in related professions to further develop the knowledge base of the international scientific community. Despite extensive efforts, there also needs to be more international collaboration amongst government, health agencies and key stakeholders to ensure the response to the outbreak is optimised and to ensure timely dissemination of accurate information. There should not be a disconnection between those communicating the information and those requiring it, importantly the internet and social media should not become the clearing house for vital health-related information for the general public. Presently, outbreaks of COVID-19 have been declared in at least thirty countries, most markedly in Italy, Iran and South Korea (BBC, 2020d). The latter, which was badly affected by MERS outbreak in 2012, is now on its highest alert. The WHO has warned the world to brace itself in preparation for a pandemic (BBC, 2020e). As nurses, we possess invaluable information on how to deal effectively with public health issues, as Professor Kitson urged we should not be afraid to speak out on those issues. At this time of great uncertainty, the voice of the nursing profession needs to be heard by the world. Not only in the battle against COVID-19, but also in preparation for the next major health challenge. Globally, public health depends upon it.
Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Programme have collaborated to produce four Cochrane overviews of systematic reviews that synthesize current available evidence from health policy and systems research (HPSR) in rehabilitation. Each overview focuses on one of the four pillars of HPSR as identified by the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy: delivery arrangements, financial arrangements, governance arrangements, and implementation strategies. This overview examined implementation strategies, defined by EPOC as interventions designed to bring about changes in healthcare organizations, the behavior of healthcare professionals, or the use of health services by healthcare recipients. This overview aimed to synthesize current evidence on implementation strategies in rehabilitation from a health policy and systems research (HPSR) perspective. Our series of four overviews have the following overarching objectives. • To offer a broad synthesis of the existing evidence on health policy and systems interventions' effects. • To direct end-users, including policymakers, towards systematic reviews that may address their health policy questions. • To identify current research gaps and set priorities for future primary HPSR. • To pinpoint the needs and priorities for new evidence syntheses where no reliable, up-to-date systematic reviews currently exist. We searched the Epistemonikos database, the Health Systems Evidence database, and EPOC Group systematic reviews to identify reviews published between 1 January 2015 and 17 November 2024. We applied no language limitations. We included Cochrane and non-Cochrane systematic reviews of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) that evaluated the effectiveness of health policy and systems interventions for rehabilitation in health systems, specifically related to implementation strategies as defined in the EPOC taxonomy. All four overview teams collaborated to screen reviews and extract data. We used AMSTAR 2 to critically appraise the quality of the reviews. Results were analyzed descriptively and are based on reviews with ratings of high-to-moderate confidence, with low-confidence reviews reported separately. We identified 7882 systematic reviews, of which 15 met our inclusion criteria. Three reviews overlapped substantially with other reviews, and eight received low- or critically low-confidence ratings. Ultimately, four moderate- to high-confidence reviews contributed to the synthesis; two were Cochrane systematic reviews. Most primary studies were from high-income countries; none were from low-income countries. Most strategies targeting healthcare professionals (e.g. guideline dissemination, interactive workshops, opinion leaders, audit and feedback) or healthcare recipients (e.g. structured monitoring, telehealth support, counseling, motivational interviewing) included more than one component. Strategies targeting healthcare recipients' use of health services in cardiac rehabilitation may show small benefits in terms of participation (enrollment, adherence, completion), but effects on other outcomes are uncertain. The effects of strategies targeting older healthcare recipients via telehealth are uncertain. Strategies targeting healthcare professionals may have little to no effect on professional or patient and carer outcomes in stroke rehabilitation. For musculoskeletal conditions, there were no evidence-certainty ratings, so intervention effects are unclear. We found no reviews of strategies targeting health service organizations or specific types of rehabilitation practice. The evidence certainty was generally low; evidence of adverse events was missing or uncertain; and reporting on organizational, implementation, economic, and equity outcomes was scarce. Current evidence on implementation strategies in rehabilitation is limited, mostly of low certainty, and derived from high-income countries. Multicomponent, patient-targeted strategies may modestly improve cardiac rehabilitation participation, but effects in other areas remain uncertain. Further high-quality research using well-defined frameworks is needed, especially in low- and middle-income countries, to identify effective strategies and evaluate organizational, implementation, and equity outcomes. Future Cochrane overviews of reviews in HPSR should consider including a broader range of study designs, such as observational, qualitative, and mixed-methods evidence, to better capture evidence on implementation strategies in rehabilitation. This Cochrane review was funded by the Italian Ministry of Health (Ricerca Corrente). The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The protocol was first published in the European Journal of Physical and Rehabilitation Medicine online on 27 January 2025. The manuscript was received on 11 November 2024 and was accepted on 26 November 2024. DOI 10.23736/S1973-9087.24.08833-6.
Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Programme have collaborated to produce four Cochrane overviews of systematic reviews that synthesize current available evidence from health policy and systems research (HPSR) in rehabilitation. Each overview focuses on one of the four pillars of HPSR as identified by the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy: delivery arrangements, financial arrangements, governance arrangements, and implementation strategies. This overview focuses on financial arrangements, which Cochrane EPOC defines as changes in how funds are collected, how insurance schemes are structured, how services are purchased, and the use of targeted financial incentives or disincentives. This overview aimed to synthesize the current evidence on financial arrangements in rehabilitation from a health policy and systems research (HPSR) perspective. Our series of four overviews, incorporating evidence on governance arrangements, delivery arrangements, financial arrangements, and implementation strategies, have the following overarching objectives. • To offer a broad synthesis of the existing evidence on health policy and systems interventions' effects. • To direct end-users, including policymakers, towards systematic reviews that may address their health policy questions. • To identify current research gaps and set priorities for future primary HPSR. • To pinpoint the needs and priorities for new evidence syntheses where no reliable, up-to-date systematic reviews currently exist. We searched the Epistemonikos database, the Health Systems Evidence database, and EPOC Group systematic reviews to identify reviews published between 1 January 2015 and 17 November 2024. We applied no language limitations. We included Cochrane and non-Cochrane systematic reviews of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) that evaluated the effectiveness of health policy and systems interventions for rehabilitation in health systems, specifically related to financial arrangements as defined in the EPOC taxonomy. All four overview teams collaborated to screen reviews and extract data. We used AMSTAR 2 to critically appraise the quality of the reviews. Reviews with ratings of high-to-moderate confidence are reported separately from low-confidence reviews. We identified two non-Cochrane systematic reviews relevant to rehabilitation and the EPOC category of financial arrangements. We excluded one review from the synthesis due to low methodological quality. The other review included 18 primary studies, but only one study reported data relevant to rehabilitation. This study, conducted in a single country (China), compared insured and uninsured children aged birth to 17 years with intellectual disabilities, focusing on the likelihood of receiving at least one rehabilitation service. The review reported that, based on this single study, enrollment in social health insurance, national health insurance, or community-based health insurance schemes may be ⁠⁠⁠⁠⁠⁠⁠associated with increased utilization of mental health services, including outpatient rehabilitation. However, due to the complexity and variability of mental health service utilization across contexts, the review authors noted that it was difficult to draw definitive conclusions about the overall impact of insurance enrollment on mental health outcomes and services. We identified two non-Cochrane systematic reviews aligned with the EPOC classification of financial arrangements that addressed rehabilitation. One review including one single-center study on rehabilitation offered low-certainty evidence on insurance schemes and access to rehabilitation services. As a result, this overview cannot provide a clear understanding of the effects of financial arrangements for rehabilitation or offer meaningful signposts to end-users, including policymakers. Future Cochrane overviews in HPSR should broaden their scope to include qualitative and mixed-methods study designs. Robust primary studies and inclusive systematic reviews are urgently needed to guide financial policy decisions that integrate rehabilitation into resilient and equitable health systems. PC, CK, and SN were supported and funded by the Italian Ministry of Health (Ricerca Corrente). The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Protocol (2025): DOI 10.23736/S1973-9087.24.08833-6.
This paper outlines the design and development of a 3-year undergraduate pre-registration mental health nursing curriculum in the United Kingdom. It resists the trend towards generic nurse education, reclaims mental health field-specific identity and equips future nurses with the knowledge, skills and values to meet the complex mental health needs of contemporary populations. International literature reflects growing concern over the dilution of mental health nursing knowledge and the erosion of professional identity, largely attributed to generic curriculum models and standardised regulatory frameworks. Critics argue that the dominance of adult-centric education compromises field-specific learning, perpetuating a theory-practice gap and leaving graduates underprepared for mental health practice. Calls for reform have intensified globally, yet practical examples of curriculum redesign to address these issues remain limited. Issues were approached through a comprehensive review and redesign of the current mental health nursing curriculum considering relevant pedagogical theory and international critiques of genericism in nursing education. The authors, as academic leads for the curriculum redesign, embedded field-specific modules, innovative assessments, restorative supervision and mental health-focused simulation. Heutagogy informed the pedagogical framework, aiming to produce self-determined, critically reflexive practitioners. The redesigned curriculum challenges genericism and reinstates mental health-specific content, with assessments and simulations contextualised to authentic practice. This approach strengthens professional identity, reduces reliance on artificial intelligence generated work through dialogical assessments and promotes critical thinking essential for ethical, person-centred care. Future evaluation will focus on student retention, satisfaction and preparedness for practice.
Mental health nurses can engage with people with mental health challenges and their families due to their presence on acute mental health units. This presence helps to facilitate recovery-focused care within a physically and emotionally safe environment. Mental health care should be person-centred, individualised, and include wherever possible family and other people in the person's support network. The objective of this systematic review was to explore the existing qualitative literature that describes experiences of collaboration between people with lived experience of mental health challenges, their family members, and nurses in relation to changes in mental state during an admission to an acute mental health unit. Qualitative systematic review. The Joanna Briggs Institute methodology for systematic reviews of qualitative evidence was followed, including the JBI quality appraisal checklist. The databases searched were CINAHL, Medline, Scopus, Emcare and PsycInfo. Included articles were written in English and published between January 2013 and September 2023. Data was extracted that provided the perspectives of adults (18-64 years), their family members and nurses (collectively known as the "Triangle of Care") regarding communication when mental state changes during an acute mental health admission to a public hospital. Perspectives of the three groups were explored separately then synthesised. The ConQual approach was used to assess confidence in the findings. This review included articles on the lived experience perspective (n = 17), the family perspective (n = 1), and the nurse perspective (n = 13). The identified articles presented common perspectives on how to facilitate person-first nursing care that is supportive of personal recovery, including the provision of one-to-one discussions and inviting input from family members. Nurses, in particular, highlighted systemic barriers and facilitators to the focus on personal recovery in clinical practice. Communication between the three members of the "Triangle of Care" is essential for the identification of mental state changes as a critical aspect of providing nursing care that promotes personal recovery. All three members of the "Triangle of Care" highlighted the importance of making time for one-on-one conversations, which are impacted by other factors such as competing demands on time and confidentiality. Further research is indicated to improve clinical practice and service provision, with extant research being particularly sparse in non-Western and non-English speaking regions. Literature Review Protocol: Prospero registration number: CRD420250639443.
Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Programme have collaborated to produce four Cochrane overviews of systematic reviews synthesizing evidence from health policy and systems research (HPSR) in rehabilitation. Each overview focuses on one of the four HPSR pillars identified by the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy: delivery, financial, and governance arrangements; and implementation strategies. This overview addresses delivery arrangements, which Cochrane EPOC defines as how health services are organized and delivered, including who provides care, how care is coordinated and managed, and where services are provided. This overview aimed to synthesize current evidence on delivery arrangements in rehabilitation from an HPSR perspective. Our series of four overviews has the following overarching objectives. • To offer a broad synthesis of existing evidence on health policy and systems interventions' effects. • To direct end-users, including policymakers, towards systematic reviews that may address their health policy questions. • To identify current research gaps and set priorities for future primary HPSR. • To pinpoint needs and priorities for new evidence syntheses where no reliable, up-to-date systematic reviews currently exist. We searched Epistemonikos Health Systems Evidence databases and EPOC Group systematic reviews with no language limitations to identify reviews published between 2015 and 17 November 2024. We included Cochrane systematic reviews (CSRs) and non-CSRs of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) evaluating the effectiveness of health policy and systems interventions for rehabilitation in health systems, specifically related to delivery arrangements as defined in the EPOC taxonomy. All four overview teams screened reviews and extracted data. We used AMSTAR 2 to critically appraise the reviews, and we analyzed the results descriptively. We included 25 systematic reviews. Three overlapped, and for 17 the AMSTAR 2 rating was low or critically low confidence. Five systematic reviews (2 CSRs and 3 non-CSRs) contributed to our synthesis. Most outcomes focused on patients, caregivers, or service use (e.g. access to rehabilitation). Equity-related outcomes were absent, and quality of care, adverse events, and our important outcomes were rarely reported. Below, we report the results of three of the five reviews judged to have moderate to high confidence for our outcomes of interest, in which authors conducted meta-analysis and assessed the certainty of the evidence. Who provides care One review analyzed advanced practice physiotherapy (APP) models, which may result in little to no difference in health-related outcomes measured by the Pain Disability Index and EuroQol 5-Dimension questionnaire after the intervention, compared with usual care in adults with spinal pain (standardized mean difference [SMD] 0.05, 95% confidence interval [CI] -0.32 to 0.42; 2 studies, 225 participants; low certainty). Information and communication technology We included two reviews in this category. One compared telerehabilitation with usual care in older adults, finding that telerehabilitation may have little or no effect on quality of life after seven to 20 weeks (SMD -0.09, 95% CI -0.23 to 0.40; 3 studies, 179 participants; low certainty). There was very low-certainty evidence on mobility after seven to 26 weeks (SMD 0.63, 95% CI -0.25 to 1.51; 5 studies, 302 participants), strength after 12 and 26 weeks (SMD 0.73, 95% CI -0.10 to 1.56; 4 studies, 226 participants), and balance after seven to 26 weeks (SMD 0.40, 95% CI -0.35 to 1.15; 3 studies, 199 participants). Another review on stroke survivors living in the community found that telerehabilitation compared with usual care probably has little or no effect on independence in activities of daily living (ADL) after 24 weeks (SMD 0.00, 95% CI -0.15 to 0.15; 2 studies, 661 participants; moderate certainty), self-reported quality of life after six to 24 weeks (SMD 0.03, 95% CI -0.14 to 0.20; 3 studies, 569 participants; moderate certainty), and depression after six to 24 weeks (SMD -0.04, 95% CI -0.19 to 0.11; 6 studies, 1145 participants; moderate certainty); and may have little or no effect on upper limb function after 12 weeks (SMD 0.33, 95% CI -0.21 to 0.87; 2 studies, 54 participants; low certainty) and mobility after six weeks (mean difference 0.01, 95% CI -0.12 to 0.14; 1 study; 144 participants; low certainty). This review also compared telerehabilitation with in-person rehabilitation and found that there may be little to no difference in independence in ADL, measured with the Modified Barthel Index at four to 12 weeks (MD 0.59, 95% CI -5.50 to 6.68; 2 studies, 75 participants; low certainty); balance, measured with the Berg Balance Scale at four to 12 weeks (MD 0.48, 95% CI -1.36 to 2.32; 3 studies, 106 participants; low certainty); and upper limb function, evaluated with the Fugl-Meyer Assessment (Upper Extremity) four weeks after intervention (MD 1.23, 95% CI -2.17 to 4.64; 3 studies, 170 participants; low certainty). Current evidence on delivery arrangements in rehabilitation is limited, mostly of low certainty, and derived from high-income countries. Reviews covered five EPOC categories, but reliable evidence for our outcomes of interest was available for only two categories. Most evidence was on telerehabilitation. Compared with usual care, APP models may have little to no effect on health outcomes in adults with spinal pain. In people with stroke, telerehabilitation compared with usual care probably has little or no effect on independence in daily living, quality of life, and depression, and may have little to no effect on upper limb function and mobility. Compared with in-person care, telerehabilitation may have little to no effect on ADL, balance, and upper limb function. Further high-quality research using well-defined frameworks is needed, especially in low- and middle-income countries, to identify effective strategies and evaluate organizational, implementation, and equity outcomes. Future Cochrane overviews in HPSR should consider a broader range of study designs, such as observational, qualitative, and mixed-design evidence, to better capture evidence on delivery arrangements in rehabilitation. PC, CK, and SN were supported and funded by the Italian Ministry of Health (Ricerca Corrente). The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Protocol (2025): DOI 10.23736/S1973-9087.24.08833-6.
The therapeutic use of self, first articulated by Peplau in the 1950s, remains fundamental to mental health nursing practice, yet continues to be interpreted in diverse ways. This paper reports findings of a qualitative descriptive study, situated within a constructivist paradigm, exploring how experienced Australian mental health nurses understand and apply the therapeutic use of self in contemporary recovery-oriented contexts. Eleven mental health nurses participated in semi-structured interviews, with data analysed using reflexive thematic analysis. Three interrelated themes were developed: 'Diverse conceptualisations of the therapeutic use of self'; 'The prominence of self-disclosure'; and 'The nurse as a therapeutic instrument'. Participants described the therapeutic use of self as an intentional and reflective use of the professional self to foster connection, presence and trust. While the value of self-awareness and relational authenticity was acknowledged, self-disclosure emerged as a significant, ethically bounded strategy within a broader reflective orientation. By recognising the diverse conceptualisations of the therapeutic use of self, this study offers a more integrative formulation of the practice as relational, contextual and also experiential, with the prominence of self-disclosure reflecting evolving socio-cultural and recovery-oriented frameworks. Such recognition strengthens shared professional language, education and critical reflection in mental health nursing practice.