3 results
Violent Experiences Suffered by Pre-Hospital Healthcare Workers During the COVID-19 Pandemic
- Sarper Yilmaz, Gizem Sebahat Çoban, Figen Ünal Çolak, Nihat Müjdat Hökenek, Rohat Ak
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
- Published online by Cambridge University Press:
- 21 November 2023, e533
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Objective:
This work was carried out to determine the causes of violence against Prehospital Emergency Medical Services Personnel (PHEMSP) who performed their duties without any special security measures during the COVID-19 pandemic, and who were subjected to violence because of their work.
Method:The approach of this research is in accordance with case study design, which is concerned with the examination of unique cases. For this study, a volunteer announcement was made on social media for PHEMSPs from 3 different branches (Emergency Medical Technicians or EMTs, paramedics, and doctors) who had been actively working in ambulances during the transportation of COVID-19 patients throughout the pandemic, and who had declared that they were subjected to verbal abuse or physical violence. The data was collected through structured interviews from 60 voluntary participants.
Results:As a result of the analysis of the data, 3 main themes were revealed as the source of violence that PHEMSPs had been exposed to during the pandemic. They are the following: (1) violence caused by the nature of the disease, (2) violence caused by society, and (3) violence caused by working areas and systems. The reasons which created these themes, were accepted as codes. The codes that arose due to the theme of (1) violence caused by the nature of the disease were ‘the fear of contagion,’ ‘the requirement for disinfection,’ and ‘triage problems,’ which caused both verbal abuse and physical violence. In addition to these codes, the code of ‘stigma’ due to protective equipment was found only to elicit verbal abuse. The codes for the theme (2) ‘violence caused by society,’ were determined as societal perceptions regarding high wages, attempts to misuse health services, and distrust. All 3 of these codes were found to evoke both verbal abuse and physical violence. The codes for the theme (3) ‘violence caused by working areas and systems,’ included team mismatch in PHEMSPs, resignation ban, and long working hours, as well as mismatch between in-hospital HCWs and PHEMSPs, mobbing, feeling unsupported, and gender disadvantage. It has been revealed among these codes that only the team mismatch in PHEMSPs caused both verbal abuse and physical violence, while all the others only lead to verbal abuse.
Conclusion:If a 0 tolerance for ‘violence in the healthcare system’ is to be targeted, it should start in the pre-hospital phase and with all PHEMSPs, since this is the 0 point where the healthcare system, and patients first meet. Additionally, this group should be considered a vulnerable group for workplace violence (WPV), especially due to the COVID-19 pandemic.
Hesitancy Regarding Medical Advice on COVID-19: An Emergency Department Perspective
- Sarper Yilmaz, Figen Ünal Çolak, Nihat Müjdat Hökenek, Rohat Ak
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 16 / Issue 3 / June 2022
- Published online by Cambridge University Press:
- 20 January 2022, pp. 1141-1151
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Objective:
The rejection of or non-compliance with treatment arises for different reasons by patients who receive treatment recommendations for various diseases. These states are described by various concepts, such as discharge against medical advice (DAMA) and medication nonadherence (MNA). The basis of the study is to determine how these states have arisen during the coronavirus disease (COVID-19) pandemic.
Method:The data of this study were collected through standardized interviews with 103 volunteer participants who were diagnosed with COVID-19 at different times and who did not use their prescribed medicine during the pandemic in Turkey. The data obtained in the research were analyzed through the MAXQDA qualitative analysis program.
Results:As a result of the analysis of the data, 4 main themes and sub-codes have been reached: (1) prescribed medicine, (2) an information source for the COVID-19 period/treatment, (3) the reason for medication nonadherence, and (4) treatment of choice. When the approach toward treatment of patients who were diagnosed with COVID-19 and had started treatment by a physician was evaluated, it was revealed that the nonadherence state emerged as a cycle. In the initial period, nonadherence due to the medication itself was observed. The second period is when the patients recognize their disease and collect information from their environment. Although this period begins before the disease, the search for informative sources intensifies, especially once the diagnosis has been received. In the third period, with their diagnosis and the information they had obtained, patients consider the reasons to use the medication and then decide whether or not to use it. In the fourth period, the patients who will not use antivirals consider other medications, such as anti-flu, anticoagulant, supplements, and nutrition.
Conclusion:Since a specific treatment protocol has not yet been revealed for COVID-19, a new conceptual framework is required. In the current condition, the state of “hesitation for medical advice” arises for non-hospitalized patients.
Vaccine Hesitancy of Health-Care Workers: Another Challenge in the Fight Against COVID-19 in Istanbul
- Sarper Yilmaz, Figen Ünal Çolak, Erdal Yilmaz, Rohat Ak, Nihat Müjdat Hökenek, Mehmet Mustafa Altıntaş
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 16 / Issue 3 / June 2022
- Published online by Cambridge University Press:
- 04 August 2021, pp. 1134-1140
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Objective:
Health-care workers (HCWs) are often seen as the most reliable source of vaccine-related information for their patients; nevertheless, various studies show that HCWs experience vaccine hesitation. In this study, the aim was to determine the reasons for vaccine hesitation among HCWs working in a large public hospital and its affiliated units in Istanbul.
Methods:A descriptive method for collecting qualitative data was designed for this study. The data of the HCWs were analyzed in line with the vaccine hesitancy factors put forward by the World Health Organization (WHO).
Results:The most important vaccine hesitancy theme that emerged was the fear and lack of confidence in the vaccines, which was expressed at a higher rate than any other theme in all HCWs. The most cited reason for fear/lack of confidence in the vaccine was the fear of its side effects. It was observed that the HCWs who reported hesitation about vaccination due to pregnancy and breastfeeding consisted of women. The second most common theme for vaccine hesitation was reported as an inconvenience in accessing the vaccines. Although HCWs have priority, they stated that their reason for vaccine hesitancy was due to heavy personal issues or workloads. The final theme was about complacency, or thinking they do not need the vaccine.
Conclusions:Vaccine hesitation is a challenge that can be overcome with detailed monitoring and policy-making. Although the vaccine seems to be more significant, we do not want to see vaccine hesitancy grow more than the vaccine itself.