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Long COVID is a growing health concern with data continuing to emerge about the psychosocial consequences of this new chronic condition. We aimed to improve understanding of the experiences of patients with Long COVID, focusing on emotional impacts arising from experiences of loss and grief caused by persistent physical symptoms and changes in lifestyle and social support. Patients (n = 21) were recruited August to September 2022 from a post-COVID recovery clinic to participate in semistructured interviews. We found that Long COVID patients (1) reported experiencing loss across multiple domains including loss of physical health, mental health, social support and connections, roles in their families, and self-identities, and (2) described experiences of grief that mirrored the 5 stages of grief in the Kubler-Ross model: denial, anger, bargaining, depression, and for some, acceptance. Our findings highlight the importance of evaluating the experiences of loss and grief among Long COVID patients as well as support systems for this patient population. Providers may be encouraged to incorporate mental health and bereavement support resources to address critical needs of Long COVID patients. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections (HAIs) remain a significant patient safety problem that can lead to illness and death, despite the implementation of clinical bundles to prevent HAIs. Management practices can support HAI prevention, but their role in HAI performance monitoring and feedback is not well understood. To address this knowledge gap, we previously conducted semi-structured interviews with staff at 18 hospitals to examine the role of management practices around the prevention of central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). Interview transcripts were analyzed to identify themes related to HAI performance monitoring and feedback. The current analysis focuses on 10 higher-performing hospitals that were successful in preventing CLABSIs and CAUTIs. These institutions had robust practices including timely event analysis, leadership engagement, and multidisciplinary participation in HAI reviews. Across these sites, we found common goals including investigating HAIs without blame and identifying opportunities for improvement. Management practices such as timely analysis of HAIs, collaboration between facility leadership and multidisciplinary team members, and a focus on identifying the failure of a procedure or protocol, rather than the failure of staff members, are all approaches that can support infection prevention efforts. These management practices may be especially important as hospitals attempt to address increases in CLABSI and CAUTI rates that may have occurred during the coronavirus pandemic. [ABSTRACT FROM AUTHOR]

Shared decision-making (SDM) aims to create a context in which patients and surgeons work together to explore treatment options and goals of care. The objective of the current study was to characterize demographic factors, behaviors, and perceptions of patient involvement among surgeons relative to SDM. Using a cross-sectional survey methodology, surgeon demographics, behaviors, and perceptions of patient involvement were assessed. Surgeon approaches to SDM were measured using a 100-point scale ranging from 'patient-led' (0) to 'surgeon-led' (100). Among 241 respondents, most were male (n = 123, 67.2%) and White (n = 124, 69.3%); roughly one-half of surgeons had been in practice ≥10 years (n = 120, 52.4%). Surgeon approaches to SDM ranged from 0 to 81.0, with a median rating of 50.0 (IQR: 35.5, 62.0). Reported approaches to SDM were associated with years in practice, sharing information, and perceptions of patient involvement. Surgeons in practice 10 + years most frequently utilized a 'Shared, Patient-led' approach to SDM (27.5%), while individuals with less experience more often employed a 'Shared, Surgeon-led' approach (33.3%, p = 0.031). Surgeons with a 'Patient-led' approach perceived patient involvement as most important (M = 3.82, SD = 0.16), while respondents who had a 'Surgeon-led' approach considered this less important (M = 3.57, SD = 0.38; p < 0.001). Surgeon factors including demographics, behaviors, and perceptions of patient involvement influenced SDM approaches. SDM between patients and surgeons should strive to be more dynamic and tailored to each specific patient's needs to promote optimal patient-centered care. [ABSTRACT FROM AUTHOR]

Facilitated poetry writing workshops are used in healthcare settings as a therapeutic approach to address stressful factors that negatively influence clinician well-being. However, owing to the novelty of this intervention and a tendency to combine poetry with other types of narrative-based techniques, proponents of poetic medicine are calling for harmonization across programs in the US. This would facilitate the study of poetry in medicine and the multiple facets of well-being it is said to promote. To address these points, we partnered with a well-established poetry center to develop and study a facilitated poetry writing workshop program for palliative care and emergency medicine clinicians during the COVID-19 pandemic. Our qualitative aim was to describe how the workshop provided a creative outlet for the sharing and processing of clinician experiences. We conducted a multiple-case study of six workshop sessions using transcripts, model poems, writing prompts, and participant-created poems to describe the program's structure and processes. Our workshop contained the core components of reading, writing, and reflection; however, our program was unique in its inclusion of a website and a pre-writing component. The facilitator's instruction on and fostering the use of poetic technique coupled with website interaction were key promoters of participant engagement with their peers in the processing of complex experiences and related emotions. Healthcare systems seeking to incorporate poetry into their wellness programming may build upon our findings to create flexible workshops suited to their clinician audience and program intent., Competing Interests: Disclosures and Conflict of Interest Statement The authors have no competing financial or non-financial interests to disclose., (Copyright © 2024. Published by Elsevier Inc.)