Aim: One of the greatest challenges in responding to the COVID-19 pandemic is preventing staff exposure and infection by ensuring consistent and effective use of personal protective equipment (PPE). This study explored health care workers' experience of prolonged PPE use in clinical practice settings and their concerns regarding PPE supply, effectiveness and training needs. Design: A descriptive cross-sectional design was adopted in this study. Methods: Health care workers (N = 592) from an acute care hospital completed an online survey from July to September 2020 assessing: (i) usage frequencies, side effects and interference with patient care; and (ii) perceptions of access to PPE, likelihood of exposure to infection and adequacy of PPE training. Results: PPE-related side effects were reported by 319 (53.8%) participants, the majority being nurses (88.4%) and those working in high-risk areas such as the emergency department (39.5%), respiratory wards (acute 22.3% and non-acute 23.8%) and COVID-19 isolation ward (13.8%). The average time wearing PPE per shift was 6.8 h (SD 0.39). The most commonly reported symptoms were from donning N95 masks and included: pressure injuries (45.5%), mask-induced acne (40.4%) and burning/pain (24.5%). Some 31.3% expressed that PPE-related side effects had negatively affected their work. The odds of having PPE-associated side effects was higher in women (OR 2.10, 95% CI [1.29–03.42], p =.003) and those working in high-risk wards (OR 3.12, 95% CI [2.17–4.60], p <.001]. Most (90.1%) agreed that PPE supplies were readily available, sufficient for all (86.1%) and there was sufficient training in correct PPE use (93.6%). Only 13.7% of participants reported being ‘highly confident’ of overall PPE protection. Conclusions: Prevention and management of PPE-related adverse effects is vital to: preserve the integrity of PPE, improve adherence and minimize viral transmission. Impact: The high incidence of PPE-associated pressure injuries and perception that PPE use can interfere with clinical care should inform future development of PPE products, and strategies to better equip health care workers to prevent and manage PPE-related side effects. © 2022 John Wiley & Sons Ltd.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8363362/

Aims: Increased patient activation levels can improve health outcomes. Hence, this study aims to examine the relationships between sociodemographic variables and domain-specific health literacies with patient activation. Design: A cross-sectional design. Methods: 200 outpatient adults with chronic diseases completed a survey that assessed their domain-specific health literacy and patient activation levels. Univariate and multivariate analysis of the variables were conducted on patient activation with 95% confidence interval (CI). Results: Multiple linear regression analyses observed a positive linear relationship between the following domain-specific health literacy variables—“actively manage my health” (p <.0001, 95% CI: 0.89–2.29), “understanding health information” (p =.008, 95% CI: 0.28–1.85), and “finding good health information” (p =.02, 95% CI 0.13–1.51) with patient activation. The other sociodemographic and clinical variables were not statistically significant. Increased focus from healthcare professionals is needed on helping patients better find and understand health information and encouraging them to actively manage their health; elements which would raise their activation levels.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9518944/

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus called SARS-CoV-2. It has affected over 200 countries and inflicted significant mortalities as well as disrupted the normal social and economic processes. In the absence of an established effective vaccination, the cornerstone of COVID-19 management largely depends on containment and mitigation strategies. However, it is increasingly felt that digital health can be widely used to facilitate COVID-19 pandemic management effectively, which is otherwise difficult to attain manually. Many countries depended on health technology to contain the impact of the virus. However, Singapore, a small country in the South-East Asian region demonstrated exemplary pandemic preparedness skills coupled with adoption of digital health technology to attain remarkable success in containing the virus.

https://doi.org/10.1371/journal.pone.0252008

Introduction Breast cancer is the leading cause of death in Singaporean women, with advanced stage rendering a poorer prognosis. This study aims to explore the barriers to early presentation, information needs and sources in patients with locally advanced breast cancer (LABC). Materials & methods A convenience sample of patients who presented with locally advanced breast cancer to the Department of General Surgery in a teaching tertiary hospital were recruited for the study. We conducted semi-structured interviews face to face with the recruited patients. We recorded the interviews, transcribed them verbatim and analysed using thematic content analysis. Results Twenty-three participants were recruited of which 12 were Chinese and 11 were Malay women. Mean age was 60 years (± 13 SD). The most common knowledge barrier resulting in delay was the misconception that a breast lump must be painful to be malignant. Other knowledge barriers include the lack of knowledge and misinformation from the internet or other social media platforms. Some perceived barriers include fear of diagnosis, fear of treatment and fear of imposing financial burden on family members. A significant proportion of participants were also not aware of a national breast screening programme. Conclusions Our study has found that barriers to early presentation of women with locally advanced breast cancer remain similar and have persisted over the years despite targeted efforts. There is a need for a rethink of existing strategies and to develop new innovative ways to reach out to this group of patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9191550/