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      Expert Consensus on Measures to Promote Physical and Psychological Health among COVID-19-Related Healthcare Workers in Korea using Delphi Technique

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          Abstract

          Background

          The coronavirus disease 2019 (COVID-19) pandemic has caused health problems and distress among healthcare workers (HCWs), so supportive measures to promote their health and relieve distress are needed.

          Materials and Methods

          We conducted two rounds of Delphi surveys with 20 COVID-19-related frontline healthcare professionals and public officials. The surveys evaluated means of supporting HCWs’ health by improving health care systems and working environments in terms of effectiveness and urgency. The validity of the measures was assessed by calculating the content validity ratio.

          Results

          The top-priority measures to support HCWs were “secure isolation units capable of treating severe cases” in the facility infrastructure category, “secure nursing staff dedicated for patients in the intensive care units” in the personnel infrastructure category, “improve communication between central office and frontline field” in the cooperation system category, “support personal protective equipment and infection control supplies” in the aid supplies category, and “realization of hazard pay” in the physical/mental health and compensation category.

          Conclusion

          There was consensus among the experts on the validity and priorities of policies in the facility, personnel, cooperation, supplies, and compensation categories regarding measures to promote COVID-19 related HCWs’ health.

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          Most cited references18

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          A QUANTITATIVE APPROACH TO CONTENT VALIDITY

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            The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus

            In December, 2019, a novel coronavirus outbreak of pneumonia emerged in Wuhan, Hubei province, China, 1 and has subsequently garnered attention around the world. 2 In the fight against the 2019 novel coronavirus (2019-nCoV), medical workers in Wuhan have been facing enormous pressure, including a high risk of infection and inadequate protection from contamination, overwork, frustration, discrimination, isolation, patients with negative emotions, a lack of contact with their families, and exhaustion. The severe situation is causing mental health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear. These mental health problems not only affect the medical workers' attention, understanding, and decision making ability, which might hinder the fight against 2019-nCoV, but could also have a lasting effect on their overall wellbeing. Protecting the mental health of these medical workers is thus important for control of the epidemic and their own long-term health. The local government of Wuhan has implemented policies to address these mental health problems. Medical staff infected with 2019-nCoV while at work will be identified as having work-related injuries. 3 As of Jan 25, 2020, 1230 medical workers have been sent from other provinces to Wuhan to care for patients who are infected and those with suspected infection, strengthen logistics support, and help reduce the pressure on health-care personnel. 4 Most general hospitals in Wuhan have established a shift system to allow front-line medical workers to rest and to take turns in high-pressured roles. Online platforms with medical advice have been provided to share information on how to decrease the risk of transmission between the patients in medical settings, which aims to eventually reduce the pressure on medical workers. Psychological intervention teams have been set up by the RenMin Hospital of Wuhan University and Mental Health Center of Wuhan, which comprise four groups of health-care staff. Firstly, the psychosocial response team (composed of managers and press officers in the hospitals) coordinates the management team's work and publicity tasks. Secondly, the psychological intervention technical support team (composed of senior psychological intervention experts) is responsible for formulating psychological intervention materials and rules, and providing technical guidance and supervision. Thirdly, the psychological intervention medical team, who are mainly psychiatrists, participates in clinical psychological intervention for health-care workers and patients. Lastly, the psychological assistance hotline teams (composed of volunteers who have received psychological assistance training in dealing with the 2019-nCoV epidemic) provide telephone guidance to help deal with mental health problems. Hundreds of medical workers are receiving these interventions, with good response, and their provision is expanding to more people and hospitals. Understanding the mental health response after a public health emergency might help medical workers and communities prepare for a population's response to a disaster. 5 On Jan 27, 2020, the National Health Commission of China published a national guideline of psychological crisis intervention for 2019-nCoV. 4 This publication marks the first time that guidance to provide multifaceted psychological protection of the mental health of medical workers has been initiated in China. The experiences from this public health emergency should inform the efficiency and quality of future crisis intervention of the Chinese Government and authorities around the world.
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              Research guidelines for the Delphi survey technique.

              Consensus methods such as the Delphi survey technique are being employed to help enhance effective decision-making in health and social care. The Delphi survey is a group facilitation technique, which is an iterative multistage process, designed to transform opinion into group consensus. It is a flexible approach, that is used commonly within the health and social sciences, yet little guidance exists to help researchers undertake this method of data collection. This paper aims to provide an understanding of the preparation, action steps and difficulties that are inherent within the Delphi. Used systematically and rigorously, the Delphi can contribute significantly to broadening knowledge within the nursing profession. However, careful thought must be given before using the method; there are key issues surrounding problem identification, researcher skills and data presentation that must be addressed. The paper does not claim to be definitive; it purports to act as a guide for those researchers who wish to exploit the Delphi methodology.
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                Author and article information

                Journal
                Infect Chemother
                Infect Chemother
                IC
                Infection & Chemotherapy
                The Korean Society of Infectious Diseases; Korean Society for Antimicrobial Therapy; The Korean Society for AIDS
                2093-2340
                2092-6448
                June 2022
                02 May 2022
                : 54
                : 2
                : 247-257
                Affiliations
                [1 ]Department of Psychiatry, National Medical Center, Seoul, Korea.
                [2 ]Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea.
                [3 ]Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Korea.
                [4 ]Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
                [5 ]Department of Infectious Diseases, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
                [6 ]Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
                [7 ]Centers for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea.
                [8 ]Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
                [9 ]Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
                [10 ]Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Jeju National University, Jeju, Korea.
                [11 ]Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
                [12 ]Department of Health Administration, Dankook University, Cheonan, Korea.
                [13 ]Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
                Author notes
                Corresponding Author: Ki Tae Kwon, MD, PhD. Division of Infectious Diseases, Kyungpook National University Chilgok Hospital, 807 Hokuk-ro, Buk-gu, Daegu 41404, Korea. Tel: +82-53-200-2616, Fax: +82-53-200-2027, ktkwon@ 123456knu.ac.kr
                Corresponding Author: Jin-Won Noh, PhD. Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, 1, Yeonsedae-gil, Heungeop-myeon, Wonju 26493, Gangwon-do, Korea. Tel: +82-33-760-2198; Fax: +82-33-760-2519, jinwon.noh@ 123456gmail.com

                *These authors contributed this work as corresponding authors.

                Author information
                https://orcid.org/0000-0002-9005-3207
                https://orcid.org/0000-0001-5172-4023
                https://orcid.org/0000-0003-4144-9077
                https://orcid.org/0000-0002-1361-9887
                https://orcid.org/0000-0003-2836-6963
                https://orcid.org/0000-0002-4538-7371
                https://orcid.org/0000-0001-7652-7093
                https://orcid.org/0000-0001-8702-1987
                https://orcid.org/0000-0001-8947-5069
                https://orcid.org/0000-0003-3334-817X
                https://orcid.org/0000-0002-1497-7037
                https://orcid.org/0000-0003-4666-0672
                Article
                10.3947/ic.2021.0137
                9259905
                35706073
                381b89eb-3f34-4445-9420-5a009ce79dd6
                Copyright © 2022 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society for AIDS

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 December 2021
                : 03 April 2022
                Funding
                Funded by: Korea Health Industry Development Institute, CrossRef https://doi.org/10.13039/501100003710;
                Award ID: HC20C0003
                Categories
                Original Article

                covid-19,delphi technique,health personnel,policy
                covid-19, delphi technique, health personnel, policy

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