Critical observations on and suggested ways forward for healthcare communication during COVID-19: pEACH position paper

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Highlights

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Communication in healthcare and COVID-19 have a mutually influential relationship that is informed by policy and has influenced practice.
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The fast-pace at which policies have been developed for and practice has adapted to COVID-19 necessitates critical reflection.
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Evidence-based guidance for communication in healthcare in COVID-19 is central to shaping approaches to public health communication.
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Evidence-based guidance is also necessary for the challenges faced in communicating with patients, their families, and carers during COVID-19.

Abstract

Objective

Communication in healthcare has influenced and been influenced by the COVID-19 pandemic. In this position paper, we share observations based on the latest available evidence and experiential knowledge that have emerged during the pandemic, with a specific focus on policy and practice.

Methods

This is a position paper that presents observations relating to policy and practice in communication in healthcare related to COVID-19.

Results

Through our critical observations as experts in the field of healthcare communication, we share our stance how healthcare communication has occured during the pandemic and suggest possible ways of improving policy and professional practice. We make recommendations for policy makers, healthcare providers, and communication experts while also highlighting areas that merit further investigation regarding healthcare communication in times of healthcare crises.

Conclusion

We have witnessed an upheaval of healthcare practice and the development of policy on-the-run. To ensure that policy and practice are evidence-based, person-centred, more inclusive and equitable, we advocate for critical reflection on this symbiotic relationship between COVID-19 and the central role of communication in healthcare.

Practice implications

This paper provides a summary of the key areas for development in communication in healthcare during COVID-19. It offers recommendations for improvement and a call to review policies and practice to build resilience and inclusive and equitable responsiveness in communication in healthcare.

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Most cited references 67

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Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Jianbo Lai, Simeng Ma, Ying Wang … (2020)

Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.

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Using social and behavioural science to support COVID-19 pandemic response

Jay Bavel, Katherine Baicker, Paulo S Boggio … (2020)

The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.

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How to fight an infodemic

John Zarocostas (2020)

WHO's newly launched platform aims to combat misinformation around COVID-19. John Zarocostas reports from Geneva. WHO is leading the effort to slow the spread of the 2019 coronavirus disease (COVID-19) outbreak. But a global epidemic of misinformation—spreading rapidly through social media platforms and other outlets—poses a serious problem for public health. “We’re not just fighting an epidemic; we’re fighting an infodemic”, said WHO Director-General Tedros Adhanom Ghebreyesus at the Munich Security Conference on Feb 15. Immediately after COVID-19 was declared a Public Health Emergency of International Concern, WHO's risk communication team launched a new information platform called WHO Information Network for Epidemics (EPI-WIN), with the aim of using a series of amplifiers to share tailored information with specific target groups. Sylvie Briand, director of Infectious Hazards Management at WHO's Health Emergencies Programme and architect of WHO's strategy to counter the infodemic risk, told The Lancet, “We know that every outbreak will be accompanied by a kind of tsunami of information, but also within this information you always have misinformation, rumours, etc. We know that even in the Middle Ages there was this phenomenon”. “But the difference now with social media is that this phenomenon is amplified, it goes faster and further, like the viruses that travel with people and go faster and further. So it is a new challenge, and the challenge is the [timing] because you need to be faster if you want to fill the void…What is at stake during an outbreak is making sure people will do the right thing to control the disease or to mitigate its impact. So it is not only information to make sure people are informed; it is also making sure people are informed to act appropriately.” About 20 staff and some consultants are involved in WHO's communications teams globally, at any given time. This includes social media personnel at each of WHO's six regional offices, risk communications consultants, and WHO communications officers. Aleksandra Kuzmanovic, social media manager with WHO's department of communications, told The Lancet that “fighting infodemics and misinformation is a joint effort between our technical risk communications [team] and colleagues who are working on the EPI-WIN platform, where they communicate with different…professionals providing them with advice and guidelines and also receiving information”. Kuzmanovic said, “In my role, I am in touch with Facebook, Twitter, Tencent, Pinterest, TikTok, and also my colleagues in the China office who are working closely with Chinese social media platforms…So when we see some questions or rumours spreading, we write it down, we go back to our risk communications colleagues and then they help us find evidence-based answers”. “Another thing we are doing with social media platforms, and that is something we are putting our strongest efforts in, is to ensure no matter where people live….when they’re on Facebook, Twitter, or Google, when they search for ‘coronavirus’ or ‘COVID-19’ or [a] related term, they have a box that…directs them to a reliable source: either to [the] WHO website to their ministry of health or public health institute or centre for disease control”, she said. Google, Kuzmanovic noted, has created an SOS Alert on COVID-19 for the six official UN languages, and is also expanding in some other languages. The idea is to make the first information that the public receive be from the WHO website and the social media accounts of WHO and Dr Tedros. WHO also uses social media for real-time updates. WHO is also working closely with UNICEF and other international agencies that have extensive experience in risk communications, such as the International Federation of Red Cross and Red Crescent Societies. Carlos Navarro, head of Public Health Emergencies at UNICEF, the children's agency, told The Lancet that while a lot of incorrect information is spreading through social media, a lot is also coming from traditional mass media. “Often, they pick the most extreme pictures they can find…There is overkill on the use of [personal protective equipment] and that tends to be the photos that are published everywhere, in all major newspapers and TV…that is, in fact, sending the wrong message”, Navarro said. David Heymann, professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, told The Lancet that the traditional media has a key role in providing evidence-based information to the general public, which will then hopefully be picked up on social media. He also observed that for both social and conventional media, it is important that the public health community help the media to “better understand what they should be looking for, because the media sometimes gets ahead of the evidence”.

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Author and article information

Journal

Journal ID (nlm-ta): Patient Educ Couns

Journal ID (iso-abbrev): Patient Educ Couns

Title: Patient Education and Counseling

Publisher: Elsevier B.V.

ISSN (Print): 0738-3991

ISSN (Electronic): 1873-5134

Publication date PMC-release: 26 December 2020

Publication date (Print): February 2021

Publication date (Electronic): 26 December 2020

Volume: 104

Issue: 2

Pages: 217-222

Affiliations

[a ]Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia

[b ]EngageMinds HUB – Consumer, Food & Health Engagement Research Center, Italy

[c ]Department of Psychology, Università Cattolica del Sacro Cuore, Italy

[d ]Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan, Italy

[e ]Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy

[f ]University Hospital Brussels, Belgium

[g ]CEMESO at the Free University Of Brussels (VUB), Belgium

[h ]Faculty of Health and Medicine, University of Newcastle, Australia

[i ]Weill Cornell Medical College, Cornell University, USA

[j ]School of Medicine, University of Wollongong, Australia

[k ]Phoenix VA Health Care System, University of Arizona College of Medicine - Phoenix, USA

[l ]Department of Health Sciences and Medicine, University of Lucerne, Switzerland

[m ]Swiss Paraplegic Research, Switzerland

[n ]Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, and Clinical Psychology, Department of Health Sciences, University of Milan, Italy

[o ]Centre for Translation Studies, School of Literature and Languages, University of Surrey, UK

Author notes

[* ]Corresponding author at: Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, 75 Talavera Rd, Macquarie University, NSW, 2109, Australia.

[** ]Corresponding author at: Centre for Translation Studies, School of Literature and Languages, University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.

Article

Publisher Item ID: S0738-3991(20)30689-3

DOI: 10.1016/j.pec.2020.12.025

PMC ID: 7833684

PubMed ID: 33419600

SO-VID: 6adb84f8-6378-498d-a5cf-4d0ec75628ae

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

History

Date received : 2 September 2020

Date revision received : 23 December 2020

Date accepted : 24 December 2020

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Critical observations on and suggested ways forward for healthcare communication during COVID-19: pEACH position paper

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Highlights

Abstract

Objective

Methods

Results

Conclusion

Practice implications

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 67

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Using social and behavioural science to support COVID-19 pandemic response

How to fight an infodemic

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Cited by 19

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