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The spread of COVID-19 outbreak in 2020 had significant impact on the functioning of the existing healthcare system and required fast adaption to new circumstances for continuing with daily practices. Community pharmacists shared responsibility of ensuring supply of medicines and medical devices, educating people on health related issues, providing pharmaceutical care etc. The aim of this study was to understand how the provision of community pharmacy services changed during the first wave of COVID-19 pandemic in spring of 2020 in Estonia. Qualitative in-depth semi-structured interviews were conducted. Recorded interviews with community pharmacists (n = 21) and experts (n =10) were transcribed verbatim and a systematic text condensation method for textual content analysis was performed. The findings indicated that a number of changes took place in provision of community pharmacy services to assure continuity in providing high-quality pharmacy services in crisis, including addressing difficulties in the supply of medicines; at the same time, to acquire new knowledge for counselling health related topics and personal protective equipment, and to provide psychological support to people in stress. Pandemic had an impact on the content and structure of traditional community pharmacy services in Estonia. The need for expanded professional role of pharmacists was clearly expressed in an emergency situation.

In the contemporary approach to ante- and postnatal care, where men are anticipated to participate more, men themselves also wish to be more included. Even though national health policy presents person-centred care as a central goal, it is not clear if and how it manifests itself for some, as men continue to feel excluded from the ante- and postnatal care process. The aim of this research was to identify the information sources that men in Estonia currently rely upon regarding the ante- and postnatal period in order to both understand the possible areas of development and the potential application of health communication tools to support men in ante- and postnatal care. The research, which was part of a master's thesis, was a qualitative study conducted with 13 men who were fathers or were about to become fathers. The results indicate that despite the new standards in health policy, there is a lack of targeted support systems to address men's information needs during the ante- and postnatal period in Estonia - a problem further intensified by the COVID-19 pandemic. The current results show that adequate information access requires advanced skills in source criticality, languages, health and digital literacy. The study found that the issue can be resolved through conscious use of health communication tools, which need to be in a person-centred format - easily found, user-friendly and logically structured. A systemic approach needs to be developed to further support men. Health communication strategies can mediate such an approach by being able to accommodate a wider range of skills and preferences. [ABSTRACT FROM AUTHOR]

Person-centredness is claimed to be one of the aims of healthcare, placing the person at the centre of healthcare (services). However, individual responsibility is expected and stressed in the implementation with limited structural support. This has led to the situation where despite the availability of HPV vaccination as the most beneficial preventive method, the coverage for girls aged 12-14 is below the recommended (>70%) rate. The objective of the research was to analyse structural constraints experienced by parents and service providers of the target group of girls regarding HPV vaccination under the circumstances of a global pandemic. Qualitative methods were used, namely in-depth interviews (n = 18) with nurses and midwives and three focus group interviews (n = 13) with parents of girls aged 12-14 years, as well as thematic textual analysis with the combination of inductive and deductive analysis methods. The research was granted ethical permission. The results outline that for parents the main challenge is the ability to find relevant supportive information for decision-making. For nurses, the challenge is to find appropriate ways to counsel and support parents and girls. The study revealed the lack of a country-wide strategy as one of the weak links in supporting the continuation of necessary preventive activities despite the external situation. Also, the skills of counselling and development of innovative communicative and educational digital tools that are target group specific yet also country- and culture-specific should be improved, as this may lead to more person-centred healthcare service for cervical cancer prevention. Inimkesksust peetakse üheks tervisekorralduse eesmärgiks, mis seab inimesed tervishoiuteenuste korralduses kesksele kohale. Samas eeldab ja rõhutab inimkesksuse rakendamine individuaalse vastutuse olulisust vähese struktuurse toetuse pakkumisega. See on viinud emakakaelavähi ennetuse kontekstis olukorrani, kus 12-14-aastaste tüdrukute HPV-vaktsineeritus on alla soovitusliku 70% vaatamata sellele, et vaktsineerimine on emakakaelavähi kõige tõhusam ennetamise viis, mis on sihtrühma tüdrukutele ka tasuta kättesaadav. Globaalne COVID-19 pandeemia on üleriigiliste piirangute tõttu esile toonud uusi väljakutseid tervishoiuteenustele, sh erinevate ennetustegevuste jätkusuutlikul osutamisel. Selle uuringu eesmärk on analüüsida nii pandeemiaga seotud kui neist sõltumatuid struktuurseid piiranguid, mida sihtrühma kuuluvate tütarlaste vanemad ja teenust osutavad tervishoiutöötajad on kogenud seoses HPV vaktsineerimisega. Andmete kogumiseks kasutati kaht erinevat kvalitatiivset meetodit: süvaintervjuusid 14 tervishoiutöötajaga (õed ja ämmaemandad) ning kolme fookusgrupi intervjuud sihtrühma kuuluvate tütarlaste 13 vanemaga. Andmeid analüüsiti temaatilise tekstianalüüsi meetodil. Uuring on kooskõlastatud eetikakomitees. Tulemused osutavad, et vanematele on peamiseks väljakutseks vaktsineerimisotsuse jaoks vajaliku asjakohase informatsiooni leidmine. Tervishoiutöötajate mure on erinevate sobivate nõustamisviiside valimine tüdrukute ja nende vanemate toetamiseks. Tulemused toovad esile riikliku strateegilise kriisiplaani vajaduse, mis tagaks jätkusuutliku ennetustegevuste pakkumise sõltumata välistest tingimustest. Samuti vajavad arendamist nõustamisoskused ja sihtrühmale sobivad ning riigi- ja kultuurispetsiifiliseks kohandatud innovaatilised kommunikatsiooni- ja tervisehariduse alased lahendused, et pakkuda inimkeskset tervishoiuteenust emakakaelavähi ennetuseks. [ABSTRACT FROM AUTHOR]

The increasing prevalence of cancer and the decreasing number of oncology specialists in Europe's workforce have led patients having to self-manage their conditions with the help of a health care professional. Ensuring cancer patients' good understanding of molecular profiling data is crucial for their active participation in illness-related decisions. Although shared decision making improves patients' knowledge and consideration of their needs, several difficulties remain in implementing shared decision making in cancer care. The objective of the research is to examine the relationship between sociodemographic aspects and knowledge of cancer-related topics and willingness to participate in cancer care. A cross-sectional study using a web-based questionnaire was conducted, including 1066 respondents among the population of Estonia. Logistic regression was used to answer research questions. There is a lack of knowledge and willingness of patients and their relatives to participate in shared decision making. Unlike in previous studies, higher readiness was observed among the ethnic minority and rural citizens. In addition to the factors previously identified, there is a need to consider a potential role of cultural and historical background of the health care system in determining the willingness and readiness of the general public to participate in shared decision making. These findings highlight the potential uniqueness of societies, in which paternalistic and autonomous approaches to patient care clash, and similar results may be found in other countries with a Soviet legacy. If there is a lack of readiness or willingness of a patient to participate, a physician should provide alternative means of support. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed many challenges to societies, individual healthcare systems and global public health. Manifestations of increasing health inequalities, social stigmatization and challenging ethical decision-making have been previously noticed. The aim of this article is to analyse the perceptions of frontline healthcare professionals regarding the potential impact of COVID-19 on the provision of healthcare services and the ethical challenges it may entail. This research is a part of a larger research project which was conducted among frontline healthcare professionals in Estonia and used both quantitative and qualitative methods of data collection. In this article, answers to specific open-ended questions from the questionnaire (n = 116) and in-depth interviews (n = 8) were analysed. For data analysis, inductive content analysis was used. The research was granted ethical approval. Findings show that through changes in regular and routinized practices in the provision of emergency medicine services, COVID-19 influences an increase of health inequality and social stigmatization. Other factors as well, such as lack of information about the disease, lack of resources, and fear of the disease, might reinforce these social phenomena. Additionally, from patient-centred and legal perspectives, issues of personal data management and privacy are highlighted. In addition to medical issues arising from COVID-19, countries worldwide should pay attention to the social and legal side effects of the illness to minimize health inequality and social stigmatization, as well as to moral, ethical and legal shortcomings in responses to the pandemic. [ABSTRACT FROM AUTHOR]

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