Nurses' experiences of care for patients with Middle East respiratory syndrome-coronavirus in South Korea

Perceived Disaster Preparedness and Willingness to Respond among Emergency Nurses in South Korea: A Cross-Sectional Study

INTRODUCTION

Emergency nurses serve a vital role in disaster situations. Understanding their disaster preparedness and willingness to respond to a disaster is important in maintaining appropriate disaster management. The purpose of this study was to explore emergency nurses' disaster preparedness and willingness to respond based on demographic and disaster-related characteristics, and their willingness to respond based on specific disaster situations.

METHODS

In this descriptive, cross-sectional study, the Disaster Preparedness Questionnaire for Nurses and willingness to report to duty by type of event were used to collect data from 158 nurses working in four regional emergency medical centers from 1 December 2019 to 30 April 2020 in the early stages of the COVID-19 pandemic.

RESULTS

Emergency nurses with personal disaster experience as a victim or witness (t = 3.65, p < 0.001), professional disaster experience (i.e., working as a nurse) (t = 3.58, p < 0.001), who were current members of Korean Disaster Medical Assistance Teams (t = 6.26, p < 0.001), and who received disaster-related training within a year (t = 5.84, p < 0.001) showed a high level of perceived disaster preparedness. Emergency nurses who have professional disaster experience (i.e., working as a nurse) (t = 2.42, p = 0.017), are on a current disaster team (t = 2.39, p = 0.018), and have received disaster training (t = 2.73, p = 0.007) showed a high level of willingness to respond. Our study showed a high willingness to respond to natural disasters and low willingness to respond to technological disasters.

DISCUSSION

To promote the engagement of emergency nurses in disaster response, disaster education programs should be expanded. Enhancing the safety of disaster response environments through supplementing medical personnel, distributing available resources, and providing sufficient compensation for emergency nurses is also essential.

Psychological Distress and Risk Factors in Frontline Nurses Confronting COVID-19 in Less Severely Affected Areas

The current study investigated the prevalence and risk factors of somatization, depression, and anxiety among 374 frontline nurses in less severely affected areas during the initial period of the coronavirus disease 2019 (COVID-19) outbreak. The prevalence of somatization, depression, and anxiety among frontline nurses was 41.4%, 40.1%, and 37.4%, respectively. Nurses from provincial-level hospitals were less likely to report somatization (odds ratio [OR] = 0.50; p = 0.018), depression (OR = 0.52; p = 0.024), and anxiety (OR = 0.35; p < 0.001) than those from county-level hospitals. Longer service duration was significantly associated with a higher likelihood of reporting somatization (OR = 1.06; p = 0.008) and depression (OR = 1.06; p = 0.006). Psychological distress exists in frontline nurses in less severely affected areas, and hospital levels and service duration are independent risk factors for psychological stress in these nurses. Maintaining nurses' mental health is an important issue in addressing the COVID-19 pandemic in addition to sufficient distribution of medical resources between hospitals at different levels. [Journal of Psychosocial Nursing and Mental Health Services, 61(4), 37-44.].

Nurses' Experiences of their Ethical Responsibilities during Coronavirus Outbreaks: A Scoping Review

Globally, nurses have experienced changes to the moral conditions of their work during coronavirus outbreaks. To identify the challenges and sources of support in nurses' efforts to meet their ethical responsibilities during SARS, MERS, and COVID-19 outbreaks a scoping review design was chosen. A search was conducted for eligible studies in Ovid MEDLINE, Ovid Embase and Embase Classic, EBSCO CINAHL Plus, OVID APA PsycInfo, ProQuest ASSIA, and ProQuest Sociological Abstracts on August 19, 2020 and November 9, 2020. The PRISMA-ScR checklist was used to ensure rigor. A total of 5204 records were identified of which 41 studies were included. Three themes were identified related challenges in meeting ethical responsibilities: 1) substandard care, 2) impeded relationships, 3) organizational and system responses and six themes relating to sources of support: 1) team and supervisor relationships, 2) organizational change leading to improved patient care, 3) speaking out, 4) finding meaning, 5) responses by patients and the public, 6) self-care strategies.Our review revealed how substandard care and public health measures resulted in nurses not being fully able to meet their ethical responsibilities of care. These included the visitation policies that impeded the support of patients by nurses and families, particularly with respect to face-to-face relationships. Organizational and system responses to the evolving outbreaks, such as inadequate staffing, also contributed to these challenges. Supportive relationships with colleagues and supervisors, however, were very beneficial, along with positive responses from patients and the public.

Exploring the Experience of Nurses in Providing Care to Patients With COVID-19: A Qualitative Study

BACKGROUND

The COVID-19 pandemic has caused conflicts in the world health system. The role of nurses is prominent because of their close contact with patients.

PURPOSE

The aim of this study was to explore the experiences of nurses in providing care to patients with COVID-19.

METHODS

This phenomenological study was conducted in 2020. Purposive sampling was used and continued until data saturation. Semistructured interviews were conducted with 14 nurses at Tohid Hospital, Sanandaj, Iran, all of whom had experience providing care to patients with COVID-19. Interviews were transcribed verbatim and analyzed using Colaizzi's phenomenological method.

RESULTS

The participants included four men and 10 women. Data analysis revealed four main themes (14 subthemes) related to the experience of the participants in providing care to patients with COVID-19. These themes included (a) fear (fear of being infected, fear of being a carrier, fear of the disease, and high mortality of patients), (b) compulsion (compulsion to care, being under pressure), (c) distinct experience (need for self-care, working with personal protective equipment, and ambiguity in care/treatment), and (d) sacrifice (altruism, compassion, self-sacrifice, and being proud of yourself).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The experience of participants in caring for patients with COVID-19, in addition to the unique experience of care, was associated with fear, compulsion, and sacrifice. Because of the ongoing COVID-19 pandemic and the unique experience of nurses serving in COVID-19 units, it is necessary to educate and support nurses to deal effectively with this situation.

Frontline nurses' burnout and its associated factors during the COVID-19 pandemic in South Korea

Background

The Coronavirus disease pandemic is a global health crisis with psychological consequences for healthcare workers.

Purpose

To identify the prevalence and potential factors influencing burnout among frontline nurses in South Korea.

Methods

This cross-sectional study comprised 161 nurses who voluntarily participated in the survey through advertisements at a general hospital. Data on sociodemographic and professional characteristics, insomnia, depression, anxiety, stress, and burnout were collected via an online questionnaire in 2021.

Results

Among the participants, 90 had a high level of burnout. Overall, 59.6 %, 23.0 %, 36.0 %, and 17.4 % of nurses experienced insomnia, depression, anxiety, and stress, respectively. The results showed that the assigned number of patients, insomnia, and depression were the major factors affecting burnout levels of nursing staff.

Conclusions

Frontline nurses were the main force in the fight against public health emergencies. The government and medical institutions must consider professional and psychological factors in ameliorating burnout and safety for nurses.

Health care workers' mental health in the face of COVID-19: a systematic review and meta-analysis

BACKGROUND

Healthcare workers are leading the way in treating patients with coronavirus disease 2019 (COVID-19). Due to the high levels of psychological stress, this group is more likely to experience psychological issues. These psychological problems in healthcare providers include depression, anxiety, insomnia, stress and post-traumatic stress disorder (PTSD). The goal of this systematic review and meta-analysis was to find out how common these problems were in the face of COVID-19.

METHODS

On 20 February 2022, systematic searches were conducted in the PubMed, Cochrane Library, Scopus, EMBASE, Science Direct, Web of Science and ProQuest databases. Two authors selected articles based on search keywords. As a last step, articles about the prevalence of psychological problems among healthcare workers in the face of COVID-19 were looked at and analysed for five different outcomes.

RESULTS

The initial search yielded 18,609 articles. After reviewing the titles, abstracts and full texts of the articles, 44 were chosen for the final analysis and 29 were subjected to a meta-analysis. Insomnia, anxiety, depression, PTSD and stress are among the psychological issues faced by healthcare workers. Furthermore, the highest pooled prevalence of depression, anxiety, insomnia, PTSD and stress was 36% (95% confidence interval (CI) 24-50%), 47% (95% CI 22-74%), 49% (95% CI 28-70%), 37% (95% CI 19-59%) and 27% (95% CI 6-69%).

CONCLUSIONS

In this meta-analysis, insomnia was found to be the most common mental health problem, followed by anxiety, PTSD, depression and stress in healthcare workers in the face of the COVID-19 pandemic. Generally, the pooled prevalence of these mental health problems was higher among physicians, nurses and older staff in the subgroup analysis. As a result, health policymakers and managers of the health care system should think about effective interventions to promote mental health, paying particular attention to these two groups.Key pointsStudies conducted in China reported more mental problems than in other countries.Health policymakers and health system managers should hold training programs to promote healthcare workers' mental health with a particular focus on more vulnerable groups.The prevalence of PTSD, stress, anxiety, depression and insomnia were higher among physicians, nurses and older staff.Health systems at both national and local levels have to take older physicians, nurses and healthcare providers into consideration while designing interventions.

Resilience among health care workers while working during a pandemic: A systematic review and meta synthesis of qualitative studies

Background

Aim

Method

Results

Conclusion

'You can't walk through water without getting wet' UK nurses' distress and psychological health needs during the Covid-19 pandemic: A longitudinal interview study

BACKGROUND

Pre-COVID-19 research highlighted the nursing profession worldwide as being at high risk from symptoms of burnout, post-traumatic stress disorder (PTSD) and suicide. The World Health Organization declared a pandemic on 11th March 2020 due to the sustained risk of further global spread of COVID-19. The high healthcare burden associated with COVID-19 has increased nurses' trauma and workload, thereby exacerbating pressure on an already strained workforce and causing additional psychological distress for staff.

OBJECTIVES

The Impact of COVID-19 on Nurses (ICON) interview study examined the impacts of the pandemic on frontline nursing staff's psychosocial and emotional wellbeing.

DESIGN

Longitudinal qualitative interview study.

SETTINGS

Nurses who had completed time 1 and 2 of the ICON survey were sampled to include a range of UK work settings including acute, primary and community care and care homes. Interviewees were purposively sampled for maximum variation to cover a broad range of personal and professional factors, and experiences during the COVID-19 pandemic, including redeployment.

METHODS

Nurses participated in qualitative in-depth narrative interviews after the first wave of COVID-19 in July 2020 (n = 27) and again at the beginning of the second wave in December 2020 (n = 25) via video and audio platform software. Rigorous qualitative narrative analysis was undertaken both cross-sectionally (within wave) and longitudinally (cross wave) to explore issues of consistency and change.

RESULTS

The terms moral distress, compassion fatigue, burnout and PTSD describe the emotional states reported by the majority of interviewees leading many to consider leaving the profession. Causes of this identified included care delivery challenges; insufficient staff and training; PPE challenges and frustrations. Four themes were identified: (1) 'Deathscapes' and impoverished care (2) Systemic challenges and self-preservation (3) Emotional exhaustion and (4) (Un)helpful support.

CONCLUSIONS

Nurses have been deeply affected by what they have experienced and report being forever altered with the impacts of COVID-19 persisting and deeply felt. There is an urgent need to tackle stigma to create a psychologically safe working environment and for a national COVID-19 nursing workforce recovery strategy to help restore nurse's well-being and demonstrate a valuing of the nursing workforce and therefore support retention.

Frontline healthcare workers' experiences of providing care during the COVID-19 pandemic at a COVID-19 centre in Bulawayo, Zimbabwe: A phenomenological study

BACKGROUND

 The coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching, negative impact on healthcare systems worldwide. Healthcare workers play a critical role in the country's healthcare delivery system, as they facilitate a continuum of care and containment of diseases such as the COVID-19 pandemic.

OBJECTIVES

 The aim of this study was to explore and describe the experiences of healthcare workers who provided care to COVID-19 patients at a central hospital in Zimbabwe.

METHOD

 The researchers used an interpretative phenomenological analysis design. In-depth interviews were conducted virtually with 10 frontline healthcare workers working at a COVID-19 centre in Zimbabwe. Data collection was guided by an interview guide. All audio-recorded interview data were transcribed verbatim into written text. Data analysis was conducted using an interpretative phenomenological analysis framework. An expert in qualitative research acted as an independent co-coder and conducted the open coding of each transcript.

RESULTS

 Findings reveal inadequate preparation and training of healthcare providers before the commencement of duty, resources-related challenges and a lack of support as significant experiences of healthcare providers. Moreover, healthcare providers have been subjected to stigma and discrimination attached to COVID-19, resulting in psychological effects on frontline healthcare providers.

CONCLUSION

 The COVID-19 pandemic brings unique and challenging experiences for frontline healthcare workers, resulting in a physically and emotionally drained workforce. This study calls for comprehensive support in the form of counselling, reasonable work schedules, training and adequate provision of personal protective equipment.

Back to the Roots of Nursing: Qualitative Study on the Experience of Nurses in the Front Line During the COVID-19 Pandemic

The COVID-19 emergency has led many health facilities to reorganize themselves in a very short time to meet the urgent needs for intensive, semi-intensive or ordinary care of SARS-CoV-2 patients. In this pandemic, characterized by speed of transmission and severity of respiratory symptoms, care has been affected by the increase in volume and clinical complexity of patients, the sudden and unpredictable staff decrease and the lack of support from family members / caregivers. At the same time, experience in the field has shown how “informal” resources have been activated, which enabled to treat the highest possible number of patients above the real availability of resources. The purpose of this study was to explore the experiences of nurses involved in frontline care (COVID Centers) during the pandemic with a particular focus on professional motivation and on the development of technical-professional and personal skills. A study with a qualitative research design using focus group technique was conducted. Two focus groups were held with nine nurses. Data were analyzed with inductive content analysis. The findings can be summarized in five main categories: professional identity; motivation and sense of mission; development of professional and personal skills; spirituality; person-centered care; uniqueness of the lived experience. These findings shed new light on the correlation between motivation, professional identity and value, sense of duty and sense of belonging to the professional group. Moreover, the experience in the COVID Centers represented a valuable opportunity for participants to rediscover some specific issues related to nursing professional identity and to develop new personal and technical-professional skills in a very short time. Finally, nurses experienced once again how the nurse-patient relationship and basic care are essential to provide effective and excellent care, even and especially for patients in critical conditions. Nurses re-discovered, in a careful body care and basic care, irreplaceable elements to give back to patients, often dying, their own dignity, and all the needed closeness and attention necessary also to compensate the absence of the loved ones. These elements represent a way to concretely and deeply express the ethics of a job well done in nursing.

Explaining the challenges and adaptation strategies of nurses in caring for patients with COVID-19: a qualitative study in Iran

BACKGROUND

Nurses, as the primary human resource in the fight against COVID-19, encounter several obstacles and concerns. As a result, the current study used a qualitative method to describe the problems and adaptation techniques of nurses caring for COVID-19 patients.

METHODS

The current study used a qualitative conventional content analysis technique with 30 nurses working in COVID-19 wards in Tehran hospitals. Purposive sampling, snowball sampling, and semi-structured interviews were used to get access to participants and gather data. The data was examined using conventional qualitative content analysis and the MAXQDA-18 program. To assess the quality of study findings, Guba and Lincoln's trustworthiness criteria were fulfilled.

RESULTS

The data analysis revealed two main categories and sixteen subcategories: (1) experiences and challenges (lack of protective equipment, high work pressure, marginalized physical health, problems related to the use of protective equipment, being excluded, a lack of a supportive work environment, problems related to patients, psychological problems, fear, marginalized personal and family life, and the challenge of communicating with patients' families); and (2) adaptation strategies for work conditions (performing religious-spiritual activities, creating an empathetic atmosphere in the workplace, spiritualizing their work, trying to convince the family and gaining their support, and strengthening their sense of self-worth and responsibility).

CONCLUSION

Nurses' working conditions can be improved by providing adequate protective equipment, a suitable work environment, and more social and financial support; paying more attention to nurses' physical and mental health; and considering appropriate communication mechanisms for nurses to communicate with their families and patients' families.

Psychological Experiences and Reactions of Physicians with COVID-19: A Qualitative Study

Doctors are the first to fight COVID-19 and their mental health is at risk. This article aimed to investigate the psychological experiences of physicians recovered from COVID-19 disease. Phenomenological method was carried out to analyze the obtained data. Participants were 16 physicians recovered from COVID-19 disease in Yazd City from January 20th to March 1st, 2020. Samples were selected via purposive sampling and the subjects participated in-depth semi-structured interviews. Twelve main themes and 48 sub-themes were extracted, including 1- Adaptive emotional reactions, 2- Adaptive cognitive reactions, 3- Adaptive behavioral reactions, 4- Adaptive communicative reactions, 5- Adaptive spiritual reactions, 6- Adaptive copings, 7- Maladaptive Emotional reactions, 8- Maladaptive Cognitive reactions, 9- Maladaptive Behavioral reactions, 10- Maladaptive Communicative reactions, 11- Maladaptive spiritual reactions, and 12- Maladaptive Copings. According to the findings, adaptive psychological reactions and maladaptive psychological reactions can affect the psychological well-being of physicians.

Health care worker occupational experiences during the COVID-19 outbreak: A cross-sectional study

BACKGROUND

Health care workers treating coronavirus disease 2019 (COVID-19) patients experience burnout and stress due to overwork and poor working conditions.

AIM

To investigate the work experiences of frontline health care workers in Wuhan city and Qinghai province, China, during the COVID-19 outbreak.

METHODS

In this cross-sectional descriptive study, a self-reported questionnaire was designed to evaluate work experiences of medical staff throughout the course of the COVID-19 pandemic. A total of 178 health care workers responded to the questionnaire between February 19 and 29, 2020. Higher questionnaire dimen-sional score confirmed dimensional advantage.

RESULTS

Of all dimensions evaluated by this questionnaire, the occupational value dimension had the highest mean score of 2.61 (0.59), followed by the support/security dimension score of 2.30 (0.74). Occupational protection scored lowest at 1.44 (0.75), followed by work environment at 1.97 (0.81). The social relationships dimension had an intermediate score of 2.06 (0.80). Significant differences in working conditions were observed across hospital departments, with the fever ward scoring lowest. Total scores also differed significantly across workplaces; the fever outpatient department scored lowest (P < 0.01). This phenomenon was likely due to the fact that work in the fever outpatient department, where many patients present to hospital, necessitates constant contact with a large number of individuals with insufficient provision of resources (such as protective equipment and social support). Medical workers in the fever outpatient department were burdened with a fear of COVID-19 infection and a lower sense of professional value as compared to workers in other hospital departments. Medical staff in Wuhan worked longer hours (P < 0.01) as compared to elsewhere. The mean support/security dimension score was higher for tertiary hospital as compared to secondary hospital medical staff as well as for Wuhan area as compared to Qinghai region staff (P < 0.01). Staff in Wuhan had a lower mean work environment score as compared to staff in Qinghai (P < 0.05).

CONCLUSION

Medical staff treating COVID-19 patients in China report poor occupational experiences strongly affected by work environment, occupational protection and social relationships. Health care managers must address the occupational needs of medical staff by ensuring a supportive and safe work environment.

The psychological experiences of Lebanese ground zero front-line nurses during the most recent COVID-19 outbreak post Beirut blast: A qualitative study

BACKGROUND

For the past 2 months the number of COVID-19 cases in Lebanon has been on the rise, while frontline nurses after the Beirut Blast of August 4th have been practicing through limited resources and a challenging context.

AIM

This paper aims at exploring the psychological experiences of Lebanese frontline nurses serving at ground zero hospital during the current COVID-19 outbreak.

SETTING

This study was carried out in three main ground-zero hospitals in Beirut which are receiving COVID-19 cases.

METHOD

This study have employed a phenomenological exploratory qualitative research design, where virtual interviews were conducted with 18 frontline nurses during the second week of January 2021.

RESULTS

Thematic analysis of the data expressed by the frontline nurses working in the approached ground-zero hospitals gave rise to five themes, namely 'helplessness and impending doom', 'increased mortality rates and depressive mood', 'fear of death and obsessive thinking', 'flashbacks, panic, and incompetence', and 'public recklessness, governmental responsibility, and anger'.

CONCLUSION

The frontline nurses working at ground zero hospitals in Beirut are facing significant psychological challenges that should be mediated by the government and health policymakers in order to safeguard the quality of care and avoid higher mortality rates.

Nurses' lived experiences of caring for patients with COVID-19: a phenomenological study

Background

COVID-19 is an infectious disease caused by a novel Coronavirus which transmits from person to person throughout the world. This study aimed to explore the lived experiences of nurses' caring for patients with COVID-2019 in the context of the healthcare system of Iran.

Methods

This is a phenomenological study with 13 participant nurses (6 men and 7 women) who were caring for COVID-19 patients in one of the university hospitals in Southeast of Iran. Qualitative data were analysed by the seven steps of Colaizzi's method.

Results

Participants reported around a five-month history of caring for COVID-19 patients. After analysis, 597 codes, 16 categories, four sub-themes, and one theme were extracted. "Caring from self-sacrifice to avoidance" was the main theme of the study with sub-themes of "Anxiety Chain", "Manifestation of Humanitarian Caring", "Ethical Challenges", and "Challenges of Overcoming Crisis".

Conclusions

Nurses explained their caring experiences with patients on a continuum from humanitarian caring and self-sacrifice to caring avoidance. Because of the multi-sources of psychological stress and ethical challenges together with this infection, healthcare managers should plan for holistic regular psychological support services, prevention of job inequalities, and do strategic planning for access to enough resources in the healthcare system.

Experiences of Radiology Personnel About the COVID-19 Crisis: A Qualitative Content Analysis

Background

The COVID-19 pandemic has affected all health care systems. During these critical times, radiology personnel and nurses have been heavily involved in the diagnosis and management of patients with COVID-19.

Purpose

This study investigates the experiences of radiology personnel about the COVID-19 crisis.

Methods

This qualitative content analysis was conducted on seven radiology personnel. In-depth semistructured interviews were used to collect data. Purposive sampling was carried out to select the participants.

Findings

The data analysis led to the emergence of six categories, including psychological-emotional reactions, knowledge-related challenges, humaneness, workplace conditions, hopefulness, and support.

Conclusion

Learning from the experiences of radiology personnel and nurses during the COVID-19 crisis can help better manage any subsequent health crises.

Are healthcare workers particularly vulnerable to loneliness? The role of social relationships and mental well-being during the COVID-19 pandemic

Loneliness is a major public health issue with renewed prominence due to the COVID-19 pandemic and associated social restrictions. Healthcare workers (HCWs) may be at heightened risk, but research is lacking. We measured the prevalence of loneliness among HCWs during the pandemic in 2020 and examined pre-pandemic predictors and pandemic experiences associated with loneliness. HCWs at a designated COVID-19 hospital in Sydney, Australia completed an online survey examining health and well-being before and during the pandemic and changes to work, family and social experiences. Loneliness had negatively affected the well-being of 129 (39%) respondents (n ​= ​330). Pre-pandemic factors predicting loneliness were younger age (<30years compared to ≥50years), having ever been told you had a mental health problem and living alone. These became non-significant when pandemic-related factors were added to the regression. Less contact with family and friends, increased conflict at home, and living alone or with family but not a partner, increased the odds of loneliness, while a sense of camaraderie with colleagues had the opposite effect. Psychological distress and poor mental health during the pandemic were also positively associated with loneliness. Efforts to promote congenial social contacts may be effective in averting loneliness among HCWs.

The perceptions of nursing students regarding coronavirus and occupation according to gender: A qualitative study

Outbreaks are experienced differently based on gender. In the context of the Covid-19 epidemic, students' perceptions of the nursing profession, their feelings related to themselves, their social circle, nursing, and the appropriateness of nursing practices are important. This study aimed to determine the perceptions of nursing students of the Coronavirus and their occupation according to gender. Twenty nursing students were interviewed using the semi-structured interview method. Content analysis and MAXQDA were performed. Five categories were identified: Visual perceptions regarding the nursing occupation and Covid-19, future nurses' occupational perceptions according to gender of pandemics such as the Coronavirus, the effect of the pandemic on occupational perception, perceptions of the people around them of their profession in relation to the pandemic, and the approach toward any pandemic in the future in terms of their profession as a nurse. Pandemics such as Covid-19 can affect the occupational perceptions of nursing students.

The Experiences of Nurses in Care Provision to COVID-19 Patients: A Qualitative Study

Introduction

Nurses are key fighters in the forefront of care provision to COVID-19 patients. Due to the diversity of nurses' experiences in different countries because of variable nursing resources, health care systems, and cultural contexts, the present study aimed to divulge a deep understanding of the essence of health system problems based on nurses' experiences of care provision to COVID-19 patients in Iran.

Methods

The present study was conducted based on the conventional content analysis method and Graneheim &amp; Lundman approach. The participants included the nurses working in the COVID-19 wards and were recruited by purposeful sampling and based on inclusion criteria. The data were collected by conducting semi-structured, one-to-one interviews, and taking field notes, until reaching data saturation.

Results

In-depth interviews with 12 nurses. represented four main categories and six subcategories. Sudden exposure to an unknown threat (nurses' feelings and concerns and nurses' reactions), being involved in an unequal war (a vicious virus and weary nurses), stressful working conditions, and efforts to confine the threat (seeking for new and adequate information and gathering all forces) were among the emerged data.

Conclusion

The nurses' experiences showed that despite passing a while since the coronavirus pandemic, there are still individual and professional concerns that all root in organizational and governmental factors.

Female Nurses’ Experience of Psychological Changes when Caring COVID-19 Patients in Indonesia: A Qualitative Study

BACKGROUND: Nurses as health workers at the frontline have major challenges in dealing with COVID-19. The COVID-19 pandemic can cause the risk of psychological changes in nurses in maintaining the quality of public health services. AIM: This study aims to explore nurses’ experiences through their psychological changes when giving treatment to COVID-19 patients. DESIGN AND METHOD: This qualitative research employed a phenomenological approach. Purposive sampling was applied to determine the participants with criteria of female nurses caring COVID-19 patients and working in hospitals until achieved data saturation. The data were collected by interviewing participants through phone and video calls. In-depth interview recordings were presented in transcriptions, and the contents were analyzed into codes, categories, and themes. RESULTS: Eight nurses participated in this study. This research resulted three themes: Self-surrender during early nursing care for COVID-19 patients, acceptance of the feelings and achievements as COVID-19 nurses, and self-empowerment supported by the environment. CONCLUSIONS: The psychological changes during the nursing care start from self-surrender in the early period of COVID-19 patient care, self-acceptance for any feelings and achievements as COVID-19 nurses, to the forms of self-empowerment and environmental support.

[Experience of Nurses in Charge of COVID-19 Screening at General Hospitals in Korea]

PURPOSE

The purpose of this study was to understand and describe the experiences of nurses in charge of COVID-19 screening at general hospitals in South Korea.

METHODS

Data were collected through individual in-depth interviews with 14 nurses who had been working for more than a month at a screening clinic operated by two general hospitals from May 11 to July 20, 2021. Verbatim transcripts were analyzed using Colaizzi's phenomenological analysis.

RESULTS

As a result of analysis, four theme clusters were extracted from nurses' experiences, as follow: the role of the hospital gatekeeper entrusted with managing the COVID-19 pandemic, struggling to maintain the protective barrier, boundlessness like a Mobius strip, and driving force to endure as a nurse in charge of COVID-19 screening.

CONCLUSION

The results of this study provide a deeper understanding of the lives of screening clinic nurses who are struggling with the COVID-19 situation. The results are expected to be useful in providing basic data for improving the infection control system and response strategies that can be applied to nursing practice in other pandemic situations.

Reflections on volunteer nurses' work and caring experiences during COVID-19: a phenomenological study

Background

With epidemics emerging at a hastened pace, a phenomenological study allows researchers to cast aside their perceptions to understand nurses' lived experiences, and from there to discover previously unavailable insights at the epicentre of a pandemic.

Aims

To understand volunteer nurses' lived experiences in Wuhan.

Methods

A descriptive phenomenological study with a purposive sampling strategy was used to describe volunteer nurses' experiences in Wuhan. Interviews continued until data saturation. Ten semi-structured interviews of 30 to 60 minutes duration were conducted from 27 to 30 March 2020. The narrative data were audiotaped, transcribed and analysed using Colaizzi's method.

Results

Four themes emerged: mission and challenges denoted the participants' realisation of the grim challenges ahead; challenges called for actions that described the concerted actions through partnerships and familial bonds; caring acts from all around revealed an external support system; and actions that made a difference portrayed the interplay of actions with feelings, thoughts and further actions to accomplish the mission.

Conclusions

This phenomenological study showed the interplay of nurses' intentions and actions, and 'actions speak louder than words' when nurses were motivated by workmates' actions to change their feelings, thoughts and actions. The concerted efforts can be used to develop educational programmes, management strategies and institutional policy on structure, system and resource utilisation, as well as dissemination of scientific knowledge to global healthcare workers and the public.

Influence of the sub-factors of self-compassion on burnout among hospital nurses: A cross-sectional study in South Korea

AIM

This study aimed to identify the effects of the sub-factors of self-compassion on hospital nurse burnout and provide basic knowledge for an intervention program to prevent nurse burnout.

BACKGROUND

Burnout in nurses has been reported to influence their own and patients' mental health and safety. Enhancing self-compassion can help to prevent burnout.

METHODS

This study involved descriptive research using a cross-sectional design. Data were collected at H University Hospital in Korea, from January to March, 2020. Of the 213 questionnaires collected, 208 were included in data analysis.

RESULTS

Burnout was higher when nurses were younger, unmarried, in poor health, general nurses, dissatisfied with their jobs, planning to leave their jobs, or receiving low social support from peers. There was a negative correlation between burnout and the self-compassion subscales. Multiple regression analysis showed that isolation and mindfulness among self-compassion, were significantly related to burnout.

CONCLUSIONS

Since individual variables and self-compassion are major elements impacting nurse burnout, it is important for nursing organizations to investigate nurses' individual variables, including sub-factors of self-compassion, to help them prevent burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse burnout might be prevented by increasing self-compassion. Hospital and nurse managers may employ individualized strategies to enhance nurses' self-compassion.

Nurses as the leading fighters during the COVID-19 pandemic: Self-transcendence

Background

The Covid 19 pandemic has led to and continues to pose challenges for healthcare systems globally, especially in intensive care units. This research was conducted to examine the self-transcendence of the leading fighters, intensive care nurses, during the Covid 19 pandemic.

Methods

The descriptive phenomenological research method was used in the study. The research was carried out between June and December 2020 with the nurses who care for Covid 19 patients in the Covid 19 intensive care service in different provinces of Turkey. The research was completed with 25 participants. A semi-structured interview form prepared based on the Theory of Self-Transcendence (vulnerability, self-transcendence, and well-being) and based on the literature was used to collect data.

Ethical considerations

Ethical requirements were respected in every phase of the research process. Results: The nurses in the study were found to experience vulnerability due to “administrative loneliness,” “inability to give care,” “fear of being a source of infection,” and “loneliness of patients.”

Conclusions

It has been found that “improvement in nursing roles and skills,” “being proud for oneself and the team,” “understanding the value of life,” and “feeling like a superhero due to the responsibilities shouldered during the pandemic” support nurses’ self-transcendence, which contributes to physical and mental well-being.

Registered Nurses' Experiences With Incivility During the Early Phase of COVID-19 Pandemic: Results of a Multi-State Survey

BACKGROUND

Incivility among workers in the health sector is recognized as an occupational hazard. The COVID-19 outbreak brought sudden and profound changes to many health care settings, many of which have been identified as antecedents to workplace incivility. The purpose of this retrospective study was to explore the experiences of registered nurses with workplace incivility, cyber-incivility, and incivility outside of work during the early phase of the COVID-19 pandemic.

METHODS

This mixed-methods study used convenience sampling. Data were collected from June to September 2020 via an online survey, which consisted of both closed- and open-ended questions. Participants were recruited from national nursing organizations and unions. Data were analyzed using descriptive statistics and thematic analysis for open-ended responses.

FINDINGS

A total of 526 nurses' responses were included in the analysis. More than one third experienced greater incivility at work during the COVID-19 outbreak than before the pandemic (37.4%), and almost half (45.7%) said they witnessed more incivility than before the pandemic. Cyber-incivility and incivility outside of work were also issues. Qualitative results indicated that respondents felt they were on edge during this period. Other themes included leadership failure, fractured co-worker relationships, heightened incivility from patients and families, and hostility and ostracism from the general public.

CONCLUSION/APPLICATION TO PRACTICE

Occupational health nurses, nursing leaders, and staff nurses need to work to restore relations that were fractured by incivility during the pandemic. In the future, improved preparedness, including establishing clear channels of communication, may lessen incivility by decreasing role stress and organizational chaos.

Lived experiences of frontline nurses and physicians infected by COVID-19 during their activities: A phenomenological study

We analyzed the lived experiences of frontline nurses and physicians who were affected by COVID-19 through a phenomenological approach, using Cohen's methodology with interview data. The participants were enrolled in the study in May 2020 during the COVID-19 pandemic in Italy. The inclusion criteria were (i) being a nurse or physician employed full time caring for COVID-19 patients before falling ill; (ii) contracting SARS-CoV-2 between February 2020 to May 2020; (iii) having recovered before enrollment; and (iv) providing informed consent to participate. Sixteen participants (60% nurses) with an average age of 45 years were included. The following main themes were extrapolated from our data analysis: "fear of diagnosis," "loneliness (as isolation)," "touch of nurses," and "feeling guilty of abandonment." Several aspects emerging from our study highlight the strong emotional impact of COVID on nurses and physicians infected during their activities, such as feelings of fear and loneliness on the one hand, and of impotence and guilt for not being able to help on the other.

Experiences of nurses providing care to patients with COVID‐19 in intensive care units: A qualitative study

Aim

The aim of this study was to evaluate the experiences of nurses providing care to intensive care unit patients diagnosed with coronavirus disease 2019 (COVID‐19) in Turkey.

Methods

The research employed the descriptive phenomenological approach. The interviews were analyzed with Colaizzi's seven‐step method.

Results

The experiences of nurses providing care to COVID‐19 patients in the intensive care unit can be summarized under three themes. It was determined that all nurses experience physical, psychological, and social difficulties along with negative emotions during the care process for COVID‐19 patients, for which nurses use coping processes.

Conclusion

This study shows the difficulties faced by nurses who provide intensive care to patients with COVID‐19. It is important to identify these challenges early to protect and improve the health of nurses.

Hospital factors that predict intention of health care workers to leave their job during the COVID ‐19 pandemic

Purpose

To identify factors responsible for hospital health care workers' intention to leave their job during the COVID‐19 pandemic.

Design

A cross‐sectional study was performed.

Methods

A self‐administered questionnaire was delivered to solicit hospital health care workers' demographics, intention to leave, workplace environment, and changes related to COVID‐19 from July to November 2020 in Taiwan. Principal component analysis was performed to compare group‐related factors. Multiple logistic regression was used to determine the risk factors for the intention of health care workers to leave their job.

Findings

Among the 1209 health care workers (mean age, 36.3 years) who participated in the study, intention to leave the job was found to be related to factors relating to COVID‐19, including perceived risk, affected social relationships, and increased workload and job stress, after adjustment for demographic and work factors. Supportive administration/management were protective factors against leaving the job. These results were supported by sensitivity analyses.

Conclusions

Our findings suggest that the intention of health care workers to leave their job during a pandemic is related to potentially modifiable factors relating to the infection itself and work environment.

Clinical relevance

High perceived risk of COVID‐19, affected social relationaops, and increased workload and job stress were positively associated with the intention of health care workers to leave their job, whereas supportive administration and management were protective factors against leaving the job. Development of workplace strategies is important to help mitigate these above factors, improve psychological wellbeing, and promote workforce stability.

Exploring the experiences of nurses caring for patients with COVID-19: a qualitative study in Iran

BACKGROUND

The coronavirus disease (COVID-19) is now a major public health emergency in the world. Nurses as key members of the COVID-19 patient care team are exposed to most challenges caused by the disease. As exploring the experiences of nurses as patient supporters and caregivers can play an important role in improving the quality of care for patients with COVID-19 disease, the present study explored the experiences of nurses caring for patients with COVID-19.

METHODS

The study employed a qualitative design. This study employed purposive sampling to select 10 nurses with bachelors and master's degrees in nursing who were taking care of patients with COVID-19 in ICUs or inpatient wards in southern Iran. Data were collected through semi-structured interviews. The collected data were analyzed using the qualitative content analysis procedure proposed by Graneheim and Lundman.

RESULTS

The analysis of the data revealed four main themes and ten sub-themes: A) physical, psychological, and social burden of care (excessive workload; fear, anxiety, worry; unpleasant social experiences; compassion fatigue) B) unmet needs (personal needs and professional needs) C) positive experiences (pleasant social experiences and inner satisfaction), and D) strategies (problem-solving strategies and stress symptom mitigation strategies).

CONCLUSIONS

An analysis of the themes and subthemes extracted in this study suggested that the nurses who participated in this study faced many personal and professional challenges. Therefore, health officials and specialists need to pay special attention to nurses' challenges and needs.

Impact of COVID-19 and other infectious conditions requiring isolation on the provision of and adaptations to fundamental nursing care in hospital in terms of overall patient experience, care quality, functional ability, and treatment outcomes: systematic review

AIM

This systematic review identifies, appraises and synthesizes the evidence on the provision of fundamental nursing care to hospitalized patients with a highly infectious virus and the effectiveness of adaptations to overcome barriers to care.

DESIGN

Systematic review.

DATA SOURCES

In July 2020, we searched Medline, PsycINFO (OvidSP), CINAHL (EBSCOhost), BNI (ProQuest), WHO COVID-19 Database (https://search.bvsalud.org/) MedRxiv (https://www.medrxiv.org/), bioRxiv (https://www.biorxiv.org/) and also Google Scholar, TRIP database and NICE Evidence, forwards citation searching and reference checking of included papers, from 2016 onwards.

REVIEW METHODS

We included quantitative and qualitative research reporting (i) the views, perceptions and experiences of patients who have received fundamental nursing care whilst in hospital with COVID-19, MERS, SARS, H1N1 or EVD or (ii) the views, perceptions and experiences of professional nurses and non-professionally registered care workers who have provided that care. We included review articles, commentaries, protocols and guidance documents. One reviewer performed data extraction and quality appraisal and was checked by another person.

RESULTS

Of 3086 references, we included 64 articles; 19 empirical research and 45 review articles, commentaries, protocols and guidance documents spanning five pandemics. Four main themes (and 11 sub-themes) were identified. Barriers to delivering fundamental care were wearing personal protective equipment, adequate staffing, infection control procedures and emotional challenges of care. These barriers were addressed by multiple adaptations to communication, organization of care, staff support and leadership.

CONCLUSION

To prepare for continuation of the COVID-19 pandemic and future pandemics, evaluative studies of adaptations to fundamental healthcare delivery must be prioritized to enable evidence-based care to be provided in future.

IMPACT

Our review identifies the barriers nurses experience in providing fundamental care during a pandemic, highlights potential adaptations that address barriers and ensure positive healthcare experiences and draws attention to the need for evaluative research on fundamental care practices during pandemics.

Lived Experiences and Challenges of the Families of COVID-19 Victims: A Qualitative Phenomenological Study in Tehran, Iran

Being COVID-19 positive and then dying causes a slew of personal, familial, and social issues for family members. Therefore, the current study was carried out to analyze the lived experiences and issues of COVID-19 victims' families in Tehran, Iran. The phenomenological approach was used in the qualitative analysis of 21 first-degree relatives of COVID-19 victims. From August 22 to October 21, 2020, data was gathered by phone (4 people) and in-person (17 people) using semi-structured interviews. The subjects were chosen through purposeful and snowball sampling. The MAXQDA-2018 program was used to organize the data, and the Colaizzi analytical technique was used to analyze it. Guba and Lincoln's criteria were also used to assess the findings' quality. After analyzing the data, 2 main categories and 14 subcategories were extracted, including (1) challenges in caring for a COVID-19 patient (being rejected, limited access to medical facilities, dissatisfaction with the behavior of medical staff, disruption of family life, the challenge of managing family members' behavior with the patient, and living with doubts and worries (2) challenges after a COVID-19 patient's death (incomplete farewell to the corpse, unbelievability of the death, ambiguity and tension in the burial process, lonely burial, the twinge of conscience, worry about not respecting the deceased, incomplete condolences, and abandonment). The troubles of victims' families can be ameliorated by developing the skills of caring for COVID-19 patients at home, providing medical and psychological services to families before and after the patient's death, appropriately informing the families to guarantee them about dignity and respect and respect of the deceased at the interment, and developing a culture of virtual condolence to provide emotional support to survivors.

Powerful Stress Relieving Medicinal Plants for Anger, Anxiety, Depression, and Stress During Global Pandemic

Consideration and improvement for anxiety and depression are important during a global pandemic. Appropriate healthcare can be obtained by paying more attention to traditional medicinal sciences. The adverse effects of stress with various symptoms can be managed by introducing plants that boost mental health. The most relevant psychological reactions in the general population related to the global pandemic are pervasive anxiety, frustration and boredom, specific and uncontrolled fear, disabling loneliness, significant lifestyle changes, and psychiatric conditions. Ginseng, chamomile, passionflower, herbal tea, lavender, saffron, kava, rose, cardamom, Chinese date, and some chief formula like yokukansan, Dan-zhi-xiao-yao-san, so-ochim-tang-gamiband, and saikokaryukotsuboreito are notable herbal treatments for mental health problems. The most common medicinal plants that have been used in Iran for the cure of stress and anxiety are Viper's-buglosses, Dracocephalum, valerian, chamomile, common hop, hawthorns, and lavender. Medicinal plants and herbs can be used for the treatment and alleviation of the negative effects of stress, anger, and depression during the global pandemic.

Experiences of nurses amidst giving care to COVID-19 patients in clinical settings in Iraqi Kurdistan: A qualitative descriptive study

AIM AND OBJECTIVE

We explored the experiences of nurses who cared for coronavirus disease 2019 patients in Iraqi Kurdistan.

BACKGROUND

Nurses play a major role in response to pandemics and epidemics in delivering patient care. The experiences of nurses who provided care have significant short and long-term consequences for individuals, communities, and the nursing profession.

METHODS

Descriptive qualitative research approach was adopted in this study. We interviewed 12 nurses (22-50 years) who cared for the coronavirus disease 2019 patients in one of the clinical units of two coronavirus disease 2019 hospitals in Iraqi Kurdistan in 2020. Interviews were conducted via phone calls and were analysed using the thematic analysis method. The Consolidated criteria for reporting qualitative research checklist was applied when constructing this paper.

RESULTS

The nurses had to care for a number of situations during the outbreak of coronavirus disease 2019 in Kurdistan. As people in the public did not believe that there was such a virus, nurses often had to deal with this lack of knowledge and aggression from some patients and their family members. Most nurses changed their preventive behaviours since the coronavirus disease 2019 outbreak at hospital or in public. This was mainly to protect not only themselves but their patients, colleagues, family members and friends. They were cautious about the use of a mask at the hospital and in public. Most nurses experienced fear, stress, anxiety and isolation during this period.

CONCLUSIONS

The patients had some concerns about their health and staying at hospitals, and some of them had aggressive behaviours towards nurses at corona hospitals. The public, close friends and relatives of the nurses had a fear of getting the infection by the virus through the nurses. However, the nurses attempted to protect themselves, colleagues and family members, and provide the best care to coronavirus disease 2019 patients. The nurses had a high obligation towards care giving at hospitals.

RELEVANCE TO CLINICAL PRACTICE

The negative experiences of the nurses regarding the care of coronavirus disease 2019 patients must be considered in clinical settings. Sensitive policy programs must be established to protect nurses from the ostracization and stigmatization of the coronavirus disease 2019 pandemic and to allow them to be able to achieve their professional practices safely.

What Neonatal Intensive Care Nurses Have Experienced in COVID-19 Pandemic in Turkey

Neonatal intensive care nurses have faced additional difficulties in adapting to a new work environment with a stressful situation brought about by the pandemic. The aim of this study is to evaluate the experiences of nurses working in neonatal intensive care units during the coronavirus disease-2019 (COVID-19) pandemic. Experiences were determined using phenomenology, a form of qualitative research. The study involved 14 neonatal intensive care nurses. The data were analyzed on the MAXQDA qualitative data analysis software in accordance with Colaizzi's 7-step method. Four themes were identified after the interviews: the experiences related to working conditions, neonatal care, psychosocial effect, and social life. In addition, 17 subthemes were created. The study revealed that neonatal intensive care nurses experienced physical, psychological, and social difficulties during the COVID-19 pandemic. It is thought that these results have become even more important to reduce the workload of nurses and to increase the quality of nursing care, especially in times of crisis such as pandemics.

Exploration of Factors Influencing Nurses’ Preparedness and Response to the COVID-19 Outbreak

Introduction and Objective

Nurses as the core of the health care workforce affect an organization's preparedness and response. This study explores the factors and unique determinants influencing nurses’ preparedness and response to the coronavirus disease 2019 (COVID-19) outbreak in Singapore.

Methods

This qualitative phenomenological study utilized purposive sampling and in-depth interviews with 10 registered nurses and two enrolled nurses who had worked or were still working in an infectious disease (ID) hospital during the COVID-19 outbreak at the point of recruitment. The data were collected from September 2020 to December 2020.

Results

(1) Before the outbreak: Factors such as knowledge, skills, and experiences that enhanced nurses’ adaptability and response through training and exposure prior to the outbreak influenced preparedness. In addition, the importance of nurses’ knowing their purpose and the role of their institute during the outbreak also influenced preparedness. (2) The COVID-19 phase: Factors such as the novelty of the disease, communication, load and demand, and coping mechanisms affected participants’ working response to the outbreak. (3) Learning and looking forth: Lessons learnt to enhance preparedness and response to future outbreaks, and positive sentiments as part of the nation's effort to combat the disease.

Conclusion

Ground nurses should be actively involved in outbreak planning to gain a better view of their responsibilities and unpredictable events that may occur. A transparent and bidirectional communication among management and nurses is crucial amidst rapid changes in an outbreak to strike a balance between the needs of nurses and leadership and to enhance nurses’ resilience throughout this challenging journey.

The Effect of Mindfulness Breathing Meditation on Psychological Well-being: A Quasi-Experimental Study Among Nurses Working for COVID-19 Patients

The study aims to test the effect of mindfulness breathing meditation on psychological well-being among nurses working for COVID-19 patients. A total of 50 nurses (25 each in the intervention and control groups) were included in the study. We found significant differences between the preintervention and postintervention mean scores of both groups, based on the Warwick-Edinburgh Mental Well-being Scale Indonesian version.

A cross-sectional study of COVID-19 pandemic-related organizational aspects in health care

Aim

This study explores how healthcare professionals included in the COVID‐19 contingency plan experienced organizational changes, and explores factors associated with the experiences. Additionally, the study aimed to identify learning points for future similar scenarios.

Design

A cross‐sectional study.

Methods

A questionnaire survey of healthcare professionals at three Danish hospitals, June 2020.

Results

A total of 1,448 healthcare professionals completed the questionnaire. Hereof, 813 (57%) were relocated to new settings/new jobs. The majority experienced that their relocation was totally (49%) or partially (31%) imposed, and 51% reported that the overall experience of the new job function was satisfactory. Type of profession and whether relocation to the new job function was imposed were the main variables associated with the overall experience of being part of the contingency plan. Suggestions for future scenarios included training adjusted to individual competencies, more targeted information, voluntariness with consideration of individual needs and clarification of expectations.

The lived experience of healthcare professionals working frontline during the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic: A qualitative systematic review

Objective

To synthesize qualitative literature exploring the lived experience of healthcare workers (HCWs) who cared for patients during the following infectious disease outbreaks (IDOs): the 2003 SARS epidemic, 2009 H1N1 pandemic, 2012 MERS outbreak, and 2014 EVD epidemic. We aim to reveal the collective experience of HCWs during these four IDOs and to create a reference for comparison of current and future IDOs.

Methods

Three electronic databases were searched, yielding 823 results after duplicates were removed. Forty qualitative and mixed-methods studies met the criteria for full file review. Fourteen studies met the inclusion and exclusion criteria. The data from the Results or Findings sections were manually coded and themes were conceptualized using thematic analysis.

Results

Of the 14 studies, 28.6% focused on SARS, 21.4% on H1N1, 21.4% on MERS, and 28.6% on EVD. Studies occurred in six different countries and included physicians, nurses, paramedics, and emergency medical technicians as participants. Five themes were conceptualized: Uncertainty, Adapting to Change, Commitment, Sacrifice, and Resilience.

Conclusion

This review identified the collective experience of HCWs caring for patients during four 21st century IDOs. This qualitative systematic review offers a reference to compare similarities and differences of other IDOs, including the COVID-19 pandemic.

The association between moral distress and mental health among nurses working at selected hospitals in Iran during the COVID-19 pandemic

BACKGROUND

In the event of an epidemic outbreak, the mental health of medical staff, including nurses who serve on the frontlines of hospitals, can be affected; thus, the identification of factors affecting nurses' mental health is of importance.

OBJECTIVE

This study aimed to examine the association between moral distress and the mental health of nurses working at four selected hospitals in Iran during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A cross-sectional questionnaire survey was conducted on 296 nurses working at the selected hospitals in Bushehr and Shiraz (south of Iran) at the time of the COVID-19 outbreak. The collected data were analyzed via logistic regression analysis.

RESULTS

The mean scores for nurses' moral distress were low (54.31±24.84). The results of this study indicated more symptoms of mental issues among nurses (73.60%). Moreover, a significant association was observed between mental health and moral distress. Among the examined demographic variables, only gender had a significant association with mental health (p-value = 0.014).

CONCLUSION

The results of this study indicated that an increase in moral distress would lead to a significant increase in mental health issues of the examined nurses. Nurse managers and hospital policymakers should develop strategies to enhance nurses' level of mental health, as well as providing adequate emotional and family support for nurses. Considering the intensifying role of gender in this association, timely interventions are necessary to reduce the negative effects of workplace pressure/stress on female nurses.

'Stressed, uncomfortable, vulnerable, neglected': a qualitative study of the psychological and social impact of the COVID-19 pandemic on UK frontline keyworkers

OBJECTIVES

Non-healthcare keyworkers face distinct occupational vulnerabilities that have received little consideration within broader debates about 'essential' work and psychological distress during the COVID-19 pandemic. The aim of this study was therefore to explore the impact of the pandemic on the working lives and mental health and well-being of non-healthcare keyworkers in the UK.

DESIGN

In-depth, qualitative interviews, analysed using a reflexive thematic analysis.

SETTING

Telephone or video call interviews, conducted in the UK between September 2020 and January 2021.

PARTICIPANTS

23 participants aged 26-61 (mean age=47.2) years employed in a range of non-healthcare keyworker occupations, including transport, retail, education, postal services, the police and fire services, waste collection, finance and religious services.

RESULTS

Keyworkers experienced adverse psychological effects during the COVID-19 pandemic, including fears of COVID-19 exposure, contagion and subsequent transmission to others, especially their families. These concerns were often experienced in the context of multiple exposure risks, including insufficient personal protective equipment and a lack of workplace mitigation practices. Keyworkers also described multiple work-related challenges, including increased workload, a lack of public and organisational recognition and feelings of disempowerment.

CONCLUSIONS

In efforts to reduce psychosocial concerns among non-healthcare keyworkers, there is a need for appropriate support during the COVID-19 pandemic and in preparation for other infections (eg, seasonal influenza) in the future. This includes the provision of psychological and workplace measures attending to the intersections of personal vulnerability and work conditions that cause unique risks and challenges among those in frontline keyworker occupations.

Nursing student experiences in turmoil: A year of the pandemic and social strife during final clinical rotations

Background

The duration and magnitude of the coronavirus (COVID-19) posed unique challenges for nursing students, whose education was altered because of the pandemic.

Purpose

To explore the perceptions and experiences of nursing students whose clinical rotations were abruptly interrupted by COVID-19's initial surge in the United States.

Methods

This qualitative study was conducted at a midwestern, academic medical center to elicit senior nursing students' experiences. An online survey was administered with eight open-ended questions asking about: initial impressions of the pandemic; experiences of being a senior nursing student; sources of stress and coping mechanisms; preparing to work as a registered nurse; and views on the nursing profession.

Results

Among the 26 students who completed the survey, the majority were female (92%), aged 28 ∓ 4.1 years. A total of 18 subcategories emerged with four main themes identified as: a) breakdown of normal systems, b) feeling alone and the inability to escape, c) protective factors/adaptability, and d) role identify and formation.

Conclusions

Findings indicate students implemented a variety of strategies while adapting to the abrupt interruption of in-person clinical rotations, mandated restrictions, and social unrest. The cascading themes illustrate the enormity of sudden changes and their significant impact on daily life.

[Nurses' Experience with Caring for COVID-19 Patients in a Negative Pressure Room Amid the Pandemic Situation]

PURPOSE

The purpose of this study was to explore nurses' experience with caring for COVID-19 patients in a negative pressure room amid the spread of the pandemic.

METHODS

This study was a qualitative research, and focus group interviews were used to collect data. Three focus groups comprising 19 nurses were interviewed from February 17 to 25, 2021. All interviews were recorded and transcribed verbatim with the consent of the participants. The verbatim transcripts were scrutinized using thematic analysis.

RESULTS

Two main themes emerged from the analysis: 'Struggling in an isolated space' and 'Limitations of nursing infrastructure and system'. The nurses caring for COVID-19 patients experienced anxiety and fear about the infection, physical exhaustion, emotional burnout, and a sense of duty as a nurse. They also acknowledged the lack of guidelines, increased task and burden, limitations of nursing care, and the demand for improving the limitations of the nursing system.

CONCLUSION

The results of this study demonstrate that nurses caring for COVID-19 patients encounter physical and emotional problems within the limited healthcare system. The study suggests that comprehensive interventions are needed for nurses. Furthermore, detailed guidelines, strengthening of nursing personnel, and improvements to the nursing system are vital to effectively cope with the pandemic. The government and medical institutions should be aware of the needs of nurses and what they are going through, and make efforts to improve the quality of life of healthcare workers and create a safe healthcare environment.

Nurses' experiences of emergency department triage during the COVID-19 pandemic in Indonesia

PURPOSE

To explore the experiences of nurses working in emergency departments in selecting and triaging patients during the COVID-19 pandemic.

DESIGN

Descriptive phenomenology was applied in this study.

METHODS

Data were collected from nurses working at hospitals in Indonesia using snowball sampling and telephone interviews. A total of 10 emergency nurses participated, and Colaizzi's method of data analysis was applied.

FINDINGS

Six themes and 10 subthemes emerged. The main themes were "extreme challenges in triage," "feeling of responsibility under uncontrolled spread and infection," "physical and psychological exhaustion," "discovering strategies under difficult circumstances," "looking for positive reinforcement," and "optimism in togetherness." Nurses had to deal with the challenge of COVID-19 in the ED triage, interestingly so, the nurses they have shown the development of professional responsibility. Nurses are also experienced in finding patient selection and triage strategies and the sense of optimism that may influence strategy and practice during the COVID-19 pandemic.

CONCLUSIONS

This findings identify nurses' experiences in dealing with the extreme challenges of emergency department triage as well as their associated strategies and optimism.

CLINICAL RELEVANCE

Providing support to emergency nurses, improving emergency department triage, and community empowerment are suggested as strategies to improve nursing care during the COVID-19 pandemic.

Lived Experiences of Nurses in the Care of Patients with COVID-19: A Study of Hermeneutic Phenomenology

BACKGROUND

Nurses are at the forefront of caring for patients with COVID-19 and face a life-threatening risk to perform their duties. The complexity of disease conditions such as emerging disease may interfere with good nursing care and holistic care. The aim of this study is to reveal the lived experiences of nurses in the care of patients with COVID-19.

MATERIALS AND METHODS

This qualitative study was conducted in Khoy, Iran from March 2020 to May 2020. Fourteen nurses underwent in-depth semi-structured interviews at COVID-19 Central Hospital. All interviews were recorded, transcribed, and analyzed. Diekelmann's hermeneutic phenomenological approach was used to analyze and interpret the data. MAXQDA software version 2007 was used to manage and organize the data.

RESULTS

After extensive analysis and reflection, four main themes emerged, including staying in an ethical dilemma, emotional turmoil, response to professional commitments, and seeking help.

CONCLUSIONS

The results of this study provided basic information about the lived experiences of nurses in different dimensions. Nursing managers need to be aware of these needs and expectations and provide a variety of programs and strategies not only to support nurses but also to ensure the quality of patient care.

Psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic - A qualitative systematic review

BACKGROUND

Frontline nurses have been directly exposed to the SARS-CoV-2 virus and come in close contact with patients during the COVID-19 pandemic. Nurses execute tasks related to disease control and face multiple psychosocial challenges in their frontline work, potentially affecting their mental well-being and ability to satisfyingly perform their tasks.

OBJECTIVES

To explore the psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic.

DESIGN

The qualitative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Registered in PROSPERO (CRD42021259111).

DATA SOURCES

Literature searches were performed through PubMed, CINAHL, and the WHO COVID-19 database. Inclusion criteria were: All types of nurses having direct contact with or taking care of patients; Primary, secondary, and tertiary health-care services admitting and treating COVID-19 patients; Experiences, perceptions, feelings, views in psychosocial aspects from the identified population group; Qualitative studies; Mixed methods studies; Language in English; Published date 2019-2021. Exclusion criteria were: Commentaries; Reviews; Discussion papers; Quantitative studies; Language other than English; Published in 2018 or earlier; Studies without an ethical approval and ethical statement.

REVIEW METHODS

The studies were screened and selected based on the inclusion and exclusion criteria. Quality appraisal was conducted according to the Critical Appraisal Skills Program qualitative study checklist. Data was extracted from included studies and a thematic synthesis was made.

RESULTS

A total of 28 studies were included in the review. The experiences of 1141 nurses from 12 countries were synthesised. Three themes were constructed: 'Nurses' emotional, mental and physical reactions to COVID-19', 'Internally and externally supported coping strategies', and 'A call for future help and support'.

CONCLUSION

Nurses working frontline during the COVID-19 pandemic have experienced psychological, social, and emotional distress in coping with work demands, social relationships, and their personal life. The results pointed to a need for increased psychological and social support for frontline nurses to cope with stress and maintain mental well-being, which may subsequently affect nursing care outcomes.

High Work-Related Stress and Anxiety as a Response to COVID-19 Among Health Care Workers in South Korea: Cross-sectional Online Survey Study

BACKGROUND

The COVID-19 outbreak had a severe impact on health care workers' psychological health. It is important to establish a process for psychological assessment and intervention for health care workers during epidemics.

OBJECTIVE

We investigated risk factors associated with psychological impacts for each health care worker group, to help optimize psychological interventions for health care workers in countries affected by the COVID-19 pandemic.

METHODS

Respondents (n=1787) from 2 hospitals in Korea completed a web-based survey during the period from April 14 to 30, 2020. The web-based survey collected demographic information, psychiatric history, and responses to the 9-item Stress and Anxiety to Viral Epidemics (SAVE-9), 9-item Patient Health Questionnaire (PHQ-9), and 7-item Generalized Anxiety Disorder-7 (GAD-7) scales. We performed logistic regression to assess contributing factors as predictor variables, using health care workers' depression as outcome variables.

RESULTS

Among 1783 health care workers, nursing professionals had significantly higher levels of depression (PHQ-9 score: meannurse 5.5, SD 4.6; meanother 3.8, SD 4.2; P<.001), general anxiety (GAD-7 score: meannurse 4.0, SD 4.1; meanother 2.7, SD 3.6; P<.001), and virus-related anxiety symptoms (SAVE-9 score: meannurse 21.6, SD 5.9; meanother 18.6, SD 6.3; P<.001). Among nursing professionals, single workers reported more severe depressive symptoms than married workers (PHQ-9 score ≥10; meannurse 20.3%; meanother 14.1%; P=.02), and junior (<40 years) workers reported more anxiety about the viral epidemic (SAVE-9 anxiety score; meannurse 15.6, SD 4.1; meanother 14.7, SD 4.4; P=.002). Logistic regression revealed that hospital (adjusted odds ratio [OR] 1.45, 95% CI 1.06-1.99), nursing professionals (adjusted OR 1.37, 95% CI 1.02-1.98), single workers (adjusted OR 1.51, 95% CI 1.05-2.16), higher stress and anxiety to the viral infection (high SAVE-9 score, adjusted OR 1.20, 95% CI 1.17-1.24), and past psychiatric history (adjusted OR 3.26, 95% CI 2.15-4.96) were positively associated with depression.

CONCLUSIONS

Psychological support and interventions should be considered for health care workers, especially nursing professionals, those who are single, and those with high SAVE-9 scores.

"Surviving to thriving": a meta-ethnography of the experiences of healthcare staff caring for persons with COVID-19

BACKGROUND

The emergence of the Coronavirus disease has heightened the experience of emotional burden among healthcare staff. To guide the development of support programmes, this review sought to aggregate and synthesise qualitative studies to establish a comparative understanding of the experiences of healthcare staff caring for persons with the disease.

DESIGN

A meta-ethnography approach was used to aggregate and synthesise primary qualitative studies. Database search was undertaken from January to November 2020. A standardised tool was used to extract data from the identified primary studies. The studies were translated into each other to formulate overarching concepts/ metaphors which formed the basis of undertaking a narrative synthesis.

RESULTS

Eight qualitative studies met the inclusion criteria. Two overarching metaphors/ concepts were formulated from the primary studies: 1) surviving to thriving in an evolving space and 2) support amid the new normal. The initial phase of entering the space of caring during the outbreak was filled with psychological chaos as healthcare staff struggled to survive within the context of an illness which was not fully understood. Gradually, healthcare staff may transition to a thriving phase characterised by resilience but still experienced heavy workload and physical/ emotional exhaustion predisposing them to burnout and compassion fatigue. Fear persisted throughout their experiences: fear of contracting the disease or infecting one's family members/ loved ones remained a key concern among healthcare staff despite infection precaution measures. Healthcare staff who contracted the disease felt isolated with additional fears of dying alone. The sources of support were varied with a strong emphasis on peer support.

CONCLUSIONS

Healthcare staff caring for persons infected with the Coronavirus disease are at risk of burnout and compassion fatigue and require ongoing mental health support commensurate to their needs. Staff who contract the disease may require additional support to navigate through the illness and recovery. Policies and concerted efforts are needed to strengthen support systems and build resilience among healthcare staff.

Nurses' experiences during the COVID-19 pandemic in Iran: a qualitative study

BACKGROUND

Nurses are at the forefront of patient care during infectious disease pandemics and they play a key role in treating and preventing the upward trend of the disease. Hence, it is crucial to consider their experiences in designing action plans to combat coronavirus disease 2019 (COVID-19). Since there is not enough data in this regard, the current study aimed to investigate the nurses' experiences in caring for patients with COVID-19 in Iran.

METHODS

In this descriptive qualitative study, a total of 20 nurses were selected by purposive sampling. Semi-structured interviews were conducted and analyzed using qualitative content analysis to collect data.

RESULTS

Data analysis revealed four main themes, including 'duality in the form of care,' 'confusion and ambiguity in care planning', 'workload', and 'social isolation in spite of positive image.'

CONCLUSION

Our findings indicated that the nurses experienced a range of paradoxes during the COVID-19 pandemic; these paradoxes included distraction from providing care due to focus on marginal factors in spite of empathy and cooperation in nurses, the presence of volunteer support staff despite the lack of equipment, lack of scientific information and the unreliability of online information, overload in the hospital due to insufficient facilities and equipment, and the physical avoidance of people in the community in spite of social support for nurses in the media. The results of this study can lead to a clear understanding for managers and healthcare policymakers in the country and aid them in taking optimal measures to support nurses and improve the quality of nursing care against COVID-19.

Experiences and Perceptions of Nursing Students during the COVID-19 Crisis in Spain

In the early stages of the 2019 coronavirus pandemic in Spain, the Spanish health system was overwhelmed, mainly due to a lack of personnel, and many hospital centers collapsed by following avalanche of patients with COVID-19; this meant that the National System of Health called for fourth-year nursing students to come to the hospital as health care personnel. Our aim was to describe the perceptions and experiences of a sample of nursing students during the early stages of the outbreak. We conducted a qualitative study with an empirical-phenomenological approach. Twenty nursing students in their final year of study in Spain were recruited using purposive and snowball sampling. They participated in in-depth interviews between 20 April and 10 May 2020. The interviews were transcribed and then analyzed using Haase’s adaptation of Colaizzi’s phenomenological method. Four main themes emerged from data analysis: “social responsibility and pride as a health worker”, “pressure caused by working with COVID-19 patients”, “feeling defenseless and let down”, and “personal growth as a health worker”. These main themes were further divided into 11 theme categories. Due to an intense work day for several days in a row, the students were tired and mentally exhausted. Even so, they managed to overcome any difficulties, demonstrating their professional dedication and resilience. Greater preparatory support should be provided to safeguard the well-being of these future healthcare providers. More intensive preparatory training is necessary for health sciences students to facilitate crisis preparedness and effective crisis management. It is necessary to implement support from healthcare systems, including sufficient personal protective equipment, as well as contracts that accurately reflect the work they do. It is necessary for nursing supervisors to have effective communication in the performance of their functions with nursing students; this dialogue helps to clearly explain which are the functions that students must perform when they are carrying out their internships. There is also a need for preparatory training in managing infectious diseases such as COVID-19.