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Manthorpe J, Harris J, Burridge S, Fuller J, Martineau S, Ornelas B, Tinelli M, Cornes M. Social Work Practice with Adults under the Rising Second Wave of Covid-19 in England: Frontline Experiences and the Use of Professional Judgement. BRITISH JOURNAL OF SOCIAL WORK 2021; 51:bcab080. [PMCID: PMC8136088 DOI: 10.1093/bjsw/bcab080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 05/23/2023]
Abstract
The impacts on adult social work in England of the Covid-19 pandemic were sudden and are proving long-standing. In England, many social workers moved to home working and virtual contact with colleagues, managers, staff from other agencies and service users. A first national lockdown was followed by a lessening of restrictions, but a second wave started at the end of Summer 2020 and restrictions were re-introduced. This study draws on telephone interviews with a sample of twenty-two social workers working with adults in a wide range of roles and settings in ten local authorities and two National Health Service Hospital Trusts, interviewed August–October 2020. Following transcription, interview data were analysed thematically. Findings are reported under three emerging themes: using professional judgement, new and emerging case work and embedding change. These are compared with findings from studies of practice in children’s services and of surveys of social workers during the Covid-19 pandemic. Implications for practice, service users and research are explored.
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Affiliation(s)
- Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce, Policy Institute, King’s College London, UK Strand, London WC2R 2LS, UK
| | - Jess Harris
- Expert Focus Ltd, c/o NIHR Policy Research Unit in Health and Social Care Workforce, Policy Institute, King's College London, Strand, London WC2R 2LS, UK
| | - Stan Burridge
- NIHR Policy Research Unit in Health and Social Care Workforce, Policy Institute, King’s College London, UK Strand, London WC2R 2LS, UK
| | - James Fuller
- NIHR Policy Research Unit in Health and Social Care Workforce, Policy Institute, King’s College London, UK Strand, London WC2R 2LS, UK
| | - Stephen Martineau
- Brighter Futures and Voices of Stoke, 5 Whittle Court, Town Road, Hanley, Stoke-on-Trent ST1 2QE, UK
| | - Bruno Ornelas
- Care Policy Evaluation Centre, London School of Economics and Political Science, Houghton St, London WC2A 2AE, UK
| | - Michela Tinelli
- NIHR Policy Research Unit in Health and Social Care Workforce, Policy Institute, King’s College London, UK Strand, London WC2R 2LS, UK
| | - Michelle Cornes
- Correspondence to Jill Manthorpe, NIHR Policy Research Unit in Health and Social Care Workforce, Policy Institute, King’s College London, Strand, London WC2R 2LS, UK. E-mail:
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Turner S, Botero-Tovar N, Herrera MA, Borda Kuhlmann JP, Ortiz F, Ramírez JC, Maldonado LF. Systematic review of experiences and perceptions of key actors and organisations at multiple levels within health systems internationally in responding to COVID-19. Implement Sci 2021; 16:50. [PMID: 33962635 PMCID: PMC8103061 DOI: 10.1186/s13012-021-01114-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND COVID-19 has presented challenges to healthcare systems and healthcare professionals internationally. After one year of the pandemic, the initial evidence on health system responses begins to consolidate, and there is a need to identify and synthesise experiences of responding to COVID-19 among healthcare professionals and other health system stakeholders. This systematic review of primary qualitative studies depicts the experiences and perceptions of organisations and actors at multiple levels of health systems internationally in responding to COVID-19. METHODS Six main databases of biomedical information, public health and health administration research were searched over the period October 1, 2019, to October 21, 2020. Information extracted from included studies was analysed thematically. RESULTS Thirty-four studies were eligible for data extraction. Nine of those studies, of lower methodological quality, were removed from the thematic analysis of study results. Considering the professional level experiences, predominant themes of the studies consisted of the new roles and responsibilities of healthcare workers, burnout and distress, recognition of ´unseen´ healthcare workers, and positive changes and emergent solutions amid the crisis. Organisational level findings of the studies included provision of psychological support, COVID-19 as "catalyst" for change, and exercise of more "open" leadership by managers and health authorities. Continuous training, regulation of working conditions, providing supportive resources, coordinating a diversity of actors, and reviewing and updating regulations were roles identified at the local health system level. CONCLUSIONS The experiences of frontline healthcare workers have been the focus of attention of the majority of primary qualitative studies as of October 2020. However, organisational and wider system level studies indicate that some responses to COVID-19 have been characterised by increased emphasis on coordination activities by local health system actors, making service adaptations at pace, and reliance on expanded roles of front-line workers. The need for theory-informed qualitative studies was identified at the organisational level. TRIAL REGISTRATION CRD42020202875.
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Affiliation(s)
- Simon Turner
- School of Management, University of los Andes, Bogotá, Colombia
| | | | | | | | - Francisco Ortiz
- School of Management, University of los Andes, Bogotá, Colombia
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Rao H, Mancini D, Tong A, Khan H, Santacruz Gutierrez B, Mundo W, Collings A, Cervantes L. Frontline interdisciplinary clinician perspectives on caring for patients with COVID-19: a qualitative study. BMJ Open 2021; 11:e048712. [PMID: 33947739 PMCID: PMC8098296 DOI: 10.1136/bmjopen-2021-048712] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To describe the drivers of distress and motivations faced by interdisciplinary clinicians who were on the frontline caring for patients with COVID-19. DESIGN 50 semistructured interviews. Transcripts were analysed using qualitative thematic analysis. SETTING A safety-net hospital in Denver, Colorado. PARTICIPANTS Interdisciplinary frontline clinicians including physicians, advance practice providers, nurses, respiratory therapists and paramedics providing inpatient hospital care to patients hospitalised for COVID-19. RESULTS Fifty clinicians (32 women and 18 men) participated. Five themes with respective subthemes (in parentheses) were identified: depersonalisation and barriers to care (impeding rapport and compassion, focusing on infection risk at the expense of high-quality care, grief from witnessing patients suffer in isolation), powerless in uncertainty (inescapable awareness of personal risk, therapeutic doubt in a void of evidence, confronting ethical dilemmas, struggling with dynamic and unfamiliar challenges), overwhelmed and exhausted (burden of personal protective equipment (PPE), information overload and confusion, overstretched by additional responsibilities at work, compounded by personal life stressors, feeling vulnerable and dispensable, compassion fatigue, distress from the disproportionate impact on socially oppressed communities), bolstering morale and confidence (motivated by community and family support, equipped with data), and driven by moral duty (responsibility to patient care and community, collegial solidarity and collaboration, contributing to the greater good). CONCLUSION Frontline clinicians reported distress due to the challenges of PPE, uncertainty and powerlessness, new responsibilities at work and home, losing control of their schedules, grief from witnessing patients suffer in isolation and witnessing healthcare disparities exacerbated by this pandemic. Clinicians feel supported by their colleagues, families, and community and were driven by a sense of moral duty. Healthcare system should adopt strategies to minimise distress faced by interdisciplinary clinicians on the frontline of COVID-19.
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Affiliation(s)
- Hassan Rao
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
| | - Diana Mancini
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Humaira Khan
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - William Mundo
- University of Colorado, Anschutz Medical Campus, Denver, Colorado, USA
| | | | - Lilia Cervantes
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
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Dinić M, Šantrić Milićević M, Mandić‐Rajčević S, Tripković K. Health workforce management in the context of the COVID-19 pandemic: A survey of physicians in Serbia. Int J Health Plann Manage 2021; 36:92-111. [PMID: 33817831 PMCID: PMC8251267 DOI: 10.1002/hpm.3141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND & AIM The study describes the experiences and opinions of Serbian physicians regarding workforce management during the COVID-19 pandemic. MATERIALS & METHODS A total of 1553 licensed physicians (65% males; average age 44.0 years) responded to an online survey in September 2020. Differences in the respondents' general data and attitudes regarding workforce management and outbreak preparedness in Serbia were analysed in relation to their engagement during the COVID-19 pandemic (Pearson χ2 and the independent samples t-test, p < 0.05). The logistic regression model explained the need for changing health workforce management. RESULTS The results reveal that the physicians engaged in the fight against the spread of COVID-19 (64.4% of the respondents) more often than their counterparts, were clinicians from the public sector, younger, with less work experience, influenced negatively by the pandemic, and reassigned to other positions (p < 0.001). Health workers dissatisfied with workplace preparedness and those reassigned due to COVID-19 were by 2.61 times and 1.38 times, respectively, more likely than their counterparts to consider changes in health workforce management. DISCUSSION & CONCLUSION COVID-19 underlines the need for changes in health workforce management during public health emergencies. An internal incident management team and a panel of external experts may support health workforce management during the prolonged and rapidly changing crises.
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Affiliation(s)
| | | | - Stefan Mandić‐Rajčević
- Faculty of MedicineInstitute of Social Medicine and the Centre‐School of Public Health and Health ManagementUniversity of BelgradeBelgradeSerbia
| | - Katica Tripković
- Department for Analysis, Planning and Organization of Health CareInstitute of Public Health of BelgradeBelgradeSerbia
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Tired, Worried and Burned Out, but Still Resilient: A Cross-Sectional Study of Mental Health Workers in the UK during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094457. [PMID: 33922281 PMCID: PMC8122760 DOI: 10.3390/ijerph18094457] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 01/07/2023]
Abstract
The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.
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Vanderslott S, Van Ryneveld M, Marchant M, Lees S, Nolna SK, Marsh V. How can community engagement in health research be strengthened for infectious disease outbreaks in Sub-Saharan Africa? A scoping review of the literature. BMC Public Health 2021; 21:633. [PMID: 33794820 PMCID: PMC8012744 DOI: 10.1186/s12889-021-10348-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Community engagement (CE) is a well-established practical and scholarly field, recognised as core to the science and ethics of health research, for which researchers and practitioners have increasingly asked questions about desired standards and evaluation. In infectious disease outbreak contexts, questions may be more complex. However, it is unclear what body of knowledge has been developed for CE specifically as it applies to emerging infectious diseases. This scoping review seeks to describe (1) How CE has been conceptualised and understood; and (2) What conclusions have research teams reached on the effectiveness of CE in these settings, including challenges and facilitators. METHODS We used a scoping review framework by Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005) to structure our review. We conducted a brainstorming session and initial trial search to inform the protocol, search terms, and strategy. Three researchers discussed, developed and applied agreed screening tools and selection criteria to the final search results. Five researchers used the screening tools to screen abstracts and full text for inclusion by consensus. Additional publications were sought from references of retrieved publications and an expert call for literature. We analysed and reported emerging themes qualitatively. RESULTS We included 59 papers from a total of 722 articles derived from our trial and final literature searches, as well as a process of "citation chasing" and an expert call for grey literature. The core material related exclusively to health research trials during the 2014-2016 West Africa Ebola outbreak. We synthesized reports on components of effectiveness of CE to identify and propose three themes as essential elements of effective CE. CONCLUSIONS While there is a large volume of literature documenting CE activities in infectious disease research settings generally, there are few accounts of effectiveness dimensions of CE. Our review proposes three themes to facilitate the effectiveness of CE initiatives as essential elements of CE activities in infectious diseases studies: (1) Communication towards building collaborative relationships; (2) Producing contextual knowledge; and (3) Learning lessons over time. As there were relatively few in-depth accounts of CE from our literature review, documentation and accounts of CE used in health research should be prioritised.
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Affiliation(s)
- Samantha Vanderslott
- Oxford Vaccine Group & Oxford Martin School, University of Oxford, 34 Broad St, Oxford, OX1 2BD, UK.
| | - Manya Van Ryneveld
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535, Republic of South Africa
| | - Mark Marchant
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Shelley Lees
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Sylvie Kwedi Nolna
- Department of Public Health, University of Yaounde I, Rue Melen, Yaounde, Cameroon
| | - Vicki Marsh
- KEMRI Wellcome Trust Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, NDM, Oxford University, Oxford, UK
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
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157
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Blake H, Gupta A, Javed M, Wood B, Knowles S, Coyne E, Cooper J. COVID-Well Study: Qualitative Evaluation of Supported Wellbeing Centres and Psychological First Aid for Healthcare Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3626. [PMID: 33807306 PMCID: PMC8036934 DOI: 10.3390/ijerph18073626] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/24/2022]
Abstract
Supported wellbeing centres were set up in UK hospital trusts as an early intervention aimed at mitigating the psychological impact of COVID-19 on healthcare workers. These provided high quality rest spaces with peer-to-peer psychological support provided by National Health Service (NHS) staff volunteers called 'wellbeing buddies', trained in psychological first aid. The aim of the study was to explore the views of centre visitors and operational staff towards this COVID-19 workforce wellbeing provision. Qualitative semi-structured interviews were undertaken with twenty-four (20F, 4M) employees from an acute hospital trust in the UK. Interviews were digitally recorded and transcribed, data were handled and analysed using thematic analysis. Interviews generated 3 over-arching themes, and 13 sub-themes covering 'exposure and job roles', 'emotional impacts of COVID-19 and 'the wellbeing centres'. Supported wellbeing centres were viewed as critical for the wellbeing of hospital employees during the first surge of COVID-19 in the UK. Wellbeing initiatives require managerial advocacy and must be inclusive. Job-related barriers to work breaks and accessing staff wellbeing provisions should be addressed. High quality rest spaces and access to peer-to-peer support are seen to benefit individuals, teams, organisations and care quality. Training NHS staff in psychological first aid is a useful approach to supporting the wellbeing of the NHS workforce during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
| | - Alisha Gupta
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (A.G.); (M.J.)
| | - Mahnoor Javed
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (A.G.); (M.J.)
| | - Ben Wood
- Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (B.W.); (S.K.); (E.C.); (J.C.)
| | - Steph Knowles
- Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (B.W.); (S.K.); (E.C.); (J.C.)
| | - Emma Coyne
- Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (B.W.); (S.K.); (E.C.); (J.C.)
| | - Joanne Cooper
- Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (B.W.); (S.K.); (E.C.); (J.C.)
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ENT trainees' experience of redeployment during the coronavirus disease 2019 pandemic: a qualitative study. The Journal of Laryngology & Otology 2021; 135:391-395. [PMID: 33734060 PMCID: PMC8047395 DOI: 10.1017/s0022215121000840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background As a response to the acute strain placed on the National Health Service during the first wave of coronavirus disease 2019 in the UK, a number of junior doctors including ENT trainees were redeployed to other clinical specialties. This presented these trainees with novel challenges and opportunities. Methods A qualitative study was performed to explore these experiences, undertaking semi-structured interviews with ENT trainees between 17th and 30th July. Participants were recruited through purposeful sampling. Interview transcripts underwent thematic analysis using Dedoose software. Results Seven ENT trainees were interviewed, ranging from specialty trainee years four to eight (‘ST4’ to ‘ST8’) in grade. Six core themes were identified: organisation of redeployment, utilisation of skill set, emotional impact of redeployment, redeployed team dynamics, concerns about safety and impact on training. Conclusion The ENT trainees’ experiences of redeployment described highlight some important lessons and considerations for future redeployments.
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Banerjee D, Sathyanarayana Rao TS, Kallivayalil RA, Javed A. Psychosocial Framework of Resilience: Navigating Needs and Adversities During the Pandemic, A Qualitative Exploration in the Indian Frontline Physicians. Front Psychol 2021; 12:622132. [PMID: 33796046 PMCID: PMC8007982 DOI: 10.3389/fpsyg.2021.622132] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/22/2021] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Frontline healthcare workers (HCW) have faced significant plight during the ongoing Coronavirus disease 2019 (COVID-19) pandemic. Studies have shown their vulnerabilities to depression, anxiety disorders, post-traumatic stress, and insomnia. In a developing country like India, with a rising caseload, resource limitations, and stigma, the adversities faced by the physicians are more significant. We attempted to hear their "voices" to understand their adversities and conceptualize their resilience framework. METHODS A qualitative approach was used with a constructivist paradigm. After an initial pilot, a socio-demographically heterogeneous population of 172 physicians working in COVID-designated centers were purposively sampled from all over India. Following in-depth virtual interviews using a pre-formed semi-structured guide, the data was transcribed and translated verbatim. The interview was focused on their challenges, needs, and processes of coping and support. Charmaz's grounded theory was used for analysis supplemented by NVivo 10 software. RESULTS Fear of infection, uncertainty, stigma, guilt, and social isolation emerged as the main challenges. Simultaneously, their "unmet needs" were flexible work policies, administrative measures for better medical protection, the sensitivity of media toward the image of HCW, effective risk communication for their health, and finally, social inclusion. Their resilience "framework" emerged as a process while navigating these adversities and consisted of three facets: forming a "resilient identity," managing the resilience, and working through the socio-occupational distress. The role of mental well-being, social network, peer support, problem negotiation, and self-care emerged as the key coping strategies. CONCLUSION The study findings support the global call for better psychosocial health and quality of life of the frontline HCWs. Their "unheard voices" explored in the study can anchor subsequent resilience-enhancing interventions and policies. Guidelines focusing on the psychological wellbeing of frontline HCWs need to be grounded in their unmet needs and lived experiences.
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Affiliation(s)
- Debanjan Banerjee
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - T. S. Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India
| | - Roy Abraham Kallivayalil
- Department of Psychiatry, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, India
| | - Afzal Javed
- Pakistan Psychiatric Research Centre, Fountain House Lahore, Islamabad, Pakistan
- President, World Psychiatric Association (WPA), Geneva, Switzerland
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Skapetis T, Law C, Rodricks R. Systematic review: bioethical implications for COVID-19 research in low prevalence countries, a distinctly different set of problems. BMC Med Ethics 2021; 22:22. [PMID: 33658019 PMCID: PMC7928193 DOI: 10.1186/s12910-021-00589-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has presented extraordinary challenges to worldwide healthcare systems, however, prevalence remains low in some countries. While the challenges of conducting research in high-prevalence countries are well published, there is a paucity from low COVID-19 countries. Methods A PRISMA guided systematic review was conducted using the databases Ovid-Medline, Embase, Scopus and Web of Science to identify relevant articles discussing ethical issues relating to research in low prevalence COVID-19 countries. Results The search yielded 133 original articles of which only 2 fit the inclusion criteria and aim, with neither specific to low prevalence. Most of the available literature focused on clinical management and resource allocation related to high prevalence countries. These results will be discussed under the ethical dimensions of equity, individual liberty, privacy and confidentiality, proportionality, public protection, provision of care, reciprocity, stewardship and trust.. Conclusions A systematic review failed to identify articles relating to COVID-19 research ethics, specific to low prevalence countries. It shows that there is a significant gap in the literature that warrants further investigation. Common ethical principles were used to present a distinct set of challenges experienced by a country with a low prevalence of COVID-19. This unique perspective of some of the common ethical problems surrounding research, may help guide further discussion and guide research in similar countries.
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Affiliation(s)
- Tony Skapetis
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Westmead Campus, NSW, 2145, Australia. .,Division of Oral Health, Western Sydney Local Health District, Westmead, NSW, Australia.
| | - Constance Law
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Westmead Campus, NSW, 2145, Australia.,Division of Oral Health, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Rohan Rodricks
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Westmead Campus, NSW, 2145, Australia.,Division of Oral Health, Western Sydney Local Health District, Westmead, NSW, Australia
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Aughterson H, McKinlay AR, Fancourt D, Burton A. Psychosocial impact on frontline health and social care professionals in the UK during the COVID-19 pandemic: a qualitative interview study. BMJ Open 2021; 11:e047353. [PMID: 33558364 PMCID: PMC7871227 DOI: 10.1136/bmjopen-2020-047353] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/14/2021] [Accepted: 01/29/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic. DESIGN This was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding. PARTICIPANTS This study involved 25 participants from a range of frontline professions in health and social care. SETTING Interviews were conducted over the phone or video call, depending on participant preference. RESULTS From the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life. CONCLUSIONS This study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.
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Affiliation(s)
- Henry Aughterson
- Department of Behavioural Science and Health, University College London Research Department of Epidemiology and Public Health, London, UK
| | - Alison R McKinlay
- Department of Behavioural Science and Health, University College London Research Department of Epidemiology and Public Health, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London Research Department of Epidemiology and Public Health, London, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London Research Department of Epidemiology and Public Health, London, UK
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Gender Matters: A Gender Analysis of Healthcare Workers’ Experiences during the First COVID-19 Pandemic Peak in England. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10020043] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The coronavirus (COVID-19) arrived in the United Kingdom (UK) in February 2020, placing an unprecedented burden on the National Health Service (NHS). Literature from past epidemics and the COVID-19 pandemic underscores the importance of using a gender lens when considering policy, experiences, and impacts of the disease. Researchers are increasingly examining the experiences of healthcare workers (HCWs), yet there is a dearth of research considering how gender shapes HCWs’ personal experiences. As the majority of HCWs in the UK and worldwide are women, research that investigates gender and focuses on women’s experiences is urgently needed. We conducted an analysis of 41 qualitative interviews with HCWs in the British NHS during the first peak of the COVID-19 pandemic in the Spring of 2020. Our findings demonstrate that gender is significant when understanding the experiences of HCWs during COVID-19 as it illuminates ingrained inequalities and asymmetrical power relations, gendered organizational structures and norms, and individual gendered bodies that interact to shape experiences of healthcare workers. These findings point to important steps to improve gender equality, the wellbeing of healthcare workers, and the overall strength of the NHS.
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Hoernke K, Djellouli N, Andrews L, Lewis-Jackson S, Manby L, Martin S, Vanderslott S, Vindrola-Padros C. Frontline healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in the UK: a rapid qualitative appraisal. BMJ Open 2021; 11:e046199. [PMID: 33472794 PMCID: PMC7818840 DOI: 10.1136/bmjopen-2020-046199] [Citation(s) in RCA: 147] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To report frontline healthcare workers' (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in the UK. To understand HCWs' fears and concerns surrounding PPE, their experiences following its guidance and how these affected their perceived ability to deliver care during the COVID-19 pandemic. DESIGN A rapid qualitative appraisal study combining three sources of data: semistructured in-depth telephone interviews with frontline HCWs (n=46), media reports (n=39 newspaper articles and 145 000 social media posts) and government PPE policies (n=25). PARTICIPANTS Interview participants were HCWs purposively sampled from critical care, emergency and respiratory departments as well as redeployed HCWs from primary, secondary and tertiary care centres across the UK. RESULTS A major concern was running out of PPE, putting HCWs and patients at risk of infection. Following national level guidance was often not feasible when there were shortages, leading to reuse and improvisation of PPE. Frequently changing guidelines generated confusion and distrust. PPE was reserved for high-risk secondary care settings and this translated into HCWs outside these settings feeling inadequately protected. Participants were concerned about differential access to adequate PPE, particularly for women and Black, Asian and Minority Ethnic HCWs. Participants continued delivering care despite the physical discomfort, practical problems and communication barriers associated with PPE use. CONCLUSION This study found that frontline HCWs persisted in caring for their patients despite multiple challenges including inappropriate provision of PPE, inadequate training and inconsistent guidance. In order to effectively care for patients during the COVID-19 pandemic, frontline HCWs need appropriate provision of PPE, training in its use as well as comprehensive and consistent guidance. These needs must be addressed in order to protect the health and well-being of the most valuable healthcare resource in the COVID-19 pandemic: our HCWs.
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Affiliation(s)
- Katarina Hoernke
- Institute for Global Health, University College London, London, UK
| | - Nehla Djellouli
- Institute for Global Health, University College London, London, UK
| | - Lily Andrews
- Institute of Epidemiology and Health Care, University College London, London, UK
| | | | - Louisa Manby
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Sam Martin
- Oxford Vaccine Group, University of Oxford, Oxford, UK
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