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Navalpotro-Pascual S, Matellán-Hernández MP, Pastor-Benito E, Soto-Cámara R, Cárdaba-García RM, García-Santa-Basilia N, Onrubia-Baticón H, Mahtani-Chugani V. Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study. Arch Public Health 2024; 82:15. [PMID: 38291523 PMCID: PMC10826038 DOI: 10.1186/s13690-023-01233-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic had a major psychological impact on health care workers (HCWs). This study was embedded in a larger quantitative study on the mental health care of out-of-hospital HCWs in Spain. To better understand this, a qualitative study was conducted to explore the experiences, coping strategies, and influencing factors of out-of-hospital HCWs who scored high (> 25 points) on the Depression Anxiety Stress Scale (DASS-21) in a previous quantitative mental health study. METHODS A qualitative study was conducted using six in-depth interviews with individuals who scored high on the depression scale and agreed to be contacted by email between May and June 2021, using the phenomenological approach. The data were analysed using Brawn and Clare's method. RESULTS The main results findings related to four themes. The emotional impact of assuming a professional role with high self-demands and responsibilities; Factors influencing the development of negative emotions such as the cruelty of the pandemic, the helplessness in relation to health management and policy, the changing role of the professional and the relationship with society; Personal protection through coping strategies to manage negative emotions such as support from colleagues and family; Good practices for the future looking for different management strategies that can influence individuals and their personal, professional, and social relationships. CONCLUSION The strong impact of the circumstances experienced points to the need to develop psychological support programmes that can protect people's mental health from depression during a crisis and improve the relationship between workers and their managers.
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Affiliation(s)
- Susana Navalpotro-Pascual
- Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.
- Emergency Medical Service of Madrid-SUMMA 112, Madrid, Spain.
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain.
| | - María Paz Matellán-Hernández
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
| | - Elena Pastor-Benito
- Emergency Medical Service of Madrid-SUMMA 112, Madrid, Spain
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
| | - Raúl Soto-Cámara
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
- Department of Health Sciences, University of Burgos, Burgos, Spain
| | - Rosa M Cárdaba-García
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Faculty of Nursing of Valladolid, Valladolid, Spain
- Nursing Care Research Group (GICE), Department of Nursing, University of Valladolid, Valladolid, Spain
| | - Noemi García-Santa-Basilia
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
| | - Henar Onrubia-Baticón
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
| | - Vinita Mahtani-Chugani
- Healthcare Quality Assessment and Information Systems Service, Santa Cruz de Tenerife, Tenerife, Spain
- Primary Care Management of Tenerife, Santa Cruz de Tenerife, Tenerife, Spain
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Huff NR, Liu G, Chimowitz H, Gleason KT, Isbell LM. COVID-19 related negative emotions and emotional suppression are associated with greater risk perceptions among emergency nurses: A cross-sectional study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023; 5:100111. [PMID: 36467310 PMCID: PMC9710107 DOI: 10.1016/j.ijnsa.2022.100111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background As the COVID-19 pandemic began, frontline nurses experienced many emotions as they faced risks relevant to both patients (e.g., making errors resulting in patient harm) and themselves (e.g., becoming infected with COVID-19). Although emotions are often neglected in the patient safety literature, research in affective science suggests that emotions may significantly impact nurses' perceptions of risk, which can have downstream consequences. Further, the use of chronic emotion regulation strategies that are known to differ in adaptability and effectiveness (i.e., emotional suppression, reappraisal) can impact risk perceptions. Objective To investigate the relationship between nurses' emotional experiences in response to the pandemic and their estimates of how likely they would be to experience adverse outcomes related to both patients and themselves within the next six months. Additionally, we investigated the extent to which the use of suppression and reappraisal processes to manage emotions are associated with these risk perceptions. Design Cross-sectional survey. Setting Online survey distributed via email to emergency nurses at eight hospitals in the northeastern United States during fall 2020. Participants 132 emergency nurses (M age = 37.05; 81.1% Female; 89.4% White). Methods Nurses reported the extent to which they experienced a variety of positive (e.g., hope, optimism) and negative (e.g., fear, sadness) emotions in response to the COVID-19 pandemic, and reported their perceptions of risk to both patients and themselves. Nurses also completed the Emotion Regulation Questionnaire, a measure of chronic tendencies to engage in emotional suppression and reappraisal. Immediately prior to providing data for this study, nurses completed an unrelated decision-making study. Results Nurses' negative emotions in response to COVID-19 were associated with greater perceptions of both patient safety risks (b = 0.31, p < .001) and personal risks (b = 0.34, p < .001). The relationships between positive emotions and risk perceptions were not statistically significant (all p values > 0.66). Greater chronic tendencies to suppress emotions uniquely predicted greater perceptions of patient safety risks (b = 2.91, p = .036) and personal risks (b = 2.87, p = .040) among nurses; however, no statistically significant relationships with reappraisal emerged (all p values > 0.16). Conclusions Understanding factors that influence perceptions of risk are important, given that these perceptions can motivate behaviours that may adversely impact patient safety. Such an understanding is essential to inform the development of interventions to mitigate threats to patient safety that emerge from nurses' negative emotional experiences and their use of different emotion regulation strategies. Tweetable abstract Covid-related negative emotions and emotional suppression are associated with greater patient and personal risk perceptions among emergency nurses @lindamisbell @Nathan_Huff_1.
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Affiliation(s)
- Nathan R. Huff
- Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA, 01003 United States
| | - Guanyu Liu
- Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA, 01003 United States
| | - Hannah Chimowitz
- Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA, 01003 United States
| | - Kelly T. Gleason
- School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, Maryland, 21205 United States
| | - Linda M. Isbell
- Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way, Amherst, MA, 01003 United States,Corresponding author
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Bandini JI, Ahluwalia SC, Timmins G, Bialas A, Meredith L, Gidengil C. "It Haunts Me": Impact of COVID-19 Deaths on Frontline Clinicians In Acute Care Settings-A Qualitative Study. Am J Crit Care 2023; 32:368-374. [PMID: 37652873 DOI: 10.4037/ajcc2023257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND The COVID-19 pandemic created unprecedented conditions for clinicians providing end-of-life care in acute care settings, yet almost 2 years since the start of the pandemic, little is known about its impact on clinicians. OBJECTIVES To qualitatively explore how clinicians experienced their role as they cared for dying patients with COVID-19 during the pandemic and the impact of these experiences on their lives as health care professionals. METHODS In-depth, hour-long interviews were conducted by phone in the spring of 2022 at a single time point with 23 physicians and nurses in critical care and emergency department settings from 2 health systems in California. The goal was to elicit perspectives on experiences with end-of-life care and the long-term impact of these experiences. Clinicians were asked to reflect on the different stages of the pandemic, and interviews were analyzed using a thematic analysis. RESULTS The interviews highlighted 2 primary themes around provision of end-of-life care during the COVID-19 pandemic. First, clinicians described challenges around their clinical duties of providing care to dying patients, which included decision-making dilemmas and professionalism challenges. Second, clinicians described the emotional aspects around end-of-life care situations they experienced, including communication with family members, "being patients' family members" at the end of life, and various degrees of meaning-making and remembrance of these experiences. CONCLUSIONS The findings highlight the sustained and cumulative emotional challenges and burden clinicians are still shouldering more than 2 years after the start of the pandemic.
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Affiliation(s)
- Julia I Bandini
- Julia I. Bandini is a behavioral/social scientist, RAND Corporation, Boston, Massachusetts
| | - Sangeeta C Ahluwalia
- Sangeeta C. Ahluwalia is a senior policy researcher, RAND Corporation, Santa Monica, California
| | - George Timmins
- George Timmins is a PhD student, Pardee RAND Graduate School and an assistant policy researcher at RAND Corporation, Santa Monica, California
| | - Armenda Bialas
- Armenda Bialas is a research assistant, RAND Corporation, Pittsburgh, Pennsylvania
| | - Lisa Meredith
- Lisa Meredith is a senior behavioral scientist, RAND Corporation, Santa Monica, California
| | - Courtney Gidengil
- Courtney Gidengil is a senior physician policy researcher, RAND Corporation, Boston, Massachusetts
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Adams GC, Reboe-Benjamin M, Alaverdashvili M, Le T, Adams S. Doctors' Professional and Personal Reflections: A Qualitative Exploration of Physicians' Views and Coping during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5259. [PMID: 37047874 PMCID: PMC10094024 DOI: 10.3390/ijerph20075259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
Numerous studies have examined the risks for anxiety and depression experienced by physicians during the COVID-19 pandemic. Still, qualitative studies investigating physicians' views, and their discovered strengths, are lacking. Our research fills this gap by exploring professional and personal reflections developed by physicians from various specialties during the pandemic. Semi-structured interviews were conducted with physicians practicing in the province of Saskatchewan, Canada, during November 2020-July 2021. Thematic analysis identified core themes and subthemes. Seventeen physicians, including nine males and eight females, from eleven specialties completed the interviews. The pandemic brought to the forefront life's temporality and a new appreciation for life, work, and each other. Most physicians found strength in values, such as gratitude, solidarity, and faith in human potential, to anchor them professionally and personally. A new need for personal fulfilment and hybrid care emerged. Negative feelings of anger, fear, uncertainty, and frustration were due to overwhelming pressures, while feelings of injustice and betrayal were caused by human or system failures. The physicians' appreciation for life and family and their faith in humanity and science were the primary coping strategies used to build adaptation and overcome negative emotions. These reflections are summarized, and implications for prevention and resilience are discussed.
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Shoorab NJ, Mirzakhani K, Aradmehr M, Irani M. Trying to Control the Situation: A Theory of Iranian Midwives' Experiences of the Coping Process with their Professional Roles Following COVID-19. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:294-300. [PMID: 36275346 PMCID: PMC9580573 DOI: 10.4103/ijnmr.ijnmr_245_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/01/2021] [Accepted: 02/16/2022] [Indexed: 11/22/2022]
Abstract
Background Midwives are at the frontlines of the fight against the Coronavirus Disease (COVID-19) pandemic. Working under these circumstances threatens their lives and that of their family members; midwives' adjustment to work increases their efficiency in providing care services to pregnant mothers, but midwives' coping process is ambiguous and complex. Thus, the aim of this study was to explore the coping process of midwives with their professional roles following COVID-19. Materials and Methods This study was conducted using grounded theory during 2020 to 2021. For this purpose, 30 midwives were purposively and theoretically selected from two educational hospitals and health centers in Mashhad and Torbat Heydarieh cities, Iran. The data were collected using in-depth semi-structured interviews. The collected data were analyzed using the Strauss and Corbin method (2008) in MAXQDA software. Results The main concern of the participants was "perception of the threats to their health" and the core category revealed from the data was "trying to control the situation." Midwives coped with the COVID-19 pandemic in four steps, namely early initial confrontation, reaction to the COVID-19 pandemic, management of challenges, and reconstructing. Support from family and the health system and religious belief were the interventional conditions in this theory. Conclusions Results of this study can be used to provide health managers with a better understanding of the conditions affecting the coping strategies of midwives with their professional roles during COVID-19. Therefore, this study provides the required data for developing an effective intervention to help nurse midwives to cope with this issue.
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Affiliation(s)
- Nahid Jahani Shoorab
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran,Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kobra Mirzakhani
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran,Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Aradmehr
- Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Morvarid Irani
- Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,Address for correspondence: Morvarid Irani, Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh Universityof Medical Sciences, Torbat Heydariyeh, Iran. E-mail:
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Curtin M, Richards HL, Fortune DG. Resilience among health care workers while working during a pandemic: A systematic review and meta synthesis of qualitative studies. Clin Psychol Rev 2022; 95:102173. [PMID: 35636130 PMCID: PMC9126830 DOI: 10.1016/j.cpr.2022.102173] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 12/23/2022]
Abstract
Background Aim Method Results Conclusion
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Affiliation(s)
- Mariah Curtin
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland
| | - Helen L Richards
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland; Department of Clinical Health Psychology, Mercy University Hospital, Cork T12 WE28, Ireland
| | - Donal G Fortune
- Department of Psychology, University of Limerick, Limerick V94 T9P, Ireland; Clinical Psychology, Health Service Executive, CHO3 Mid West, Ireland.
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