Being a Nurse at the Ground Zero of Care in Turkey During the COVID-19 Pandemic: A Qualitative Study

Stigmatization experiences of healthcare workers in the context of the COVID-19 pandemic: a scoping review

BACKGROUND

During the COVID-19 pandemic, healthcare workers face the stigmatization of those caring for COVID-19 patients, creating a significant social problem. Therefore, this study investigated the stigmatization of healthcare workers in the context of the COVID-19 pandemic.

METHODS

In this scoping review study, searches were conducted from December 2019 to August 2023 in Persian and English using various databases and search engines including PubMed (Medline), Embase, Scopus, ISI Web of Science, ProQuest, Science Direct, Springer, Cochrane Library, Google Scholar, and national databases. The study used English keywords such as Social Stigma, Health Personnel, Healthcare Worker, Medical Staff, Medical Personal, Physicians, doctors, Nurses, nursing staff, COVID-19, and coronavirus disease 2019, and their Persian equivalents, and their Persian equivalents to explore healthcare workers' experiences of COVID-19-related stigma.

RESULTS

From a total of 12,200 search results, 77 eligible studies were included in this study. stigmatization of healthcare workers caring for COVID-19 patients was evident from the literature because of fear, misinformation, and negative self-image. Manifestations were violence and deprivation of social rights, resulting in adverse biopsychosocial, occupational, and economic consequences. This condition can affect negatively health staff themselves, their families, and society as well. Anti-stigmatization measures include informing society about the realities faced by healthcare workers, presenting an accurate and empathetic image of health workers, providing psychosocial support to health workers, and encouraging them to turn to spirituality as a coping mechanism. There are notable research gaps in comprehending the phenomenon, exploring its variations across diverse healthcare roles and cultural contexts, examining its long-term effects, and monitoring shifts in stigma perceptions over time.

CONCLUSION

The COVID-19 pandemic has resulted in the stigmatization of healthcare workers, causing mistreatment and rights violations. This stigma persists even post-pandemic, posing a psychological dilemma for caregivers. Addressing this requires comprehensive strategies, including tailored stigma prevention programs and research to understand its psychological impact.

Turkish Validity and Reliability of the Self-Applied Acute Stress Scale (EASE) for Healthcare Providers

Background

Acute stress induced by a sudden burden of emergency conditions and traumatic events, such as wars, earthquakes, situations requiring isolation, pandemics, and disasters, can have pathological consequences on healthcare providers (HCPs) if not diagnosed early. Therefore, the objective of this investigation is to culturally validate the self-administered Acute Stress Scale (EASE) in the Turkish context.

Method

The study consisted of 127 HCPs working with COVID-19 patients in services and clinics during the pandemic. The individual information form and EASE were used for data collection. Confirmatory factor analysis (CFA) was used to test the factor structure of the EASE.

Results

All the statistical procedures showed that the Turkish version of the EASE scale is a valid and reliable measurement tool for the Turkish culture. The content validity index (CVI = 0.84), intraclass correlation coefficient (ICC = 0.912), and model fit indices (χ 2/df = 1.826, RMSEA = 0.083, CFI = 0.947, NFI = 0.893, GFI = 0.905) explained two-factor structure.

Conclusion

Institutional approaches are necessary to support the psychological needs of HCPs. The Turkish version of the EASE scale demonstrated adequate reliability and validity properties. The scale could provide appropriate support during the early stages of acute stress among HCPs related to needs during isolation conditions or unexpected emergencies such as recent pandemics and epidemics in the future.

Nurses' perspectives on professional self-concept and its influencing factors: A qualitative study

BACKGROUND

Nurses with a strong professional self-concept tend to exhibit a positive mindset and strong work engagement, delivering high-quality patient care. Although numerous quantitative studies have examined the factors impacting professional self-concept, there remains a limited exploration of these factors from the perspective of nurses themselves.

METHODS

This qualitative descriptive study uses the PERMA theory and Social Cognitive Theory as the theoretical framework. Semi-structured interviews were conducted with 15 nurses from six public hospitals in China. The data were analyzed thematically using a combination of inductive and deductive approaches.

RESULTS

Nurses' understanding of professional self-concept could be divided into four categories: professional identity, competence, care, and knowledge. Factors influencing nurses' professional self-concept were categorized into eight subthemes in three domains: (1) personal factors, including psychological qualities and attitude towards the nursing profession; (2) occupational-related behavioral factors, including role-oriented behavior and knowledge-oriented behavior; and (3) work environment and external factors, including external evaluation and perceptions of nurses, time allocation, nursing work tasks, work atmosphere, school education, and perceived supports.

CONCLUSIONS

This study found that, although nurses had different personal experiences, their perceptions of professional self-concept were similar. Nurses' professional self-concept is a multidimensional concept and involves various factors, such as personality, work-related characteristics, environment, and family. To thrive in a nursing career, nurses must discern the factors that can enhance or hinder their professional self-concept. By identifying and adjusting these factors, personalized support and positive interventions can be tailored to meet nurses' specific needs, which ultimately nurtures their professional development.

TRIAL REGISTRATION

This study was registered on December 14, 2022, in the Chinese Clinical Trial Registry (ChiCTR2200066699) as part of our ongoing study.

How do shared values improve eudaimonic workplace well-being: role of perceived justice and emotional exhaustion among nurses

PURPOSE

This study aims to explore how shared values improve eudaimonic workplace well-being, the fulfillment that comes from personal development and the utilization of personal capabilities. The authors investigate the serial mediating role that perceived overall justice and emotional exhaustion play in how shared values relate to well-being.

DESIGN/METHODOLOGY/APPROACH

Using data collected from three hundred nurses in Turkish healthcare institutions during the COVID-19 pandemic (Male = 113, Female = 187). The age of participants ranged from 19 to 58 and the average age was 34. The snowball sampling method was used to form the sample and self-administered surveys that could be completed online were delivered to the sampled nurses.

FINDINGS

The authors analysis using partial least square structural equation modeling (PLS-SEM) supported the expected relationship between shared values and eudaimonic workplace well-being as well as the mediating role of perceived overall justice and emotional exhaustion. The authors also show a serial mediation where shared values are related to justice perceptions which in turn negatively relate to emotional exhaustion which subsequently relates to higher levels of eudaimonic workplace well-being.

ORIGINALITY/VALUE

The results of this study suggest that when the shared values between the healthcare institution and the employees are aligned, the eudaimonic well-being of employees is higher. The findings provide implications for the mental health of frontline employees in health organizations to have higher levels of eudaimonic well-being which is especially important in times of intense pressure such as the period during the COVID-19 pandemic.

Facing the unknown COVID-19 pandemic: A qualitative study with nurses and nursing assistants in three European countries

Background

The coronavirus disease (COVID-19) is now a worldwide public health emergency. As essential and central parts of the COVID-19 patient care team, nurses and nurse assistants are facing all kinds of challenges caused by the disease and the pandemic. Understanding these challenges and the way nurses and nurse assistants handle and cope with them provides important knowledge on how to improve management of future pandemics and endemic situations. Thus, the present study explored the challenges faced by nurses and nurse asssitants who cared for COVID-19 patients in hospitals and long term care facilities in Italy, Austria and Germany.

Methods

The study employed a qualitative design. Purposive sampling was used to select the participants consisting on nurses (n = 30), nurse coordinators (n = 6) and nurse assistants (n = 5) from hospitals (n = 32) and long-term care facilities (n = 9) in Austria, Germany, and Italy. Data were collected between August and December 2020 through semi-structured interviews. The collected data were analyzed using qualitative content analysis.

Results

The analysis of the data revealed three main themes with twelve sub-categories: (i) Knowledge, skills, and training (lack of knowledge; skills; organizational issues; training); (ii) resources and risk (lack of protective equipment; difficulties with protective equipment; risk and infection; feelings and isolation); (iii) coping strategies (humor; adaption; team effort; self-care; family and friends).

Conclusion

Nurses and nurse assistants who participated in this study faced many personal and professional challenges, and used different coping strategies to manage the situation. Some of these strategies can be applied to reduce these challenges and create better working conditions for nurses and nurse assistants in similar events. Further research, training of staff, and adaptation of institutional policies may help develop new strategies to face future pandemics successfully.

Experiences of nurses diagnosed with COVID-19 and recovered: A qualitative research

AIM

This study aimed to explain the feelings and experiences of nurses who survived COVID-19 in their care and recovery processes, based on Watson's theory of human caring.

BACKGROUND

The COVID-19 pandemic was an extraordinary time when nurses both took care of their patients and dealt with their illness by catching the disease themselves. In this process, nurses who contracted the disease experienced the fear of transmitting the disease to their relatives.

METHOD

A qualitative descriptive research design was used in this study. The sample consists of 15 nurses selected by the convenience sampling method and diagnosed with COVID-19 and recovered. The data were collected in face-to-face interviews using the individual in-depth interview method through a semi-structured interview form. A thematic analysis was performed on the data according to the 10 carative factors of Watson's theory of human caring.

RESULTS

It was determined that the spiritual and professional difficulties experienced by nurses who recovered from COVID-19 during the disease and symptom management process were the fear of death, infecting their family members and losing them, and the importance of life.

CONCLUSION

It is considered that care practices based on Watson's theory of human caring will be beneficial in the management of these processes.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurses diagnosed with COVID-19 should be supported by the nursing management during their illness so that their negative experiences will not be repeated. Watson's theory of human caring can help eliminate this sense of fear and loss.

Experiences and needs of front-line nurses during the COVID-19 pandemic: A systematic review and qualitative meta-synthesis

Background

Front-line nurses have played a critical role during the coronavirus disease 2019 (COVID-19) pandemic. A number of qualitative studies reported front-line nurses' experiences and needs in caring for patients with COVID-19. However, the application of evidence from a single qualitative study to guide clinical practice has limitations. This study aimed to explore front-line nurses' experiences and needs during the COVID-19 pandemic through a qualitative meta-synthesis.

Methods

Seven databases were searched from 1 December 2019 to 20 January 2022, including PubMed, Web of Science, Cochrane COVID-19 study register, CINAHL, PsycINFO, MedRxiv, and bioRxiv. The quality of included studies was appraised using the Critical Appraisal Skills Program (CASP) qualitative research appraisal tool. Meta-synthesis was used to synthesize the data from included studies.

Results

A total of 70 studies were included, and five synthesized findings were developed: (1) Although nurses actively devoted themselves to fighting against COVID-19, considering their professional responsibility and historical previous experience with mankind, they were not invulnerable; (2) There were various difficulties and challenges in caring for patients with COVID-19, including fear related to providing patients with care, shortage of protective equipment and manpower, and negative attitude of family members; (3) Facing difficulties and challenges, nurses could only partly cope by using mixed means to overcome those, including media, learning, gaining skills, responding together, and organizational assistance; (4) To better respond to the COVID-19 pandemic, nurses' needs should be paid attention to. Counseling, training, information, resources, and investment are pivotal; (5) Despite the hardships, nurses became stronger and gained gratitude, positivity, mental peace, and confidence.

Conclusions

This study reveals that the psychological experiences of front-line nurses varied, and they faced a variety of challenges. Although nurses had some coping strategies, they still needed multifaceted support to meet the challenges.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, PROSPERO: CRD42021255468.