Exploring stress coping strategies of frontline emergency health workers dealing Covid-19 in Pakistan: A qualitative inquiry

What we learned from the infection control and what we need in the future: A quantitative and qualitative study on hospital infection prevention and control practitioners (HIPCPs) in Tianjin, China

BACKGROUND

In December 2022, the epidemic prevention and control policy was upgraded, and China entered a different stage of epidemic control. This study aims to identify implications for better infection control and health care supply during the epidemic.

METHODS

A longitudinal quantitative and qualitative study was performed based on 2 comprehensive questionnaire surveys among 497 hospital infection prevention and control practitioners (HIPCPs) before and during the epidemic peak in Tianjin, China.

RESULTS

The workload (8.2 hours vs 10.14 hours, P = 0) and self-reported mental health problems (23.5% vs 61.8%, P < .05) among the HIPCPs increased significantly in the peak period. Ward reconstruction and resource coordination were the most needed jobs in hospital infection control, and rapidly increased medical waste during the epidemic needs to be considered in advance. Community support for health care personnel and their families, maintaining full PPE to reduce simultaneous infection of medical staff, and clinical training of infectious diseases for medical staff, especially doctors, in advance are the most important things we learned.

CONCLUSION

Although it has been 4 years since the first outbreak of coronavirus disease 2019, more improvements should be made to prepare for the next epidemic of potential diseases.

Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care

OBJECTIVE

To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services.

DESIGN

Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021).

METHODS

The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health.

RESULTS

The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care.

CONCLUSIONS

Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality.

IMPLICATIONS

The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk.

REPORTING METHOD

We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

Lived experiences of COVID-19 patients admitted in isolation wards of healthcare centers in Peshawar, Pakistan: A phenomenological perspective

The emergence of COVID-19 caused a significant global threat, affecting populations worldwide. Its impact extended beyond just physical health, as it inflicted severe damage and challenges to individuals' well-being, leading to a deterioration in mental health. The lived experiences of patients hold a paramount position to explore and understand their perception of care which can ultimately strengthen the health system's delivery domain. This study explores the lived experiences of patients in the isolation ward, their recovery, and the quality of care being provided in the hospital and its effects on their mental health.

Study design

A phenomenological qualitative study using in-depth interviews.

Methods

We conducted 11 in-depth interviews of COVID-19 patients admitted to the isolation ward of the public hospitals of Peshawar, Pakistan. Participants who stayed for a minimum of 10 days in an isolation ward were included in this study. Interviews were transcribed and analyzed using NVivo 12 software and generated five themes through inductive analysis.

Results

Five themes emerged from the participants' lived experiences: Heading towards the hospital, Health Care Quality, Impact on Mental Health, Recovering from COVID-19 and Back on one's feet. These included all the positive and negative lived experiences. Socio-environmental factors along with their experiences of the disease itself and with the healthcare providers guided their reaction which was important conciliators in their experiences during the pandemic.

Conclusion

Based on the findings, the environment of isolation had a major influence on the mental well-being of the individuals involved. Considering the important role of the ward environment in shaping patient experiences and outcomes prompts a reevaluation of healthcare practices and policies. By addressing these factors healthcare systems can strive for greater effectiveness, resilience, and compassion in managing the pandemic's impact on patient care.

The Perspectives of Healthcare Professionals on the Strategies, Challenges, and Community Responses to Health System Response and Interventions Towards Lassa Fever Infections and Mortality in Sierra Leone

Background

Lassa fever is a critical public health issue in Sierra Leone that demands appropriate health system responses and interventions to mitigate infections and reduce mortality.

Methods

A qualitative study was conducted to delve into healthcare workers' experiences with Lassa fever management and interventions across diverse healthcare settings in Sierra Leone, including the Eastern Province and Freetown's Directorate of Health Security and Emergency (DHSE). Engaging ten key informants through purposive sampling, the study employed NVivo version 10 for a detailed thematic analysis using Query and Coding to systematically identify, classify, and organize key themes regarding knowledge, diagnostics, management roles, and community impact.

Results

The findings indicate a well-informed healthcare workforce but highlight gaps in early detection, diagnostic accuracy, and procedural standardization. Concerns were raised about the potential overestimation of disease incidence due to improved diagnostics, suggesting a historical under-detection of Lassa fever. The analysis underscores the need for a multifaceted management approach, emphasizing international collaboration and culturally sensitive community engagement to effectively tackle the disease. A significant concern identified is the high mortality rate resulting from delayed referrals and communication challenges within the health system, leading to actionable recommendations for enhancing Lassa fever response strategies. The study's thematic analysis provides a nuanced understanding of the challenges and areas for improvement, emphasizing the critical role of healthcare professionals in combating Lassa fever.

Conclusion

Combating Lassa fever in Sierra Leone demands an integrative strategy that extends beyond medical interventions to encompass educational and infrastructural enhancements. This research pays homage to the commitment of healthcare professionals, underscoring the importance of sustained support and recognition of their essential contributions to advancing Lassa fever management and interventions.

Frontline health workers' experiences of providing care for people living with non-communicable diseases during the COVID-19 pandemic in Ghana: a qualitative study

BACKGROUND

The COVID-19 pandemic has significantly impacted frontline health workers. However, a neglected dimension of this discourse was the extent to which the pandemic impacted frontline healthcare workers providing non-communicable diseases (NCDs) care. This study aims to understand the experiences of healthcare workers with no prior exposure to pandemics who provided care to people living with NCDs (PLWNCDs).

METHODS

A qualitative study design was employed, using a face-to-face in-depth interviews. Interviews were conducted in primary healthcare facilities in three administrative regions of Ghana, representing the Northern, Southern and Middle Belts. Only frontline health workers with roles in providing care for PLWNCDs were included. Purposive snowballing and convenience sampling methods were employed to select frontline health workers. An open-ended interview guide was used to facilitate data collection, and thematic content analysis was used to analyse the data.

RESULTS

A total of 47 frontline health workers were interviewed. Overall, these workers experienced diverse patient-driven and organisational challenges. Patient-level challenges included a decline in healthcare utilisation, non-adherence to treatment, a lack of continuity, fear and stigma. At the organisational levels, there was a lack of medical logistics, increased infection of workers and absenteeism, increased workload and burnout, limited motivational packages and inadequate guidelines and protocols. Workers coped and responded to the pandemic by postponing reviews and consultations, reducing inpatient and outpatient visits, changing their prescription practices, using teleconsultation and moving to long-shift systems.

CONCLUSION

This study has brought to the fore the experiences that adversely affected frontline health workers and, in many ways, affected the care provided to PLWNCDs. Policymakers and health managers should take these experiences into account in plans to mitigate the impact of future pandemics.

"Who Else If Not Us": An Exploratory-Descriptive Qualitative Study of Kazakhstani Frontline Professionals' Experience and Perceptions During the Coronavirus Disease 2019 Pandemic

Little is known about the experiences of frontline professionals in Kazakhstan. Although studies of frontline workers have been conducted worldwide, it is imperative that caution should be exercised when extrapolating findings from disparate societies and generalizing them to Central Asian countries. As such, the purpose of this study was to explore and describe the firsthand experiences, perceptions, and knowledge gained from the experience of Kazakh frontline physicians and nurses during the COVID-19 pandemic. An exploratory-descriptive qualitative (EDQ) study was conducted over the course of a year in COVID-19 hospitals in Kazakhstan, with physicians (n = 23) and nurses (n = 7). Each participant was interviewed three times between May 2021 and May 2022. Braun and Clarke's six-step method was used for the thematic analysis. Three overarching themes and subthemes were identified: (1) Longitudinal Journey ("Nobody knew, nobody understood, nobody was ready"; "It's just life"); (2) Facets of Professionalism ("In my lifetime this is something unique"; "Who else if not us"; "We survived the war and the enemy"); and (3) Facets of Resilience ("God's providence"; "A good word heals too"). In light of the lack of research that has previously been conducted in Kazakhstan, the results of this study offer important new insight into the experiences of medical professionals during the COVID-19 epidemic.

Nurses' mental workload and public health emergency response capacity in COVID-19 pandemic: A cross-sectional study

AIMS

The aim of this study was to assess the level of mental workload of Chinese nurses through a latent profile analysis and to explore its relationship with public health emergency response capacity.

DESIGN

A cross-sectional design with a convenience sample.

METHODS

A convenience sample of nurses from five tertiary hospitals in Chengdu between May and December 2022. Demographic, work-related information, Nurse's version of NASA's Task Load Index Scale and Nurse's Public Health Emergency Response Capacity Scale were used in this study.

RESULTS

The mean scores for mental workload and emergency response capacity for nurses were (57.19 ± 15.67) and (3.58 ± 0.77) respectively. We found that the mental workload of nurses fell into three potential categories. In addition, there were differences in psychological training and supply of epidemic prevention materials in the department among nurses with different mental workload subtypes. There was a moderate negative correlation between nurses' mental workload and public health emergency response capacity.

CONCLUSION

Our results show that there is still a strong mental workload on a proportion of nurses, and enhanced psychological training and material supply support are beneficial in relieving nurses' mental workload. The better the nurses' capacity to cope with public health emergencies, the lower their mental workload.

IMPACT

Nursing managers should pay ongoing attention to the mental workload status of nurses in the latter stages of a pandemic and individual differences in nurses' mental workload. In addition, nursing managers should be aware of the impact of public health emergency response capacity on nurses' mental workload. They can intervene in nurses mental workload from a new perspective.

PATIENT OR PUBLIC CONTRIBUTION

560 registered nurses participated in this study.

Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study

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.

Perceived risk of infection, ethical challenges and motivational factors among frontline nurses in Covid-19 pandemic: prerequisites and lessons for future pandemic

BACKGROUND

Infection risk was significant for front-line nurses during the Covid-19 outbreak. The pandemic presented several ethical difficulties and sapped nurses' drive to labor harder for longer periods. This study evaluates registered nurses' perceptions of Covid-19 infection risk, ethical dilemmas, and motivating factors.

MATERIALS AND METHODS

During March and April 2022, 400 registered nurses from a newly established tertiary care hospital participated in this cross-sectional exploratory survey. The risk assessment scale, motivation to work scale, and ethical dilemma scale were used to assess the perceived risk of infection, motivational factors and ethical challenges experienced by the nurses. Appropriate descriptive and inferential statistics were applied to compute the results.

RESULTS

76.4% of nurses feared working as a nurse put them at higher risk of infection. Besides the fear of contracting infection, nurses believed they were the source of infection to family members (70.8%) and people around (67.5%). 63.3% of nurses agree that they do not have the right to refuse treatment and every patient has the right to receive optimal care, regardless of age, gender, and medical conditions. Professional obligation to treat patients (72.3%) and sound professional knowledge and experience (83.5%) are important motivating factors to work during the pandemic. Multilinear regression analysis revealed that professional education (95% CI, 3.845 - 0.694, p = 0.005), Covid-19 positive status (95% CI,0.455-2.756, p = 0.006), and post-Covid-19 hospitalization (95% CI, 1.395-6.978, p = 0.003) and duration of hospitalization (95% CI, 0.754-0.058, p = 0.022) are independent predictors of higher perceived risk of infection among nurses.

CONCLUSIONS

During the pandemic, nurses were afraid to work and faced personal and family risks of contracting the virus. Despite these challenges, they still feel a strong sense of commitment and dedication to providing the best possible care. Nurse administrators need to create a supportive environment that follows ethical principles and meets the needs of nurses to boost their motivation and encourage them to continue working for longer periods.

Mental Health Among Healthcare Workers During the COVID-19 Pandemic in Vietnam

OBJECTIVES

The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors.

METHODS

A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale.

RESULTS

In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05).

CONCLUSIONS

Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

From pervasive chaos to evolutionary transition: The experience of healthcare providers during the COVID-19 pandemic

AIM

The outbreak of the COVID-19 pandemic confronted healthcare providers, especially physicians and nurses, with many unprecedented changes and physical and psychological pressures. This study aimed to explore the healthcare providers' experiences providing healthcare services for patients during the COVID-19 pandemic in "Golestan, Northeast Iran".

DESIGN

Qualitative, conventional content analysis.

METHODS

A total of 13 eligible participants were recruited through the purposeful sampling method. Data were gathered using semi-structured in-depth individual interviews. Transcripts were analysed using an inductive content analysis based on the Elo and Kyngas model. The COREQ checklist was used to prepare the manuscript.

RESULTS

The analysis of the data in this study led to the development of 16 subthemes and 5 themes emerged as follows pervasive chaos, imposed difficulties, paradoxical perceptions, committed efforts, and constructive transition.

CONCLUSION

The experience of HCPs during the COVID pandemic in "Iran" showed that despite the physical, mental, emotional, and social consequences, a kind of constructive evolution and transition has also taken place in personal, professional, and organizational dimensions. It is suggested that managers while strengthening and protecting the capabilities and skills that have emerged, to reduce the tensions of HCPs, have developed programs for comprehensive support from them in physical, psychological, social, and financial dimensions.

RELEVANCE TO CLINICAL PRACTICE

It is necessary to improve inter-professional cooperation, empathy, teamwork, professional commitment, and continuous learning in crises.

Mental health and protective strategies among community-based health workers in region 3, Philippines during COVID-19 pandemic

The COVID-19 crisis in the Philippines posed both physical and psychological threats to health workers. It is vital to determine practices to protect them. This study determined the prevalence of mental health outcomes among community-based health workers during the COVID-19 pandemic and examined the association of protective strategies with symptoms of mental health outcomes. A cross-sectional study design was applied to the records of community-based health workers conducted through online psychological assessment by Department of Health - Central Luzon between September 1-30, 2020. Respondents' age, sex, mental health status, and protective strategies were extracted using Abstraction Form, and analyses were done using OpenEpi. A total of 324 records of community-based health workers were included in the analysis. Ten percent of the respondents present symptoms of stress, 26% anxiety symptoms, and 18% depressive symptoms. The majority of the respondents were using deep breathing techniques, having a constant social connection with family and friends, and engaging in their regular spiritual/religious activities as protective strategies during the pandemic. Engagement in regular spiritual/religious practices was found associated with symptoms of stress through Fisher's exact test. Participants who engaged in religious/spiritual practices were less likely to report symptoms of stress. Community-based health workers showed evident rates of symptoms of stress, anxiety, and depression. The majority of the participants engaged in various protective strategies but only engagement in regular religious/spiritual practices was found associated with symptoms of stress.

A cross-sectional study on coping strategies of frontline healthcare workers amid the COVID-19 pandemic in a developing country

Objectives

Frontline healthcare workers encountered a heightened susceptibility to negative psychological symptoms and behavioral shifts in light of the coronavirus disease 2019 pandemic. This study determined the coping strategies adopted by frontline healthcare workers in Ghana as well as assessed any differences based on demographics, job title, and ranking in four coronavirus disease 2019-designated centers in the Greater Accra region of Ghana.

Methods

Using a hospital-based, mixed-method approach, the study was conducted between May 2021 and September 2021. A total of 94 frontline healthcare workers were randomly sampled and given a self-administered questionnaire, while 13 healthcare workers took in-depth interviews. Data from the survey were analyzed using both IBM SPSS and IBM AMOS and the interview data were transcribed verbatim and coded using thematic analysis.

Results

The study revealed that coronavirus disease 2019 has affected the psycho-social life of frontline healthcare workers mainly in the form of depression, anxiety, and stress. The three main coping strategies adopted by frontline healthcare workers include personal preventative measures (most dominant), seeking external expert support, and obtaining institutional support. While healthcare workers within the age group 30-39 years were found most compliant with the adoption of personal preventive measures and those below 30 years were found least compliant.

Conclusion

This study concludes that frontline healthcare workers have been affected by a considerable level of anxiety, stress, and depression during the coronavirus disease 2019 pandemic. The study recommends a robust psychological support system at various levels of health care and an Employee Assistance Program with access to a 24-h hotline counseling service for frontline healthcare workers, continuous personal protective equipment provision, regular evidence-based updates on the management of coronavirus disease 2019 patients, and increased commitment from the government in addressing the medical needs of infected frontline healthcare workers.

Enhancing a Willingness to Respond to Disasters and Public Health Emergencies Among Health Care Workers, Using mHealth Intervention: A Multidisciplinary Approach

Health care workers (HCWs) are increasingly faced with the continuous threat of confronting acute disasters, extreme weather-related events, and protracted public health emergencies. One of the major factors that determines emergency-department-based HCWs' willingness to respond during public health emergencies and disasters is self-efficacy. Despite increased public awareness of the threat of disasters and heightened possibility of future public health emergencies, the emphasis on preparing the health care workforce for such disasters is inadequate in low-and-middle-income countries (LMICs). Interventions for boosting self-efficacy and response willingness in public health emergencies and disasters have yet to be implemented or examined among emergency HCWs in LMICs. Mobile health (mHealth) technology seems to be a promising platform for such interventions, especially in a resource-constrained setting. This paper introduces an mHealth-focused project that demonstrates a model of multi-institutional and multidisciplinary collaboration for research and training to enhance disaster response willingness among emergency department workers in Pakistan.

The impact of COVID-19 on the mental health and well-being of ambulance care professionals: A rapid review

The COVID-19 pandemic has a significant impact on the health and well-being of all healthcare professionals. However, for ambulance care professionals it is unknown on which health outcomes the impact of COVID-19 is measured, and what the actual impact on these health outcomes is. Therefore, the aim of this study was to gain insight in a) which type of health outcomes were measured in relation to the impact of COVID-19 among ambulance care professionals, and b) to determine the actual impact on these outcomes. A rapid review was performed in PubMed (including MEDLINE) and APA PsycInfo (EBSCO). All types of study designs on health and well-being of ambulance care professionals were included. Selection on title an abstract was performed by pairs of two reviewers. Full text selection, data extraction and quality assessment were performed by one reviewer, with a check by a second independent reviewer. The systematic searches identified 3906 unique hits, seven articles meeting selection criteria were included. Six studies quantitatively measured distress (36,0%) and PTSD (18.5%-30.9%), anxiety (14.2%-65.6%), depression (12.4%-15.3%), insomnia (60.9%), fear of infection and transmission of infection (41%-68%), and psychological burden (49.4%-92.2%). These studies used a variety of instruments, ranging from internationally validated instruments to self-developed and unvalidated questionnaires. One study qualitatively explored coping with COVID-19 by ambulance care professionals and reported that ambulance care professionals use five different strategies to cope with the impact of COVID-19. There is limited attention for the health and well-being of ambulance care professionals during the COVID-19 pandemic. Although the included number of studies and included outcomes are too limited to draw strong conclusions, our results indicate higher rates of distress, PTSD and insomnia compared to the pre-COVID-19 era. Our results urge the need to investigate the health and well-being of ambulance care professionals during and after the COVID-19 pandemic.

Stress coping strategies of Iranian healthcare staff during the COVID-19 pandemic: A cross-sectional study

The COVID-19 pandemic has exposed healthcare staff to mental distress. Given the importance of applying effective strategies to cope with stress caused by COVID-19, this study aimed to assess the stress-coping strategies of Iranian healthcare providers. This cross-sectional study was performed through a web-based survey. Data collection was done online using a demographic data questionnaire and the short form of Endler and Parker's coping inventory. The mean scores of task-oriented strategies (27.06 ± 5.13) were higher than avoidance-oriented (19.42 ± 5.77) and emotion-oriented strategies (18.45 ± 5.76), and the healthcare workers mainly used task-oriented styles to cope with COVID-19-related stress. There was a significant difference between the score of task-oriented strategy in terms of age groups (P < 0.001), work experience (P = 0.018), level of education (P < 0.001), having children (P = 0.002), and type of hospital (P = 0.028). The score of task-oriented strategies was lower in employees who were in the age group of 20-30 years and had less than 10 years of work experience, and it was higher in employees who had children, worked in private hospitals, and had a master's degree or higher. The score of emotion-oriented strategies in the age group of 51-60 years was significantly lower than other age groups (P < 0.01) and was significantly higher in employees with a bachelor's degree than those with a master's degree or higher (P = 0.017). There was no significant difference between the scores of avoidance-oriented strategies and any socio-demographic variables. According to the findings of this study, young and less experienced employees were more inclined to utilize emotion-oriented coping styles. Therefore, considering appropriate training programs for these employees to apply effective coping strategies is extremely important.

Experience of chinese counter-marching nurses with COVID-19 patients' death in Wuhan: a qualitative study

BACKGROUND

The COVID-19 pandemic was occurring worldwide with over a 6.5 million deaths. It's important to explore the instructions for the global nursing community by identifying the personal coping methods of Chinese nurses in Wuhan to deal with patient deaths.

METHODOLOGY

The study used a qualitative conventional content analysis with 14 Chinese Counter-marching nurses. Purposive sampling, snowball sampling, and semi-structured interviews were used for participants and data collection. To assess the quality of the findings, Guba and Lincoln's criteria for confidence were fulfilled.

RESULTS

The data analysis results in 4 main categories:(1) psychological shocks related to COVID-19 patient's death; (2) personal psychological adjustment and demands; (3) insights on life and values; (4) Needs for relevant knowledge and skills.

CONCLUSIONS

During the outbreak of the epidemic or pandemic, adequate psychological care resources need to be provided to nurses when facing the death of infectious patients, to reduce the negative emotions brought by death. Effective coping strategies should also be formulated to enhance their resilience and promote their professional competence.

Mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic in Luton, England

BACKGROUND

The COVID-19 pandemic intensified the risk factors for poor mental health among care workers in the UK. However, there is inadequate evidence on the mental health impact of COVID-19 on Black, Asian, and minority ethnic (BAME) care workers in particular. This study seeks to explore mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic.

METHOD

This is a qualitative study conducted between February and May, 2021 in Luton, England. A sample of n = 15 care workers from BAME background working in nursing and residential care homes were recruited purposively using the snowball sampling technique. In-depth interviews were conducted around topics such as views on COVID-19, the impact of the COVID-19 pandemic on mental health and coping during the COVID-19 pandemic. Data from the interviews was analysed using the Framework Analysis Approach.

RESULTS

The COVID-19 pandemic had a negative impact on the participants' mental health as they experienced stress, depression, anxiety, trauma and paranoia. The majority of the participants explained that they managed their mental health by belief in God and religious practices, by keeping themselves busy doing activities they were passionate about, following government guidelines on the prevention of COVID-19, seeing the service users happy and some participants managed through support that was offered by the government. However, some participants did not have any support for their mental health.

CONCLUSION

Issues such as increased workload associated with COVID-19 restrictions engendered mental health problems among BAME care workers, however, the workload only further increased during the pandemic, but the health and social care sector was already affected by heavy workload due to staff shortages and this needs to be addressed through increasing their wages to encourage more people to work in the health and social care sector. In addition, some BAME care workers never received any support for their mental health during the pandemic. Hence, integrating mental health services such as counselling, supportive psychotherapy and recreational therapies in care homes could help to support the mental health of care workers in the COVID-19 era.

Coping strategies adopted by frontline nurses in dealing with COVID-19 patients in a developing country during the pandemic: A qualitative study

AIM

This study aimed to explore the coping strategies adopted by frontline nurses in dealing with COVID-19 patients during the pandemic in Bangladesh.

DESIGN

A qualitative descriptive study.

METHODS

Purposive sampling was used to recruit seventeen frontline nurses from three COVID-19-specific hospitals in Dhaka City. In-depth online interviews and semi-structured questionnaires were used to collect data through the Google Meet platform. Interview sessions audio-video were recorded, interpreted, analysed, verbatim transcribed and quotes of the participants were verified by member checking. Thematic analysis was used in this research. The study's reporting guidelines were based on the consolidated criteria for reporting qualitative research.

RESULTS

Seven themes were identified after careful data analysis: (i) A positive attitude in dealing with challenging situation, (ii) Intimate partner's influence, (iii) Self-emotional regulation, (iv) The tendency to avoid negativity, (v) Motivated by professional obligations, (vi) Religious influence, (vii) Recreational activities.

NO PATIENT OR PUBLIC CONTRIBUTION

This study explored various coping strategies employed by frontline nurses in caring for COVID-19 patients. No patient or public contribution was investigated.

Burnout and coping strategies among resident physicians at an Indonesian tertiary referral hospital during COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has increased the burden on resident physicians. They may use different coping strategies to manage those burdens, which partly determine their mental health outcomes, including burnout syndrome. This study explores the relationship between coping strategies and burnout among resident physicians during the COVID-19 pandemic in an Indonesian tertiary referral hospital.

METHODS

This online cross-sectional study was conducted from June to August 2020, involving nine residency programs in the Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital. Burnout syndrome was assessed using Maslach Burnout Inventory, while Brief COPE measured coping strategies.

RESULTS

A total of 388 residents participated in this study. High emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA) were found in 15.5%, 5.2%, and 39.2%, respectively. Residents more often use adaptive than maladaptive coping strategies. Higher PA was correlated to residents using problem-focused (r = 0.299; p < 0.001) and emotion-focused (r = 0.397; p < 0.001). Meanwhile, dysfunctional coping strategies are moderately correlated with EE (r = 0,518; p <0,001) and DP (r = 0,507; p<0,001).

CONCLUSION

The use of dysfunctional coping strategies is linked to higher emotional exhaustion and depersonalization aspect of burnout. However, a higher sense of personal accomplishment is linked to problem-focused and emotion-focused strategies. Appropriate identification and intervention of residents with dysfunctional coping strategies may be beneficial in reducing burnout risk.

Prevalence of and risk factors associated with depression among nursing students acting on the frontline of COVID-19 pandemic: A cross-sectional study

Introduction

The widespread devastation caused by the ongoing waves of COVID-19 imposed a significant burden on the healthcare labor force. At the frontline in the battle against the deadly COVID-19 virus, nursing students in Vietnam were at a much-increased risk of developing mental health conditions. This study aims to identify the prevalence of depression and its related factors, along with coping strategies used by nursing students in the COVID-19 pandemic in Vietnam.

Materials and methods

The study was cross-sectional in nature, with convenient sampling at the epicenters of COVID-19 outbreaks in Vietnam (N = 191) from April to November 2021. After conducting a questionnaire pilot, the data was collected strictly using an internet-based approach. The Depression, Anxiety, and Stress Scale-21 items were used to identify the risk of depression among nursing students. The Chi-square test was used to assess the differences between coping strategies among nursing students. A multivariate logistic regression model was used to identify risk factors associated with depression.

Findings

The percentage of nursing students affected by depression was 21.5%, and almost half of the nursing students (49.2%) had no coping strategies for dealing with mental health concerns. Among the remaining nursing students, video-based mental consultation was the most popular method (25.7%). Being females (AOR: 2.7, 95% CI: 1.1-6.7), collecting bio-samples (AOR: 2.9, 95% CI: 1.4-6.2), providing support to vaccination spots (AOR: 2.3, 95% CI: 1.1-5.1), and not vaccinating against COVID-19 (AOR: 3.1, 95% CI: 1.1-9.1) were found as risk factors for depression among nursing students.

Conclusion

Our research revealed a significant number of nursing students suffering from depressive symptoms and underscoring the need for more effective methods of dealing with this condition. Depression management and coping skills focusing on female populations and those whose direct contacts with infectious sources should be implemented in the nursing curricula and continuous training credits. Those trainings, would support future nurses in handling crisis situations better.

Are we ready for the next pandemic? Lessons learned from healthcare professionals' perspectives during the COVID-19 pandemic

Background

The mental health and wellbeing of people watching the Corona Virus Disease 2019 (COVID-19) pandemic unfold has been discussed widely, with many experiencing feelings of anxiety and depression. The state of mental health of medical staff on the frontlines providing care should be examined; medical staff are overworked to meet the demands of providing care to the rise in cases and deterioration in capacity to meet demands, and this has put them under great psychological pressure. This may lead to an increase in medical errors, affect quality of care, and reduce staff retention rates. Understanding the impact the pandemic has had on healthcare professionals is needed to provide recommendations to prepare for future crises.

Objectives

To be able to meet the needs of the medical workforce on the frontlines and inform psychological support interventions and strategies for future pandemics, we aim to identify and explore the psychological impact of COVID-19 in Kuwait on healthcare professionals in close contact with patients.

Methods

Using semi-structured interviews, we conducted interviews between February and July 2021 with 20 healthcare professionals across Ministry of Health hospitals who were part of COVID teams. Interviews were transcribed verbatim, and analysis was conducted using principles of thematic framework analysis.

Results

Three themes emerged to help prepare future healthcare frontline workers on an individual, organizational, and national level: enhance self-resilience, a better-equipped workforce and healthcare environment, and mitigate stigma and increase public awareness.

Conclusion

The results have assisted in highlighting areas of improvement to support the healthcare workforce in the current environment, as well as better prepare them for future pandemics. The findings have also provided insight to recommend targeted interventions. These should improve the psychological wellbeing and help in supporting healthcare professionals to reduce burnout, continue effective care of patients, and enhance resilience.

Nurses and Respiratory Therapists Lived Experience During COVID-19 Pandemic: A Qualitative Study

Introduction

Nurses and respiratory therapists working on the frontline during the pandemic surge were short-staffed and worked extended hours while adding new tasks to already demanding workloads. As the world watched news covering COVID-19's effect, nurses and respiratory therapists lived through the daily stress of treating each patient with care, dignity, and compassion. Limited studies have focused on this population, which is vital to providing care and saving lives; research is needed to understand nurses' and respiratory therapists' experiences during the COVID-19 pandemic.

Objective

The study aimed to understand nurses' and respiratory therapists' experiences during the COVID-19 pandemic.

Methods

A qualitative descriptive study, informed by naturalistic philosophy, was designed to obtain a detailed account of participants' experiences during the pandemic surge. A purposive sample was recruited and enrolled from the community through professional organizations and snowball sampling from December 2021 to September 2022. Data was analyzed using thematic analysis.

Results

Participants were seven registered nurses and six respiratory therapists employed full-time in an intensive care unit, step-down intensive care unit, emergency department, or medical-surgical unit; seven (53.8%) with an associate degree, and six (46.2%) with a bachelor's degree. Eight (66.7%) self-identified as White, one Asian, one non-Hispanic Black, and two Pacific Islanders. The mean age was 40, and 10 (76.9%) were female. Six primary themes emerged: (a) the work-life experience before the COVID-19 pandemic, (b) the work-life experience during the COVID-19 pandemic, (c) the personal life experience during COVID-19, (d) the coping period, (e) the professional role change, and (f) the work and personal life experiences post COVID-19 surge.

Conclusion

The knowledge gained from this study can help improve understanding of the professional quality of life, the need for organizational and community support, and for healthcare professionals to seek help and practice self-care to prevent burnout and secondary traumatic stress.

The impact of working in COVID-19 hospital on indonesian nurses' mental health and wellbeing: a qualitative study

BACKGROUND

The outbreak of coronavirus disease (COVID-19) has impacted the lives of more than 580 million people and killed more than six million people globally. Nurses are one of the most impacted groups as they are at the frontline to fight against the virus and to try to save the lives of everyone affected. The present study aimed to explore the impact of working in COVID-19 wards on the mental health and wellbeing of nurses in the early stage of the pandemic in a hospital in East Nusa Tenggara, Indonesia.

METHODS

A qualitative study was conducted with 22 nurses, recruited using purposive sampling. Data collection was conducted from April to May 2022 and data analysis was guided by qualitative framework analysis.

RESULTS

The findings show that nurses experienced a range of mental health impacts including fear of being infected and infecting loved ones; fear of early death; psychological distress related to the conflict between the lack of personal protective equipment (PPE) and both professionalism and moral responsibility for patients; stress due to long waiting period to know the result of the COVID-19 tests; stress and worry due to public indifference and lack of role models; the negative impact of community doubt and distrust around COVID-19; and distress due to stigma and discrimination towards nurses caring for COVID-19 patients and their families.

CONCLUSIONS

The current findings indicate further psychological intervention programs to support nurses, especially the ones in resource poor settings and enhance their psychological resilience.

Mental health problems and coping strategy among pulmonary resident physicians during the COVID-19 pandemic in a tertiary respiratory hospital in Indonesia: a serial cross-sectional study

BACKGROUND Pulmonary resident physicians are part of the frontline workers for COVID-19 in the hospital and might require a suitable coping strategy to manage stress. Here, we described their mental health status and coping strategy during the COVID-19 pandemic. METHODS A cohort study was done to evaluate stress, anxiety, depression, and coping strategies among pulmonary resident physicians in a tertiary referral hospital. Questionnaires were administered in 4 time points between August 2020 and June 2021. The DASS-21 questionnaire measured depression, anxiety, and stress, while Brief COPE instrument qualified the coping strategy. RESULTS The total respondents who filled the questionnaire in 4 time points in August 2020, October 2020, February 2021, and June 2021 were 60, 93, 96, and 94 resident physicians with mean stress levels of 4.3, 6.1, 5.4, and 6.3, respectively. Depression, stress, and anxiety were less frequent during the study period, mostly mild or moderate. However, moderate anxiety slightly increased in June 2021 when the pandemic reached its peak. Most of them (95.8%) had effective coping strategies related to religious beliefs. CONCLUSIONS Effective coping strategies might preserve the pulmonary resident physicians’ mental health during the pandemic. Furthermore, the sociodemographic and cultural background might affect the coping strategy. Practicing religion and praying or meditating might be essential factors in coping with psychological distress and a key to adapt to the COVID-19 pandemic.

Synthesis of Evidence to Support EMS Personnel's Mental Health During Disease Outbreaks: A Scoping Review

Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel's mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel's mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel's basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a launching pad for further research and intervention development.

Kopfkino: Phases of quarantine among asymptomatic SARS-COV-2 carriers in Germany

Although a majority of SARS-COV-2 diagnosis are asymptomatic, presymptimatic or minimally symptomatic, little has been described and understood about the illness careers of these individuals. This study explored the lived experience of a SARS-COV-2 diagnosis and subsequent quarantine among individuals in Germany who were diagnosed with SARS-COV-2 during the second wave of the pandemic (late 2020-early 2021), but whose diagnosis was unexpected due to a lack of a known contact, or the asymptomatic nature of their case at the time of diagnosis. In-depth interviews (n ​= ​22) were conducted by phone or video call, audio-recorded, and transcribed verbatim. Routine debriefings guided data collection and facilitated analysis, which followed a framework approach. Regardless of age, gender or socioeconomic status, data consistently demonstrated a diagnosis and quarantine career marked by five emotional phases: overconfidence, shock and denial, coming to grips and asking questions, enduring, and cautious optimism as quarantine ended. These experiences suggest that providing trustworthy, easily accessible information regarding certain key aspects of the post diagnosis and quarantine period could benefit patients in terms of reducing stress, understanding the consequences of a diagnosis and mitigating foreseeable challenges in terms of personal, logistical and emotional issues. Follow-up research with providers and public health bureaus could inform how to best tailor such messaging for clients who experience an unexpected diagnosis.

Religiousness in the first year of COVID-19: A systematic review of empirical research

The COVID-19 pandemic emerged suddenly in early 2020, posing a serious health threat and creating tremendous stress and distress across the world. Religion has been shown to play important and varied roles in previous disasters and health crises, but its roles in the pandemic have yet to be outlined. We aimed to summarize the research conducted on religion and COVID-19 in the first year of the pandemic with a systematic review of studies that specifically involved individual-level religiousness and COVID-19. Searches were conducted in PubMed, Scopus, CINAHL, and PsycINFO covering a one-year period from the first published mention of the novel coronavirus (Jan. 5, 2020) through January 4, 2021. We included articles about COVID-19 that were peer-reviewed and empirical, measured and reported results on religion on an individual level, and were available in English. Our search produced 137 empirical articles that met the inclusion criteria. In the course of sorting studies by their primary focus, eight categories of empirical findings emerged: general distress and wellbeing (53 articles), COVID-19-specific stress (24 articles), beliefs in science, conspiracies, and misinformation (15 articles), COVID-19 public health behaviors (12 articles), perceived risk of COVID-19 (10 articles), perceived growth or positive changes taking place during the pandemic (nine articles), health behaviors (three articles), and consumer behavior (three articles). Findings indicated that religiousness was associated with both unique benefits and challenges and played a significant role in the pandemic. Religiousness was associated with a broad range of outcomes across geographical regions and populations during the first year of COVID-19. It was a commonly reported coping mechanism with varying levels of favorable associations with mental health and COVID-19-related behaviors.

Psychometric Analysis of the Quarantine Coping Strategies Scale (Q-COPE) in the Spanish Language

The possibility of facing an epidemic or pandemic resulting in mandatory isolation or quarantine has become a relevant construct for comparing and evaluating coping strategies under such conditions. The objective of this research was to develop and analyze the psychometric properties of a scale to assess quarantine coping strategies (Q-COPE). This was an instrumental study and 1110 Peruvian adults (M = 26.9 years; SD = 9.77) participated in the context of social isolation. For the construction of the scale, qualitative and quantitative procedures were followed. The internal structure was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The content analysis by expert judges supports the representativeness of the items related to the construct. EFA and CFA allowed the establishment of five factors: Emotional regulation, Information, Accommodation, Social support, and Altruism. The first-order model presents adequate goodness-of-fit indices: χ² = 489.048, df = 220, χ²/df = 2.223, SRMR = 0.025, CFI = 0.969, TLI = 0.965, RMSEA = 0.047. Likewise, the second order model presented similar values: χ² = 499.674, df = 225, χ²/df = 2.221, SRMR = 0.026, CFI = 0.969, TLI = 0.965, RMSEA = 0.047. The 23-item version was consistent with the proposed theory, obtained adequate fit indices and acceptable factor loadings (>0.70), and presented good internal consistency indexes evaluated by Cronbach's α, ordinal α, omega (ω), and H coefficient. It is concluded that the Q-COPE scale presents good psychometric properties that justify its use in an adult population and allows the assessment of the coping strategies that people use in the face of a quarantine situation.

Understanding the mental health impact and needs of public healthcare professionals during COVID-19 in Pakistan : a qualitative study

OBJECTIVES

A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.

DESIGN

An exploratory qualitative study.

SETTING

Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.

PARTICIPANTS

In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.

RESULTS

The study identified three overarching themes: (1) mental health impact of COVID-19 on health service providers that included the fear of acquiring the infection and transmitting it to their family members, fear of social isolation and stigma, anxiety related to the uncertainty of COVID-19, nervousness due to media exaggeration and stress associated with excessive workload; (2) mental health needs of health service providers involved in the COVID-19 crisis and available support from the healthcare system, including the expression of the need for counselling services and safe working conditions, the need for paid rest periods, and the need for appreciation and motivation to work in the pandemic; and (3) suggestions to address mental health needs of healthcare workers, including provision of specialised mental healthcare/services, formal training of health managers on managing mental health needs of health facility staff, and assessment and addressing of these needs of the health workforce.

CONCLUSION

The study emphasises the need to strengthen health system preparedness for recognising and addressing the needs of healthcare professionals. At the system level, there is a need for a specialised unit to provide mental health services and better communication strategies. At the staff level, continuous motivation and appreciation should be given to healthcare professionals either through monetary incentives or formal acknowledgement of their performance.

Stress and coping strategies in the general population of Greece and Cyprus in response to the COVID-19 pandemic: a cross-sectional study

The COVID-19 pandemic and the lockdown policy had a profound psychological impact on the general population worldwide. The aim of this study was to assess the level of stress and coping strategies used during the initial stage of the COVID-19 outbreak and their association. Secondary aims were to a) identify the most important coping strategies and b) investigate predictors of stress. A cross-sectional study was conducted by using an anonymous online questionnaire. The study was carried out from April 23 to May 4 2020. A snowball sampling method was conducted to recruit potential participants from the general population of Greece and Cyprus. Participants over 18 years old who were familiar with the Greek language were included. The psychological impact was assessed by the Impact of Event Scale-Revised (IES-R). Coping strategies were assessed using 15 statements detected from a review of the literature. Participants were asked to rate each one of the coping strategies according to how important it was to them, on a four-point likert scale. The sample consisted of 3941 participants (74.2% women, N=2926), with a mean age of 36.9 years old. The most important coping strategies adopted were 1) "Dealing the situation with a positive attitude" (96.5%), 2) "Follow strict personal protective measures" (95,9%), 3) "Acquiring knowledge about coronavirus" (94.6%), 4) "Engaging in health-promoting behaviors" (89.6%), 5) "Limiting the time spent on media" (75.5%). The highest and positive coefficients were recorded for the association of IES-R scales with 1) "Talking with family and friends to reduce stress", 2) "Seeking help from a mental health professional", 3) "Limiting the time spent on media", 4) "Relieving and managing emotions", 5) "Practicing relaxation techniques". 26.5% showed severe psychological impact. Conclusion: Addressing stress levels with the use of functional coping strategies can be beneficial to protect the general population from adverse psychological outcomes.

COVID-19 stress and wellbeing: A phenomenological qualitative study of Pakistani Medical Doctors

The COVID-19 stress and increased job pressure have largely affected healthcare professionals’ various life domains. This study particularly explores the effect of stress caused by treating COVID-19 patients on medical doctors’ wellbeing. To explore this phenomenon, we interviewed 12 doctors treating COVID-19 patients in hospitals of metropolitan cities in Pakistan. The thematic analysis using NVivo V.12 Plus software of interviews resulted in four major themes, COVID-19 Stressors, Effects of Stress, Nature and Personality, Stress Relievers, and Stress Coping Strategies. Physicians were physically and emotionally stressed as a result of the intense work. Although they were carrying a lot of pain and hurt on their insides, participants demonstrated a sense of professional determination to overcome obstacles. Physicians are currently dealing with their emotional issues, and they should have access to complete professional help to ensure their wellbeing. The COVID-19 pandemic’s mental health effects are anticipated to last far longer than the physical health effects. This study is well-positioned to investigate frontline physicians’ opinions and attitudes concerning the COVID-19 and its impact on their daily lives and mental health. This research will help implement context-specific innovative mental health solutions to help the frontline workers.

Providing Solution in an Emergency: COVID-19 and Voice Behavior of Healthcare Professionals

This study investigates the mechanism between idiosyncratic deals (I-deals) and voice behavior, considering display aggression and deontic justice as mediating variables. We collected data from 702 nurses and their immediate supervisors who work with COVID-19 patients through survey questionnaires at two different times, and we analyzed the data using structural equation modeling (SEM). We found that I-deals are significantly associated with deontic justice and voice behavior. Moreover, I-deals are significant but negatively associated with displayed aggression, which is significant and negatively associated with voice behavior. In addition, deontic justice and display aggression mediate the association between I-deals and voice behavior. These findings suggest that the hospitals' top management should provide I-deals to nurses to improve their voice behavior.

"Endless Vicious Circle ..." Psychosocial Difficulties and Needs of Nurses Working in the Emergency Department During the COVID-19 Pandemic

Emergency nurses are one of the groups at risk most during the COVID-19 pandemic. The purpose of the authors of this qualitative study was to reveal the psychosocial difficulties and needs of nurses working in the emergency department of a university hospital during the COVID-19 pandemic. This descriptive phenomenological study was conducted in the emergency department of a university hospital in the West of Turkey. In-depth interviews were conducted with 14 emergency nurses. Colaizzi's descriptive analysis method was used. Findings regarding the psychological difficulties and needs of nurses during the COVID-19 pandemic were collected under the following 4 themes: being a nurse in the emergency department in the pandemic, emotional chaos, living with losses, and the support needs. Not only did the emergency nurses state that working as a nurse in the pandemic was challenging and exhausting but they also emphasized the vital importance of nursing care in the pandemic. During the pandemic, the nurses went through different emotional processes according to the stages of the pandemic. Although they needed psychological support, they were expected to meet organizational requirements.

Narratives of hospital health care professionals during the pandemic in the Northern Philippines: A phenomenological study

Hospital health care professionals (HCPs) play a vital and crucial role in saving the lives of patients afflicted with the coronavirus disease 2019 (COVID-19). As the incidence of the disease keeps increasing, health care workers in hospitals face difficulties in discharging their duties. This study aimed to describe the lived experiences of HCPs. Particularly, it determined their challenges, motivations and coping strategies to craft grassroots policies for the enhancement of health care delivery in the Northern Philippines. Employing a phenomenological study design, 24 study participants were purposively selected and their narratives were elicited through focus group discussion. Responses were transcribed verbatim. After data analyses, the challenges, coping strategies and motivations of HCPs were identified. Results revealed that HCPs experienced a lot of challenges. Some of these were brought by the rapid changes in their environment as HCPs. Moreover, there was lack of comprehensive strategies that made them unprepared along with a lack of human and material resources. Furthermore, they experienced physical fatigue because of overwhelming workload, anxiety, fear and discrimination that led to depression. Despite these difficulties, they remain resilient because of religious coping, being true to their duty as HCPs and the support they receive from their fellows. Thus, the study recommends that protocols to ensue should centre on adequate pandemic preparedness and capacitation of HCPs.

Cognitive appraisals and coping strategies of registered nurses in the emergency department combating COVID-19: A scoping review

OBJECTIVE

Explore the relevant evidence about stress-related cognitive appraisal and coping strategies among registered nurses in the emergency department (EDRNs) coping with the COVID-19 pandemic.

METHODS

This scoping review followed the methodological framework of Arksey and O'Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus electronic databases for related studies from inception through February 2, 2022. This review further conducted study selection based on the PRISMA flow diagram and applied Lazarus and Folkman's Psychological Stress and Coping Theory to systematically organize, summarize, and report the findings.

FINDINGS

Sixteen studies were included for synthesis. Most of the studies showed that the majority of EDRNs were overwhelmed by the COVID-19 pandemic. Depression, triaging distress, physical exhaustion, and intention to leave ED nursing were cited as major threats to their wellness. Additionally, comprehensive training, a modified triage system, a safe workplace, psychological support, promotion of resilience, and accepting responsibility may help EDRNs cope with pandemic-related challenges effectively.

CONCLUSION

The long-lasting pandemic has affected the physical and mental health of EDRNs because they have increased their effort to respond to the outbreak with dynamically adjusted strategies. Future research should address a modified triage system, prolonged psychological issues, emergency healthcare quality, and solutions facing EDRNs during the COVID-19 or related future pandemics.

CLINICAL RELEVANCE

EDRNs have experienced physical and psychological challenges during the pandemic. The ED administrators need to take action to ensure EDRNs' safety in the workplace, an up-to-date triage system, and mental health of frontline nurses to provide high-quality emergency care for combating COVID-19.

Psychotherapy and Follow-Up in Health Care Workers After the COVID-19 Epidemic: A Single Center's Experience

Objective

The present study aims to analysis the mental health of high-risk health care workers (HHCWs) and low-risk HCWs (LHCWs) who were respectively exposed to COVID-19 wards and non-COVID-19 wards by following up on mental disorders in HCWs in China for 6 months.

Methods

A multi-psychological assessment questionnaire was used to follow up on the psychological status of HCWs in the Affiliated Hospital of Xuzhou Medical University in Xuzhou City (a non-core epidemic area) at 6 months after the first evaluation conducted during the COVID-19 epidemic. Based on the risk of exposure to COVID-19 patients, the HCWs were divided into two groups: high-risk HCWs, who worked in COVID-19 wards, and low-risk HCWs, who worked in non-COVID-19 wards.

Results

A total of 198 HCWs participated in the study, and 168 questionnaires were selected for evaluation. Among them, 93 (55.4%) were in the HHCW group and 75 (44.5%) were in the LHCW group. Significant differences were observed in salary, profession, and altruistic behavior between the two groups (P < 0.05). There were no significant differences in the anxiety, depression, insomnia, or posttraumatic stress disorder (PTSD) scores between the two groups. Logistic regression revealed that work stress was a major joint risk factor for mental disorders in HCWs. Among all the HCWs, a total of 58 voluntarily participated in psychotherapy; the analysis showed a significant decrease in anxiety, depression, PTSD, work stress, and work risk after attending psychotherapy. There were also significant differences in positive and negative coping styles before and after psychotherapy.

Conclusion

In the present follow-up, work stress was the major contributing factor to mental disorders in HCWs. Psychotherapy is helpful in terms of stress management and should be provided to first-line COVID-19 HCWs.

Lived experience of Jordanian front-line healthcare workers amid the COVID-19 pandemic: a qualitative study

OBJECTIVES

This study aimed to explore the lived experience of Jordanian front-line healthcare workers (FHCWs), including their experienced challenges and adaptations amid the COVID-19 pandemic.

DESIGN

A phenomenological qualitative design was used to highlight the experiences of a sample Jordanian FHCWs during the COVID-19 pandemic. Qualitative interviews were conducted using a semistructured guide with open-ended questions, audiotaped and then transcribed verbatim. Thematic analysis of the transcribed narratives was conducted using an open coding line by line to develop themes and related subthemes.

SETTING

Mobile COVID-19 testing and contact tracing units during an active surge of cases in Jordan between May and September 2020.

PARTICIPANTS

Participants were recruited using purposive sampling method and consisted of 15 FHCWs (2 physicians, 10 nurses, 2 paramedics and 1 laboratory technician) who have worked in testing and contact tracing teams in the community and have dealt with suspected or confirmed cases of COVID-19 infection.

RESULTS

Participant narratives were classified into two main overarching themes; challenges and adaptation themes. The challenges theme was exhibited as follows: (1) an excruciating encounter with an invisible enemy, (2) distorted knowledge about COVID-19 and (3) organisational and administrative challenges. The adaptation theme was exhibited as follows: (1) seeking relevant knowledge about the disease and (2) seeking more connectedness.

CONCLUSIONS

The COVID-19 pandemic exerted many challenges for FHCWs at multiple levels; intrapersonal and interpersonal, organisational and societal levels. Nevertheless, a number of adaptation strategies within these levels have been reported. This study helps to provide the base on which healthcare officials and public health personnel can formulate preparedness plans that tackle challenges faced by front-line workers, which ultimately enhance the resilience of healthcare systems to withstand future pandemics.

Hierarchical Structure of Depression Knowledge Network and Co-word Analysis of Focus Areas

Contemporarily, depression has become a common psychiatric disorder that influences people's life quality and mental state. This study presents a systematic review analysis of depression based on a hierarchical structure approach. This research provides a rich theoretical foundation for understanding the hot spots, evolutionary trends, and future related research directions and offers further guidance for practice. This investigation contributes to knowledge by combining robust methodological software for analysis, including Citespace, Ucinet, and Pajek. This paper employed the bibliometric methodology to analyze 5,000 research articles concerning depression. This current research also employed the BibExcel software to bibliometrically measure the keywords of the selected articles and further conducted a co-word matrix analysis. Additionally, Pajek software was used to conduct a co-word network analysis to obtain a co-word network diagram of depression. Further, Ucinet software was utilized to calculate K-core values, degree centrality, and mediated centrality to better present the research hotspots, sort out the current status and reveal the research characteristics in the field of depression with valuable information and support for subsequent research. This research indicates that major depressive disorder, anxiety, and mental health had a high occurrence among adolescents and the aged. This present study provides policy recommendations for the government, non-governmental organizations and other philanthropic agencies to help furnish resources for treating and controlling depression orders.

The impact of COVID-19 on social support perception and stress of prehospital care providers

Background

This study seeks to explore the impact of COVID-19 outbreak on the social support perception and acute stress disorder of prehospital care providers (PCPs) in the province of Denizli.

Methods

This descriptive and cross-sectional study was conducted between December 25, 2020 and January 25, 2021. Out of 510 ambulatory care staff constituting the study population, there were 287 PCPs (%56.2), including 13 physicians, 89 paramedics, 134 emergency medical technicians, and 51 individuals from other occupational groups (nurse, driver, cleaning staff, medical secretary) based at emergency health services. The data collection tools employed in the study include an introductory information form, Multidimensional Scale of Perceived Social Support (MSPSS), and National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS), which was organized as an online questionnaire.

Results

We analyzed the data from 287 PCPs that completed the form and scales. The mean score of the NSESSS was calculated as 1.53 ± 0.79. The PCPs who experienced health problems (1.85 ± 0.69), suffered from mental problems and received psychotherapy and medication (2.57 ± 0.57), encountered COVID-19 patients (1.58 ± 0.8), provided care for COVID-19 patients (1.59 ± 0.79), and took polymerase chain reaction (PCR) tests (1.68 ± 0.78) had higher acute stress symptom levels. The total mean score of MSPSS was calculated as 66.28 ± 17.22. Total MSPSS scores of the participants varied significantly in terms of age, marital status, taking a COVID-19 test, suffering from mental problems, status of encountering a COVID-19 patient, and workplace satisfaction (p < 0.05).

Conclusions

The findings are suggestive of high perceptions of multidimensional social support and low acute stress symptom levels of the PCPs during the COVID-19 pandemic period.

Wellbeing and Stress Coping among Healthcare and Pharmacy Workers: Experiences during the First COVID-19 Lockdown in Lithuania

(1) Background. During the COVID-19 pandemic, healthcare professionals faced psychological and social challenges in addition to a sharp increase in workload. The aim of this work was to reveal how healthcare and pharmacy workers assessed their wellbeing and the methods of coping they employed to overcome stress during quarantine. (2) Methods. The mixed-method study was conducted between August and October 2020, integrating quantitative (n = 967) and qualitative (n = 27) strategies. Doctors, nurses, healthcare administrative staff, pharmacy specialists, and other employees of the healthcare system were interviewed retrospectively about their experiences during and following lockdown (March–June 2020). (3) Results. Overall, 38.7% of the respondents reported a decrease in psychological wellbeing, while 23.4% of the respondents reported a decrease in physical wellbeing during quarantine. The healthcare professionals’ narratives identified a shift from nonspecific fears at the beginning of the pandemic to the more concrete fear of contracting COVID-19, of infecting others, and about their loved ones, as well as undifferentiated fear. Multivariate analysis revealed that a subjective decrease in wellbeing was typical in professionals who had had direct contact with patients infected with COVID-19, as well as those with stronger fears, and those who were more likely to employ compulsive distancing and substance use as ways to cope with stress. (3) Conclusions. The results suggest that lockdown had a negative impact on healthcare workers’ wellbeing during the first pandemic wave in 2020.

Preferences for Hotels with Biophilic Design Attributes in the Post-COVID-19 Era

Since the COVID-19 crisis has caused the cancellation of a great number of travel plans in the last two years, this study examines the prospects of the post-COVID-19 era, during which we expect tourism will return strongly. The impact of the epidemic on people’s attitudes toward tourism, particularly their tourist choices, appears to be a major challenge for post-COVID-19 international tourism development. Very little is known about tourists’ accommodation preferences during the period emerging after the COVID-19 crisis. With a long and challenging experience of lockdowns, stress, and fear of disease, the current study attempts to examine peoples’ preferences for hotel attributes during the post-COVID-19 era. It examines factors contributing to peoples’ preferences for hotels with biophilic attributes. A total of 507 Iranian undergraduate and graduate students participated in the study. They answered questions on their perceived stress, level of depression, the specific burden of COVID-19, the perceived benefits of nature, and their preferences for biophilic design attributes in their accommodation. The online survey was conducted from August to October 2021. We found that the burden of COVID-19 increased the stress level of the respondents, which consequently increased the chance of depression. We further found that perceived stress and the benefits of nature significantly affect tourists’ preferences for exposure to nature and hotels with biophilic attributes. Based on the data, we suggest that the demand for biophilic buildings will be strongly increased during the post-COVID-19 era.

Health care workers' experiences during the COVID-19 pandemic: a scoping review

BACKGROUND

COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers' (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs' experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included.

RESULTS

161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs' well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs' personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs' experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs' experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries.

DISCUSSION

This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs' experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs' circumstances.

CONCLUSIONS

Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.

Level and correlates of empathy and altruism during the Covid-19 pandemic. Evidence from a representative survey in Germany

Aim

Our purpose was to clarify the level and correlates of empathy and altruism in the German population during the Covid-19 pandemic.

Methods

A nationally representative survey (n = 3,075) was conducted in August/September 2021. To measure empathy, a short scale based on the Interpersonality Reactivity Index (IRI; German version: Saarbrucken personality questionnaire, SPF) was used (SPF-K). Based on the International Personality Item Pool (IPIP; IPIP-5F30F-R1), the subscale altruism was used to quantify altruism.

Results

The average altruism score was 3.3 (SD: 0.7), ranging from 1 to 5. Moreover, the average empathy score was 13.1 (SD: 2.8), ranging from 4 to 20. The level of empathy significantly differed between the subgroups. For example, high levels of empathy were identified among women (average: 13.7, SD: 2.7), individuals with children (average: 13.5, SD: 2.8), and individuals with migration background (average: 13.6, SD: 2.8). Effect sizes were mostly small. Similar differences (in terms of effect size) were identified between these groups regarding altruism. Additionally, regressions showed that higher levels of both empathy and altruism were associated with being female, younger age, having children, sports activities and having at least one chronic disease. Moreover, vaccination against Covid-19 was only associated with higher altruism, but not with higher empathy.

Conclusion

Our study emphasized the moderately high level of empathy and altruism in Germany during times of the pandemic. Identifying the correlates of these factors may help to address individuals with very low levels of these 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.

A scoping review of COVID-19-related stress coping resources among nurses

Objective

The entire mental health hazard among the nurses dealing with COVID-19 is just the tip of the iceberg. The goal of this study was to find acceptable and adaptive coping techniques for nurses in order to keep the healthcare system resilient during and after the COVID-19 pandemic.

Method

The scoping review search took place from January 2020 to May 2021 published articles, and the results were saved in Endnote software. For data synthesis and review, the Joanna Briggs Institute manual and PRISMA-ScR principles were followed. Following backward and forward screening to exclude redundant, irrelevant, and ineligible studies, 13 studies (3,613 nurses) were finally selected for this review.

Results

The majorities of participants in these studies were female and had children, and worked in departments of critical care, emergency, and fever clinics. Safety concerns for family or colleagues, as well as a lack of safe working environment, were the primary causes of the mental illness. Professional responsibility attitude, COVID-19 training, workplace safety, team spirit, and a few relaxation activities such as deep breathing, reading books, watching movies, and praying, on the other hand, were found to be beneficial for stress coping among nurses.

Conclusion

Mentally fit nurses are more capable and flexible in the face of any life-threatening outbreak, even if it is very contagious. Several coping strategies were found to be effective for nurses during the COVID-19 pandemic, whereas problem-specific intervention trials might yield even better results. We should not delay specific mental health interventions to keep them viable and more efficient during a pandemic battlefield, whereas Post-Traumatic Stress Disorder and suicide rates can destroy the entire health care system.

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.

Utilizing Multilingual Methods and Rapid Analysis for Global Qualitative Research During a Pandemic

Historically, qualitative research has complemented quantitative biologic and epidemiologic studies to provide a more complete understanding of pandemics. The COVID-19 pandemic has generated unique and novel challenges for qualitative researchers, who have embraced creative solutions including virtual focus groups and rapid analyses to continue their work. We present our experience conducting a multilingual global qualitative study of healthcare resilience among teams of pediatric oncology professionals during the COVID-19 pandemic. We provide an in-depth description of our methodology and an analysis of factors we believe contributed to our study’s success including our use of technology, engagement of a large multilingual team, global partnerships, and framework-based rapid analysis. We hope these techniques may be useful to qualitative researchers conducting studies during the current pandemic, as well as for all pediatric oncology studies including multiple languages or geographically disparate subjects.

Sustaining the Australian respiratory workforce through the COVID-19 pandemic - a scoping literature review

The outbreak of the COVID‐19 pandemic in late 2019 and in 2020 presented challenges to healthcare workers (HCW) around the world that were unexpected and dramatic. The relentless progress of infection, starting in China and rapidly spreading to Europe, North America and elsewhere gave more remote countries, like Australia, time to prepare but also time for unease. HCW everywhere had to readjust and change their work practices to cope. Further waves of infection and transmission with newer variants pose challenges to HCW and health systems, even after mass vaccination. Respiratory medicine HCW found themselves at the frontline, developing critical care services to support intensive care units and grappling with unanticipated concerns about safety, risk and the need to retrain. Several studies have addressed the need for rapid changes in the healthcare workforce for COVID‐19 and the impact of this preparation on HCW themselves. In this paper, we present a scoping review of the literature on preparing HCW for the pandemic, explore the Australian experience of building the respiratory workforce and propose evidence‐based recommendations to sustain this workforce in an unprecedented high‐risk environment.

Healthcare Workers' SARS-CoV-2 Omicron Variant Uncertainty-Related Stress, Resilience, and Coping Strategies during the First Week of the World Health Organization's Alert

BACKGROUND

As the SARS-CoV-2 Omicron variant emerged and spread globally at an alarming speed, healthcare workers' (HCWs) uncertainties, worries, resilience, and coping strategies warranted assessment. The COVID-19 pandemic had a severe psychological impact on HCWs, including the development of Post-Traumatic Stress symptoms. Specific subgroups of HCWs, such as front-line and female workers, were more prone to poor mental health outcomes and difficulties facing stress.

METHODS

The responses to an online questionnaire among HCWs in the Kingdom of Saudi Arabia (KSA) were collected from 1 December 2021 to 6 December 2021, aiming to assess their uncertainties, worries, resilience, and coping strategies regarding the Omicron variant. Three validated instruments were used to achieve the study's goals: the Brief Resilient Coping Scale (BRCS), the Standard Stress Scale (SSS), and the Intolerance of Uncertainty Scale (IUS)-Short Form.

RESULTS

The online survey was completed by 1285 HCWs. Females made up the majority of the participants (64%). A total of 1285 HCW's completed the online survey from all regions in KSA. Resilient coping scored by the BRCS was negatively and significantly correlated with stress as scored by the SSS (r = -0.313, p < 0.010). Moreover, intolerance of uncertainty scored by the IUS positively and significantly correlated with stress (r = 0.326, p < 0.010). Increased stress levels were linked to a considerable drop in resilient coping scores. Furthermore, being a Saudi HCW or a nurse was linked to a significant reduction in resilient coping ratings. Coping by following healthcare authorities' preventative instructions and using the WHO website as a source of information was linked to a considerable rise in resilient coping.

CONCLUSIONS

The negative association between resilient coping and stress was clearly shown, as well as how underlying intolerance of uncertainty is linked to higher stress among HCWs quickly following the development of a new infectious threat. The study provides early insights into developing and promoting coping strategies for emerging SARS-CoV-2 variants.