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Pasay-An E, Alshammari F, Mostoles R, Gattud V, Cajigal J, Buta J. [A qualitative study on nurses' experiences with social stigma in the context of COVID-19]. ENFERMERIA CLINICA 2022; 32:75-82. [PMID: 34149283 PMCID: PMC8196320 DOI: 10.1016/j.enfcli.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/24/2021] [Indexed: 12/01/2022]
Abstract
Aim This study aimed to examine the social stigma experienced by healthcare workers caring for people diagnosed with COVID-19. Methods This research employed a qualitative-phenomenological approach. It was conducted at the COVID centers of the Hail region, Kingdom of Saudi Arabia. Both purposive and snowball sampling were used, resulting in 15 participants. However, saturation was identified in the 11th participant. Interviews were conducted online through a Zoom platform, with at least 50 min per participant. Thematic analysis was used in analysing the data. Results The nurses recorded four themes and three subthemes based on one-on-one interviews. These themes included (1) Labeling nurses as "COVID Nurses," with a subtheme of frustration, (2) "Fear of the unknown," with a subtheme of "uncertainties," (3) Nurses' need for support, and (4) the Love for the profession, with a subtheme of "nurses' worth." Conclusion Nurses who cared for patients diagnosed with COVID-19 experienced stigma. They were labeled "COVID Nurses." They experienced fear of the unknown and uncertainties and felt they needed support. Despite these experiences, the nurses felt fulfilled as they have a high regard for their profession. The experiences of these nurses call for intervention to help them before, during, and after any health-related crisis. In this context, nurses will be prepared mentally and emotionally to face the challenges in their career.
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Affiliation(s)
| | | | | | | | | | - Joyce Buta
- College of Nursing, University of Hail, Saudi Arabia
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Pasay-An E, Alshammari F, Mostoles R, Gattud V, Cajigal J, Buta J. Estudio cualitativo sobre las experiencias de las enfermeras en cuanto a estigma social en el contexto de la COVID-19. ENFERMERÍA CLÍNICA (ENGLISH EDITION) 2022; 32:75-82. [PMID: 35577412 PMCID: PMC9099372 DOI: 10.1016/j.enfcle.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/24/2021] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | | | | | - Joyce Buta
- College of Nursing, University of Hail, Saudi Arabia
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3
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Lee HA, Ahn MH, Byun S, Lee HK, Kweon YS, Chung S, Shin YW, Lee KU. How COVID-19 Affected Healthcare Workers in the Hospital Locked Down due to Early COVID-19 Cases in Korea. J Korean Med Sci 2021; 36:e325. [PMID: 34873888 PMCID: PMC8648608 DOI: 10.3346/jkms.2021.36.e325] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/08/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The healthcare workers (HCWs) were exposed to never-experienced psychological distress during the early stage of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to investigate how the COVID-19 pandemic affected the mental health of HCWs during the hospital lockdown period due to mass healthcare-associated infection during the early spread of COVID-19. METHODS A real-time online survey was conducted between April 14-18, 2020 among HCWs who worked at the university hospital where COVID-19 was confirmed in a patient, and the hospital was shut down for 3 weeks. Along with demographic variables and work-related information, psychological distress was measured using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Maslach Burnout Inventory-General Survey scale, and the Stress and Anxiety to Viral Epidemics-9. RESULTS The HCWs working in the cohort ward and those who have experienced social discrimination had significantly higher level of depression (PHQ-9 score; 5.24 ± 4.48 vs. 4.15 ± 4.38; P < 0.01 and 5.89 ± 4.78 vs. 3.25 ± 3.77; P < 0.001, respectively) and anxiety (GAD-7 score; 3.69 ± 3.68 vs. 2.87 ± 3.73; P < 0.05 and 4.20 ± 4.22 vs. 2.17 ± 3.06; P < 0.001, respectively) compared to other HCWs. Worries regarding the peer relationship and the skepticism about job were associated with depression (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.07-1.79; P < 0.05 and OR, 1.69; 95% CI, 1.31-2.17; P < 0.001, respectively) and anxiety (OR, 1.73; 95% CI, 1.21-2.49; P < 0.01 and OR, 1.54; 95% CI, 1.09-2.17; P < 0.05, respectively), while fear of infection or worsening of health was not. Path analysis showed that work-related stress associated with the viral epidemic rather than anxiety about the viral epidemic mainly contributed to depression. CONCLUSION The present observational study indicates that mental health problems of HCWs exposed to COVID-19 are associated with distress in work and social relationship. Early intervention programs focusing on these factors are necessary.
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Affiliation(s)
- Hyeon-Ah Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myung Hee Ahn
- Division of Psychiatry, Health Screening and Promotion Center, Asan Medical Center, Seoul, Korea
| | - Seonjeong Byun
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Kook Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Sil Kweon
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong-Wook Shin
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Kyoung-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Murray E, Kaufman KR, Williams R. Let us do better: learning lessons for recovery of healthcare professionals during and after COVID-19. BJPsych Open 2021; 7:e151. [PMID: 34457351 PMCID: PMC8376907 DOI: 10.1192/bjo.2021.981] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/09/2021] [Accepted: 07/24/2021] [Indexed: 11/23/2022] Open
Abstract
The COVID-19 pandemic emphasises the need to rethink and restructure the culture of healthcare organisations if we are to ensure the long-term well-being and mental health of healthcare provider organisations and their staff. In this paper, we recognise the high levels of stress and distress among staff of healthcare services before the COVID-19 pandemic began. We identify lessons for care of healthcare staff and illustrate the paths by which support mobilises and later deteriorates. Although this paper focuses on NHS staff in the UK, we contend that similar effects are likely in most healthcare systems.
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Affiliation(s)
- Esther Murray
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Kenneth R. Kaufman
- Rutgers Robert Wood Johnson Medical School, New Jersey, USA; and Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Richard Williams
- Welsh Institute for Health and Social Care, University of South Wales, UK; Royal College of Psychiatrists, UK; and Faculty of Pre-Hospital Care, Royal College of Surgeons of Edinburgh, UK
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Rose S, Hartnett J, Pillai S. Healthcare worker's emotions, perceived stressors and coping mechanisms during the COVID-19 pandemic. PLoS One 2021; 16:e0254252. [PMID: 34242361 PMCID: PMC8270181 DOI: 10.1371/journal.pone.0254252] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/23/2021] [Indexed: 12/23/2022] Open
Abstract
Increasing cases, insufficient amount of personal protection equipment, extremely demanding workloads, and lack of adequate therapies to save lives can contribute to a psychological burden directly related to working during disease outbreaks. Healthcare workers (HCWs) are at a high risk of contracting COVID-19 due to its ability to spread efficiently through asymptomatic and symptomatic individuals. There are limited studies assessing the pandemic's psychological impact on HCWs, specifically those in close proximity to hospitalized patients with COVID-19. Our study explored the emotions, perceived stressors, and coping strategies of front-line HCWs at high risk of exposure to COVID-19 during the first surge at our community-based teaching hospital, the epicenter of COVID-19 in Connecticut. A validated comprehensive questionnaire derived and modified from previous epidemics was used to inquire about staff feelings, factors that caused stress and factors that mitigated stress. Personal coping strategies and factors that can increase staff's motivation to work during future events of similar nature were also asked. Emotional reactions, coping mechanisms, and stressors varied by healthcare role, while some experiences and reactions were similar among groups. Willingness to participate in a second wave of the pandemic or future outbreaks is strongly driven by adequate personal protective equipment, financial recognition, and recognition from management, similarly reported in previous disease outbreaks. All groups felt a reduction in stress due to a sense of camaraderie and teamwork, as well as when sharing jokes or humor with colleagues. Our HCWs at high risk of exposure experienced significant emotional distress during the first wave of the COVID-19 pandemic. By understanding the needs and experiences of our HCWs at highest risk, we can improve our psychological support using targeted interventions during future waves of this pandemic or similar devastating events.
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Affiliation(s)
- Suzanne Rose
- Office of Research and Clinical Trials, Stamford Hospital, Stamford, Connecticut, United States of America
| | - Josette Hartnett
- Office of Research and Clinical Trials, Stamford Hospital, Stamford, Connecticut, United States of America
| | - Seema Pillai
- Department of Nursing, Stamford Hospital, Stamford, Connecticut, United States of America
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Sun P, Wang M, Song T, Wu Y, Luo J, Chen L, Yan L. The Psychological Impact of COVID-19 Pandemic on Health Care Workers: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:626547. [PMID: 34305703 PMCID: PMC8297953 DOI: 10.3389/fpsyg.2021.626547] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/25/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: The COVID-19 epidemic has generated great stress throughout healthcare workers (HCWs). The situation of HCWs should be fully and timely understood. The aim of this meta-analysis is to determine the psychological impact of COVID-19 pandemic on health care workers. Method: We searched the original literatures published from 1 Nov 2019 to 20 Sep 2020 in electronic databases of PUBMED, EMBASE and WEB OF SCIENCE. Forty-seven studies were included in the meta-analysis with a combined total of 81,277 participants. Results: The pooled prevalence of anxiety is 37% (95% CI 0.31–0.42, I2 = 99.9%) from 44 studies. Depression is estimated in 39 studies, and the pooled prevalence of depression is 36% (95% CI 0.31–0.41, I2 = 99.6%). There are 10 studies reported the prevalence of insomnia, and the overall prevalence of insomnia is 32% (95% CI 0.23–0.42, I2 = 99.5%). The subgroup analysis showed a higher incidence of anxiety and depression among women and the frontline HCWs compared to men and non-frontline HCWs respectively. Conclusions: The COVID-19 pandemic has caused heavy psychological impact among healthcare professionals especially women and frontline workers. Timely psychological counseling and intervention ought to be implemented for HCWs in order to alleviate their anxiety and improve their general mental health.
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Affiliation(s)
- Ping Sun
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Manli Wang
- The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Tingting Song
- The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yan Wu
- The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jinglu Luo
- The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Lili Chen
- The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.,Chen Lili's Clinic, Korla, China
| | - Lei Yan
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,The Eighth People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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Srivastava A, Srivastava S, Upadhyay R, Gupta R, Jakhar K, Pandey R. Stressor Combat Strategies and Motivating Factors Among Health Care Service Providers During COVID-19 Pandemic. Cureus 2021; 13:e14726. [PMID: 34079676 PMCID: PMC8160474 DOI: 10.7759/cureus.14726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 01/04/2023] Open
Abstract
Context Since its inception in December 2019 in Wuhan, China, the severe acute respiratory syndrome coronavirus-2, the etiological agent for coronavirus disease 2019 (COVID-19), is spreading rapidly both locally and internationally, and became certified as a pandemic by the World Health Organization (WHO) in March 2020. Working in an environment of high risk, coupled with adherence to quarantine and stressors related to the job, has been found to exacerbate the psychological health of frontline healthcare workers. Aims To assess the perceived stressors, combat strategies, and motivating factors among health care service providers during the COVID-19 pandemic. Setting and design A cross-sectional study was conducted among healthcare workers at a tertiary care hospital in the north-central region of India from May to September 2020. Methods and materials A convenience sample of 150 health care workers was taken. A self-reported pretested structured "COVID 19 staff questionnaire" was used as a study tool. The health care workers (HCWs) included nurses, physicians, laboratory technicians, and radiology technicians who worked in high-risk areas (isolation ward, COVID intensive care unit, emergency department, and outpatient cough outdoor walk-in clinics) during the outbreak constituted our study population. Statistical analysis used The varying levels of stress or effectiveness of measures were reported as mean and standard deviation, as appropriate. Descriptive statistics were used for data presentation. A Mann-Whitney U test was used to analyse differences between two groups of non-normally distributed data. A p-value of less than 0.05 was considered statistically significant. Results As compared to doctors, paramedical staffs were more stressed with frequent protocol changes (88%), emotional exhaustion (68%), and conflicts with duties (62.7%). The factors like seeing colleague getting better (78.7%) and hoping for financial compensation (49.3%) were reported as stress busters; family compensation in case of death at the workplace and disability benefits in case of disease-related disability development were more effective motivational factors for paramedical staff in case of future outbreaks (p-value <0.05). Conclusions It is needful that secondarily traumatized team members should be always observed, educated, and properly handled. Certain personal coping strategies adopted by health workers should be well addressed and motivated if scientifically sustainable. We have to include psychiatric preparedness and stress monitoring also for health care teams along with emphasizing hygiene, temperature monitoring, and fever management, in planning to fight the pandemic.
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Affiliation(s)
- Anurag Srivastava
- Community Medicine, Government Institute of Medical Sciences, Greater Noida, IND
| | - Saurabh Srivastava
- Internal Medicine, Government Institute of Medical Sciences, Greater Noida, IND
| | - Rashmi Upadhyay
- Pulmonary Medicine, Government Institute of Medical Sciences, Greater Noida, IND
| | - Rakesh Gupta
- Community Medicine, Government Institute of Medical Sciences, Greater Noida, IND
| | - Kiran Jakhar
- Psychiatry, Government Institute of Medical Sciences, Greater Noida, IND
| | - Ruchi Pandey
- Community Medicine, Government Institute of Medical Sciences, Greater Noida, IND
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Warchoł-Biedermann K, Daroszewski P, Bączyk G, Greberski K, Bugajski P, Karoń J, Mojs E, Ziarko M, Jasielska A, Samborski W. Dysfunctional Coping Mediates the Relationship between Stress and Mental Health in Health-Care Staff Working amid the COVID-19 Pandemic. Med Princ Pract 2021; 30:395-400. [PMID: 33780942 PMCID: PMC8339028 DOI: 10.1159/000516181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/28/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This cross-sectional study aimed to assess the stress outcomes in health-care staff working during the COVID-19 pandemic and to explore the role of coping in the relationship between stress outcomes and mental health dimensions with Preacher & Hayes's mediation analysis. SUBJECTS AND METHODS One hundred seventy participants including physicians (n = 41; 24.1%), nurses (n = 114, 67.1%), and paramedics (n = 15, 8.8%) with a mean age of 37.69 ± 12.23 years and an average seniority of 14.40 ± 12.32 years were administered the Toronto Alexithymia Scale-20, Cohen's Perceived Stress Scale (PSS-10), the Emotional Processing Scale, and Positive and Negative Affect Schedule. The data were analyzed by estimation of simple correlation coefficients and a Preacher and Hayes's mediation procedure. RESULTS Participants reported elevated levels of stress (7-8 sten on the sten scale developed for the PSS-10 questionnaire). Statistically significant differences in the stress levels between nurses, paramedics, and physicians could not be determined. In contrast, significant association between mental health outcomes and the occupational category could not be found. CONCLUSION Our observations support the assumption about a controlling role of coping in the relationship between work-related stress, alexithymia, emotional processing loneliness and positive/negative affect in medical staff working amid pandemic.
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Affiliation(s)
- Katarzyna Warchoł-Biedermann
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznań, Poland
- *Katarzyna Warchoł-Biedermann,
| | - Przemysław Daroszewski
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland
| | - Grażyna Bączyk
- The Department of Practice Nursing, Poznan University of Medical Sciences, Poznań, Poland
| | - Krzysztof Greberski
- Department of Cardiovascular Disease Prevention, Poznan University of Medical Sciences, Poznań, Poland
- Department of Cardiac Surgery Józef Strus Hospital, Poznań, Poland
| | - Paweł Bugajski
- Department of Cardiovascular Disease Prevention, Poznan University of Medical Sciences, Poznań, Poland
- Department of Cardiac Surgery Józef Strus Hospital, Poznań, Poland
| | - Jacek Karoń
- Department of General and Colorectal Surgery Józef Strus Hospital, Poznań, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznań, Poland
| | - Michał Ziarko
- Faculty of Psychology and Cognitive Sciences (FPCS AMU), Adam Mickiewicz University, Poznań, Poland
| | - Aleksandra Jasielska
- Faculty of Psychology and Cognitive Sciences (FPCS AMU), Adam Mickiewicz University, Poznań, Poland
| | - Włodzimierz Samborski
- Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznań, Poland
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Khanam A, Dar SA, Wani ZA, Shah NN, Haq I, Kousar S. Healthcare Providers on the Frontline: A Quantitative Investigation of the Stress and Recent Onset Psychological Impact of Delivering Health Care Services During COVID-19 in Kashmir. Indian J Psychol Med 2020; 42:359-367. [PMID: 33402797 PMCID: PMC7746896 DOI: 10.1177/0253717620933985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Frontline healthcare workers (FHCWs) are at an increased risk of contracting COVID-19. We aimed to assess the stress and psychological impact of the COVID-19 pandemic among FHCWs. METHODS This was an exploratory hospital-based study. A semistructured e-questionnaire was developed and shared through emails, WhatsApp groups, Facebook, and Twitter. The study instruments used were stress questionnaire and the impact of event scale-revised. RESULTS We received 133 valid responses. A total of 81 (61.4%) of the respondents were single, 74 (55.6) were male, 70 (52.6%) were between 20 and 29 years of age, and 91 (68.4%) were from urban background. A total of 83 (62.4%) of respondents were doctors and 28 (21.1%) were registered nurses. A total of 36 (27.1%) were posted in emergency and 34 (25.6%) were in the in-patient department. Feeling sad and pessimistic, feeling of being avoided by others, the burden of change in the quality of work, and worrying whether the family will be cared for in their absence were significantly more in nurses as compared to the doctors. Stress due to burden in an increase in the quantity of work was seen more in FHCWs working in the swab collection center as compared to those working in the in-patient department, emergency, or theaters. Severe psychological impact was seen in 81 (60.9%) of FHCWs. The psychological impact was significantly more in males and in those who were married. It was also significantly related to the place of posting. CONCLUSION More than half of the FHCWs had a severe psychological impact owing to COVID-19. The psychological impact was more in males and those who were married, and it was related to the place of posting of the FHCWs. Nurses had significantly higher stress as compared to doctors.
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Affiliation(s)
- Aaliya Khanam
- Dept. of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Shabir Ahmad Dar
- Dept. of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Zaid Ahmad Wani
- Dept. of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Naveed Nazir Shah
- Dept. of Chest Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Inaamul Haq
- Dept. of Social and Preventive Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Shazia Kousar
- Dept. of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
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Emotional touchpoints; the feelings nurses have about explaining multi-resistant organisms to colonised patients. Infect Dis Health 2020; 25:113-123. [DOI: 10.1016/j.idh.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/26/2019] [Accepted: 12/30/2019] [Indexed: 11/18/2022]
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Harris J, Walsh K, Dodds S. Are Contact Precautions ethically justifiable in contemporary hospital care? Nurs Ethics 2017; 26:611-624. [PMID: 28617193 DOI: 10.1177/0969733017709335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Hospital infection control practices known as Contact Precautions are recommended for the management of people with pathogens such as methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococci. Background: The patient is isolated, and staff are required to wear gloves, and a gown or apron when providing care. A notice is displayed to remind staff of these requirements and an 'alert' message is placed in the patient's medical record. Objective: The aim of this article is to discuss and explore whether practices used in hospitals to reduce the transmission of endemic antibiotic-resistant organisms are ethically justified in today's healthcare environment in the developed world. In order to do this, the history of the development of these practices is summarised, and the evidence base for their effectiveness is reviewed. Key bioethics principles are then discussed and contextualised from the perspective of hospital infection prevention and control, and an ethically superior model for the prevention and control of healthcare associated infection is proposed.
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Affiliation(s)
- Joanna Harris
- Illawarra Shoalhaven Local Health District (ISLHD), Australia; University of Tasmania, Australia
| | - Kenneth Walsh
- University of Tasmania, and Tasmanian Health Service, Australia
| | - Susan Dodds
- University of NSW Arts & Social Sciences, Sydney NSW, Australia
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12
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Psychological Effects on Medical Doctors from the Middle East Respiratory Syndrome (MERS) Outbreak : A Comparison of Whether They Worked at the MERS Occurred Hospital or Not, and Whether They Participated in MERS Diagnosis and Treatment. ACTA ACUST UNITED AC 2017. [DOI: 10.4306/jknpa.2017.56.1.28] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Corley A, Hammond NE, Fraser JF. The experiences of health care workers employed in an Australian intensive care unit during the H1N1 Influenza pandemic of 2009: a phenomenological study. Int J Nurs Stud 2009; 47:577-85. [PMID: 20036360 PMCID: PMC7125717 DOI: 10.1016/j.ijnurstu.2009.11.015] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 11/14/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND The H1N1 Influenza A pandemic arrived in Australia in early May 2009. In Queensland, the highest number of H1N1 cases were admitted to the intensive care unit when compared with the other Australian states. While many recent studies examining the H1N1 pandemic have focussed on service delivery and disease epidemiology, few have explored the lived experiences of frontline health care workers caring for the patients in the intensive care unit. OBJECTIVES The purposes of this study were to: document and describe the lived experiences of the nursing and medical staff caring for patients in the intensive care unit during the H1N1 pandemic; to validate the staffs' experiences; and to assist in informing future pandemic planning by highlighting the collective experiences of these frontline health care workers. DESIGN A phenomenological study method was used. SETTING AND PARTICIPANTS 34 staff from a tertiary referral hospital in Brisbane, Australia participated in the study. METHODS Data was collected using an open ended questionnaire and focus groups. The resulting responses were analysed using Colaizzi's framework to discover regular patterns of meaning that emerged. RESULTS Eight common themes emerged: the wearing of personal protective equipment; infection control procedures; the fear of contracting and transmitting the disease; adequate staffing levels within the intensive care unit; new roles for staff; morale levels; education regarding extracorporeal membrane oxygenation; and the challenges of patient care. These eight themes articulate the lived experience of the staff during the height of the H1N1 Influenza pandemic period. CONCLUSIONS Planning for a pandemic situation is invariably difficult due to the unpredictable nature of the event itself. Recommendations for future pandemic planning which can be drawn from this study include the appointment of a dedicated infection control representative to provide information and support regarding infection control matters; the maintenance of effective communication channels is crucial; and the increased staffing requirements across nursing, medical, allied health and ancillary staff to cope with the higher patient numbers and acuity must be anticipated and planned for.
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Affiliation(s)
- Amanda Corley
- Clinical Research Nurse, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.
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Considine J, Mitchell B. Chemical, biological and radiological incidents: preparedness and perceptions of emergency nurses. DISASTERS 2009; 33:482-497. [PMID: 19178546 DOI: 10.1111/j.1467-7717.2008.01084.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Despite their important role in chemical, biological and radiological (CBR) incident response, little is known about emergency nurses' perceptions of these events. The study aim was to explore emergency nurses' perceptions of CBR incidents and factors that may influence their capacity to respond. Sixty-four nurses from a metropolitan Emergency Department took part. The majority were willing to participate in CBR incidents and there was a positive association between willingness to participate and postgraduate qualification in emergency nursing. Willingness decreased, however, with unknown chemical and biological agents. One third of participants reported limitations to using personal protective equipment. Few participants had experience with CBR incidents although 70.3 per cent of participants had undergone CBR training. There were significant differences in perceptions of choice to participate and adequacy of training between chemical, biological and radiological incidents. The study results suggest that emergency nurses are keen to meet the challenge of CBR incident response.
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Affiliation(s)
- Julie Considine
- School of Nursing, Deakin University-Northern Health Clinical Partnership, Australia.
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15
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Ott M, Shen J, Sherwood S. Evidenced-based practice for control of methicillin-resistant Staphylococcus aureus. AORN J 2005; 81:361-4, 367-72; quiz 375-8. [PMID: 15768546 DOI: 10.1016/s0001-2092(06)60418-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has become a global issue and affects nursing practice in many clinical areas. This article explores methods for effective control of MRSA in hospital settings. Based on infection control guidelines provided by the Centers for Disease Control and Prevention, the College of Nurses of Ontario, AORN, the World Health Organization, and several evidence-based studies, strategies for MRSA infection control measures include hand hygiene, contact isolation, and hospital environment hygiene.
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Affiliation(s)
- Marilyn Ott
- School of Nursing, McMaster University, Hamilton, Ontario
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16
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Lee SH, Juang YY, Su YJ, Lee HL, Lin, YH, Chao CC. Facing SARS: psychological impacts on SARS team nurses and psychiatric services in a Taiwan general hospital. Gen Hosp Psychiatry 2005; 27:352-8. [PMID: 16168796 PMCID: PMC7132375 DOI: 10.1016/j.genhosppsych.2005.04.007] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2004] [Accepted: 04/05/2005] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The outbreak of severe acute respiratory syndrome (SARS) in 2003 resulted in 346 probable SARS cases and 37 deaths in Taiwan. This descriptive study, which was conducted from May to June 2003, intended to identify staff stress and coping strategies among a SARS team of nursing staff during the outbreak. METHOD Twenty-six female nurses of the SARS team completed a questionnaire about their experiences serving in the SARS team. RESULTS SARS had both positive and negative psychological impacts on the nurses. While worrying about infecting their families and colleagues, nurses were able to cope with the situation through various means. Additional findings include the need for more psychiatric staff to provide flexible and continuous service, the importance of meetings to improve teamwork and reduce conflict between doctors and nurses and the useful discovery that video cell phones provided needed reassurance from afar to the worried families of the nurses. CONCLUSION This study reinforces the importance and benefits of psychiatric services for SARS team members in reducing their secondary traumatization. It is hoped that the results will enhance our knowledge on the needs of frontline health care workers and support the planning of better psychiatric services in future epidemics.
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Affiliation(s)
- Shwu-Hua Lee
- Department of Psychiatry, Chang Gung Memorial Hospital, Kweisan, Taoyuan 333, Taiwan
| | - Yeong-Yuh Juang
- Department of Psychiatry, Chang Gung Memorial Hospital, Kweisan, Taoyuan 333, Taiwan
| | - Yi-Jen Su
- Department of Psychiatry, Chang Gung Memorial Hospital, Kweisan, Taoyuan 333, Taiwan
| | - Hsiu-Lan Lee
- Department of Emergency, Chang Gung Memorial Hospital, Kweisan, Taoyuan 333, Taiwan
| | - Yi-Hui Lin,
- Department of Psychiatry, Chang Gung Memorial Hospital, Kweisan, Taoyuan 333, Taiwan
| | - Chia-Chen Chao
- Graduate Institute of Clinical Behavioral Science, Chang Gung University, Kweisan, Taoyuan 333, Taiwan
- Corresponding author. Tel.: +886 3 3289270; fax: +886 3 3289270.
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Maunder R. The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: lessons learned. Philos Trans R Soc Lond B Biol Sci 2004; 359:1117-25. [PMID: 15306398 PMCID: PMC1693388 DOI: 10.1098/rstb.2004.1483] [Citation(s) in RCA: 243] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The outbreak of severe acute respiratory syndrome (SARS) in the first half of 2003 in Canada was unprecedented in several respects. Understanding the psychological impact of the outbreak on healthcare workers, especially those in hospitals, is important in planning for future outbreaks of emerging infectious diseases. This review draws upon qualitative and quantitative studies of the SARS outbreak in Toronto to outline the factors that contributed to healthcare workers' experiencing the outbreak as a psychological trauma. Overall, it is estimated that a high degree of distress was experienced by 29-35% of hospital workers. Three categories of contributory factors were identified. Relevant contextual factors were being a nurse, having contact with SARS patients and having children. Contributing attitudinal factors and processes were experiencing job stress, perceiving stigmatization, coping by avoiding crowds and colleagues, and feeling scrutinized. Pre-existing trait factors also contributed to vulnerability. Lessons learned from the outbreak include: (i) that effort is required to mitigate the psychological impact of infection control procedures, especially the interpersonal isolation that these procedures promote; (ii) that effective risk communication is a priority early in an outbreak; (iii) that healthcare workers may have a role in influencing patterns of media coverage that increase or decrease morale; (iv) that healthcare workers benefit from resources that facilitate reflection on the effects of extraordinary stressors; and (v) that healthcare workers benefit from practical interventions that demonstrate tangible support from institutions.
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Affiliation(s)
- Robert Maunder
- Integrated Medicine Project, Mount Sinai Hospital and Department of Psychiatry, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
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18
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Maunder RG, Lancee WJ, Rourke S, Hunter JJ, Goldbloom D, Balderson K, Petryshen P, Steinberg R, Wasylenki D, Koh D, Fones CSL. Factors associated with the psychological impact of severe acute respiratory syndrome on nurses and other hospital workers in Toronto. Psychosom Med 2004; 66:938-42. [PMID: 15564361 DOI: 10.1097/01.psy.0000145673.84698.18] [Citation(s) in RCA: 246] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES A survey was conducted to measure psychological stress in hospital workers and measure factors that may have mediated acute traumatic responses. METHODS A self-report survey was completed by 1557 healthcare workers at three Toronto hospitals in May and June 2003. Psychological stress was measured with the Impact of Event Scale. Scales representing attitudes to the outbreak were derived by factor analysis of 76 items probing attitudes to severe acute respiratory syndrome. The association of Impact of Event Scale scores to job role and contact with severe acute respiratory syndrome patients was tested by analysis of variance. Between-group differences in attitudinal scales were tested by multivariate analysis of variance. Attitudinal scales were tested as factors mediating the association of severe acute respiratory syndrome patient contact and job role with total Impact of Event Scale by linear regression. RESULTS Higher Impact of Event Scale scores are found in nurses and healthcare workers having contact with patients with severe acute respiratory syndrome. The relationship of these groups to the Impact of Event Scale score is mediated by three factors: health fear, social isolation, and job stress. CONCLUSIONS Although distress in response to the severe acute respiratory syndrome outbreak is greater in nurses and those who care for patients with severe acute respiratory syndrome, these relationships are explained by mediating variables that may be available for interventions to reduce stress in future outbreaks. In particular, the data suggest that the targets of intervention should include job stress, social isolation, and health fear.
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Affiliation(s)
- Robert G Maunder
- Department of Psychiatry, University of Toronto and Mount Sinai Hospital, Ninth Floor, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
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Nickell LA, Crighton EJ, Tracy CS, Al-Enazy H, Bolaji Y, Hanjrah S, Hussain A, Makhlouf S, Upshur REG. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. CMAJ 2004; 170:793-8. [PMID: 14993174 PMCID: PMC343853 DOI: 10.1503/cmaj.1031077] [Citation(s) in RCA: 450] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The outbreak of SARS in 2003 had a dramatic effect on the health care system in Toronto. The main objective of this study was to investigate the psychosocial effects associated with working in a hospital environment during this outbreak. METHODS Questionnaires were distributed to all willing employees of Sunnybrook and Women's College Health Sciences Centre between Apr. 10 and 22, 2003. The survey included questions regarding concern about SARS, precautionary measures, personal well-being and sociodemographic characteristics; a subsample also received the 12-item version of the General Health Questionnaire (GHQ-12). RESULTS Of the 4283 questionnaires distributed, 2001 (47%) were returned, representing 27% of the total hospital employee population of 7474. The proportions of respondents who were allied health care professionals, nurses and doctors and who worked in areas other than patient care were representative of the hospital staff population as a whole. Of the 2001 questionnaires, 510 contained the GHQ-12. Two-thirds of the respondents reported SARS-related concern for their own or their family's health. A total of 148 respondents (29%) scored above the threshold point on the GHQ-12, indicating probable emotional distress; the rate among nurses was 45%. Masks were reported to be the most bothersome infection control precaution. Logistic regression analysis identified 4 factors as being significantly associated with increased levels of concern for personal or family health: perception of a greater risk of death from SARS (adjusted odds ratio [OR] 5.0, 95% confidence interval [CI] 2.6-9.6), living with children (adjusted OR 1.8, 95% CI 1.5-2.3), personal or family lifestyle affected by SARS outbreak (adjusted OR 3.3, 95% CI 2.5-4.3) and being treated differently by people because of working in a hospital (adjusted OR 1.6, 95% CI 1.2-2.1). Four factors were identified as being significantly associated with the presence of emotional distress: being a nurse (adjusted OR 2.8, 95% CI 1.5-5.5), part-time employment status (adjusted OR 2.6, 95% CI 1.2-5.4), lifestyle affected by SARS outbreak (adjusted OR 2.2, 95% CI 1.4-3.5) and ability to do one's job affected by the precautionary measures (adjusted OR 2.9, 95% CI 1.9-4.6). INTERPRETATION Our findings indicate that the SARS outbreak had significant psychosocial effects on hospital staff. These effects differed with respect to occupation and risk perception. The effect on families and lifestyle was also substantial. These findings highlight the need for interventions to address psychosocial distress and concern and to provide support for employees during such crises.
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Affiliation(s)
- Leslie A Nickell
- Primary Care Research Unit, Department of Family and Community Medicine, E-352, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
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