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Tekin S, Nicholls H, Lamb D, Glover N, Billings J. Impact of occupational stress on healthcare workers' family members before and during COVID-19: A systematic review. PLoS One 2024; 19:e0308089. [PMID: 39298458 DOI: 10.1371/journal.pone.0308089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/17/2024] [Indexed: 09/21/2024] Open
Abstract
We aimed to explore the experiences, needs, and mental health impact of family members of healthcare workers (HCWs) before and during the COVID-19 pandemic. Eleven quantitative and nine qualitative studies were included in this review. Based on the narrative synthesis, we identified five outcomes: 'Mental health outcomes', 'Family relationships, 'Coping skills and resilience', 'Quality of life and social life', and 'Practical outcomes'. Our findings indicated that there was a high risk to the mental health and well-being of families of healthcare workers both before and during the pandemic. However, with the COVID-19 pandemic, some experiences and mental health issues of families were worsened. There was also a negative association between working long hours/shift work and family relationships/communication, family social life, and joint activities, and family members taking on more domestic responsibilities. Families tended to use both positive and negative coping strategies to deal with their loved one's job stress. Organisations and support services working with people in health care work should consider widening support to families where possible. With this understanding, HCWs and their families could be supported more effectively in clinical and organisational settings. Trial registration: Systematic Review Registration Number: CRD42022310729. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022310729.
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Affiliation(s)
- Sahra Tekin
- Division of Psychiatry, University College London, London, United Kingdom
| | - Helen Nicholls
- Division of Psychiatry, University College London, London, United Kingdom
| | - Dannielle Lamb
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Naomi Glover
- Division of Psychiatry, University College London, London, United Kingdom
| | - Jo Billings
- Division of Psychiatry, University College London, London, United Kingdom
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Ghaljaei F, Najafi F. Experiences of family caregivers of nurses infected with COVID-19: a qualitative study. BMC Nurs 2024; 23:631. [PMID: 39256680 PMCID: PMC11389317 DOI: 10.1186/s12912-024-02320-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 09/03/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Nurses, as the main healthcare workers during the COVID-19 pandemic, were at high risk of contracting the disease. Family caregivers played a vital role in the support and recovery of patients with COVID-19. The experiences of family caregivers of nurses are very important due to the nature of their job. However, little information is available in this field. To this end, the present study aimed to explore the experiences of family caregivers of nurses who recovered from COVID-19. METHODS This descriptive qualitative study was conducted in one of the hospitals in southeastern Iran in 2022. The participants were 12 family caregivers of nurses who recovered from COVID-19 and were selected through purposive sampling. The data were collected through semi-structured interviews and analyzed using conventional content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings. RESULTS The analysis of the data revealed psychosocial consequences as main theme, three categories and nine subcategories including negative emotions and attitudes (fear of deterioration/death, fear of frequent infection, fear of transmitting infection to others, despair of recovery, Changing attitudes toward the nursing profession), caregiver burden (role conflict, economic pressure) and lack of support, ineffective interactions and isolation (Lack of support from nursing managers and colleagues, ineffective interactions and isolation). CONCLUSION Like other caregivers, family caregivers of nurses recovered from COVID-19 experienced psychosocial consequences and a heavy burden of responsibility. However, what differentiates our findings from the results reported in previous studies is the change in caregivers' attitudes toward nursing and regret for their family members being nurses. The lack of support from medical staff and managers for nurses, the condition of nurses frequently contracting COVID-19 due to the nature of their profession, and the fear of transmitting the infection to others due to contact with COVID-19 patients in the workplace expose these caregivers to additional stress and many risks. Thus, these caregivers need more attention and support in similar situations; an issue that seems to have been neglected during the COVID-19 pandemic.
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Affiliation(s)
- Fereshteh Ghaljaei
- Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fereshteh Najafi
- Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
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Powling R, Brown D, Tekin S, Billings J. Partners' experiences of their loved ones' trauma and PTSD: An ongoing journey of loss and gain. PLoS One 2024; 19:e0292315. [PMID: 38354114 PMCID: PMC10866491 DOI: 10.1371/journal.pone.0292315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 09/18/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Traumatic life events can have a profound impact on the physical and psychological wellbeing of not only those who directly experience them, but others who are indirectly affected, such as victims' partners. AIMS This study aimed to explore the experiences and views of partners of individuals who have a history of trauma and diagnosis of posttraumatic stress disorder (PTSD). METHODS In-depth semi-structured interviews were conducted with six partners of people who had experienced trauma and were diagnosed with PTSD and awaiting or receiving treatment at a specialist Trauma Service. The data was analysed using Interpretative Phenomenological Analysis. RESULTS One overarching theme resulted from the data: partners experienced trauma and PTSD as an ongoing journey of loss and gain. This was supported by three superordinate themes: making sense of the trauma and ensuing consequences, shifting identities, and accessing and experiencing outside resources. Partners' journeys were characterised by striving and struggling to make sense of the trauma and its ensuing consequences, whilst grappling with the identities of themselves, their partners and relationships shifting over time. Participants navigated their journeys in the context of external resources and support from friends, family, colleagues and professionals. CONCLUSIONS The results of this study highlight the need for greater information and support for partners of people with PTSD.
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Affiliation(s)
- Rosie Powling
- School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Dora Brown
- School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Sahra Tekin
- Division of Psychiatry, University College London, London, United Kingdom
| | - Jo Billings
- Division of Psychiatry, University College London, London, United Kingdom
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Ford JD, Seedat S. On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021-2023. Eur J Psychotraumatol 2023; 14:2281988. [PMID: 38038964 PMCID: PMC10990445 DOI: 10.1080/20008066.2023.2281988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/17/2023] [Indexed: 12/02/2023] Open
Abstract
This Special Issue of the European Journal of Psychotraumatology (EJPT) presents 51 articles published between 2021 and 2023 and follows the Special Issue on pandemic-related traumatic stress research published in 2021 (O'Donnell, M. L., & Greene, T. [2021]. Understanding the mental health impacts of COVID-19 through a trauma lens. European Journal of Psychotraumatology, 12(1), 1982502). Research on traumatic stress during the pandemic has cast the spotlight on vulnerable populations and groups, notably front-line healthcare workers; people faced with major losses including the deaths of loved ones; those who personally survived debilitating and often life-threatening viral infection; and students who were isolated and experienced profound delays in their education, relationships, and emerging independence. The papers in this collection underscore the associations between COVID-19 related stressors and a plethora of adverse mental health sequelae, including posttraumatic stress reactions, and draw attention to the ubiquity of grief and moral injury and their wide-ranging and detrimental impact. Currently, there is a paucity of evidence on interventions to enhance resources, self-efficacy, and hope for affected groups and individuals through societal, organisational, and healthcare systems; however early research on the prevention of COVID-related traumatic stress disorders provides a basis for both hope and preparedness for the future.
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Affiliation(s)
- Julian D. Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Soraya Seedat
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Zhao JL, Shen L, Shields J, Wang YX, Wu YJ, Yu Z, Li YX. Nurses' Work-Family Strategies during COVID-19 Lockdown and Their Association with Individual Health and Family Relations. Healthcare (Basel) 2023; 11:2960. [PMID: 37998452 PMCID: PMC10671543 DOI: 10.3390/healthcare11222960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
The COVID-19 lockdown forced people to stay at home and address their family duties more equally. However, since nurses themselves were involved in the closed-loop management in hospitals and unable to return home, there was also an increased likelihood of non-traditional work-family strategies emerging. To ascertain the extant and implications of this phenomenon, this cross-sectional study explores work-family management strategies among nurses during the COVID-19 lockdown and their association with nurses' individual health, family relationships, and job performance. Survey data were collected from 287 nurses who were involved in the closed-loop management in Shanghai hospitals from March to June 2022. Latent Class Analysis of seven categorical variables of nurses' work-family status (e.g., the division of childcare labor) produced a best-fit solution of five strategies (BLRT (p) < 0.001, LMR (p) = 0.79, AIC = 5611.34, BIC = 6302.39, SSA-BIC = 5703.65, Entropy = 0.938): (1) fully outsourcing to grandparents, (2) partially outsourcing to grandparents, with the husband filling in the gap, (3) the husband does it all, (4) egalitarian remote workers, and (5) a neo-traditional strategy. Nurses who applied the egalitarian strategy had less psychological distress and relationship tension and better performance than those who applied the neo-traditional strategy and performed most of the childcare. The "husband does it all" strategy and the outsourcing strategies seem to have double-edged effects, with better job performance and family relations but also more distress and fewer sleeping hours among nurses. Overall, with a view to future risk mitigation, policymakers and practitioners should be aware of the diversity of the work-family strategies among nurse families during the lockdown period, and their association with individual and family outcomes, and provide tailored support.
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Affiliation(s)
- Jia-Lin Zhao
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
| | - Li Shen
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, Nanjing 210014, China
| | - John Shields
- Discipline of Work and Organisational Studies, The University of Sydney Business School, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Ya-Xuan Wang
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
| | - Yu-Jia Wu
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
| | - Zhan Yu
- Department of Social Work, School of Social Development, East China Normal University, Shanghai 200062, China;
- Shanghai Social Science Innovation Research Base of “Research on Transitional Sociology with Chinese Characteristics”, Shanghai 200062, China
| | - Yi-Xin Li
- Department of Sociology, College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai 200234, China; (J.-L.Z.); (Y.-X.W.); (Y.-J.W.); (Y.-X.L.)
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Brooks SK, Patel D, Greenberg N. "Exceptionally challenging time for all of us": Qualitative study of the COVID-19 experiences of partners of diplomatic personnel. PLoS One 2023; 18:e0293557. [PMID: 37917599 PMCID: PMC10621840 DOI: 10.1371/journal.pone.0293557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Although the romantic partners of diplomatic personnel frequently accompany their spouses to overseas postings and face the challenges of having to adjust to new cultures and separation from friends and family, they have rarely been the focus of academic research. This study explores the lived experiences of the partners/spouses of diplomatic personnel from the United Kingdom's Foreign, Commonwealth and Development Office (FCDO) during the COVID-19 pandemic. METHODS Partners of FCDO staff took part in semi-structured interviews about how COVID-19 had affected their lives and their perceptions of the organisation's response to the pandemic. Thematic analysis was used to analyse the data. RESULTS Eleven partners of FCDO staff took part, who between them had lived in 14 different countries during the pandemic. The analysis identified six key themes: deployment-specific challenges such as travel restrictions, quarantine and evacuation; children; impacts of the pandemic including financial and psychological; perceptions of the organisational response to COVID-19; support and help-seeking; and suggestions for the future. Overall participants reported experiencing a number of challenges, many of which left them feeling powerless and not in control of their own lives. Participants frequently described a lack of clarity around policies and support. Social support appeared to be valuable, but many participants wanted more support from the organisation and from informal networks. CONCLUSIONS Diplomatic (and similar) organisations could enhance the wellbeing of the partners of their staff through improved communication and support. Keeping families informed about restrictions, requirements, policies and available help during a crisis, and reaching out to them to offer advice and support, would likely be beneficial. It is important that lessons are learned from the COVID-19 crisis in order for organisations to be able to support their employees and families if another prolonged crisis were to occur.
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Affiliation(s)
- Samantha K. Brooks
- Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Dipti Patel
- Overseas Health and Welfare, Foreign, Commonwealth and Development Office, London, United Kingdom
| | - Neil Greenberg
- Department of Psychological Medicine, King’s College London, London, United Kingdom
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Billings J. The effect of the COVID-19 pandemic on health-care workers. Lancet Psychiatry 2023; 10:3-5. [PMID: 36526344 PMCID: PMC9750182 DOI: 10.1016/s2215-0366(22)00410-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, London, UK.
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Tjin A, Traynor A, Doyle B, Mulhall C, Eppich W, O'Toole M. Turning to 'Trusted Others': A Narrative Review of Providing Social Support to First Responders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16492. [PMID: 36554368 PMCID: PMC9778548 DOI: 10.3390/ijerph192416492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
First responders, such as paramedics and firefighters, encounter duty-related traumatic exposures, which can lead to post-traumatic stress (PTS). Although social support protects against PTS, we know little about how first responders' families, spouses/partners, friends, and care-partners (i.e., 'trusted others') provide social support. This narrative review explores support behaviors, coping strategies, and resources trusted others use to support first responders. A structured literature search yielded 24 articles. We used House's (1981) conceptual framework to inform our analysis. We identified three main themes: providing support, finding support, and support needs. Additionally, we describe trusted others' self-reported preparedness, coping strategies, and barriers to providing social support. We found that trusted others provided different types of support: (a) emotional (fostering a safe space, giving autonomy over recovery, facilitating coping mechanisms, prioritizing first responders' emotional needs); (b) instrumental (prioritizing first responders' practical needs, handling household tasks, supporting recovery); (c) appraisal (active monitoring, verbal reassurance, positive reframing), and (d) informational (seeking informal learning). In their role, trusted others sought formal (organizational) and informal (peer and personal) support and resources, alongside intrapersonal and interpersonal coping strategies. Identified barriers include inadequate communication skills, maladaptive coping, and disempowering beliefs. Thus, we offer practical, treatment, and social support recommendations.
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Affiliation(s)
- Anna Tjin
- RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Angeline Traynor
- RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Brian Doyle
- RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Claire Mulhall
- RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Walter Eppich
- RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Michelle O'Toole
- RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
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Helou M, El Osta N, Husni R. Impact of the COVID-19 pandemic on healthcare workers’ families. World J Clin Cases 2022; 10:9964-9966. [PMID: 36186190 PMCID: PMC9516914 DOI: 10.12998/wjcc.v10.i27.9964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/03/2022] [Accepted: 08/15/2022] [Indexed: 02/05/2023] Open
Abstract
The coronavirus disease 2019 pandemic had a significant effect on the mental health, social lives, and family relationships of healthcare workers. During the pandemic, these workers had to prioritize their work over parenting, spending time with their kids or partners, planning weddings, and childbearing plans. Therefore, special recognition should be given to the families of these employees.
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Affiliation(s)
- Mariana Helou
- Department of Emergency Medicine, Lebanese American University school of Medicine, Beirut, Lebanon
- Lebanese American University- Rizk Hospital, Beirut, Lebanon
| | - Nour El Osta
- Department of Emergency, Lebanese American University School of Medicine, Beirut, Lebanon
- Lebanese American University- Rizk Hospital, Beirut, Lebanon
| | - Rola Husni
- Department of Infectious Diseases, Lebanese American University School of Medicine, Beirut, Lebanon
- Lebanese American University- Rizk Hospital, Beirut, Lebanon
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