Nursing Perspectives on the Impacts of COVID-19

Information Circulation Among Spanish-Speaking and Caribbean Communities Related to COVID-19: Social Media-Based Multidimensional Analysis

BACKGROUND

Scientific studies from North America and Europe tend to predominate the internet and benefit English-speaking users. Meanwhile, the COVID-19 death rate was high at the onset of the pandemic in Spanish-speaking countries, and information about nearby Caribbean countries was rarely highlighted. Given the rise in social media use in these regions, the web-based dissemination of scientific information related to COVID-19 must be thoroughly examined.

OBJECTIVE

This study aimed to provide a multidimensional analysis of peer-reviewed information circulation related to COVID-19 in Spanish-speaking and Caribbean regions.

METHODS

COVID-19-related, peer-reviewed resources shared by web-based accounts located in Spanish-speaking and Caribbean regions were identified through the Altmetric website, and their information was collected. A multidimensional model was used to examine these resources, considering time, individuality, place, activity, and relations. Time was operationalized as the 6 dates of data collection, individuality as the knowledge area and accessibility level, place as the publication venue and affiliation countries, activity as the Altmetric score and number of mentions in the selected regions, and relations as coauthorship between countries and types of social media users who disseminated COVID-19-related information.

RESULTS

The highest information circulation peaks in Spanish-speaking countries were from April 2020 to August 2020 and from December 2020 to April 2021, whereas the highest peaks in Caribbean regions were from December 2019 to April 2020. Regarding Spanish-speaking regions, at the onset of the pandemic, scientific expertise was concentrated on a few peer-reviewed sources written in English. The top scientific journals mentioned were from English-speaking, westernized regions, whereas the top scientific authorships were from China. The most mentioned scientific resources were about breakthrough findings in the medical and health sciences area, written in highly technical language. The top relationships were self-loops in China, whereas international collaborations were between China and the United States. Argentina had high closeness and betweenness, and Spain had high closeness. On the basis of social media data, a combination of media outlets; educational institutions; and expert associations, particularly from Panama, influenced the diffusion of peer-reviewed information.

CONCLUSIONS

We determined the diffusion patterns of peer-reviewed resources in Spanish-speaking countries and Caribbean territories. This study aimed to advance the management and analysis of web-based public data from non-white people to improve public health communication in their regions.

Professional identity, job satisfaction, and intention to stay among clinical nurses during the prolonged COVID-19 pandemic: A mediation analysis

AIM

This study aims to examine the relationship between professional identity and job satisfaction and their impact on intention to stay among clinical nurses in China during the prolonged COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted from April 30 to May 25, 2021, in China. Data were collected using professional identity, job satisfaction, and intention to stay questionnaires from 1425 clinical nurses. A single mediation analysis was utilized to test the interrelationship among the variables, and the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist as a reporting guide.

RESULTS

Nurses indicated a medium level of professional identity, job satisfaction, and intention to stay, with mean scores of 3.85, 3.25, and 3.47, respectively. The professional identity displayed positive indirect effect on nurses' intention to stay through job satisfaction (indirect effect = 0.498, 95% CI [0.439, 0.558]).

CONCLUSION

Cultivating professional identity among nurses can increase their job satisfaction and ultimately enhance the intention to stay in the nursing profession. However, this study also suggests paying more attention to job satisfaction to keep nursing retention. These may be helpful to retain the nursing workforce.

Structural Equation Modelling of Professional Values and Competency of Nurses During the COVID-19 Pandemic

Background

The COVID-19 pandemic is a global health crisis that affected nurses’ professional values and competence.

Aim

Our study examined the relationship between nurses’ professional values and competence in Saudi Arabia during the COVID-19 pandemic.

Methods

This study used a descriptive cross-sectional design with 748 nurses from Saudi Arabia. Two self-report instruments were used to collect data. Structural equation modelling was conducted to analyse the data.

Findings

The emerging model showed acceptable model fit indices. Two dimensions of nurse professional values significantly affected professional competence: professionalism and activism. Professionalism significantly affected the other four facets (e.g., caring, activism, trust, and justice) of nurse professional values. The dimension of caring had a strong, direct effect on activism. Justice had a moderate, direct impact on trust, while activism had a weak, direct impact on trust. Professionalism and caring had strong, indirect effects on professional competence by mediating the dimension of activism.

Discussion

The study’s findings highlight the need for strategies to evaluate and strengthen the various areas of professional values to foster professional competence among nurses. Moreover, nurse administrators should encourage nurses to participate in continuing nursing education programs or provide in-service educational training to promote professional values and competence.

Conclusion

This study provides a structural model of the interaction between nurses’ professional values and competence during the pandemic. Nurse administrators can leverage the presented model to develop policies and strategies to evaluate and strengthen nurses’ professional values and competence.

Factors Facilitating or Creating Barriers to Returning to Work in Head and Neck Cancer Patients Within the First 6 Months After Treatment

Head and neck cancer (HNC) patients who are unable to return to work after completing treatment might face financial loss and reduced self-esteem. The aim of this study was to identify factors influencing a return to work in HNC cancer patients in the first 6 months after treatment. This cross-sectional study examined HNC patients who completed treatment from the outpatient radiation department of a single cancer center in northern Taiwan. Patients were assessed according to psychological distress, patient-perceived health status, barriers to returning to work, and facilitators of returning to work. Of the 106 HNC patients surveyed, 54.7% successfully returned to work. Barriers to returning to work included poor self-perception of health, greater psychological distress, and age ≥50 years. Patients who had higher psychological distress, returned to work after start of the pandemic, or received reconstruction surgery were less likely to experience a positive environment facilitating a return to work.

Lived Experience of Nurses in COVID-19 Units - A Phenomenological Study from Eastern India

Introduction: Nurses are the frontline workers who had to play multiple functions like in acute care, community, etc. but, it was stated that COVID-19 has caused immense trauma to nurses globally. Methods: A descriptive phenomenological study to explore the lived experience of nurses working in COVID-19 units was conducted among nine senior nursing officers recruited by purposive homogenous sampling and interviewed with an open-ended interview guide by ensuring data saturation. COREQ guideline were adopted for this qualitative study. Results: Qualitative data were analysed using Giorgi's framework, and themes and sub-themes were derived. The major themes that emerged in the present study were "Reactions and preparation", "Feelings and satisfaction in active duty", "Role of a helping hand", "Working experience in PPE", and "Pandemic and socialization". Each theme had further sub-themes to classify the verbatims. Conclusion: Most of the nurses had anxiety and prepared themselves to play with fire, had unrealistic hope, and mixed emotions, kept their family away and intentionally concealed information to reduce family's fear, were satisfied with training and preparation, and had unpleasant experiences with PPE, had to restrict their social activities and felt social stigma. It also concludes with the recommendation that warrants the need to improve their professional quality of life and working conditions by safeguarding nurses' physical and mental health.

Nurses' professional values and competency in Saudi Arabia: A structural equation modelling approach

AIMS AND OBJECTIVES

To explore the relationship between Saudi nurses' professional values and competence.

BACKGROUND

Professionals are bound by ethical standards specific to their profession. Accordingly, the COVID-19 pandemic is the most significant event that has impacted nurses' professional values and competency.

DESIGN

A descriptive cross-sectional design adhering to STROBE guidelines.

METHODS

Clinical nurses from four tertiary government hospitals (n = 659) participated and completed two self-report instruments. Study variables were analysed using the structural equation modelling approach.

RESULTS

The emerging model displayed acceptable model fit indices. Professionalism and activism were two dimensions of nurse professional values that significantly impacted professional competency. Professionalism significantly impacted the four other aspects of nurse professional values: caring, activism, trust, and justice. Caring had a significant and direct impact on activism. Activism had a weak, direct effect on trust, whereas justice had a moderate, direct effect on trust. Through the mediation of the dimension of activism, both the dimensions of professionalism and caring had a strong, indirect impact on professional competency.

CONCLUSIONS

This research presents a structural model of the interrelationship between nurse professional values and competency. Nurse administrators can use the proposed model to develop approaches and policies for assessing, improving and evaluating professional values among nurses.

RELEVANCE FOR CLINICAL PRACTICE

Nursing professionals are committed to upholding their ethical and moral standards while performing their caregiver roles. Nurse administrators can implement activities and strategies to develop nurses' professional competence further, as professional values represent the ideal values expected of nurses providing patient care.

Nursing students' professional image in the Covid-19 pandemic in Turkey: A cross-sectional study

BACKGROUND

Nursing students' professional perceptions are affected by the environment they live in. Nursing students think that the nursing profession is important during the pandemic.

PURPOSE

This descriptive, cross-sectional study was conducted to determine the nursing students' professional image perceptions and the affecting factors during the Covid-19 pandemic in Turkey.

METHODS

The research population consisted of all nursing students (N = 750) of two universities in Turkey. The research data were collected using a personal information form and the Scale for the Image of Nursing Profession (SINP).

RESULTS

Of the students, 76.4% were not infected with Covid-19, 30.8% had an individual in their family infected with Covid-19; 34% had an immediate family member who died of Covid-19; 99.4% thought that the nursing profession is important during the Covid-19 pandemic. A statistically significant difference was found between the place where the students live and the SINP (p < .05).

CONCLUSION

The students' image perceptions toward the nursing profession were found to be at a good level. This indicates that image perception toward nursing profession has increased during the pandemic. It can be said that the place where the students are in the pandemic process and their thoughts about the nursing profession affect their professional image perceptions.

New Challenges in Surgical Approaches for Colorectal Cancer during the COVID-19 Pandemic

(1) Background: The COVID-19 pandemic put a great burden on national healthcare systems, causing delays and disruptions in the medical care of non-COVID-19 patients. This paper aims to analyze the COVID-19 pandemic impact upon the quality of care in colorectal surgery. (2) Materials and Methods: We performed a retrospective study on the colorectal cancer cases operated in the Fourth Department of General Surgery, Emergency Hospital Bucharest Romania, over the period March 2020–February 2021 (pandemic group) vs. March 2019–February 2020 (non-pandemic group). (3) Results: The number of patients in the pandemic group decreased by 70% (36 vs. 118 patients), with lower accessibility from rural areas (11.1% vs. 37.2%, p = 0.035). Most cases in the pandemic group were emergencies (69% vs. 37.3%, p = 0.009), admitted for bowel obstruction (63.8% vs. 27.9%, p = 0.008). There was no in-hospital COVID-19 infection in patients operated for colorectal cancer. The 30-day mortality was significantly higher in the pandemic group (25% vs. 6.7%, p = 0.017), mostly due to septic shock (36.1% vs. 5%, p = 0.0001). (4) Conclusions: Colorectal cancer surgery may be performed safely during the COVID-19 pandemic, with strict adherence to the SARS-CoV-2 prevention protocols. However, the significant increase in colorectal cancers in the emergency was associated with worse outcomes and higher mortality during the COVID-19 pandemic.

Relationship between Psychological Ownership of the Nursing Profession and Turnover Intention: A Correlational Survey among Taiwanese Nurses

AIMS

To examine the relationship between psychological ownership of the nursing profession and turnover intention.

BACKGROUND

There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated.

METHODS

This study adopted a cross-sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical center in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self-Efficacy Scale, and developed Having a Place Scale.

RESULTS

Psychological ownership comprises three dimensions: self-efficacy, nurse identity, and "having a place" in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self-efficacy and "having a place" are negatively related to nurses' intention to leave a hospital (r=-.23 and -.31, p<.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r=-.38, p<.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r=.76, p<.001).

CONCLUSION

The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management Nurse managers can enhance nurses' self-efficacy and sense of "having a place" to retain nurses in hospitals, while enhance nurse identity to retain nurses in the profession.

Characteristics of early-career nurse researchers negatively impacted during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

This study aimed to identify typical patterns and determinants of early-career nurse researchers (ECNRs: age ≤45 years) who reported that their research activities were negatively impacted during the COVID-19 pandemic, using a data mining methodology. To gain a deeper understanding of the characteristics of these ECNRs, we compared them with the characteristics of senior nurse researchers (SNRs: age ≥46 years).

DESIGN

A cross-sectional study.

PARTICIPANTS

1532 nurse researchers.

DATA COLLECTION AND ANALYSIS

We conducted an anonymous online questionnaire survey that assessed individual and professional attributes of nurse researchers and their experiences from April to June 2020. We analysed the association between the impact on research activities and the individual and professional attributes using cross-tabulation, and employed the chi-square automatic interaction detection technique to perform population segmentation.

RESULTS

We found that difficulties in research management, an increased burden of student education and organisational management, and organisational management position were relatively important factors for determining the negative impact of COVID-19 on the research activities of ECNRs (p<0.05). For both ECNRs and SNRs, the most relevant determinant of disrupted research activities was 'difficulties in research management' (χ²=34.7 and 126.5, respectively, p<0.001 for both). However, only ECNRs yielded 'position in organisational management' and was extracted only for ECNRs (χ²=7.0, p=0.008).

CONCLUSIONS

Difficulties in research management and an increased burden of student education and organisational management had an unfavourable impact on the research activities of ECNRs. To ensure quality of nursing care and nursing science development during and after the COVID-19 era, it is important to support ECNRs in their nursing research activities and career development. Our findings could contribute to the prioritisation of interventions and policymaking for ECNRs who are particularly at risk of being negatively affected by the pandemic.

The Influence of Research Follow-Up during COVID-19 Pandemic on Mental Distress and Resilience: A Multicenter Cohort Study of Treatment-Resistant Depression

Background: During the COVID-19 outbreak, patients with mental disorders have faced more negative psychological consequences than the public. For people with treatment-resistant depression (TRD), it is unclear whether research engagement would protect them from the deterioration of their symptoms. The study aimed to examine if chronic depressive patients would have improved resilience and mental distress levels after follow-up interviews during an observation period under COVID-19. Methods: The study was nested within a three-year prospective cohort study. A two-group comparison design was conducted, i.e., the follow-up group with regular research interviews every three months after baseline assessment and the control group with one assessment-only interview. The two groups were compared with demographics, psychosocial, and suicide information. Results: Baseline assessments were not significantly different in sociodemographic variables, suicide risks, mental distress, and resilience between groups. Significant differences were detected in resilient coping and mental distress levels (p < 0.05). The follow-up group (n = 46) experienced a higher level of resilient coping (37% vs. 25%) and lower level of mental distress (47.8% vs. 64.7%) than the control group (n = 68). Conclusions: Findings highlight under universal government strategy against COVID-19, TRD patients receiving regular research follow-ups exhibited better resilience and less mental distress than those without regular support from healthcare providers.

Impact of SARS-CoV-2 Pandemic on Psychosocial Burden and Job Satisfaction of Long-Term Care Nurses in Poland

Psychosocial consequences of the coronavirus pandemic are severe for health care workers due to their higher levels of exposure. Nurses often experience tremendous psychological pressure as a result of their workload in a high-risk environment. The purpose of this study was to determine the impact of the SARS-CoV-2 pandemic on the psychosocial burden and job satisfaction of nurses employed in long-term care. One hundred thirty-eight nurses employed in long-term care participated in the study. The respondents were 96.4% female and 3.6% male. The mean age of the respondents was 53.99 (standard deviation-4.01). The study was conducted between February and June 2021. The research tool was a standardized psychosocial risk scale questionnaire, which is a scientifically validated diagnostic tool with high reliability and accuracy coefficients. The primary tests used during the statistical analyses were non-parametric Mann-Whitney U (for two samples) and Kruskal-Wallis (for more than two samples) tests for assessing differences. During these analyses, in addition to standard statistical significance, appropriate p-values were calculated using the Monte Carlo method. Correlations between ordinal or quantitative variables were made using Spearman's rho coefficient. The results obtained allow us to conclude that the respondents rated the characteristics present in the workplace that constitute psychosocial risks at an average level. Emotional commitment and continuance-type commitment to the respondents' job position were also at a medium level. Respondents' self-rated ability to work for nurses employed in long-term care during the SARS-CoV-2 pandemic and commitment to patient care was high at 4.0 and 4.18, with a maximum of 5 points.

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.

Requirements for Creating a Position for Community Health Nursing Within the Iranian Primary Health Care System: A SWOT Analysis

Background: Accepting community health nursing in the primary care system of each country and focusing on creating a position for community health nurses is of significant importance. The aim of this study was to examine the stakeholders' perception of the requirements for establishing a position for community health nursing in the Iranian primary health care system. Methods: This qualitative study was done using 24 semi-structured interviews conducted from May 2020 to February 2021 in Iran. The participants were selected through purposive sampling and consisted of nursing policy makers, the policy makers of the Health Deputy of Ministry of Health, the managers and the authorities of universities of medical sciences all across the country, community health nursing faculty members, and community health nurses working in health care centers. After recording and transcribing the data, data analysis was performed in MAXQDA10 software, using Elo and Kyngas's directed content analysis approach and based on WHO's community health nursing role enhancement model. The statements for each main category were summarized in SWOT classification. To examine the trustworthiness of the data, Lincoln & Guba's criteria were used. Results: By analyzing the interviews 6 main categories identified consist of creating a transparent framework for community health nursing practice, enhancing community health nursing education and training for practice in the primary health care system and community settings, seeking support, strengthening the cooperation and engagement among the key stakeholders of the primary health care system, changing the policies and the structure of the health system, and focusing on the deficiencies of the health system. Each main categories including the subcategories strengths, weaknesses, opportunities and threats (SWOT). Conclusions: Based on the participants' opinions, focusing on the aforementioned dimensions is one of the requirements of developing a position for community health nursing within the Iranian PHC system. It seems that correct and proper implementation of these strategies in regard with the cultural context of society can help policymakers manage challenges that prevent the performance of community health nursing in the health system.

Factors associated with preventive behaviors for COVID-19 among adolescents in South Korea

PURPOSE

COVID-19's infection rate among adolescents is increasing; hence, it is important to prevent it as it can spread in the community through transmission in schools. It is crucial to determine the extent to which adolescents follow COVID-19 preventive measures and identify factors relating to such behaviors to implement more effective health education. This study aimed to understand factors related to COVID-19 preventive behaviors using the theory of planned behavior (TPB) and the health belief model (HBM) among adolescents in South Korea.

DESIGN AND METHODS

A cross-sectional face-to-face questionnaire survey was conducted among 272 adolescents in South Korea. Structural equation modeling was used to examine the relationships between perceived susceptibility, perceived severity, attitude, subjective norms, perceived behavioral control, intention, and COVID-19 preventive behaviors.

RESULTS

Among adolescents' COVID-19 preventive behavior scores, wearing masks was the highest and distancing was the lowest. Adolescents' adherence to COVID-19 preventive behaviors was directly or indirectly associated with their perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention.

CONCLUSIONS

Attention to mitigate social isolation is important to improve compliance with COVID-19 preventive behaviors. Perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention explained 61.3% of adolescents' COVID-19 preventive behaviors, there is a need for education to promote relevant factors.

PRACTICE IMPLICATIONS

To increase adolescent awareness of COVID-19 and increase attitudes, subjective norms, and perceived behavior control, nurses need to provide education including the evidence for COVID-19 preventive behavior to increase adolescents' understanding and active implementation of those behaviors.

Media use, positive and negative emotions, and stress levels of adults during COVID-19 pandemic in Turkey: A cross-sectional study

AIM

This study was conducted to determine media use, positive and negative emotions, and stress levels of adults during the COVID-19 pandemic.

BACKGROUND

Using media tools in the pandemic process has impacted the mental health of individuals. As the COVID-19 outbreak is a new disease fear, anxiety and stress about this situation can cause strong emotions in adults.

METHODS

The research was carried out using a cross-sectional design. The sample consisted of 1541 adults. The Positive and Negative Emotion Scale, and the Perceived Stress Scale were used to collect the data.

RESULTS

The Positive Emotion Scale mean scores were lower (p < 0.05) for those people whose daily media use time was more than 4 h and who followed the developments about COVID-19 through the media once a day. It was found that those with daily media use of more than 4 h/day had higher Perceived Stress Scale scores than those with lower use (p > 0.05).

CONCLUSION

This study concluded that the use of media in adults increased during the COVID-19 outbreak and that media use was associated with positive and negative emotions and stress levels. Health professionals should assess the effect of the COVID-19 outbreak on mental health in various community groups and develop interventions to prevent negative consequences of increased media use.

The Impact of COVID-19 from the Perspectives of Dutch District Nurses: A Mixed-Methods Study

Little is known about how COVID-19 affects older patients living at home or how it affects district nursing teams providing care to these patients. This study aims to (1) explore, from the perspectives of Dutch district nurses, COVID-19's impact on patients receiving district nursing care, district nursing teams, and their organisations during the first outbreak in March 2020 as well as one year later; and (2) identify the needs of district nurses regarding future outbreaks. A mixed-methods, two-phase, sequential exploratory design was followed. In total, 36 district nurses were interviewed during the first outbreak (March 2020), of which 18 participated in the follow-up questionnaire in April 2021. Thirteen themes emerged, which showed that the COVID pandemic has substantially impacted patient care and district nursing teams. During the first outbreak, nurses played a crucial role in organising care differently and worked under high pressure, leading to exhaustion, tiredness, and psychosocial problems, including fear of infection. A year later, nurses were better prepared to provide COVID care, but problems regarding work pressure and mental complaints remained. The identified needs focus on a sustainable implementation of leadership roles for district nurses. At the organisational and national levels, more support and appreciation are needed in terms of trust and appropriate policies.

COVID-19 and nursing research across five countries/regions: Commonalities and recommendations

With the recent impact by the COVID-19 pandemic, nursing research has gone through unexpected changes across the globe. The purpose of this special report is to present the commonalities in the impact of the COVID-19 pandemic on nursing research across four countries, including the United States, South Korea, Japan, and Taiwan, and one region, that is, Hong Kong, and to make recommendations for future nursing research during the immediate postpandemic period and future pandemic situations. To identify the commonalities, seven researchers/leaders from the five countries/regions had discussions through 3 days of an international workshop. The content for this discussion paper derived from: (a) the exemplars/cases of the COVID-19 impact on the research process, (b) researchers/leaders' presentations on the COVID-19 impact, and (c) memos from the workshop. The materials were analyzed using a simple content analysis. The commonalities included: (a) "a heavy emphasis on teaching and fluctuating productivity," (b) "increased funding opportunities and governmental support," (c) "gendered experience complicated by professional differences," (d) "delays and changes/modifications in research process," (e) "limited research settings and difficulties in getting access," and (f) "increased online dissemination activities with positive changes in the image of nursing." With all collective wisdom that nurse researchers have obtained during the COVID-19 pandemic, nursing research will evolve again for the successful future of the nursing discipline.

Qualitative study of UK health professionals' experiences of working at the point of care during the COVID-19 pandemic

OBJECTIVES

To develop an understanding of health professionals' experiences of working at the point of care during the COVID-19 pandemic, the impact on their health and well-being and their support needs.

DESIGN

A qualitative study using semistructured interviews. Data were analysed using framework analysis.

SETTING

One large National Health Service integrated care trust.

PARTICIPANTS

A purposive sample of 19 qualified health professionals (doctors, nurses or allied health professionals), working with patients with COVID-19 admitted to the hospitals between March and May 2020 were eligible to take part.

RESULTS

Eight major categories were identified: (1) Working in a 'war zone', (2) 'Going into a war zone without a weapon', (3) 'Patients come first', (4) Impact of COVID-19, (5) Leadership and management, (6) Support systems, (7) Health professionals' support needs, and (8) Camaraderie and pride. Health professionals reported increased levels of stress, anxiety and a lack of sleep. They prioritised their patients' needs over their own and felt a professional obligation to be at work. A key finding was the reported camaraderie among the health professionals where they felt that they were 'fighting this war together'.

CONCLUSIONS

This study provides a valuable insight into the experiences of some of the frontline health professionals working in a large London-based hospital trust during the first COVID-19 peak. Findings from this study could be used to inform how managers, leaders and organisations can better support their health professional staff during the current pandemic and beyond.

Nursing and midwifery workforce readiness during a global pandemic: A survey of the experience of one hospital group in the Republic of Ireland

AIM

To explore the mobilization of nurses/midwives in a designated hospital group in Ireland during a global pandemic.

BACKGROUND

The recent global pandemic has resulted in the large-scale worldwide mobilization of registered nurses and midwives working in the acute care sector. There is a dearth of literature reporting the mobilization of this professional workforce.

METHOD

Mixed-methods design using an electronic survey and facilitated discussion across one Irish hospital group.

RESULTS

Eight of 11 hospitals responded to the survey. There was a 2% vacancy rate prior to the pandemic. Mobilization included reconfiguration of clinical areas and redeployment of 9% of the nursing/midwifery workforce within 2 weeks of the pandemic. A total of 11% (n = 343) of nurses/midwives were redeployed in 3 months. Nurses/midwives required re-skilling in infection prevention control, enhancement of critical care skills and documentation.

CONCLUSIONS

Three key areas were identified to enable the nursing workforce readiness. These are referred to as the three 'R's': Reconfiguration of specific resources, Redeployment of nurses to dedicated specialist areas and Re-skilling of nurses to safely care for the patients during the pandemic.

IMPLICATIONS FOR NURSING MANAGEMENT

A centralized approach to reconfiguration of clinical areas. Redeployment is enabled by closing non-essential departments. Hands-on re-skilling and reorientating staff are essential.

Nurses' experiences of caring for people with COVID-19 in Hong Kong: a qualitative enquiry

OBJECTIVES

Nurses are the largest group of healthcare workers on the front line of efforts to control the COVID-19 pandemic. An understanding of their nursing experiences, the challenges they encountered and the strategies they used to address them may inform efforts to better prepare and support nurses and public health measures when facing a resurgence of COVID-19 or new pandemics. This study aimed to explore the experiences of nurses caring for people with suspected or diagnosed COVID-19 in Hong Kong.

DESIGN

A qualitative study was conducted using individual, semistructured interviews. All interviews were audio-recorded and transcribed verbatim for thematic analysis.

SETTING

Participants were recruited from acute hospitals and a public health department in Hong Kong from June 2020 to August 2020.

PARTICIPANTS

A purposive sample of registered nurses (N=39) caring for people with COVID-19 in Hong Kong were recruited.

RESULTS

Two-thirds of the nurses had a master's degree and over a third had 6-10 years of nursing experience. Around 40% of the nurses cared for people with COVID-19 in isolation wards and a quarter performed COVID-19-related work for 31-40 hours/week. Most (90%) had training in COVID-19 and three-quarters had experience of working in infection control teams. Six key themes emerged: confronting resource shortages; changes in usual nursing responsibilities and care modes; maintaining physical and mental health; need for effective and timely responses from relevant local authorities; role of the community in public health protection and management; and advanced pandemic preparedness.

CONCLUSIONS

Our study found that nurses possessed resilience, self-care and adaptability when confronting resource shortages, changing nursing protocols, and physical and mental health threats during the COVID-19 pandemic. However, coordinated support from the clinical environment, local authorities and community, and advanced preparedness would likely improve nursing responses to future pandemics.

Future Challenges of Nursing in Health System of Iran

Purpose: Nursing development is considered as one of the most important ways to achieve the universal health coverage and sustainable development goals in different countries. Nursing in Iran has the potential to provide services at all levels of universal health coverage. Therefore, planning for nursing in Iran needs to recognize the future challenges. This study aims to explore the future challenges of nursing in the health system of Iran from the perspective of nursing experts. Methods: In this qualitative study, 11 semi-structured interviews were conducted with nursing experts by purposive sampling in 2017-2018. Interviews were recorded and transcribed and framework analysis method was used to analysis the data. Results: The results showed that a favorable future requires planning in three areas of nursing "governance challenges" including centralized nursing stewardship, policy-making and legislation, monitoring and evaluation, and cooperation and communication with other institutions, "inadequacy of professional development with social demands" including community-based nursing, nursing upgrades with disease patterns, expanding home care, expanding care centers, and use of technology, "human resource challenges "including nursing education tailored to the needs of the community, empowering nursing managers, recruiting and retaining nurses, and specialized nursing. Conclusions: A favorable future requires a coherent nursing government, professional development of nursing based on social demands, and enhancing human resources in line with the emerging needs of the future.

Resilience of frontline nurses during the COVID pandemic in China: A qualitative study

The aim of this study was to describe the resilience of nurses who cared for patients with a confirmed COVID-19 diagnosis, as well as factors that potentially contributed to that resilience. A total of 23 frontline nurses who cared for patients with COVID-19 were recruited from a COVID-19-designated facility in Shanghai, China, using purposive sampling strategies. In-depth interviews were conducted from March to May 2020. Qualitative data were transcribed verbatim and content analysis was used. Nurses exhibited psychological resilience while caring for patients with COVID-19. They displayed an ability to bounce back from negative mental experiences and transform to a positive mindset to cope with the stress they faced. Factors that enhanced the nurses' resilience during the pandemic were their becoming familiar with infectious disease protocols, having a sense of professional achievement, receiving social support, having trust in the infection-control response team in the hospital, and using self-regulation strategies. This study could guide the design of future resilience-enhancing interventions that provide positive coping strategies for nurses caring for individuals with infectious diseases during a pandemic.

Exhausted and Burned Out: COVID-19 Emerging Impacts Threaten the Health of the Pediatric Advanced Practice Registered Nursing Workforce

INTRODUCTION

The purpose of this study was to describe the holistic impacts of COVID-19 on pediatric advanced practice registered nurses (APRNs).

METHOD

AA convenience sample of APRNs affiliated with the National Association of Pediatric Nurse Practitioners participated in this cross-sectional descriptive study. An investigator-developed survey explored multifocal, holistic impacts of COVID-19.

RESULTS

A total of 886 participants were provided the survey, with 796 (90%) completing the entire survey. Respondents indicated adverse impacts across personal, clinical, educational, and research foci. Among the most alarming findings, 34% indicated moderate or extreme concern for feeling professionally burned out, 25% feeling nervous or anxious, and 15% feeling depressed or hopeless.

DISCUSSION

The pediatricAPRN workforce pipeline is at significant risk for provider burnout and compromised mental health. Acknowledgment of pandemic-related trauma on families, children and APRNs is essential. Sustained intentional efforts to cultivate holistic wellness are critically emergent.

State anxiety levels of nurses providing care to patients with COVID-19 in Turkey

PURPOSE

This study investigates the state anxiety levels of nurses providing care to patients with coronavirus disease-2019 (COVID-19) in Turkey.

DESIGN AND METHODS

This cross-sectional study is based on the COVID-19 pandemic situation. The State-Trait Anxiety Inventory was used to collect the study data.

FINDINGS

Nurses' state anxiety levels were high (51.51 ± 9.94). Participants evaluated for state anxiety were female; who were married; worked in intensive care units; were service nurses, having more professional experiences; and experienced hand irritation (p < 0.05).

PRACTICE IMPLICATIONS

The mental health of nurses providing primary care to patients with COVID-19 should be evaluated in the long term.

Factors associated with preventive behaviors of COVID-19 among Indonesian nursing students: application of Health Belief Model

Objectives — This study aimed to examine factors associated with preventive behaviors of COVID-19 among Indonesian nursing students through The Health Belief Model. Material and Methods — A cross-sectional design was used in this study. This study was conducted in a school of nursing in Malang, Indonesia. A total of 112 undergraduate nursing students were recruited using convenience sampling. Data were collected by online-based questionnaires which were the demographic characteristics, questions about health belief model constructs, and questions about the preventive behaviors from COVID–19 during July 2020. Pearson product-moment was used to analyze the data. Results — This study found that cues to action have positive and significant correlation to preventive behavior of Covid-19. Perceive self-efficacy and perceive benefit have positive and significant correlation to cues to action. Furthermore, perceive self-efficacy also has positive correlation to perceive severity, perceive benefit, and has negative correlation to perceive barrier. Perceive benefit has negative correlation to perceive barrier. Conclusion — Cues to action was related to preventive behavior of Covid-19 among nursing student in this study. Therefore, the nursing student should improve their action in preventive behavior of COVID-19.

Building capacity in times of crisis: Increasing cultural competence of healthcare professionals in the context of the COVID-19

BACKGROUND

Nurses are the frontline healthcare professionals fighting the medical and social effects of the current COVID-19 pandemic. Although they work with diverse populations, there is a lack of literature on culturally competent education during an emergency such as a pandemic.

AIMS AND OBJECTIVES

To examine the effectiveness of an online education programme aimed at increasing cultural competence among rescue teams and healthcare professionals facing the challenges of the COVID-19 pandemic.

DESIGN

Pre-post-web-based intervention study.

METHODS

Pre-post-intervention surveys were administered to a matched sample of Israeli healthcare and rescue organisation professionals. The initial sample included 303 participants (52% women) who completed the pre-intervention survey. More than half of the sample (56%, n = 170) were paid workers or volunteers in health organisations. Of the initial sample, 154 participants completed the post-intervention survey following the online cultural competence education programme. Descriptive statistics and multivariate analysis were used to evaluate participants' gains in culturally competent attitudes, knowledge, skills and encounters. This study followed the STROBE guidelines.

RESULTS

Participants found the online programme useful in improving their cultural competence during the COVID-19 pandemic. The highest gains were found in the attitudes domains, whereas the lowest in the knowledge domain. Pre-intervention cultural competence scores and incorporating the programme in the educational curricula predicted increased gains in cultural competence.

CONCLUSIONS

Online educational interventions showed potential for increasing professionals' awareness of cultural biases, differences and attitudes, leading to more open and accepting attitudes towards patients of different backgrounds.

RELEVANCE TO CLINICAL PRACTICE

Recognising the need for real-time, low-cost and available training, the World Health Organization recommended using online courses for healthcare professionals struggling in the pandemic frontline. Online education programmes provide a useful platform for training health professionals in times of emergency.

Faculty perspectives on transitioning public health nursing clinical to virtual in response to COVID-19

The COVID‐19 pandemic has highlighted the need for public health nursing as an integral part of a strong public health workforce. However, it has also created challenges in preparing future nurses as much of nursing instruction, including clinical experiences, needed to urgently transition learning to a virtual environment. This paper describes the process faculty experienced during spring 2020 to quickly transition public health nursing clinicals from in‐person to virtual learning in response to COVID‐19. Further, faculty lessons learned are shared and include the importance of creating a supportive team dynamic, embracing innovation, continuing to engage with community partners, and adapting to meet emerging student needs during the evolving pandemic. The process and lessons learned may act as a guide for other nursing programs as we continue to navigate nursing education during this and future pandemics.

COVID-19 Fear Level of Surgical Nurses Working in Pandemic and Surgical Units

Purpose

Nurses who care for COVID-19 patients are more likely to be affected psychologically than nurses who do not, and reactions such as increased fear may lead to psychological problems among nurses. The aim of this study was to determine the COVID-19 fear level of surgical nurses by using the Fear of COVID-19 Scale.

Design

A descriptive and cross-sectional study.

Methods

Totally, 202 surgical nurses who take care of suspected or infected COVID-19 patients working in pandemic and surgical units of a university hospital were included in the study. For data collection, “Nurse Characteristics Form” and “Fear of COVID-19 Scale” were used. Study data was analyzed with the descriptive statistics, Mann-Whitney U test, Spearman Correlation test.

Findings

The mean total COVID-19 fear score of the nurses was 25.09 ± 7.29 (min: 7, max: 35) and nurses who received training related to COVID-19 had statistically lower fear than those who did not (U = 3773.500; P= .027). Losing a patient because of COVID-19, being older and experienced in nursing significantly affected the total fear score of nurses (respectively, U = 3899.000; P= .004; r_s = 0.152; P = .031, r_s = 0.205; P = .003).

Conclusions

Surgical nurses have a moderate level of COVID-19 fear and it is recommended to conduct appropriate on-line training programs to develop psychological support strategies.

Psychosocial risks and job satisfaction: A meaningful relationship for oncology workers

Objective: To determine the relationship between psychosocial risk factors and professional satisfaction of workers working in oncology and palliative care units in a region of Chile. Material and Method: Non experimental, cross-sectional, correlational study with quantitative approach. In the last semester of 2016, the census of health workers was carried out, using an instrument composed of three parts for data collection: a) bio-sociodemographic history, b) SUSESO-ISTAS 21 questionnaire for psychosocial risks, and c) for work satisfaction. International bioethical principles were respected throughout the research. Results: There is a relationship with statistical significance (p≤0,05) between psychosocial risks and job satisfaction at work, the dimension of psychosocial risk with higher risk is psychological demand (x:11,24; DP: 3,06) and dual presence (x: 3,23; DP: 1,90) and the factor in which less satisfaction is perceived is the physical work environment (x: 4,32 DP: 1,77). Conclusion: With the results obtained, it can be affirmed that the workers who work in oncologic units and perceive greater psychosocial risk at work present less satisfaction at work, which can impact on the quality of assistance.

What place does nurse-led research have in the COVID-19 pandemic?

AIM

Reflect upon the visibility of nursing-led research during the COVID-19 pandemic.

BACKGROUND

The emerging SARS-CoV-2 infection has galvanized collaborative and multidisciplinary efforts in clinical and research practice worldwide. The scarce evidence-base to manage patients with COVID-19 has included limited nurse-led research.

INTRODUCTION

Clinical research nurses have greatly contributed to the delivery of COVID-19 research, yet the number of COVID-19 nursing-led research papers appears to be limited, with even fewer nurse-led research projects funded.

METHODS

Authors' views and PubMed search on 'COVID-19 and nursing'.

FINDINGS

There is a dearth of nursing-led research. Most papers describe the nursing contribution to COVID-19 care, changes in nursing working arrangements and emotional burden. There are opportunities to explore the consequences to vulnerable population groups of public health measures implemented to stop the progress of the COVID-19 pandemic.

DISCUSSION

Workforce gaps, limited integration in research structures and clinical redeployment may have hampered nurse-led research. COVID-19 may exacerbate staffing deficits by disrupting the education pipeline, obstructing the transition from clinical to academic practice, particularly in areas where clinical academic roles are yet to emerge.

CONCLUSION

The absence of nurse-led research in COVID-19 can be explained by chronic, underlying factors and the features of the pandemic response. Emerging models of care, effective staffing and inequalities related to COVID-19 appear obvious research areas. Nursing leadership needs to strengthen its political voice and lobbying skills to secure nurse-led research funding.

IMPLICATIONS FOR NURSING POLICY

Embracing international nursing research, strengthening collaborations and lobbying policymakers for investment in nurse-sensitive research would enhance the response to COVID-19.

Challenges experienced by ICU nurses throughout the provision of care for COVID-19 patients: A qualitative study

Aim

To explore the challenges experienced by ICU nurses throughout the provision of care for COVID‐19 patients.

Background

The intensive care unit nurses, who are at the frontline of fighting against COVID‐19 and defusing this crisis, are faced with various challenges throughout the provision of care for COVID‐19 patients.

Methods

In this qualitative descriptive study, a total of 17 nurses working in intensive care units were selected using purposive sampling. Data were collected using semi‐structured face‐to‐face interviews. After recording and transcribing interviews, the concepts were extracted using the content analysis method.

Findings

The nurses reported the four following challenges throughout the provision of care for COVID‐19 patients: ‘organization's inefficiency in supporting nurses’, ‘physical exhaustion’, ‘living with uncertainty’ and ‘psychological burden of the disease’.

Conclusion

The present study portrayed a clear understanding of the challenges faced by nurses working in intensive care units during the crisis of the COVID‐19 pandemic based on their lived experiences.

Implications for Nursing Management

A profound understanding of these challenges in the current critical situation can help health care authorities adopt appropriate measures to resolve these challenges, provide health care facilities, support the health workforce, give accurate and evidence‐based information and perform psychological interventions on how to handle the current crisis.

The Psychological Impact of COVID-19 Outbreak on Nurses Working in the Northwest of Amhara Regional State Referral Hospitals, Northwest Ethiopia

Introduction

The psychosocial consequences of the coronavirus pandemic are serious for health professionals including nurses because of a higher level of exposure. Nurses often face huge psychological pressure as a result of workload, long hours, and working in a high-risk environment. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress among nurses working in northwest Amhara referral hospitals.

Methods

Institution-based cross-sectional study was conducted from 25th September to 20th October 2020. A total of 302 nurses were selected using a simple random sampling technique. A structured pretested self-administered questionnaire was used to collect data. The data were entered into EpiData version 3 and analyzed using SPSS version 21. A binary logistic regression model was used to compute bivariable and multivariable analyses.

Results

The prevalence of anxiety, depression, and stress among nurses was 69.6%, 55.3%, and 20.5%, respectively. Unavailability of a guideline, fear of infecting family, and having chronic diseases increase the risk of developing anxiety. Nurses who did not have a guideline, received negative feedback from families, had a history of mental disorders, and chronic diseases have a higher odds of depression. Working in the night shift, lack of training, fear of infecting family, negative feedback from families, presence of confirmed/suspected cases in the family, and having chronic diseases increase the risk of developing stress.

Conclusion

More than two-thirds, more than half, and nearly one-fifth of the nurses had anxiety, depression, and stress, respectively. It is better to create awareness for the community, avail a guideline, train nurses, and give special attention to nurses with chronic disease and a history of mental disorders to minimize the psychological impact of the COVID-19 pandemic on nurses and protect their mental health. The government shall develop and implement national programs for occupational health and safety, prevent violence in the workplace, improve psychological well-being, and protect from physical and biological hazards to take care of the mental health of healthcare professionals during this pandemic.

Multidisciplinary Approach to the Diagnosis and In-Hospital Management of COVID-19 Infection: A Narrative Review

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 or COVID-19 disease) was declared a pandemic on 11th March 2020 by the World Health Organization. This unprecedented circumstance has challenged hospitals' response capacity, requiring significant structural and organizational changes to cope with the surge in healthcare demand and to minimize in-hospital risk of transmission. As our knowledge advances, we now understand that COVID-19 is a multi-systemic disease rather than a mere respiratory tract infection, therefore requiring holistic care and expertise from various medical specialties. In fact, the clinical spectrum of presentation ranges from respiratory complaints to gastrointestinal, cardiac or neurological symptoms. In addition, COVID-19 pandemic has created a global burden of mental illness that affects the general population as well as healthcare practitioners. The aim of this manuscript is to provide a comprehensive and multidisciplinary insight into the complexity of this disease, reviewing current scientific evidence on COVID-19 management and treatment across several medical specialties involved in the in-hospital care of these patients.

Assessment of Turkish oncology nurses' knowledge regarding COVID-19 during the current outbreak in Turkey

PURPOSE

To assess Turkish oncology nurses' knowledge regarding novel coronavirus (COVID-19) during the current outbreak in Turkey.

METHODS

This descriptive study was carried out with the 185 oncology nurses between April and May 2020 in Turkey. Research data were collected through online survey using "Nurse Information Form" and "Nurse Information Scale for COVID-19." Multilinear regression analysis was used in determining the factors affecting oncology nurses' information regarding COVID-19.

RESULTS

According to the data delivered from 185 oncology nurses, 57.7% of the participants had an undergraduate degree, 74.1% were working in adult oncology units, and 52.4% of them were working as clinical nurses, 48.1% of the nurses received education for COVID-19 (51.9% did not receive) and 70.3% followed and read the COVID-19 Guidelines published by the Ministry of Health (29.7% did not follow guidelines). Using multiple regression analysis, a model based on the relationship between the variables was created. In the model, the descriptive characteristics of the oncology nurses and their experiences of COVID-19 were found to explain 29.1% of their knowledge level for COVID-19. Nurses' education level, the presence of a relative diagnosed with COVID-19, and following the COVID-19 guidelines were found to statistically significantly affect the knowledge levels of COVID-19.

CONCLUSION

These findings suggest that hospital management and the Ministry of Health should provide more information for the oncology nurses to better control of cancer patients from the infectious disease.