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Bartlett CD, Monagle J. Concept Analysis: The Occupational Experiences of Long-Term Care Nurses-Navigating Fragmented Transitions. J Adv Nurs 2024. [PMID: 39400377 DOI: 10.1111/jan.16442] [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: 04/25/2024] [Revised: 08/06/2024] [Accepted: 08/20/2024] [Indexed: 10/15/2024]
Abstract
AIM Transitions are broadly defined as movements from one place, stage, or subject to another. However, transitions which are broken and incomplete are referred to fragmented transitions. The aims of this concept analysis were to analyze the navigation of fragmented occupational transitions among long-term care nurses and to develop a working conceptual definition of fragmented occupational transitions to inform diverse stakeholders. DESIGN Concept analysis. DATA SOURCES Google Scholar, PubMed, and the Cumulative Index of Nursing and Allied Health Literature databases were accessed. Identified sources were interprofessional scholarly literature published between January 1, 2018, and January 1, 2024, and seminal references. METHOD Walker and Avant's eight-stage concept analysis method. RESULTS Occupational transitions in long-term care are fragmented leading to grievous challenges across multiple aspects of nurses' lives. An analysis of the literature using a Transitions Theory lens reveals that their thoughts, feelings and ethical decisions are influenced over time by these transitions. Cardinal attributes include: (1) Fragmentation, (2) Ill-timing, (3) Disruption, (4) Liminality, (5) Ambiguity, (6) Ambivalence and (7) Facilitators/Inhibitors. Antecedents stem from external sources and facility-led initiatives. Consequences encompass product and process outcomes. Product outcomes include physical and psychological conditions, and process outcomes encompass resilience, flexibility, connection, coping, creativity, and communication. CONCLUSION This concept analysis advances the science for understanding nurses' occupational transitional experiences in long-term care. It will assist in risk assessment and instrument development ultimately improving the quality of long-term care. IMPLICATIONS Fragmented occupational transitions in long-term care are multifaceted and complex phenomena that require distinct responses from government, healthcare leaders, and scholars to improve the plight of long-term care nurses and stakeholders. PATIENT OR PUBLIC CONTRIBUTION Dr. A. I. Meleis contributed to this article by sharing her vast insight into transitions.
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Nkodo JA, Gana W, Debacq C, Aïdoud A, Camus V, Leroy V, Fougère B. Support for Nursing Home Caregivers During the COVID-19 Pandemic: A Review. J Gerontol Nurs 2024; 50:24-33. [PMID: 39361639 DOI: 10.3928/00989134-20240912-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
PURPOSE To review support systems for nursing home caregivers (NHCGs) that were implemented during the first year of the coronavirus disease 2019 (COVID-19) pandemic. METHOD Database searches in PubMed, ScienceDirect, and CINAHL resulted in five publications. RESULTS Studies differed in design, interventions, and outcomes. An urgent eye movement desensitization and reprocessing protocol was feasible and effective among nurses in services highly mobilized during the acute phase of the pandemic. The "self-help plus" psychological intervention was not associated with significant reductions in anxiety or posttraumatic symptoms but prompted exploration of non-specific factors influencing its effectiveness. The Extension for Community Healthcare Outcomes in Long-Term Care of the Elderly virtual program increased confidence among NHCGs. Self-compassion training was associated with positive changes for certified nursing assistants. Weekly debriefing sessions implemented at one hospital highlighted pathogenic and salutogenic factors. CONCLUSION The COVID-19 pandemic had a marked psychosocial impact on NHCGs and necessitated targeted interventions. Despite their limitations, these promising studies provided insights into potential support avenues. Policy considerations should stress the pivotal role of advanced practice nurses in shaping supportive work environments. Future research should focus on robust assessments of the efficacy of psychosocial interventions for NHCGs facing ongoing challenges posed by the pandemic, and even recurrent viral epidemics. [Journal of Gerontological Nursing, 50(10), 24-33.].
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Eltaybani S, Igarashi A, Cal A, Lai CKY, Carrasco C, Sari DW, Cho E, Haugan G, Bravo JD, Abouzeid NA, Wachholz PA, Isaramalai SA, Dawood SS, Pappas Y, Abd-El-Moneam AAEG, Rodríguez AB, Alqahtani BA, Pereira CLN, Jenssen CRS, Yu DSF, Mendes FRP, Randhawa G, Ahmed HAESH, Suzuki H, Aydin-Avci I, Waluyo I, Nurbaeti I, Vseteckova J, Horne JK, Liu JYW, Ingstad K, Kashiwabara K, Grant L, Abd-El-Moniem MM, Sakka M, Abdelgawad ME, Subu MA, Kentzer N, Almadani NA, Tomas-Carus P, Rodrigues-Garcia RCM, Indarwati R, Maneerat S, Chien WT, Amamiya Y, Cavalcanti YW, Yamamoto-Mitani N. Promoting workplace retention during global crises: An international survey of the preventive role of psychological support among victims of social discrimination in long-term care facilities. Geriatr Nurs 2024; 59:94-102. [PMID: 38996770 DOI: 10.1016/j.gerinurse.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/05/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024]
Abstract
This international cross-sectional survey examined the potential role of organizational psychological support in mitigating the association between experiencing social discrimination against long-term care (LTC) facilities' healthcare professionals (HCPs) and their intention to stay in the current workplace during the COVID-19 pandemic. Participants included a convenience sample of 2,143 HCPs (nurses [21.5 %], nurse aids or residential care workers [40.1 %], social workers [12.1 %], and others [26.4 %]) working at 223 LTC facilities in 13 countries/regions. About 37.5 % of the participants reported experiencing social discrimination, and the percentage ranged from 15.3 % to 77.9 % across countries/regions. Controlling for socio-demographic and work-related variables, experiencing social discrimination was significantly associated with a lower intention to stay, whereas receiving psychological support showed a statistically significant positive association (p-value=0.015 and <0.001, respectively). The interaction term between social discrimination and psychological support showed a statistically significant positive association with the intention to stay, indicating a moderating role of the psychological support.
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Affiliation(s)
- Sameh Eltaybani
- Global Nursing Research Center, The University of Tokyo, Japan.
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Japan
| | - Ayse Cal
- Department of Nursing, School of Health Sciences, Ankara Medipol University, Turkey
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR
| | | | | | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University, College of Nursing, South Korea
| | - Gørill Haugan
- Norwegian University of Science and Technology, Department of Public Health Nursing, Norway, Nord University, Faculty of Nursing and Health Science, Levanger, Norway
| | - Jorge D Bravo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal. Comprehensive Health Research Centre(CHRC), Universidade de Évora, Évora, Portugal
| | - Nesreen A Abouzeid
- Department of Medical Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Saudi Arabia
| | | | | | - Shaimaa Samir Dawood
- Gerontological nursing department, Faculty of Nursing, Alexandria University, Egypt
| | - Yannis Pappas
- Institute for Health Research, University of Bedfordshire, England
| | | | - Ana Beatriz Rodríguez
- Neuroimmunophysiology and Chrononutrition Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain
| | | | - Catarina Lino Neto Pereira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal. Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | | | - Doris S F Yu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Felismina Rosa P Mendes
- Departamento de Enfermagem, Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal. Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, England
| | | | - Haruno Suzuki
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Japan
| | - Ilknur Aydin-Avci
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University
| | - Imam Waluyo
- Padma Kumara Foundation and Consultant International, Collaboration Physiotherapy School YAB, Indonesia
| | - Irma Nurbaeti
- Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah Jakarta, Indonesia
| | - Jitka Vseteckova
- Faculty of Wellbeing, Education and Language Studies, The Open University, England
| | | | | | | | | | - Louise Grant
- Faculty of Health and Social Sciences, University of Bedfordshire, England
| | | | - Mariko Sakka
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Japan
| | | | | | - Nichola Kentzer
- Faculty of Wellbeing, Education and Language Studies, The Open University, England
| | - Noura A Almadani
- Community health nursing department, Princess Nourah Bint Abdulrahman University, Saudi Arabia
| | - Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal. Comprehensive Health Research Centre(CHRC), Universidade de Évora, Évora, Portugal
| | | | | | - Sonthaya Maneerat
- Prapokklao Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Thailand
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuko Amamiya
- Department of Nursing, Faculty of Healthcare Sciences, Chiba Prefectural University of Health Sciences, Japan
| | | | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Japan
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Yang L, Wang Y, Mu X, Liao Y. A visualized and bibliometric analysis of nursing research during the COVID-19 pandemic. Medicine (Baltimore) 2024; 103:e39245. [PMID: 39121302 PMCID: PMC11315485 DOI: 10.1097/md.0000000000039245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 07/19/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The global spread of Coronavirus disease 2019 (COVID-19) has been increasing since December 2019. A total of 8460 publications were obtained from the Web of Science Core Collection from 2019 to 2023, providing insights into the progress of nursing research throughout the COVID-19 pandemic. METHODS Bibliometric analysis was conducted on these articles using CiteSpace. The analysis focused on examining the distribution of these publications in terms of space and time, distribution of authors, subject categories, distribution of topics, and cited references. RESULTS These results may be explained from 3 perspectives. Initially, the number of yearly publications on nursing research consistently increased during the COVID-19 pandemic. Furthermore, a co-occurrence analysis of the countries and the authors revealed that certain countries, including the United States, China, and England, have successfully implemented organized and standardized nursing models. These countries also have well-developed and established nursing research systems. Notably, academic communities in specific regions, such as the team led by MD Stefan Gravenstein, Mor Vincent, and White Elizabeth at Brown University in the United States, have emerged as leaders in this field. Furthermore, examining the papers' subject categories and topic distribution indicate that nursing during the COVID-19 pandemic has been predominantly interdisciplinary, encompassing various disciplines such as clinical medicine, essential medicine, psychology, public health management, and even telematics science. CONCLUSION SUBSECTIONGS Our study provided valuable insights into acquiring knowledge on nursing research during the COVID-19 pandemic, pinpointed possible partners for researchers interested in nursing, and uncovered prevalent research patterns and popular subjects.
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Affiliation(s)
- Lu Yang
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yao Wang
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xin Mu
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yanbiao Liao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
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Vong II, Rothan-Tondeur M, Nohra RG. Characteristics and quality of reporting qualitative nursing research related to the COVID-19 pandemic: a systematic search and critical review. BMC Nurs 2024; 23:498. [PMID: 39039598 PMCID: PMC11265066 DOI: 10.1186/s12912-024-02138-x] [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: 04/12/2024] [Accepted: 07/01/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The COVID-19 (Coronavirus disease of 2019) pandemic caused major disruption to nursing research, especially qualitative research. Researchers had to overcome numerous challenges that potentially impacted the quality of the studies carried out. OBJECTIVES The aim of this study is to assess the characteristics and quality of reporting qualitative nursing articles on the COVID-19 pandemic. METHODS A systematic search and critical review using content analysis was conducted on published nurse-led articles using a qualitative approach related to the COVID-19 pandemic. A combination of the Consolidated Criteria for Reporting Qualitative Research (COREQ) and Standards for Reporting Qualitative Research (SRQR) checklists and additional items identified from the literature were used to assess the characteristics and overall quality of reporting of qualitative research. RESULTS Out of 63,494 articles screened, 444 met the inclusion criteria. Most studies were published in high-impact, Quartile 1 journals, with the majority originating from the USA. Common themes included workforce experiences and the impact of pandemic restrictions. Methodological quality varied, with a notable underuse of standardized reporting checklists. Despite pandemic-induced challenges in data collection, interviews remained the predominant method. However, the adoption of remote research methods and analysis software was limited. DISCUSSION The findings underscore the resilience and adaptability of nursing researchers during the pandemic. High-quality publications in top-tier journals indicate rigorous academic standards. However, the low utilization of reporting checklists suggests a need for greater emphasis on methodological transparency and adherence to established quality guidelines. This review highlights the importance of enhancing qualitative research practices to improve the rigor and reliability of studies, particularly in crisis contexts.
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Affiliation(s)
- Ian-In Vong
- Nursing Sciences Research Chair, Laboratory Educations and Health Promotion (LEPS), University Sorbonne Paris Nord, UFR SMBH, Villetaneuse, EA, 3412, F-93430, France.
| | - Monique Rothan-Tondeur
- Nursing Sciences Research Chair, Laboratory Educations and Health Promotion (LEPS), University Sorbonne Paris Nord, UFR SMBH, Villetaneuse, EA, 3412, F-93430, France
- Nursing Sciences Research Chair, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, F- 75005, France
| | - Rita Georges Nohra
- Nursing Sciences Research Chair, Laboratory Educations and Health Promotion (LEPS), University Sorbonne Paris Nord, UFR SMBH, Villetaneuse, EA, 3412, F-93430, France
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Rudman A, Boström AM, Wallin L, Gustavsson P, Ehrenberg A. The use of the evidence-based practice process by experienced registered nurses to inform and transform clinical practice during the COVID-19 pandemic: A longitudinal national cohort study. Worldviews Evid Based Nurs 2024; 21:14-22. [PMID: 38084830 DOI: 10.1111/wvn.12692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/18/2023] [Accepted: 10/29/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, many registered nurses (RNs) worked on the frontline caring for severely ill patients. They did so with limited knowledge of how to treat and prevent the disease. This extreme situation puts pressure on RNs to find evidence on which to base the care of their patients. AIMS To examine: (1) the extent to which evidence-based practice (EBP) process was applied by Swedish RN cohorts 15-19 years after graduation during the pandemic, (2) whether there was any change to their EBP process from pre-pandemic to late pandemic, (3) the relationship between RNs' use of the EBP process and the duration of exposure to work situations severely affected by the COVID-19 pandemic, and (4) whether level of education, position and care setting were associated with the extent of RNs' EBP process. METHODS In 2021, the level of EBP activities was investigated among 2237 RNs 15-19 years after graduation. The scale used to measure EBP consisted of six items of the EBP process. Unpaired t-tests or one-way analysis of variance (ANOVA) were used in the analysis. RESULTS RNs used the EBP process to a moderate extent to inform and transform their clinical practice. There was a minor but significant decrease in practicing the EBP process from pre-pandemic to late in the pandemic. RNs who were most affected by the pandemic scored higher on the scale than less-affected colleagues. RNs in nonclinical positions reported more EBP activities, as did RNs in management positions. RNs working in outpatient settings reported more EBP activities than their colleagues in hospitals. LINKING EVIDENCE TO ACTION It is imperative that RNs hone their skills in EBP if they are to be prepared for future healthcare crises. Healthcare providers have a duty to facilitate the development of EBP and, in this regard, RNs in clinical positions in hospitals need particular support.
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Affiliation(s)
- Ann Rudman
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- R&D Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Lars Wallin
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Petter Gustavsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anna Ehrenberg
- School of Health and Welfare, Dalarna University, Falun, Sweden
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Srinivasan V, Abathsagayam K, Suganthirababu P, Alagesan J, Vishnuram S, Vasanthi RK. Effect of vagus nerve stimulation (taVNS) on anxiety and sleep disturbances among elderly health care workers in the post COVID-19 pandemic. Work 2024; 78:1149-1156. [PMID: 38143418 DOI: 10.3233/wor-231362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) have been significantly impacted by the pandemic. Elderly health care workers carry out a variety of duties at work and have years of clinical expertise. Anxiety and insomnia are among the more commonly encountered problems in senior physicians and other geriatric medical professional populations. OBJECTIVE The study aims to determine the effect of vagal nerve stimulation on anxiety and sleep disturbances among geriatric medical professionals. METHODS 42 participants were enrolled in this study based on the inclusion and exclusion criteria. The participants were divided into two groups using the closed envelope approach, and they took part in therapy sessions lasting 30 minutes, three times per week for a period of four weeks. The Experimental group A received non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) and Control group A received Jacobson's progressive muscle relaxation technique. RESULTS With a p value of 0.001, taVNS stimulation significantly improved sleep quality and reduced anxiety after 4 weeks. The post-intervention assessment revealed a highly significant improvement in Group A, with a T value of 251 (p < 0.001). CONCLUSION The findings suggest that taVNS may be an effective intervention for addressing anxiety and sleep issues in geriatric medical professionals. These results contribute to the exploration of non-invasive strategies to enhance the well-being of healthcare professionals working in demanding environments.
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Affiliation(s)
- Vignesh Srinivasan
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, India
| | - Kumaresan Abathsagayam
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, India
| | - Prathap Suganthirababu
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, India
| | - Jagatheesan Alagesan
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, India
| | - Surya Vishnuram
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, India
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Fernández-Martínez S, Armas-Landaeta C, Pérez-Aranda A, Guzmán-Parra J, Monreal-Bartolomé A, Carbonell-Aranda V, García-Campayo J, López-Del-Hoyo Y. Post-COVID job Stressors and Their Predictive Role on Mental Health: A Cross-Sectional Analysis Between Physicians and Nurses. SAGE Open Nurs 2024; 10:23779608241278861. [PMID: 39290451 PMCID: PMC11406590 DOI: 10.1177/23779608241278861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 07/08/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024] Open
Abstract
Introduction Health care providers face heightened stress and increased rates of anxiety and depression post-COVID-19. The pandemic, officially declared over in May 2023, continues to impact their wellbeing significantly, with ongoing mental health monitoring and tailored interventions crucial for support. Objectives The aim of this study was to describe the frequency of job stressors in a sample of Spanish health care providers post-COVID and to explore potential differences between physicians and nurses, hypothesizing that while both professional categories could experience similar job stressors, some of them could have a differential impact on the mental health of each subgroup. Methods This cross-sectional substudy is part of the MINDxYOU project. The data were collected from 191 health care providers from two regions in Spain. Participants completed the UNIPSICO test battery, used to assess job stressors, and questionnaires to evaluate perceived stress, depressive symptomatology, anxiety, and resilience. Descriptive analyses, bivariate correlations, and linear regression models were performed to compare the two professions that were the most representative of our sample: physicians (n = 82) and nurses (n = 54). Results The most frequent job stressors were workload, lack of positive feedback, and inequity in social interactions. Physicians reported worse outcomes in terms of workload, autonomy, role conflicts, inequity in social interactions, and work-family balance compared to nurses. Mobbing, despite not being very frequent, significantly predicted different mental health outcomes for both physicians and nurses. Inequity in social interactions and job satisfaction were significant predictors of physicians' mental health, while role ambiguity, interpersonal conflicts, and career turnover intentions predicted nurses' mental health. Conclusion As hypothesized, our findings highlight that certain job stressors (i.e., inequity in social interactions, conflicts in the workplace) might be affecting physicians' and nurses' mental health differently. Therefore, effective strategies addressing each subgroup's specific stressors would be necessary to prevent the development of burnout syndrome and other serious mental health conditions associated with occupational stress. These strategies would imply organizational changes in most cases.
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Affiliation(s)
| | | | - Adrián Pérez-Aranda
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, Spain
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - José Guzmán-Parra
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Alicia Monreal-Bartolomé
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Psychology and Sociology Department, Faculty of Human and Education Sciences, University of Zaragoza, Zaragoza/Huesca, Spain
| | - Vera Carbonell-Aranda
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Javier García-Campayo
- Psychiatry Department, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
| | - Yolanda López-Del-Hoyo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Hospital Universitario Miguel Servet, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Psychology and Sociology Department, Faculty of Human and Education Sciences, University of Zaragoza, Zaragoza/Huesca, Spain
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Eltaybani S, Igarashi A, Cal A, Lai CKY, Carrasco C, Sari DW, Cho E, Haugan G, Bravo JD, Abouzeid NA, Wachholz PA, Isaramalai SA, Dawood SS, Pappas Y, Abd El Moneam AAEG, Rodríguez AB, Alqahtani BA, Pereira CLN, Jenssen CRS, Yu DSF, Ahmed FR, Mendes FRP, Randhawa G, Ahmed HAESH, Suzuki H, Prambudi H, Avci IA, Waluyo I, Nurbaeti I, Vseteckova J, Horne JK, Liu JY, Ingstad K, Kashiwabara K, Grant L, Abd El Moniem MM, Sakka M, Abdelgawad ME, Subu MA, Kentzer N, Almadani NA, Tomas-Carus P, Rodrigues Garcia RCM, Indarwati R, Maneerat S, Chien WT, Amamiya Y, Cavalcanti YW, Yamamoto-Mitani N. Long-term care facilities' response to the COVID-19 pandemic: An international, cross-sectional survey. J Adv Nurs 2024; 80:350-365. [PMID: 37452500 DOI: 10.1111/jan.15785] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/01/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Abstract
AIMS To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions. DESIGN Cross-sectional survey. METHODS Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines. RESULTS The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance. CONCLUSIONS Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks. IMPACT This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Sameh Eltaybani
- Global Nursing Research Center, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Ayse Cal
- Department of Nursing, School of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong SAR
| | - Cristina Carrasco
- Neuroimmunophysiology and Chrononutrition Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain
| | | | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University, College of Nursing, Seoul, South Korea
| | - Gørill Haugan
- Norwegian University of Science and Technology, Department of Public Health Nursing, Trondheim, Norway
- Nord University, Faculty of Nursing and Health Science, Levanger, Norway
| | - Jorge D Bravo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre(CHRC), Universidade de Évora, Évora, Portugal
| | - Nesreen A Abouzeid
- Department of Medical Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Medical Surgical Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | | | | | - Shaimaa Samir Dawood
- Gerontological nursing department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Yannis Pappas
- Institute for Health Research, University of Bedfordshire, luton, UK
| | | | - Ana Beatriz Rodríguez
- Neuroimmunophysiology and Chrononutrition Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain
| | | | - Catarina Lino Neto Pereira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | | | - Doris S F Yu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Fatma Refaat Ahmed
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Felismina Rosa P Mendes
- Departamento de Enfermagem, Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, luton, UK
| | | | - Haruno Suzuki
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Hery Prambudi
- An Nasher Institute of Healh Sciences, Cirebon, Cirebon West Java, Indonesia
| | - Ilknur Aydin Avci
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Imam Waluyo
- Padma Kumara Foundation and Consultant International, Collaboration Physiotherapy School YAB, Jakarta, Indonesia
| | - Irma Nurbaeti
- Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah, Jakarta, Indonesia
| | - Jitka Vseteckova
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | | | - Justina Yw Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong SAR
| | - Kari Ingstad
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | | | - Louise Grant
- Faculty of Health and Social Sciences, University of Bedfordshire, Luton, UK
| | | | - Mariko Sakka
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Muhammad Arsyad Subu
- University of Sharjah, Sharjah, United Arab Emirates
- Universitas Binawan, Jakarta, Indonesia
| | - Nichola Kentzer
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | - Noura A Almadani
- Community health nursing department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | | | - Retno Indarwati
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Sonthaya Maneerat
- Prapokklao Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Chantaburi, Thailand
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Yuko Amamiya
- Department of Nursing, Faculty of Healthcare Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | | | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
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10
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Bryant VE, Sorna MJ, Dana A, Leon KG, Guastello AD, Sambuco N, Huxhold A, Allen B, Cuffe SP, Mathews CA, Dale LP. Protective and risk factors associated with substance use coping among healthcare workers during the COVID-19 pandemic. Front Psychol 2023; 14:1228517. [PMID: 38173849 PMCID: PMC10761529 DOI: 10.3389/fpsyg.2023.1228517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Background Healthcare workers (HCWs) experienced high levels of stress and mental health consequences associated with the COVID-19 pandemic, which may have contributed to unhealthy coping behaviors, such as substance use coping (SUC). This study aimed to understand the extent of and predictors of SUC. Methods The sample consisted of 263 HCWs in North Central Florida. Univariable and multivariable logistic regression analyses investigated whether moral injury and other work risk factors, protective factors, and clinically relevant symptoms (i.e., work exhaustion, interpersonal disengagement, depression, anxiety, and/or PTSD) were associated with likelihood of SUC. Results Clinically relevant levels of interpersonal disengagement and anxiety increased the likelihood of SUC. Mediational analyses found that interpersonal disengagement and anxiety explained 54.3% of the relationship between Self Moral Injury and SUC and explained 80.4% of the relationship between professional fulfillment and SUC. Conclusion Healthcare supervisors should be aware that providers who are experiencing moral injury and less professional fulfillment may be experiencing significant interpersonal disengagement and anxiety, which could lead to SUC. Future studies should examine the effects of implementing targeted prevention and treatment interventions, along with longitudinal outcomes related to SUC behaviors.
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Affiliation(s)
- Vaughn E. Bryant
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Michael J. Sorna
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Audrey Dana
- Department of Psychology, University of North Florida, Jacksonville, FL, United States
| | - Kalie G. Leon
- Department of Psychology, University of North Florida, Jacksonville, FL, United States
| | - Andrea D. Guastello
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicola Sambuco
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Ashley Huxhold
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Brandon Allen
- Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Steven P. Cuffe
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Carol A. Mathews
- Department of Psychiatry, Center for OCD, Anxiety and Related Disorders, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Lourdes P. Dale
- Department of Psychiatry, College of Medicine – Jacksonville, University of Florida, Jacksonville, FL, United States
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11
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Peter E, Mohammed S, Boakye P, Rose D, Killackey T. Registered Practical Nurses' Experiences of the Moral Habitability of Long-Term Care Environments during the COVID-19 Pandemic. Can J Aging 2023; 42:719-727. [PMID: 37721011 DOI: 10.1017/s0714980823000491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
The COVID-19 pandemic has had a deleterious impact on the lives of nurses who work in long-term care; however, the moral conditions of their work have been largely unexamined. The purpose of this qualitative study, therefore, was to explore registered practical nurses' (RPNs) experiences of the moral habitability of long-term care environments in Ontario, Canada during the COVID-19 pandemic. Four themes were identified: (1) Striving to meet responsibilities in a failed system; (2) bearing the moral and emotional weight of residents' isolation and dying in a context of strict public health measures; (3) knowing the realities of the work, yet failing to be heard, recognized, or supported by management; and (4) struggling to find a means of preservation for themselves and the profession. Attention to the moral habitability of RPNs' work environments is necessary to achieve a high-quality, ethically attuned, and sustainable nursing workforce in long-term care.
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Affiliation(s)
- Elizabeth Peter
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Shan Mohammed
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Priscilla Boakye
- Daphne Cockwell School of Nursing, Toronto Metropolitan University Toronto, ON, Canada
| | - Donald Rose
- Daphne Cockwell School of Nursing, Toronto Metropolitan University Toronto, ON, Canada
| | - Tieghan Killackey
- School of Nursing, York University, Health, Nursing and Environmental Studies, Toronto, ON, Canada
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12
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Bußmann A, Pomorin N. Psychosocial burdens in palliative care - a longitudinal cohort study in nursing homes and impacts of the COVID-19 pandemic. BMC Palliat Care 2023; 22:163. [PMID: 37891538 PMCID: PMC10612279 DOI: 10.1186/s12904-023-01292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND In Germany, palliative care in nursing homes is becoming increasingly important. Simultaneously, nursing homes are particularly affected by the COVID-19 pandemic due to their vulnerable residents leading to increased burdens for nursing staff. Although a separate unit for palliative care may not be present in nursing homes as it is in, e.g., hospitals, palliative care occupies a large portion of the workday in nursing homes. As no study addressing this topic could be found, this study focused on the research questions of how the psychosocial burdens faced by nursing staff in palliative care have been affected by the COVID-19 pandemic and how those burdens differ from the psychosocial burdens encountered in general care. METHODS Basen on a longitudinal cohort study design, a total of 113 nurses, nursing assistants and caregivers drawn from two nursing homes in North Rhine-Westphalia, Germany, were surveyed pre-pandemic in 2019 and during the pandemic in 2022 using the Copenhagen Psychosocial Questionnaire (COPSOQ) III. Data were examined descriptively following the standardised COPSOQ procedure. Additionally, chi-squared test was conducted to investigate the homogeneity between the groups. Mean differences (MD) were provided and Cohen's d was calculated to evaluate relevant differences in psychosocial burdens between 2019 and 2022. In a second step, t-tests were performed to test statistical significance. RESULTS Relevant positive changes could be identified in 'Quantitative demands' (d = 0.321; MD = 5.9), 'Influence at work' (d = 0.244; MD = 5.4), 'Job insecurity' (d = 0.321; MD = 6.5), 'Insecurity over working conditions' (d = 0.296; MD = 6.8), 'Burnout symptoms related to residents' (d = 0.201; MD = 3.8), 'Degrees of freedom' (d = 0.455; MD = 9.6) and 'Presenteeism' (d = 0.425; MD = 11.8). Relevant negative changes were found in 'Dissolution' (d = 0.217; MD = 5.4; i.e., setting boundaries between work and private life), 'Role conflicts' (d = 0.282; MD = 5.5), 'Role clarity' (d = 0.251; MD = 3.3) and 'Burnout symptoms related to relatives' (d = 0.318; MD = 6.0). Relevant changes that were statistically significant according to the t-test could be identified in 'Degrees of freedom' (t-value=-2.40; p = 0.018) and 'Presenteeism' (t-value = 2.26; p = 0.026). Responses to questions concerning nursing homes' handling of the COVID-19 pandemic exhibited a mean score of 68.2 for 'Organisation/communication' and a mean score of 78.1 concerning 'Operational measures and overall assessment' during the COVID-19 pandemic. CONCLUSIONS Besides negative changes during the COVID-19 pandemic, some categories showed more positive results. The burdens of palliative care in nursing homes may be perceived differently than those of general care in nursing homes. Furthermore, the results indicate that perceptions of challenges in palliative care in nursing homes during the pandemic seem to be highly dependent on organisational working conditions and support that can strengthen the individual resources and resilience of the staff.
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Affiliation(s)
- Anna Bußmann
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany.
| | - Natalie Pomorin
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, Germany
- FOM Hochschule für Oekonomie & Management gemeinnützige Gesellschaft mbH, Düsseldorf, Germany
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13
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Cho E, Lee KH, Kang B, Jang J, Shin J, Eltaybani S, Yamamoto-Mitani N, Kim MJ. Perceived Work Environment, Educational Status, Staffing Levels, and Work Outcomes in Long-Term Care Settings During COVID-19. J Am Med Dir Assoc 2023; 24:1600-1605. [PMID: 37696496 DOI: 10.1016/j.jamda.2023.08.009] [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: 11/22/2022] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES Coronavirus disease (COVID-19) has severely affected older residents in long-term care (LTC) settings. However, care workers' perceptions of their work environment and potential impact on their work outcomes during the pandemic is not well known. This study examined associations between care staff's perceived work environment, educational status, and facility staffing levels and work outcomes of care staff in LTC settings during the COVID-19 pandemic. DESIGN This study employed a cross-sectional, observational, correlational design. SETTING AND PARTICIPANTS A total of 207 care staff were conveniently recruited from 30 LTC settings in South Korea. METHODS The perceived work environment, educational status of care staff, and facility staffing levels (ie, beds-to-registered nurse [RN] and beds-to-nursing assistant [NA] or care worker ratios), as well as their work outcomes (ie, general and COVID-19 specific outcomes) were collected using questionnaires. Multivariable binary logistic regressions were conducted, controlling for the characteristics of care staff (ie, age, sex, occupation, and career length) and facilities (ie, location, bed size, ownership, and residents' disease and care profiles). RESULTS Approximately 45% of the participants were either NAs or care workers, and 38% were RNs. More than half (53.14%) perceived their work environment to be good. LTC staff who perceived their work environment to be poor were more likely to be dissatisfied with their work [odds ratio (OR) 20.88), experience high burnout (OR 8.63), intend to leave the facility within a year (OR 5.00), and experience increased overtime work (OR 3.58) and work-life imbalance (OR 1.93) due to COVID-19. CONCLUSIONS AND IMPLICATIONS LTC work environments should be improved and government-led initiatives for ensuring such improvements should be implemented to enable a better response to future public health crises and maintain the quality of care for and safety of residents in LTC settings.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Kyung Hee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Jiyoon Jang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Jinhee Shin
- Woosuk University College of Nursing, Wanju-Gun, Jeollabuk-do, South Korea
| | - Sameh Eltaybani
- Department of Gerontological Home Care and Long-term Care Nursing, University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, University of Tokyo, Tokyo, Japan
| | - Min Jung Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea.
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14
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Chong YY, Frey E, Chien WT, Cheng HY, Gloster AT. The role of psychological flexibility in the relationships between burnout, job satisfaction, and mental health among nurses in combatting COVID-19: A two-region survey. J Nurs Scholarsh 2023; 55:1068-1081. [PMID: 36610054 DOI: 10.1111/jnu.12874] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND A growing body of evidence suggests that the COVID-19 pandemic is adversely impacting the mental health and well-being of frontline nurses worldwide. It is therefore important to understand how such impact can be mitigated, including by studying psychological capacities that could help the nurses regulate and minimize the impact. AIM To examine the role of psychological flexibility in mitigating the adverse impacts of burnout and low job satisfaction on mental health problems (i.e., anxiety, depression, and stress) and well-being among the frontline nurses in Hong Kong and Switzerland during the COVID-19 pandemic. DESIGN Cross-sectional, two-region survey study. METHOD Four hundred fifty-two nurses from Hong Kong (n = 158) and Switzerland (n = 294) completed an online survey. An adjusted structured equation model was used to examine the interrelationship of the constructs. RESULTS Psychological flexibility was found to partially mediate the effects of job satisfaction on mental well-being (β = 0.32, 95% CI [0.19, 0.57], p = 0.001) and mental health problems (β = -0.79, 95% CI [-1.57, -0.44], p = 0.001), respectively. Similarly, this partial mediation was found in the effects of burnout on mental well-being (β = -0.35, 95% CI [-0.89, -0.15], p = 0.002) and mental health problems (β = 0.89, 95% CI [0.48, 3.65], p = 0.001). CONCLUSION Psychological flexibility could be a crucial psychological resilience factor against the adverse impact of nurses' burnout on their mental health problems and well-being during COVID-19. CLINICAL RELEVANCE Organizational measures should focus on fostering psychological flexibility in nurses through highly accessible, brief psychotherapeutic interventions, such as Acceptance and Commitment Therapy, to reduce the impact on mental health.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eveline Frey
- Division of Clinical Psychology and Intervention Science, Faculty of Psychology, University of Basel, Switzerland
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Andrew T Gloster
- Division of Clinical Psychology and Intervention Science, Faculty of Psychology, University of Basel, Switzerland
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15
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Scheepers RA, van den Broek T, Cramm JM, Finkenflügel H, Nieboer AP. Changes in work conditions and well-being among healthcare professionals in long-term care settings in the Netherlands during the COVID-19 pandemic: a longitudinal study. HUMAN RESOURCES FOR HEALTH 2023; 21:59. [PMID: 37507814 PMCID: PMC10385940 DOI: 10.1186/s12960-023-00847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals working in long-term care facilities reported heavy job demands and a lack of job resources during the 2019 coronavirus disease (COVID-19) pandemic. However, how job demands and resources in these facilities changed during the pandemic, and how possible changes affected professionals' work-related well-being, remains unclear. Thus, we explored changes in job demands and resources in the face of surging COVID-19 infection rates, and investigated associations of these changes with changes in burnout and work engagement, among healthcare professionals working in long-term care facilities in the Netherlands. METHODS This longitudinal study was conducted with healthcare professionals working in five long-term care facilities in the Netherlands. Data were collected in early and late 2021, when infection rates in long-term care facilities were low and high (mean, 29.1 and 275.4 infections/day), respectively. In total, 173 healthcare professionals completed the validated Job Demands and Resources Questionnaire, Copenhagen Burnout Inventory, and Utrecht Work Engagement Scale at both timepoints. We performed paired-samples t tests to examine changes in job demands and resources, and fixed-effects linear regression analyses to examine associations of within-person changes in job demands and resources with those in burnout and work engagement. RESULTS Healthcare professionals perceived increased workloads, associated with increased burnout and decreased work engagement during the study period. Within-person increases in perceived collegial support were associated positively with work engagement and negatively with burnout symptoms. CONCLUSIONS Healthcare professionals in long-term care facilities perceived increased workloads in the wake of surging infection rates during the COVID-19 pandemic, resulting in increased burnout and decreased work engagement. These changes in burnout and work engagement were also perceived in response to declining collegial support. Efforts to protect the work-related well-being of healthcare professionals working in long-term care facilities in the pandemic context that focus on workload reduction and the promotion of collegial support may be most beneficial.
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Affiliation(s)
- Renée A Scheepers
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands.
| | - Thijs van den Broek
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
| | - Harry Finkenflügel
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
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Engström M, Jarnheden SH, Tham P. Staff quality of working life and turnover intentions in municipal nursing care and social welfare: a cross-sectional study. BMC Nurs 2023; 22:171. [PMID: 37202759 DOI: 10.1186/s12912-023-01339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/15/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Nurses and social workers are two common professions with a university degree working within municipal nursing care and social welfare. Both groups have high turnover intention rates, and there is a need to better understand their quality of working life and turnover intentions in general and more specifically during the Covid-19 pandemic. This study investigated associations between working life, coping strategies and turnover intentions of staff with a university degree working within municipal care and social welfare during the Covid-19 pandemic. METHODS A cross-sectional design; 207 staff completed questionnaires and data were analyzed using multiple linear regression analyses. RESULTS Turnover intentions were common. For registered nurses 23% thought of leaving the workplace and 14% the profession 'rather often' and 'very often/always'. The corresponding figures for social workers were 22% (workplace) and 22% (profession). Working life variables explained 34-36% of the variance in turnover intentions. Significant variables in the multiple linear regression models were work-related stress, home-work interface and job-career satisfaction (both for the outcome turnover intentions profession and workplace) and Covid-19 exposure/patients (turnover intentions profession). For the chosen coping strategies, 'exercise', 'recreation and relaxation' and 'improving skills', the results (associations with turnover) were non-significant. However, comparing the groups social workers reported that they used 'recreation and relaxation' more often than were reported by registered nurses. CONCLUSIONS More work-related stress, worse home-work interface and less job-career satisfaction together with Covid-19 exposure/patients (Covid-19 only for turnover profession) increase turnover intentions. Recommendations are that managers should strive for better home-work interface and job-career satisfaction, monitor and counteract work-related stress to prevent turnover intentions.
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Affiliation(s)
- Maria Engström
- Department of Caring Science, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
- Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui city, China.
| | - Sofia Hanberger Jarnheden
- Department of Social Work and Criminology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Pia Tham
- Department of Social Work and Criminology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
- Department of Social Work, Uppsala University, Uppsala, Sweden
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Araya AX, Palacios J, Oyanedel F, Iriarte E. Providing Care During the COVID-19 Pandemic: The Experience of Formal Caregivers in Long-Term Care Facilities in Chile. J Gerontol Nurs 2023; 49:39-44. [PMID: 37126009 DOI: 10.3928/00989134-20230414-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The current study aimed to identify the main challenges to formal caregivers from different long-term care facilities (LTCFs) that care for older adults (aged ≥60 years) in Chile during the coronavirus disease 2019 pandemic. Chile's national LTCF governing body (SENAMA) sent a survey to 1,190 LTCFs, receiving 996 responses. LTCF characteristics were number of residents, certification with SENAMA, licensure, geographic zone, and poverty level. Four dimensions were assessed: (a) concerns, (b) challenges, (c) needs, and (d) opportunities for improvement. The majority of respondents replied negatively to these four dimensions. Among those who responded positively, the fear of infecting a loved one, staff shortages and overwork, the need for access to psychological support, and improving payments were among formal caregivers' primary concerns. Targeting supportive interventions for formal caregivers, clinically and psychologically, is essential to preserve caregivers' health. [Journal of Gerontological Nursing, 49(5), 39-44.].
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Deng Y, Xie L, Wang L, Chen Y. Psychoanalysis of COVID-19 Patient Narratives: A Descriptive Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:712. [PMID: 37109670 PMCID: PMC10145710 DOI: 10.3390/medicina59040712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: COVID-19 patients are a psychologically vulnerable patient group who suffer from both physical symptoms and psychological problems. The present study is a psychoanalytic investigation of COVID-19 patients utilizing Lacan's desire theory. We aimed to explore the manner in which patients' desire is presented in their lived experience narratives and sought to discover factors which directly impacted on this process. Materials and Methods: In-depth semi-structural interviews were conducted with 36 COVID-19 patients in China. During each interview, participants narrated their lived experiences of COVID-19 infection. Emotions, metaphors, and behaviors in patient narratives were collated as the main points for psychoanalysis. Results: Our findings demonstrated that the desire for being a healthy person made patients emotionally sensitive to the social environment. Anxiety and obsessive behaviors emerged in the process, which reveals their desire for that which they lack. Furthermore, public fear with respect to COVID-19 was somehow converted to psychological pressure on COVID-19 patients. Thus, these patients attempted to "de-identify" their identity as "patients". Positive responses of COVID-19 patients to the external world included admiring medical personnel, government, and country, while negative responses included interpersonal conflicts or complaints about discrimination. Following the rules of the Other, COVID-19 patients were influenced by the Other's desire in constructing their own image of a healthy person. Conclusions: This study revealed COVID-19 patients' psychological need to rid themselves of the identity of "patient" at the individual and social level. Our findings have clinical implications in helping COVID-19 patients to reshape their identity and to live a normal life.
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Affiliation(s)
- Yu Deng
- College of Language Intelligence, Sichuan International Studies University, Chongqing 400031, China;
| | - Luxue Xie
- School of English Studies, Sichuan International Studies University, Chongqing 400031, China
| | - Li Wang
- Science and Education Department, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Yaokai Chen
- Department of Infection Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
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Vilaplana-Prieto C, Gómez Martínez CS, Echevarría Pérez P, Legaz I. Sociosanitary Legal and Economic Aspects in Nursing Homes for the Elderly in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4928. [PMID: 36981839 PMCID: PMC10048867 DOI: 10.3390/ijerph20064928] [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: 02/03/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
AIM The study aimed to identify and compare aspects of the different Spanish regulations on the minimum conditions that nursing homes must meet and to compare whether these requirements significantly affect the price of a nursing home place in each region. METHODS We analyzed and compared the 17 regional regulations that must be met by nursing homes in terms of equipment and social and healthcare staff and combined this information with regional information concerning the price and coverage of public and subsidized places in nursing homes. RESULTS The study revealed significant regional inequality in physical facilities and human resources. However, the number of regulatory measures referring to the mandatory availability of physical space or specific material resources was not positively correlated with an increase in the price of a place in a public or subsidized nursing home. CONCLUSIONS No unified regulations throughout Spain regulate the aspects that residential centers must comply with. There is a need to move towards a person-centered approach, providing an environment as close to home as possible. The regulation of minimum standards to be met by all nursing homes at the national level should not significantly impact prices.
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Affiliation(s)
- Cristina Vilaplana-Prieto
- Department of Fundamentals of Economic Analysis, Faculty of Economics and Business, University of Murcia, 30120 Murcia, Spain
| | | | | | - Isabel Legaz
- Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence Campus Mare Nostrum, University of Murcia, 30100 Murcia, Spain
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Doyle M, Louw JS, Corry M. Experiences of a Nursing Team Working in a Residential Care Facility for Older Adults During the COVID-19 Pandemic. J Gerontol Nurs 2023; 49:40-46. [PMID: 36852987 DOI: 10.3928/00989134-20230210-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Experiences of staff working in residential long-term care facilities (LTCFs) during the coronavirus disease 2019 (COVID-19) pandemic are likely to differ from that of staff working in acute hospitals. The aim of the current study was to describe the experiences of the nursing team supporting frail older adults with high medical and care needs living in a LTCF. Using a descriptive qualitative design, data were gathered via one-to-one semi-structured interviews and thematically analyzed. Four themes emerged: Providing Care During COVID-19, Impact of COVID-19 on Staff, Organizational Management of COVID-19, and Training and Education. Visitation restrictions and staff shortages impacted all aspects of work life. Staff reported increased stress and exhaustion with COVID-19 infection resulting in long-term health issues. It is important to learn from these experiences to inform and empower staff to manage future outbreaks of infectious diseases. [Journal of Gerontological Nursing, 49(3), 40-46.].
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Abstract
Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses' ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses' own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner.
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Affiliation(s)
- Hillestad AH
- Lovisenberg Diaconal University College, Oslo, Norway
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Song Y, Thorne TE, Duan Y, Cummings G, Norton PG, Squires J, Estabrooks CA. Pre-COVID-19 work-life quality of regulated nurses in Canadian nursing homes. Geriatr Gerontol Int 2023; 23:148-150. [PMID: 36627104 DOI: 10.1111/ggi.14536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/09/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Yuting Song
- School of Nursing, Qingdao University, Qingdao, China.,Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Trina E Thorne
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Greta Cummings
- College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Peter G Norton
- Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Janet Squires
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Tingvold L, Moholt JM, Førland O, Jacobsen FF, Tranvåg O. Intended, Unintended, Unanticipated? Consequences of Social Distancing Measures for Nursing Home Residents During the Covid-19 Pandemic. Glob Qual Nurs Res 2023; 10:23333936231176204. [PMID: 37261277 PMCID: PMC10227487 DOI: 10.1177/23333936231176204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 06/02/2023] Open
Abstract
During the outbreak of the COVID-19 pandemic, Norwegian health authorities introduced social distancing measures in nursing homes. The aim was to protect vulnerable residents from contracting the potentially deadly infection. Drawing on individual interviews with nursing home managers and physicians, and focus groups with nursing staff, we explore and describe consequences the social distancing measures had on nursing home residents' health and wellbeing. The analysis indicates that most residents became socially deprived, while some became calmer during the nursing home lockdown. Nursing home staff, physicians and managers witnessed that residents' health and functional capacity declined when services to maintain health, such as physiotherapy, were put on hold. In conclusion, we argue that although Norwegian health authorities managed to keep the infection rates low in nursing homes, this came at a high price for the residents however, as the social distancing measures also negatively impacted their health and wellbeing.
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Affiliation(s)
- Laila Tingvold
- Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | | | - Oddvar Førland
- Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Oscar Tranvåg
- Western Norway University of Applied Sciences, Bergen, Norway
- Norwegian Research Centre for Women’s Health, University Hospital, Oslo, Norway
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24
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Birt L, Lane K, Corner J, Sanderson K, Bunn D. Care-home Nurses' responses to the COVID-19 pandemic: Managing ethical conundrums at personal cost: A qualitative study. J Nurs Scholarsh 2023; 55:226-238. [PMID: 36464814 PMCID: PMC9878168 DOI: 10.1111/jnu.12855] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The COVID-19 pandemic had an unprecedented effect on those living and working in care-homes for older people, as residents were particularly vulnerable to contracting the SARS-CoV-2 virus, associated with high morbidity and mortality. Often undervalued, care-home nurses (RNs) are leaders, managing complex care while working in isolation from their professional peers. The pandemic made this more apparent, when care and treatments for COVID-19 were initially unknown, isolation increased due to withdrawal of many professional health services, accompanied by staff shortages. OBJECTIVE To explore RNs' experiences of working in older people's care-homes during the COVID-19 pandemic. DESIGN Qualitative interview study. SETTING Care-homes for older people in England and Scotland, UK. METHODS Recruitment via direct contact with care-homes, social media, and links provided by national partners, then purposive sampling for age, gender, type of care-home, and location. Data collected through one-to-one online interviews using topic guide developed collaboratively with care-home nurses, focusing on how COVID-19 impacted on nurses' resilience and mental wellbeing. Data analyzed thematically using Tronto's ethics of care framework to guide development of interpretative themes. RESULTS Eighteen nurses (16 female; 16 adult, and two mental health nurses) were interviewed March-June 2021; majority aged 46-55 years; mean time registered with Nursing and Midwifery Council: 19 years; 17 had nursed residents with COVID-19. RNs' experiences resonated with Tronto's five tenets of ethical care: attentiveness, responsibility, competence, responsiveness, and solidarity. All nurses described being attentive to needs of others, but were less attentive to their own needs, which came at personal cost. RNs were aware of their professional and leadership responsibilities, being as responsive as they could be to resident needs, processing and sharing rapidly changing guidance and implementing appropriate infection control measures, but felt that relatives and regulatory bodies were not always appreciative. RNs developed enhanced clinical skills, increasing their professional standing, but reported having to compromise care, leading to moral distress. Broadly, participants reported a sense of solidarity across care-home staff and working together to cope with the crisis. CONCLUSION Care-home nurses felt unprepared for managing the COVID-19 pandemic, many experienced moral distress. Supporting care-home nurses to recover from the pandemic is essential to maintain a healthy, stable workforce and needs to be specific to care-home RNs, recognizing their unique pandemic experiences. Support for RNs will likely benefit other care-home workers either directly through wider roll-out, or indirectly through improved wellbeing of nurse leaders. CLINICAL RELEVANCE The COVID-19 pandemic, an international public health emergency, created many challenges for Registered Nurses (RNs) working in long-term care facilities for older people, as residents were particularly vulnerable to the impact of the SARS-CoV-2 virus. Care-home RNs faced challenges distinct from their hospital-based nursing peers and non-nursing social care colleagues due to their isolation, leadership roles, professional legal obligations, and ethical responsibilities, leading to psychological distress on the one hand, but also a newly found confidence in their existing and newly developed skills, and increased recognition by the wider health community of their specialisms.
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Affiliation(s)
- Linda Birt
- School of Health SciencesUniversity of East AngliaNorfolkUK,Present address:
School of HealthcareUniversity of LeicesterLeicesterUK
| | - Kathleen Lane
- School of Health SciencesUniversity of East AngliaNorfolkUK
| | - Jason Corner
- School of Health SciencesUniversity of East AngliaNorfolkUK
| | | | - Diane Bunn
- School of Health SciencesUniversity of East AngliaNorfolkUK
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Boamah SA, Weldrick R, Havaei F, Irshad A, Hutchinson A. Experiences of Healthcare Workers in Long-Term Care during COVID-19: A Scoping Review. J Appl Gerontol 2022; 42:1118-1136. [PMID: 36541274 PMCID: PMC9780558 DOI: 10.1177/07334648221146252] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Although healthcare workers (HCWs) in long-term care (LTC) have experienced significant emotional and psychological distress throughout the pandemic, little is known about their unique experiences. Objective: This scoping review synthesizes existing research on the experiences of HCWs in LTC during the COVID-19 pandemic. Method: Following Arksey and O'Malley's framework, data published between March 2020 to June 2022, were extracted from six databases. Results: Among 3808 articles screened, 40 articles were included in the final analysis. Analyses revealed three interrelated themes: carrying the load (moral distress); building pressure and burning out (emotional exhaustion); and working through it (a sense of duty to care). Conclusion: Given the impacts of the pandemic on both HCW wellbeing and patient care, every effort must be made to address the LTC workforce crisis and evaluate best practices for supporting HCWs experiencing mental health concerns during and post-COVID-19.
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Affiliation(s)
- Sheila A. Boamah
- School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada,Sheila A. Boamah, School of Nursing, McMaster University, Hamilton Faculty of Health Sciences, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Rachel Weldrick
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Farinaz Havaei
- University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Ahmed Irshad
- McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
| | - Amy Hutchinson
- McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
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26
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López-Del-Hoyo Y, Fernández-Martínez S, Pérez-Aranda A, Barceló-Soler A, Guzman-Parra J, Varela-Moreno E, Campos D, Monreal-Bartolomé A, Beltrán-Ruiz M, Moreno-Küstner B, Mayoral-Cleries F, García-Campayo J. Effectiveness and implementation of an online intervention (MINDxYOU) for reducing stress and promote mental health among healthcare workers in Spain: a study protocol for a stepped-wedge cluster randomized trial. BMC Nurs 2022; 21:308. [PMID: 36357881 PMCID: PMC9647243 DOI: 10.1186/s12912-022-01089-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The World Health Organization has formally recognized that healthcare professionals are at risk of developing mental health problems; finding ways to reduce their stress is mandatory to improve both their quality of life and, indirectly, their job performance. In recent years, particularly since the COVID-19 pandemic outbreak, there has been a proliferation of online interventions with promising results. The purpose of the present study is twofold: to test the effectiveness of an online, self-guided intervention, MINDxYOU, to reduce the stress levels of healthcare workers; and to conduct an implementation study of this intervention. Additionally, an economic evaluation of the intervention will be conducted. METHODS The current study has a hybrid effectiveness-implementation type 2 design. A stepped wedge cluster randomized trial design will be used, with a cohort of 180 healthcare workers recruited in two Spanish provinces (Malaga and Zaragoza). The recruitment stage will commence in October 2022. Frontline health workers who provide direct care to people in a hospital, primary care center, or nursing home setting in both regions will participate. The effectiveness of the intervention will be studied, with perceived stress as the main outcome (Perceived Stress Scale), while other psychopathological symptoms and process variables (e.g., mindfulness, compassion, resilience, and psychological flexibility) will be also assessed as secondary outcomes. The implementation study will include analysis of feasibility, acceptability, adoption, appropriateness, fidelity, penetration, and sustainability. The incremental costs and benefits, in terms of quality-adjusted life years, will be examined by means of cost-utility and cost-effectiveness analyses. DISCUSSION MINDxYOU is designed to reduce healthcare workers' stress levels through the practice of mindfulness, acceptance, and compassion, with a special focus on how to apply these skills to healthy habits and considering the particular stressors that these professionals face on a daily basis. The present study will show how implementation studies are useful for establishing the framework in which to address barriers to and promote facilitators for acceptability, appropriateness, adoption, feasibility, fidelity, penetration, and sustainability of online interventions. The ultimate goal is to reduce the research-to-practice gap. TRIAL REGISTRATION This study was registered in ClinicalTrials.gov on 29/06/2022; registration number: NCT05436717.
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Affiliation(s)
- Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Departamento de Psicología Y Sociología, Facultad de Ciencias Humanas Y de La Educación, Universidad de Zaragoza, Saragossa/Huesca, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
| | - Selene Fernández-Martínez
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
| | - Adrián Pérez-Aranda
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain.
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola Del Vallès, Spain.
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain.
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain.
| | - Jose Guzman-Parra
- Mental Health Clinical Management Unit, Regional University Hospital of Malaga, Málaga, Spain
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
| | - Esperanza Varela-Moreno
- Mental Health Clinical Management Unit, Regional University Hospital of Malaga, Málaga, Spain
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Malaga, Málaga, Spain
| | - Daniel Campos
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Departamento de Psicología Y Sociología, Facultad de Ciencias Humanas Y de La Educación, Universidad de Zaragoza, Saragossa/Huesca, Spain
| | - Alicia Monreal-Bartolomé
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
| | - María Beltrán-Ruiz
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
| | - Berta Moreno-Küstner
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Malaga, Málaga, Spain
- MARISTAN Network, Málaga, Spain
| | - Fermín Mayoral-Cleries
- Mental Health Clinical Management Unit, Regional University Hospital of Malaga, Málaga, Spain
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
- Department of Psychiatry, Faculty of Medicine, University of Zaragoza, Saragossa, Spain
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Zhang H, Wu Y, Wang N, Sun X, Wang Y, Zhang Y. Caregivers' experiences and perspectives on caring for the elderly during the COVID-19 pandemic: A qualitative systematic review. J Nurs Manag 2022; 30:3972-3995. [PMID: 36208194 PMCID: PMC9874760 DOI: 10.1111/jonm.13859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/19/2022] [Accepted: 10/02/2022] [Indexed: 01/27/2023]
Abstract
AIMS The goal of this study was to explore caregivers' experiences, perspectives, emotions, knowledge and needs in caring for older people during the COVID-19 pandemic. These included, but were not limited to, experiences in hospital care, home care and nursing home care. BACKGROUND Because of the high mortality rate associated with the COVID-19 pandemic, senior care is critical. During the COVID-19 pandemic, caregivers caring for older people have had unique experiences potentially affecting the quality of care provided. This topic has received substantial attention since the start of the pandemic and has been studied by numerous researchers. However, experiences may differ among countries and time periods. In addition, no qualitative systematic reviews on this topic appear to have been published. EVALUATION In this systematic review of qualitative studies, data were collected from the following electronic databases: PubMed, Web of Science, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Science Direct and PsycINFO. Titles and abstracts were screened according to the inclusion and exclusion criteria, full texts were screened and the methodological quality of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research by two independent reviewers. KEY ISSUE(S) A total of 141 findings were extracted and aggregated into 20 categories; 6 synthesized findings were identified. CONCLUSION This review indicates caregivers' experiences and perceptions regarding caring for older people during the COVID-19 pandemic. The results of a qualitative systematic review show that caregivers' emotions, cognitions and knowledge have affected the quality of caregivers' senior care services during the pandemic. Caregivers caring for older adults should practise self-awareness, understanding their knowledge and attitudes to improve the quality of senior care. Moreover, health care administrators and policymakers should make concerted efforts to cultivate a better working environment. IMPLICATIONS FOR NURSING MANAGEMENT Managers should formulate timely and effective management strategies. During the COVID-19 pandemic, the workload of caregivers has increased, thus requiring better scheduling by managers. Furthermore, managers should consider the negative emotions of caregivers and prevent negative emotions from affecting their work. Besides, virtual technology should be applied to senior care and psychological support be provided for caregivers in this special care setting.
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Affiliation(s)
- Huichao Zhang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuan Wu
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Nannan Wang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Xuhan Sun
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuqing Wang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuxi Zhang
- Geriatric Hematology/Radiotherapy Wardthe First Affiliated Hospital of Nanjing Medical University300 Guangzhou RoadNanjingJiangsuChina
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Gray KL, Birtles H, Reichelt K, James IA. The experiences of care home staff during the COVID-19 pandemic: A systematic review. Aging Ment Health 2022; 26:2080-2089. [PMID: 34967232 DOI: 10.1080/13607863.2021.2013433] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: To examine experiences of care home staff to better understand how to support them during the ongoing pandemic and in the future.Method: A systematic review examining experiences of care staff over the last year (March 2020-2021).Results: Fourteen papers related to experiences of staff and one was an intervention study. Quantitatively there was evidence of anxiety, PTSD and depression amongst the staff. Qualitatively, seven themes were identified: Poor working conditions; Lack of skills and knowledge; Psychological/Mental health concerns; Feeling undervalued and abandoned; Fears of contagion; Support and the positive impacts of COVID. The intervention study recommended employing needs-based approaches, including educational and wellbeing components.Conclusion: Recommendations are made in terms of how to work with staff, both practically and clinically. There are also suggestions about how to deal with similar situations if they were to reoccur. It is evident that lessons need to be learned because errors were made. Indeed, from a UK perspective, discharging thousands back to care homes, without testing, cost lives. This may have been done to protect the NHS, but it unwittingly 'lockdown' the virus within the care sector.
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Affiliation(s)
- Kristina Lily Gray
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, North East and North Cumbria staff wellbeing hub, Akenside Psychology Offices, Campus for ageing and vitality, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Heather Birtles
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Older adult psychology services, United Kingdom of Great Britain and Northern Ireland
| | - Katharina Reichelt
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Older adult psychology services, United Kingdom of Great Britain and Northern Ireland
| | - Ian Andrew James
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Older adult psychology services, United Kingdom of Great Britain and Northern Ireland
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Dujmovic M, Roederer T, Frison S, Melki C, Lauvin T, Grellety E. COVID-19 in French nursing homes during the second pandemic wave: a mixed-methods cross-sectional study. BMJ Open 2022; 12:e060276. [PMID: 36127110 PMCID: PMC9490301 DOI: 10.1136/bmjopen-2021-060276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/01/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION French nursing homes were deeply affected by the first wave of the COVID-19 pandemic, with 38% of all residents infected and 5% dying. Yet, little was done to prepare these facilities for the second pandemic wave, and subsequent outbreak response strategies largely duplicated what had been done in the spring of 2020, regardless of the unique needs of the care home environment. METHODS A cross-sectional, mixed-methods study using a retrospective, quantitative data from residents of 14 nursing homes between November 2020 and mid-January 2021. Four facilities were purposively selected as qualitative study sites for additional in-person, in-depth interviews in January and February 2021. RESULTS The average attack rate in the 14 participating nursing facilities was 39% among staff and 61% among residents. One-fifth (20) of infected residents ultimately died from COVID-19 and its complications. Failure to thrive syndrome (FTTS) was diagnosed in 23% of COVID-19-positive residents. Those at highest risk of death were men (HR=1.78; 95% CI: 1.18 to 2.70; p=0.006), with FTTS (HR=4.04; 95% CI: 1.93 to 8.48; p<0.001) or in facilities with delayed implementation of universal FFP2 masking policies (HR=1.05; 95% CI: 1.02 to 1.07; p<0.001). The lowest mortality was found in residents of facilities with a partial (HR=0.30; 95% CI: 0.18 to 0.51; p<0.001) or full-time physician on staff (HR=0.20; 95% CI: 0.08 to 0.53; p=0.001). Significant themes emerging from qualitative analysis centred on (1) the structural, chronic neglect of nursing homes, (2) the negative effects of the top-down, bureaucratic nature of COVID-19 crisis response, and (3) the counterproductive effects of lockdowns on both residents and staff. CONCLUSION Despite high resident mortality during the first pandemic wave, French nursing homes were ill-prepared for the second, with risk factors (especially staffing, lack of medical support, isolation/quarantine policy, etc) that affected case fatality and residents' and caregivers' overall well-being and mental health.
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Affiliation(s)
- Morgane Dujmovic
- Department of Epidemiology and Training, Epicentre, Paris, France
| | - Thomas Roederer
- Department of Epidemiology and Training, Epicentre, Paris, France
| | - Severine Frison
- Department of Epidemiology and Training, Epicentre, Paris, France
| | - Carla Melki
- Emergency Cell, Médecins Sans Frontières, Paris, France
| | - Thomas Lauvin
- Emergency Cell, Médecins Sans Frontières, Paris, France
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Stress and Resilient Coping among Nurses: Lessons Learned from the COVID-19 Pandemic. PSYCH 2022. [DOI: 10.3390/psych4030047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
(1) Background: the COVID-19 pandemic is still taking over the world, and with new virus strains, the burden on the health systems and healthcare teams is yet to end. The study explored stress and employed resilient coping measures among nurses working with COVID-19 patients. (2) Methods: the current study used a convergent triangulation design using a qualitative and quantitative approach, with a sample of 113 nurses working at Beni-Suef University Hospital between November 2021 and April 2022 using an online form. Data were collected using a sociodemographic characteristics questionnaire, the Nursing Stress Scale, Brief Resilient Coping Scale, and a qualitative interview. (3) Results: the studied nurses experienced severe stress, with moderate-to-low resilient coping in total. There was a strong negative highly statistically significant correlation between stress and coping. Qualitative data analysis showed that attention to the spiritual side, communicating with friends and family, accepting the current situation, and helping others in need were key themes that emerged to moderate studied nurses’ stress. (4) Conclusions: nurses who work with COVID-19 patients experience high levels of stress regardless of their characteristics; spiritual coping strategies, communication with family, and helping others were the dominant resilient coping approaches employed by nurses to moderate stress.
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Experiences of Nurses in Nursing Homes during the COVID-19 Pandemic in Germany: A Qualitative Study. Geriatrics (Basel) 2022; 7:geriatrics7050094. [PMID: 36136803 PMCID: PMC9498521 DOI: 10.3390/geriatrics7050094] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: The aim of this qualitative study was to examine pandemic-related changes in nursing work in nursing homes, the resulting work-related stresses and external as well as internal alleviating measures. (2) Methods: We conducted 10 interviews from March to June 2021 with nurses from eight facilities. Data were analysed according to qualitative content analysis. (3) Results: Nurses faced increased workloads due to regulations and guidelines paired with staffing shortages. Work became more difficult due to personal protective equipment (PPE), conflict with residents’ relatives and, in the case of outbreaks, excess death and suffering. Nurse-to-resident care work became more emotionally demanding, with residents more distressed due to the lockdown, while families and social workers were not allowed into the facility. Residents with dementia posed an additional challenge, as they did not remember hygiene and distancing rules. Internal and external measures were not sufficient to alleviate the situation. However, some measures, such as training programmes or existing palliative care concepts, were considered helpful. (4) Conclusions: Facing other possible upcoming pandemics, ways to improve facility administration to prepare for future pandemics are highly needed, such as regular training programmes to prepare for possible lockdown scenarios, PPE use or potential hygiene measures.
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Peter E, Variath C, Mohammed S, Mitchell M, Killackey T, Maciver J, Chiasson C. Nurses' Experiences of their Ethical Responsibilities during Coronavirus Outbreaks: A Scoping Review. Can J Nurs Res 2022; 54:246-260. [PMID: 35167396 PMCID: PMC9379388 DOI: 10.1177/08445621221080153] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Globally, nurses have experienced changes to the moral conditions of their work during coronavirus outbreaks. To identify the challenges and sources of support in nurses' efforts to meet their ethical responsibilities during SARS, MERS, and COVID-19 outbreaks a scoping review design was chosen. A search was conducted for eligible studies in Ovid MEDLINE, Ovid Embase and Embase Classic, EBSCO CINAHL Plus, OVID APA PsycInfo, ProQuest ASSIA, and ProQuest Sociological Abstracts on August 19, 2020 and November 9, 2020. The PRISMA-ScR checklist was used to ensure rigor. A total of 5204 records were identified of which 41 studies were included. Three themes were identified related challenges in meeting ethical responsibilities: 1) substandard care, 2) impeded relationships, 3) organizational and system responses and six themes relating to sources of support: 1) team and supervisor relationships, 2) organizational change leading to improved patient care, 3) speaking out, 4) finding meaning, 5) responses by patients and the public, 6) self-care strategies.Our review revealed how substandard care and public health measures resulted in nurses not being fully able to meet their ethical responsibilities of care. These included the visitation policies that impeded the support of patients by nurses and families, particularly with respect to face-to-face relationships. Organizational and system responses to the evolving outbreaks, such as inadequate staffing, also contributed to these challenges. Supportive relationships with colleagues and supervisors, however, were very beneficial, along with positive responses from patients and the public.
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Affiliation(s)
- Elizabeth Peter
- Lawrence S. Bloomberg Faculty of Nursing, Joint Centre for
Bioethics, University of Toronto, Toronto, ON, Canada
| | - Caroline Variath
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Faculty of Health Sciences and Wellness, Humber College, Toronto, Canada
| | - Shan Mohammed
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Mikaela Mitchell
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Tieghan Killackey
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Jane Maciver
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Conor Chiasson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Bergqvist M, Bastholm‐Rahmner P, Gustafsson LL, Holmgren K, Veg A, Wachtler C, Schmidt‐Mende K. How much are we worth? Experiences of nursing assistants in Swedish nursing homes during the first wave of COVID-19. Int J Older People Nurs 2022; 18:e12498. [PMID: 35978489 PMCID: PMC9539304 DOI: 10.1111/opn.12498] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND NHs have been severely exposed during the COVID-19 pandemic. Little is known about how staff who provide practical daily care of older residents experienced work during the pandemic. The aim of this study was to understand how nursing assistants (NAs) experienced their work at nursing homes (NHs) for older people during the first wave of the COVID-19 pandemic. METHODS We conducted a qualitative study of focus group discussions with in total 20 participants from four NHs in Stockholm, Sweden. Discussions were held in November 2020. Transcripts were analyzed using inductive thematic analysis. RESULTS We identified three major themes: 1) We felt abandoned, scared and disrespected, 2) We made sure we made it through, and 3) We can do good work with appropriate resources. NAs felt disregarded as they were often left alone without adequate support from managers, registered nurses and the municipalities. NAs felt distressed and guilty and developed their own strategies to cope and manage their work. CONCLUSION AND IMPLICATION FOR PRACTICE During the first wave of the COVID-19 pandemic NAs felt abandoned and burdened due to lack of leadership. Organizational improvements are required to protect the wellbeing of NAs and to ensure sustainability of patient safety. NAs are crucial in the care for vulnerable older people and their experiences should constitute a keystone for development of future policy and practice in NHs.
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Affiliation(s)
- Monica Bergqvist
- Division of Nursing, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
| | - Pia Bastholm‐Rahmner
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska InstitutetKarolinska University HospitalStockholmSweden,Academic Primary Care CenterStockholmSweden
| | - Lars L Gustafsson
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska InstitutetKarolinska University HospitalStockholmSweden
| | | | - Anikó Veg
- Health Care AdministrationStockholmSweden
| | - Caroline Wachtler
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
| | - Katharina Schmidt‐Mende
- Academic Primary Care CenterStockholmSweden,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
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Laher Z, Robertson N, Harrad-Hyde F, Jones CR. Prevalence, Predictors, and Experience of Moral Suffering in Nursing and Care Home Staff during the COVID-19 Pandemic: A Mixed-Methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9593. [PMID: 35954948 PMCID: PMC9368354 DOI: 10.3390/ijerph19159593] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 12/07/2022]
Abstract
(1) Background: Nursing and care home staff experienced high death rates of older residents and increased occupational and psychosocial pressures during the COVID-19 pandemic. The literature has previously found this group to be at risk of developing mental health conditions, moral injury (MI), and moral distress (MD). The latter two terms refer to the perceived ethical wrongdoing which contravenes an individual's moral beliefs and elicits adverse emotional responses. (2) Method: A systematic review was conducted to explore the prevalence, predictors, and psychological experience of MI and MD in the aforementioned population during the COVID-19 pandemic. The databases CINAHL, APA PsychINFO, APA PsychArticles, Web of Science, Medline, and Scopus were systematically searched for original research studies of all designs, published in English, with no geographical restrictions, and dating from when COVID-19 was declared a public health emergency on the 30 January 2020 to the 3 January 2022. Out of 531 studies screened for eligibility, 8 studies were selected for review. A thematic analysis was undertaken to examine the major underpinning themes. (3) Results: MI, MD, and related constructs (notably secondary traumatic stress) were evidenced to be present in staff, although most studies did not explore the prevalence or predictors. The elicited major themes were resource deficits, role challenges, communication and leadership, and emotional and psychosocial consequences. (4) Conclusions: Our findings suggest that moral injury and moral distress were likely to be present prior to COVID-19 but have been exacerbated by the pandemic. Whilst studies were generally of high quality, the dearth of quantitative studies assessing prevalence and predictors suggests a research need, enabling the exploration of causal relationships between variables. However, the implied presence of MI and MD warrants intervention developments and workplace support for nursing and care home staff.
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Affiliation(s)
- Zainab Laher
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7HA, UK
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7HA, UK
| | - Fawn Harrad-Hyde
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Ceri R. Jones
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7HA, UK
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Schulze S, Merz S, Thier A, Tallarek M, König F, Uhlenbrock G, Nübling M, Lincke HJ, Rapp MA, Spallek J, Holmberg C. Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic: a cross-sectional study with quantitative and qualitative data. BMC Health Serv Res 2022; 22:949. [PMID: 35883124 PMCID: PMC9315075 DOI: 10.1186/s12913-022-08333-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. METHODS We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). RESULTS Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. CONCLUSIONS Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.
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Affiliation(s)
- Susanne Schulze
- Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Sibille Merz
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Anne Thier
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Marie Tallarek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Franziska König
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Greta Uhlenbrock
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Matthias Nübling
- Freiburg Research Centre for Occupational Sciences (FFAW), Freiburg, Germany
| | - Hans-Joachim Lincke
- Freiburg Research Centre for Occupational Sciences (FFAW), Freiburg, Germany
| | - Michael A Rapp
- Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Jacob Spallek
- Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg University of Technology Cottbus -Senftenberg, Senfenberg, Germany
| | - Christine Holmberg
- Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.
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Rasing NL, Janus S, Vink A, Zuidema S. The impact of COVID-19 on music therapy provision in Dutch care homes. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2084637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Naomi Larissa Rasing
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Sarah Janus
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Annemieke Vink
- Department of Music Therapy, ArtEZ University of the Arts, Academy of Music, Enschede, the Netherlands
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Melnikov S, Kagan I, Felizardo H, Lynch M, Jakab-Hall C, Langan L, Vermeir P, Luiking-Martin ML. Practices and experiences of European frontline nurses under the shadow of COVID-19. Nurs Health Sci 2022; 24:405-413. [PMID: 35238460 PMCID: PMC9115500 DOI: 10.1111/nhs.12936] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/16/2022] [Accepted: 02/26/2022] [Indexed: 11/28/2022]
Abstract
The COVID-19 pandemic has caused health professionals to deal with new situations they have not encountered before. Nurses were forced to cope with increased workloads, seriously ill patients, numerous patient deaths, and unresolved ethical dilemmas. This study aimed to examine the lived experiences of nurses across Europe during the first wave of the COVID-19 pandemic. This was a qualitative narrative research study. Eighteen nurses from eight European countries (four each from the UK and Israel, three from Portugal, two each from the Netherlands and Ireland, and one each from Belgium, Italy, and Sweden) submitted narratives about their professional experiences during May-June 2020. The narratives were analyzed using thematic analysis. Seven categories across the narratives were condensed and interpreted into three themes: opportunities and growth, care management, and emotional and ethical challenges. The COVID-19 pandemic has affected nurses emotionally and provided an opportunity to actively develop systems and skills needed to minimize harm and maximize benefits to patients and nurses.
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Affiliation(s)
- Semyon Melnikov
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilya Kagan
- Nursing Department, Ashkelon Academic College, Ashkelon, Israel
| | | | | | | | - Lisa Langan
- Department of Nursing and Healthcare Sciences, Institute of Technology, Tralee, Ireland
| | - Peter Vermeir
- Faculteit Geneeskunde en Gezondheidswetenschappen Universiteit Gent, Gent, Belgium
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Affiliation(s)
- Debra Jackson
- Sydney Nursing School, University of Sydney, Sydney, Victoria, Australia
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39
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Hartstra E, Kroezen M, van der Velden C, van der Roest HG. The influence of the down- and upscaling of activities in long-term care facilities during the COVID-19 visitor ban on caregivers' exhaustion and ability to provide care and support: A questionnaire study. Geriatr Nurs 2022; 45:118-124. [PMID: 35405533 PMCID: PMC8938184 DOI: 10.1016/j.gerinurse.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/21/2022]
Abstract
In the Netherlands, a national visitor-ban was in place in LTCFs during the first outbreak of COVID-19 in 2020. Meaningful activities were cancelled or downscaled, while others were performed more often. It is known that a lack of activities has several negative effects on residents, while the impact on caregivers remains largely unexplored. Here we investigate the influence of the down- and upscaling of activities on caregivers' physical and emotional exhaustion and their perceived ability to provide care and support. Downscaling of activities for residents, in particular watching television and musical activities, had a negative impact on caregivers' emotional exhaustion. The downscaling of watching television increased caregivers 'physical exhaustion. Furthermore, the downscaling of both activities had a negative impact on caregivers' perceived ability to provide ADL care and emotional support. This study triggers the need for more knowledge about the function of meaningful activities for residents, from a LTCF caregivers' perspective.
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Affiliation(s)
- Egbert Hartstra
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, 3500, AS Utrecht, the Netherlands.
| | - Marieke Kroezen
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, 3500, AS Utrecht, the Netherlands
| | - Claudia van der Velden
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, 3500, AS Utrecht, the Netherlands
| | - Henriëtte G van der Roest
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, 3500, AS Utrecht, the Netherlands
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40
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van Dijk Y, Janus SIM, de Boer MR, Achterberg WP, Roelen CAM, Zuidema SU. Job Demands, Work Functioning and Mental Health in Dutch Nursing Home Staff during the COVID-19 Outbreak: A Cross-Sectional Multilevel Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074379. [PMID: 35410060 PMCID: PMC8998775 DOI: 10.3390/ijerph19074379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/26/2022] [Accepted: 04/02/2022] [Indexed: 12/24/2022]
Abstract
COVID-19 posed enormous challenges for nursing home staff, which may have caused stress and mental health problems. This study aimed to measure the prevalence of mental health problems among nursing home staff and investigate the differences in job demands, work functioning and mental health between staff with and without COVID contact or COVID infection and across different levels of COVID worries. In this cross-sectional study, 1669 employees from 10 nursing home organizations filled in an online questionnaire between June and September 2020. The questionnaire measured the participants’ characteristics, COVID contact, infection and worries, job demands, work functioning, depressive symptoms and burnout. Differences were investigated with multilevel models to account for clustering at the organization level. Of the participants, 19.1% had high levels of depressive symptoms and 22.2% burnout. Job demands, work functioning, depressive symptoms and burnout differed between participants who never worried and participants who often or always worried about the COVID crisis. Differences were smaller for participants with and without COVID contact or infection. Most models improved when clustering was accounted for. Nursing homes should be aware of the impact of COVID worries on job demands, work functioning and mental health, both at the individual and organizational level.
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Affiliation(s)
- Ylse van Dijk
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9700 AD Groningen, The Netherlands; (S.I.M.J.); (M.R.d.B.); (S.U.Z.)
- Correspondence:
| | - Sarah I. M. Janus
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9700 AD Groningen, The Netherlands; (S.I.M.J.); (M.R.d.B.); (S.U.Z.)
| | - Michiel R. de Boer
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9700 AD Groningen, The Netherlands; (S.I.M.J.); (M.R.d.B.); (S.U.Z.)
| | - Wilco P. Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, 2300 RC Leiden, The Netherlands;
| | - Corne A. M. Roelen
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, 9700 AD Groningen, The Netherlands;
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9700 AD Groningen, The Netherlands; (S.I.M.J.); (M.R.d.B.); (S.U.Z.)
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Martin AK, Green TL, McCarthy AL, Sowa PM, Laakso EL. Healthcare Teams: Terminology, Confusion, and Ramifications. J Multidiscip Healthc 2022; 15:765-772. [PMID: 35422626 PMCID: PMC9005079 DOI: 10.2147/jmdh.s342197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/11/2022] [Indexed: 11/23/2022] Open
Abstract
One strategy to meet increasing consumer demand for healthcare services in the pandemic era has been to reorganize the healthcare workforce. This can be achieved by reorganizing healthcare teams, which are associated with improved workforce productivity and better patient outcomes. However, healthcare teams are described using numerous terminologies and labels, which has led to conceptual confusion for researchers and research users. In this paper, we explore the disparate nature of healthcare team terminology, ramifications of conceptual confusion, and we propose standardized terminology with synthesized definitions focused on characteristics of clinically based healthcare teams including unidisciplinary, multidisciplinary, interprofessional, and transdisciplinary teams.
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Affiliation(s)
- Aleysha K Martin
- Faculty of Medicine, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia
- Correspondence: Aleysha K Martin, Faculty of Medicine, Mater Research Institute – The University of Queensland, Level 2 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4101, Australia, Tel +61 457 993 248; +61 7 3163 2550, Email
| | - Theresa L Green
- School of Nursing, Midwifery and Social Work, The University of Queensland – MNHHS Surgical Treatment and Rehabilitation Service, Brisbane, QLD, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia
| | - P Marcin Sowa
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia
| | - E-Liisa Laakso
- Allied Health, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast, Australia
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Chemali S, Mari-Sáez A, El Bcheraoui C, Weishaar H. Health care workers' experiences during the COVID-19 pandemic: a scoping review. HUMAN RESOURCES FOR HEALTH 2022; 20:27. [PMID: 35331261 PMCID: PMC8943506 DOI: 10.1186/s12960-022-00724-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/09/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers' (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs' experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included. RESULTS 161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs' well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs' personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs' experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs' experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries. DISCUSSION This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs' experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs' circumstances. CONCLUSIONS Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.
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Affiliation(s)
- Souaad Chemali
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Almudena Mari-Sáez
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Charbel El Bcheraoui
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Heide Weishaar
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
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43
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Hoedl M, Thonhofer N, Schoberer D. COVID
‐19 pandemic: Burdens on and consequences for nursing home staff. J Adv Nurs 2022; 78:2495-2506. [PMID: 35285060 PMCID: PMC9111450 DOI: 10.1111/jan.15193] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/20/2021] [Accepted: 01/15/2022] [Indexed: 01/13/2023]
Abstract
The objective of this study was to assess burdens placed on and consequences of the COVID‐19 pandemic on nursing home staff.
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Affiliation(s)
- Manuela Hoedl
- Institute of Nursing Science Medical University of Graz Graz Austria
| | - Nina Thonhofer
- Institute of Nursing Science Medical University of Graz Graz Austria
| | - Daniela Schoberer
- Institute of Nursing Science Medical University of Graz Graz Austria
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Sweeney MR, Boilson A, White C, Nevin M, Casey B, Boylan P, Staines A. Experiences of residents, family members and staff in residential care settings for older people during COVID-19: A mixed methods study. J Nurs Manag 2022; 30:872-882. [PMID: 35246894 PMCID: PMC9115212 DOI: 10.1111/jonm.13574] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to explore the COVID-19 pandemic as it was experienced by people on the front line in residential care settings for older people in the Republic of Ireland (ROI). BACKGROUND The COVID-19 pandemic had a disproportionate effect in residential care settings for older people in Ireland. METHODS A 2-phased mixed methods study was conducted, consisting of an online survey administered shortly after the 1st wave of the virus to staff, residents and family members and one-to-one interviews with family members shortly after wave 2 of the virus. RESULTS Isolation, loss of connectedness as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. Family input to care was suspended, with adverse consequences. IMPLICATIONS FOR NURSING MANAGEMENT Strategies to ensure that residents' physical, emotional and social needs and staffs' professional and personal needs are appropriately supported during future waves of the pandemic should now be implemented. CONCLUSION The pandemic had an extremely adverse impact on residents, family members and staff in care settings for older people.
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Affiliation(s)
- Mary Rose Sweeney
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Andrew Boilson
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Ciara White
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Mary Nevin
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Briege Casey
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Patrick Boylan
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Anthony Staines
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
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Hering C, Gangnus A, Budnick A, Kohl R, Steinhagen-Thiessen E, Kuhlmey A, Gellert P. Psychosocial burden and associated factors among nurses in care homes during the COVID-19 pandemic: findings from a retrospective survey in Germany. BMC Nurs 2022; 21:41. [PMID: 35139842 PMCID: PMC8830035 DOI: 10.1186/s12912-022-00807-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
Background Care homes were hit hard by the COVID-19 pandemic. Although high levels of psychosocial burden (i.e., anxiety, depression and stress) during the pandemic have been described for healthcare workers in hospitals, evidence on the psychosocial burden for nurses in care homes during the pandemic is scarce. Methods A total of 811 nurses participated in a retrospective online survey between November 2020 and February 2021. Information about the COVID-19 situation (i.e., working demands, COVID-19 cases in their facility, and COVID-19-related burden) of nurses in German care homes during the first wave of the pandemic (March 2020 to June 2020) was gathered. The Stress Scale of the Depression Anxiety and Stress Scales (SDASS-21), the Generalized Anxiety Disorder Scale-2 (GAD-2), the Patients-Health-Questionnaire-2 (PHQ-2), and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used to screen for psychosocial burden. Results Among nurses, 94.2% stated that working demands since the COVID-19 pandemic increased. Further, 59.1% showed clinically relevant levels of either stress, anxiety, and/or depression. Multiple regression analysis showed significant associations between COVID-19-related burden and qualification (p < .01), dissatisfaction with COVID-19 management of care home manager (p < .05), COVID-19-related anxiety (p < .001), and dementia as a focus of care (p < .05). Stress, depression, and anxiety showed associations with COVID-19 related burden at work (p < .01), COVID-19-related anxiety (p < .001), social support (p < .01), and sense of community (p < .05). Stress was also associated with COVID-19 cases among residents (p < .05), and size of care home (p < .05). Conclusion Short- and long-term strategies (i.e., psychosocial counseling, mandatory team meetings, more highly qualified nurses, additional training) in the work environment of nursing, in crises, but beyond, should be encouraged to reduce the burden on nursing staff in care homes. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00807-3.
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Affiliation(s)
- Christian Hering
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Germany, Virchowweg 22, 10117, Berlin, Germany.
| | - Annabell Gangnus
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Germany, Virchowweg 22, 10117, Berlin, Germany
| | - Andrea Budnick
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Germany, Virchowweg 22, 10117, Berlin, Germany
| | - Raphael Kohl
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Germany, Virchowweg 22, 10117, Berlin, Germany
| | | | - Adelheid Kuhlmey
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Germany, Virchowweg 22, 10117, Berlin, Germany
| | - Paul Gellert
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Germany, Virchowweg 22, 10117, Berlin, Germany
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Marceau M, Ledoux I, Lavoie S, Benyamina Douma N, Mailhot-Bisson D, Gosselin É. Exploration of the occupational and personal dimensions impacted by the COVID-19 pandemic for nurses: A qualitative analysis of survey responses. J Adv Nurs 2022; 78:2150-2164. [PMID: 35133027 PMCID: PMC9111505 DOI: 10.1111/jan.15167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/20/2021] [Accepted: 01/11/2022] [Indexed: 12/26/2022]
Abstract
Aim To explore the occupational and personal life dimensions that have been impacted by the COVID‐19 pandemic for registered nurses (RN) and licensed practical nurses (LPN). Design Qualitative interpretive description approach. Methods Between July and September 2020, a web‐based cross‐sectional study was conducted among RNs and LPNs in Quebec, Canada. Included in this survey was an open‐ended question allowing nurses to describe the occupational and personal life dimensions that were impacted by the COVID‐19 pandemic. Thematic analysis was used to interpret the qualitative data from this open‐ended question. Reporting followed the Standards For Reporting Qualitative Research (SRQR). Results Of the 1860 survey respondents, 774 RNs and 43 LPNs responded to the open‐ended question (total n = 819). For the occupational dimension, six themes were identified: impacts of infection control on work, change in daily work tasks, offloading and reorganization of care, deterioration of working conditions, increased stress at work and issues related to the profession. For the personal dimension, four themes were found: impacts on the family, dealing with changes about leisure and personal life, impacts on physical and psychological health. Conclusion Knowing the dimensions affected by the COVID‐19 pandemic could help to identifying appropriate interventions to support RNs and LPNs. Impact The COVID‐19 pandemic has significantly impacted the occupational and personal lives RNs and LPNs working in the Quebec healthcare system. More specifically, Quebec's nurses experienced a major reorganization of care generated by important government decisions. Knowing how the pandemic affected different life dimensions will help in the development of support adapted to nurses' realities. Even in a pandemic context, improvements in the work environment or appropriate support could lead to an improved psychological health for nurses.
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Affiliation(s)
- Mélanie Marceau
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Isabelle Ledoux
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Stéphan Lavoie
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Nabiha Benyamina Douma
- Health Sciences Department, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada
| | - Didier Mailhot-Bisson
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Émilie Gosselin
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
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van den Besselaar JH, Spaargaren M, Smalbrugge M, Koene FMHPA, Termeulen L, Hertogh CMPM, Buurman BM. Implementation of a national testing policy in Dutch nursing homes during SARS-CoV-2 outbreaks. J Am Geriatr Soc 2022; 70:940-949. [PMID: 35080774 PMCID: PMC9305839 DOI: 10.1111/jgs.17687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/10/2022] [Accepted: 01/16/2022] [Indexed: 11/30/2022]
Abstract
Background To evaluate how a national policy of testing for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) regardless of symptoms was implemented during outbreaks in Dutch nursing homes in the second wave of the pandemic and to explore barriers and facilitators to serial testing. Methods We conducted a mixed‐method study of nursing homes in the Netherlands with a SARS‐CoV‐2 outbreak after 15 September 2020. Direct care staff and management from 355 healthcare organizations were invited to participate in a digital survey. A total of 74 out of 355 (20.9%) healthcare organizations participated and provided information about 117 nursing homes. We conducted 26 in‐depth interviews on the outbreak and the testing strategy used. We also conducted four focus group meetings involving managers, physicians, nurses, and certified health assistants. Recordings were transcribed and data were thematically analyzed. Results One hundred and four nursing homes (89%) tested residents regardless of their symptoms during the outbreak, and 85 nursing homes (73%) tested the staff regardless of their symptoms. However, interviews showed testing was sometimes implemented during later stages of the outbreak and was not always followed up with serial testing. Barriers to serial testing regardless of symptoms were lack of knowledge of local leaders with decisional making authority, lack of a cohort ward or skilled staff, and insufficient collaboration with laboratories or local public health services. Important facilitators to serial testing were staff willingness to undergo testing and the availability of polymerase chain reaction (PCR) tests. Conclusions Serial testing regardless of symptoms was only partially implemented. The response rate of 21% of nursing home organizations gives a risk of selection bias. Barriers to testing need to be addressed. A national implementation policy that promotes collaboration between public health services and nursing homes and educates management and care staff is necessary.
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Affiliation(s)
- Judith H van den Besselaar
- Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam, the Netherlands
| | - Marije Spaargaren
- Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam, the Netherlands
| | - Fleur M H P A Koene
- Department of Medical Microbiology, Amsterdam UMC, Meibergdreef 9, Amsterdam, the Netherlands.,Department of Infectious Diseases, Public Health Laboratory, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Loes Termeulen
- Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam, the Netherlands
| | - Bianca M Buurman
- Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam, the Netherlands.,Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
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Schmidt AJ, García Y, Pinheiro D, Reichert TA, Nuño M. Using Non-Pharmaceutical Interventions and High Isolation of Asymptomatic Carriers to Contain the Spread of SARS-CoV-2 in Nursing Homes. Life (Basel) 2022; 12:180. [PMID: 35207468 PMCID: PMC8877375 DOI: 10.3390/life12020180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 11/25/2022] Open
Abstract
More than 40% of the deaths recorded in the first wave of the SARS-CoV-2 pandemic were linked to nursing homes. Not only are the residents of long-term care facilities (LTCFs) typically older and more susceptible to endemic infections, the facilities' high degree of connection to wider communities makes them especially vulnerable to local COVID-19 outbreaks. In 2008, in the wake of the SARS-CoV-1 and MERS epidemics and anticipating an influenza pandemic, we created a stochastic compartmental model to evaluate the deployment of non-pharmaceutical interventions (NPIs) in LTCFs during influenza epidemics. In that model, the most effective NPI by far was a staff schedule consisting of 5-day duty periods with onsite residence, followed by an 4-to-5 day off-duty period with a 3-day quarantine period just prior to the return to work. Unlike influenza, COVID-19 appears to have significant rates of pre-symptomatic transmission. In this study, we modified our prior modeling framework to include new parameters and a set of NPIs to identify and control the degree of pre-symptomatic transmission. We found that infections, deaths, hospitalizations, and ICU utilization were projected to be high and largely irreducible, even with rigorous application of all defined NPIs, unless pre-symptomatic carriers can be identified and isolated at high rates. We found that increasingly rigorous application of NPIs is likely to significantly decrease the peak of infections; but even with complete isolation of symptomatic persons, and a 50% reduction in silent transmission, the attack rate is projected to be nearly 95%.
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Affiliation(s)
- Alec J. Schmidt
- Deparment of Public Health Sciences, University of California Davis, Davis, CA 95616, USA
| | - Yury García
- Centro de Investigación en Matemática Pura y Aplicada (CIMPA), University of Costa Rica, San José 11501, Costa Rica;
| | - Diego Pinheiro
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, CA 95817, USA;
| | | | - Miriam Nuño
- Deparment of Public Health Sciences, University of California Davis, Davis, CA 95616, USA
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Obschonka M, Cai Q, Chan ACY, Marsalis S, Basha SAJ, Lee SK, Gewirtz AH. International psychological research addressing the early phase of the COVID-19 pandemic: A rapid scoping review and implications for global psychology. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2021; 57:1-19. [PMID: 34904220 DOI: 10.1002/ijop.12823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/13/2021] [Indexed: 12/21/2022]
Abstract
In March 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic. Given that keeping abreast of international perspectives and research results is of particular importance for such massive global emergencies, we employed a scoping review methodology to rapidly map the field of international psychological research addressing this important early phase of the pandemic. We included a total of 79 studies, with data mostly collected between March and June 2020. This review aimed to systematically identify and map the nature and scope of international studies examining psychological aspects of the unfolding COVID-19 pandemic. We mapped key research themes, subfields of psychology, the nature and extent of international research collaboration, data methods employed, and challenges and enablers faced by psychological researchers in the early stages of the pandemic. Among the wide range of themes covered, mental health and social behaviours were the key themes. Most studies were in clinical/health psychology and social psychology. Network analyses revealed how authors collaborated and to what extent the studies were international. Europe and the United States were often at the centre of international collaboration. The predominant study design was cross-sectional and online with quantitative analyses. We also summarised author reported critical challenges and enablers for international psychological research during the COVID pandemic, and conclude with implications for the field of psychology.
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Affiliation(s)
- Martin Obschonka
- School of Management, Queensland University of Technology, Brisbane, QLD, Australia
| | - Qiyue Cai
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Athena C Y Chan
- Department of Family Social Science, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Scott Marsalis
- University Libraries, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Sydni A J Basha
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Sun-Kyung Lee
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Abigail H Gewirtz
- Department of Psychology, Arizona State University, Tempe, AZ, USA.,Department of Family Social Science, University of Minnesota Twin Cities, Minneapolis, MN, USA
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50
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Trends in nursing burnout management in foreign studies (literature review). ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.5.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This review provides a general foreign overview of the current understanding and prevalence of professional burnout among medical workers and summarizes the emerging trends in the management of the organization of work of nurses, preventing burnout, and an analysis of practices aimed at preventing burnout. Burnout negatively affects both mental and physical health, as well as increases economic losses and employee turnover.Burnout depends on factors such as job satisfaction, professional rank, hospital level, gender, professional values, negative emotions, and core competencies.Burnout syndrome is closely related to compassion fatigue syndrome, compassionate gratification and is part of the broader concept of professional quality of life. Compassion refers to recognition, understanding, emotional resonance, empathic concern and tolerance for the suffering of others, and motivation and action in relationships to help others.The analysis of foreign literature has shown the relevance of this problem and, first of all, for nurses. The peculiarities of the work of nurses lead to the fact that their burnout is higher than among other medical workers. Various approaches to the management of professional burnout have been proposed. Burnout management can focus on the organization, the individual, or a combination of interventions.When people have a positive belief system, work involvement, and access to many personal resources, they are less likely to experience stress and burnout.Nursing burnout has worsened during the COVID-19 period and has exposed new pressing health issues. The COVID-19 pandemic has shown a shortage of nurses and has become a major problem in many countries.The attitude of the community, the importance and the need for specialized and professional care, especially in situations of great difficulty and suffering, is important for medical personnel. Public sincere gratitude for the work of healthcare professionals will help build compassion for professionals who risk their lives to help people.
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