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Usberg G, Clari M, Conti A, Põld M, Kalda R, Kangasniemi M. COVID-19 and nurses' ethical issues: Comparisons between two European countries. Nurs Ethics 2024:9697330241255936. [PMID: 38835232 DOI: 10.1177/09697330241255936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
BACKGROUND The global pandemic raised ethical issues for nurses about caring for all patients, not just those with COVID-19. Italy was the first European country to be seriously affected by the first wave, while Estonia's infection and death rates were among the lowest in Europe. Did this raise different ethical issues for nurses in these two countries as well? AIM The aim was to describe and compare ethical issues between nurses working during the first wave of the COVID-19 pandemic in Estonia and Italy. RESEARCH DESIGN A cross-sectional survey study with a self-administered questionnaire. The impact of COVID-19 emergency on nursing care questionnaire was used. PARTICIPANTS AND RESEARCH CONTEXT Convenience sampling was used to recruit 1098 nurses working during the first wave of the pandemic in 2020: 162 from Estonia and 936 from Italy. ETHICAL CONSIDERATIONS Research ethics approvals were obtained, and the nurses provided informed consent. RESULTS The most frequent ethical issues for Estonian nurses were professional communication and ensuring access to care for patients without COVID-19, and for Italian nurses, the end-of-life care and the risk of them getting the virus and transmitting it to their loved ones. There were no statistically significant differences in the frequency of ethical issues between Estonian nurses working with patients with and without COVID-19. Italian nurses caring for COVID-19 patients faced statistically significantly more (both p < .001) issues around prioritising patients and end-of-life. Nurses working with patients without COVID-19 in Italy faced more issues about access to care (p < .001). CONCLUSIONS Estonian and Italian nurses, working in different clinical contexts during the first wave of the pandemic, faced different ethical issues. Local contextual aspects need to be considered to support nurses' ethical decision-making in providing care during future crises and to ensure ethical care for patients.
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Zaghini F, Fiorini J, Moons P, Sili A. Cardiovascular nurses and organizational well-being: a systematic review. Eur J Cardiovasc Nurs 2024; 23:213-220. [PMID: 37561990 DOI: 10.1093/eurjcn/zvad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023]
Abstract
AIMS This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it. METHODS AND RESULTS The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive. CONCLUSION Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes. REGISTRATION PROSPERO: CRD42022355669.
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Affiliation(s)
- Francesco Zaghini
- Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Jacopo Fiorini
- Department of Nursing Professions, University Hospital of Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35 PB 7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
| | - Alessandro Sili
- Department of Nursing Professions, University Hospital of Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
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Zabaleta-Del-Olmo E, Santesmases-Masana R, Martín-Payo R, Romero-Collado À, Zamora-Sánchez JJ, Urpí-Fernández AM, Gonzalez-Del-Rio M, Lumillo-Gutiérrez I, Sastre-Rus M, Jodar-Fernández L, Hernández-Martínez-Esparza E. Research on missed nursing care during the COVID-19 pandemic: A scoping review. Worldviews Evid Based Nurs 2023; 20:559-573. [PMID: 37743584 DOI: 10.1111/wvn.12682] [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: 05/18/2023] [Revised: 07/18/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care. AIM This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic. METHODS This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer. RESULTS We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes. LINKING EVIDENCE TO ACTION Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.
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Affiliation(s)
- Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain
- Barcelona Primary Care Directorate, Barcelona Regional Management, Institut Català de la Salut, Barcelona, Spain
| | - Rosalía Santesmases-Masana
- School of Nursing, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rubén Martín-Payo
- Faculty of Medicine and Health Sciences, Universidad de Oviedo, Oviedo, Spain
- PRECAM Research Group, ISPA-Asturias, Oviedo, Spain
| | | | - Juan-José Zamora-Sánchez
- Barcelona Primary Care Directorate, Barcelona Regional Management, Institut Català de la Salut, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ana-María Urpí-Fernández
- Barcelona Primary Care Directorate, Barcelona Regional Management, Institut Català de la Salut, Barcelona, Spain
- School of Nursing, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marina Gonzalez-Del-Rio
- Nursing Research Unit, Hospital Univrsitari Dr. Josep Trueta, Girona, Spain
- Neurodegeneration and Neuroinflammation Research Group, Girona, Spain
- Biomedical Research Institute (IDIBGI), Girona, Spain
- Girona Neuroimmunology and Multiple Sclerosis Unit, Neurology Department, Dr Josep Trueta Hospital and Santa Caterina Hospital, Girona-Salt, Spain
| | - Iris Lumillo-Gutiérrez
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain
- Chronic Disease Management Team, Baix Llobregat Centre Primary Care Service, Costa de Ponent Primary Care Directorate, Metropolitana Sud Regional Management, Institut Català de la Salut, Cornellà de Llobregat, Barcelona, Spain
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Meritxell Sastre-Rus
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Gimbernat School of Nursing, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lina Jodar-Fernández
- Montbaig Primary Care Centre, Delta Primary Care Service, Costa de Ponent Primary Care Directorate, Metropolitana Sud Regional Management, Institut Català de la Salut, Barcelona, Spain
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Practices and Strategies of Health Professionals during the COVID-19 Pandemic—Between Limitations and Opportunities. Healthcare (Basel) 2022; 10:healthcare10101817. [PMID: 36292264 PMCID: PMC9601796 DOI: 10.3390/healthcare10101817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
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Scandinavian Nurses’ Use of Social Media during the COVID-19 Pandemic—A Berger and Luckman Inspired Analysis of a Qualitative Interview Study. Healthcare (Basel) 2022; 10:healthcare10071254. [PMID: 35885781 PMCID: PMC9321788 DOI: 10.3390/healthcare10071254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
There is a knowledge gap about nurses’ use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to explore how nurses in the Scandinavian countries used social media for professional purposes in relation to the first 15 months of the COVID-19 pandemic. Qualitative, semi-structured interviews with 30 nurses in three Scandinavian countries (Denmark, Norway, and Sweden) were conducted. Thematic analyses were made, methodically inspired by Braun and Clarke, and theoretically inspired by Berger and Luckmann’s theory about the construction of social reality. The Standards for Reporting Qualitative Research (SRQR) checklist was used. The results showed that social media was a socialisation tool for establishing new routines in clinical practice. Virtual meeting places supported collective understandings of a specific COVID-19 ‘reality’ and ‘knowledge’ amongst nurses, with the pandemic bringing to the fore the issue of e-professionalism among nurses relating to their clinical practice. However, social media and virtual education were not commonly used in patient contacts. Further, nurses attempted a re-socialisation of the public to proper COVID-19 behaviour through social media. Moreover, blurred boundaries between acting as a private individual and a professional nurse were identified, where ethics of the nursing profession extended to nurses’ private lives.
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Piredda M, Fiorini J, Marchetti A, Mastroianni C, Albanesi B, Livigni L, Carrabs G, Zaghini F, De Marinis MG, Sili A. The Wounded Healer: A Phenomenological Study on Hospital Nurses Who Contracted COVID-19. Front Public Health 2022; 10:867826. [PMID: 35875015 PMCID: PMC9302606 DOI: 10.3389/fpubh.2022.867826] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/30/2022] [Indexed: 01/10/2023] Open
Abstract
Since the pandemic began nurses were at the forefront of the crisis, assisting countless COVID-19 patients, facing unpreparedness, social and family isolation, and lack of protective equipment. Of all health professionals, nurses were those most frequently infected. Research on healthcare professionals' experience of the pandemic and how it may have influenced their life and work is sparse. No study has focused on the experiences of nurses who contracted COVID-19 and afterwards returned to caring for patients with COVID-19. The purpose of this study was therefore to explore the lived personal and professional experiences of such nurses, and to describe the impact it had on their ways of approaching patients, caring for them, and practicing their profession. A phenomenological study was conducted with 54 nurses, through 20 individual interviews and 4 focus groups. The main finding is that the nurses who contracted COVID-19 became “wounded healers”: they survived and recovered, but remained “wounded” by the experience, and returned to caring for patients as “healers,” with increased compassion and attention to basic needs. Through this life-changing experience they strengthened their ability to build therapeutic relationships with patients and re-discovered fundamental values of nursing. These are some of the ways in which nurses can express most profoundly the ethics of work done well.
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Affiliation(s)
- Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | - Jacopo Fiorini
- Nursing Research Team, Tor Vergata University Hospital, Rome, Italy
| | - Anna Marchetti
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | - Chiara Mastroianni
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy
| | - Beatrice Albanesi
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Lucilla Livigni
- Occupational Health Service, University of Rome Tor Vergata, Rome, Italy
| | - Gemma Carrabs
- Occupational Health Service, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Zaghini
- Nursing Research Team, Tor Vergata University Hospital, Rome, Italy
- *Correspondence: Francesco Zaghini
| | | | - Alessandro Sili
- Nursing Research Team, Tor Vergata University Hospital, Rome, Italy
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Brynskog E, Larsson M, Bjuresäter K, Rosell L, Smith F. Altered prerequisites: A cross-sectional survey regarding cancer care in Sweden during COVID-19 from the viewpoint of contact nurses in cancer care. NORDIC JOURNAL OF NURSING RESEARCH 2022. [PMCID: PMC9204122 DOI: 10.1177/20571585221101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Contact nurses in cancer care were vital in sustaining cancer care in Sweden during the COVID-19 pandemic. The aim of this study was to investigate their experiences of providing care to people with cancer in these exceptional circumstances to identify emerging challenges and opportunities that must be addressed moving forward. A survey distributed to contact nurses was supplemented with questions regarding the pandemic. The study design was a cross-sectional survey, analyzed with descriptive statistics and content analysis, reported in accordance with STROBE. Almost half of respondents ( n = 337) reported not being able to provide the same support as before the pandemic. Analysis of open-ended question responses ( n = 232) revealed a main theme: Altered prerequisites for providing care. Three categories related to altered interaction, accessibility, and nursing reality were revealed. Thorough reflection is needed to make use of lessons learned and avoid sustaining the short-term solutions needed to cope with the acute phase of the pandemic.
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Affiliation(s)
| | - Maria Larsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Kaisa Bjuresäter
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Linn Rosell
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Regional Cancer Centre South, Lund, Sweden
| | - Frida Smith
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden and Regional Cancer Centre West, Gothenburg, Sweden
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