Exploring the experiences of nurses caring for patients with COVID-19: a qualitative study in Iran

Self-care practices among professional nurses employed in primary health care clinics

BACKGROUND

 Professional nurses typically promote and advocate self-care practices to their patients to achieve better health outcomes, but rarely engage in these practices themselves.

METHODS

 A qualitative, descriptive phenomenological approach was used in this study. Ten professional nurses employed in different primary health care facilities were purposively sampled. Semi-structured interviews were conducted to collect data, which were analysed using Colaizzi's data analysis strategy, and data saturation was reached.

RESULTS

 Two themes were identified. Theme 1: the participants expressed that internal and external factors compromised self-care practices, such as subconscious self-neglect, insufficient resources, and a depressed economy, which encouraged them to work extended hours. Theme 2: participants' holistic well-being was compromised, as they neglected their mental well-being.

CONCLUSION

 Self-care practices among professional nurses seem unachievable. The extent of this population's self-care neglect was evident during the coronavirus disease 2019 (COVID-19) pandemic when professional nurses globally gave of themselves relentlessly.Contribution: This is the first study conducted on the topic in the City of Ekurhuleni, and the findings will provide relevant stakeholders with a directive on what strategies, policies, and guidelines to develop and implement to make self-care practices attainable for professional nurses.

Experiences of family caregivers of nurses infected with COVID-19: a qualitative study

BACKGROUND

Nurses, as the main healthcare workers during the COVID-19 pandemic, were at high risk of contracting the disease. Family caregivers played a vital role in the support and recovery of patients with COVID-19. The experiences of family caregivers of nurses are very important due to the nature of their job. However, little information is available in this field. To this end, the present study aimed to explore the experiences of family caregivers of nurses who recovered from COVID-19.

METHODS

This descriptive qualitative study was conducted in one of the hospitals in southeastern Iran in 2022. The participants were 12 family caregivers of nurses who recovered from COVID-19 and were selected through purposive sampling. The data were collected through semi-structured interviews and analyzed using conventional content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings.

RESULTS

The analysis of the data revealed psychosocial consequences as main theme, three categories and nine subcategories including negative emotions and attitudes (fear of deterioration/death, fear of frequent infection, fear of transmitting infection to others, despair of recovery, Changing attitudes toward the nursing profession), caregiver burden (role conflict, economic pressure) and lack of support, ineffective interactions and isolation (Lack of support from nursing managers and colleagues, ineffective interactions and isolation).

CONCLUSION

Like other caregivers, family caregivers of nurses recovered from COVID-19 experienced psychosocial consequences and a heavy burden of responsibility. However, what differentiates our findings from the results reported in previous studies is the change in caregivers' attitudes toward nursing and regret for their family members being nurses. The lack of support from medical staff and managers for nurses, the condition of nurses frequently contracting COVID-19 due to the nature of their profession, and the fear of transmitting the infection to others due to contact with COVID-19 patients in the workplace expose these caregivers to additional stress and many risks. Thus, these caregivers need more attention and support in similar situations; an issue that seems to have been neglected during the COVID-19 pandemic.

Healthcare staff experiences on the impact of COVID-19 on emergency departments: a qualitative study

BACKGROUND

The COVID-19 pandemic has had a major impact on the access and delivery of healthcare services, posing unprecedented challenges to healthcare staff worldwide. Frontline healthcare staff faced unique stressors and challenges that impact their well-being and patient care. This qualitative study aimed to explore the experiences and perspectives of frontline ED healthcare staff on emergency care services during the COVID-19 pandemic, providing valuable insights into the challenges, adaptations, and lessons learned in delivering emergency care.

METHODS

This study utilized a qualitative approach. In-depth semi-structured interviews were conducted with 30 ED healthcare staff from three different hospitals located in Turkey between 15/03/2022 and 30/04/2022. Convenience sampling was used to recruit participants. The duration of the interviews ranged from 28 to 37 min. Data saturation was reached as no new information was gathered. The data were analyzed using the thematic analysis method. NVivo software was used to manage the data analysis process. Member check was carried out to ensure that the generated themes conformed to the participants' views.

RESULTS

15 sub-themes under three themes emerged: (1) the impact of COVID-19 on emergency care services, including sub-themes of "introducing a COVID-19 unit in the ED", "changes in the routine functioning of EDs", "changes in the number of ED visits", "quality of care", "resources", and "increased workload"; (2) the psychological effects of COVID-19 on ED healthcare staff, including sub-themes of "staying away from family", "fear", "society's perspective on healthcare professionals", "morale-staff burnout", "psychological and emotional effects", and "unable to receive sufficient support"; and (3) the difficulties faced by ED healthcare staff, including sub-themes of "difficult working conditions", "community-based effects difficulties", and "COVID-19 is an unknown situation".

CONCLUSION

Staff burnout threatens the quality of patient care and staff retention, and therefore this should be addressed by ED directors and leaders. This study could inform appropriate stakeholders regarding lessons learned from COVID-19 to better manage future pandemics. Learning from such lived experiences and developing appropriate interventions to minimize the difficulties faced during COVID-19 would allow better management of future pandemics. This study calls for a reform to address the challenges faced by healthcare staff, improve the overall response to public health crises, and enhance the resilience of healthcare systems for future crises.

Exploring the Care Experiences Among Clinical Staffing During Emerging Infectious Disease: From the COVID-19 Pandemic Approach

PURPOSE

The coronavirus disease 2019 (COVID-19), one of the most significant recent emerging infectious diseases, has evolved into a global pandemic, resulting in an unprecedented public health crisis with substantial morbidity. The aim of this study was to investigate the care experiences of nursing staff during the COVID-19 pandemic.

METHODS

A qualitative, exploratory interview study. This study was conducted from August 2022 to January 2023. Participants were recruited from a medical center in northern Taiwan. A purposive sampling approach was employed to select the participants, and in-depth interviews were conducted with a total of 30 individuals. The collected data were analyzed using content analysis.

RESULTS

The findings of this study revealed five themes that summarized the care experiences of participants during the COVID-19 pandemic, enhanced nursing competence in pandemic mitigation, adherence to clear safety measures, effective adaptation to the stress of the "unknown," and recognition of the meaning of the pandemic mitigation experience.

CONCLUSION

This study informs pandemic readiness for nurses and policy enhancement. Medical institutions and governments must prioritize policies ensuring staffing, PPE access, and mental health support. Educators and administrators should elevate on-the-job crisis management training. Future planning should cater to Taiwanese nurses' needs during unforeseen crises such as COVID-19.

Wounded healer nurses: a qualitative content analysis of the positive traits of nurses affected by chronic cardiovascular disease

BACKGROUND

The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers.

METHODS

A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process.

RESULTS

The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care.

CONCLUSIONS

The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap.

"Growth under pressure": The Experience of COVID-19 ICU Nurses - A Qualitative Study

Background

As an epidemic, COVID-19 has brought a new shock to the world's healthcare system. The crisis caused by this disease and the prolonged involvement of communities and healthcare systems have intensified the duties and psychological burden of nurses. The current study aimed to explain the experience of ICU nurses during the COVID-19 crisis.

Materials and Methods

The present study was conducted using conventional content analysis in 2021. Twenty nurses of the COVID-19 ICU of Ahvaz hospitals were selected by purposive sampling. The main method of data collection was semistructured interview. The process of data analysis was done based on Granheim and Lundman's approach using MAXQDA-2020. For the scientific rigor of the findings, Guba and Lincoln's four criteria were abided by. The COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist was used to ensure the study met the recommended standards of qualitative data reporting.

Results

After data analysis, 22 subcategories, eight categories, and one theme (growth under pressure) were extracted. The eight main categories included (psychological crisis, physical exhaustion, family conflicts, complex care, professional development, expertise, life enrichment, and full support).

Conclusions

Despite the pressures that ICU nurses faced during the COVID-19 pandemic, they were able to grow by benefiting from positive experiences. These findings can lead to the development and implementation of effective interventions to improve adaptation strategies of nurses, especially those working in the intensive care unit, during the COVID-19 and other future crises.

Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey

BACKGROUND

It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities.

METHODS

We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach's alpha, assessed the questionnaire's validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms.

RESULTS

The questionnaire was found to be reliable in assessing HCWs' knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach's alpha = 0.9), but not heat strain symptoms (Cronbach's alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced.

CONCLUSIONS

The questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs' attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.

Lived Experiences of ICU Nurses During COVID-19

This qualitative, phenomenological study described ICU nurses' lived experiences caring for patients with COVID-19 while trying to engage in self-care and care for their families. Eleven ICU nurses shared their individual experiences working in a hospital ICU. Watson's theory of Caring Science guided the study to ensure a holistic interpretation of the data. Six themes and fifteen subthemes emerged, which revealed that ICU nurses faced barriers to self-care. The conclusion of the data analysis was that hospital leaders need to make Caring Science evident to ICU nurses during crises by trained Caritas coaches to build resilient frontline nurses through compassion.

Risk and prediction of job burnout in responding nurses to public health emergencies

BACKGROUND

In public health emergencies, nurses are vulnerable to adverse reactions, especially job burnout. It is critical to identify nurses at risk of burnout early and implement interventions as early as possible.

METHODS

A cross-sectional survey of the hospitals in Xiangyang City was conducted in January, 2023 using stratified cluster sampling. Anonymized data were collected from 1584 working nurses. The Impact of Events Scale-Revised (IES-R) and the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) were used to evaluate the post-traumatic stress disorder (PTSD) and burnout of nurses in public health emergencies. Logistic regression analysis was established to screen for risk factors of burnout, and a nomogram was developed to predict the risk of burnout. A calibration curve and the area under the receiver operating characteristic (ROC) curve were used to validate the nomogram internally.

RESULTS

This study showed that only 3.7% of nurses were completely free of PTSD during a public health emergency. We found that PTSD varied by age, marital status, procreation status, length of service, employee status, and whether working in the ICU. The nurses aged 30 ~ 40 years old, single, married without children, non-regular employees, worked for less than three years or worked in the ICU had higher levels of PTSD. Regarding the prevalence of burnout, 27.4%, 48.5%, and 18.6% of nurses had a high level of emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA), respectively. There, 31.1% of nurses had more than two types of job burnout. The number of night shifts, the type of hospital, marital status, and the severity of PTSD were all associated with higher rates of exhaustion among nurses. As a graphical representation of the model, a nomogram was created and demonstrated excellent calibration and discrimination in both sets (AUC = 0.787).

CONCLUSIONS

This study confirmed the PTSD and burnout are common problems for in-service nurses during public health emergencies and screened out the high-risk groups of job burnout. It is necessary to pay more attention nurses who are single and working in general hospitals with many night shifts, especially nurses with severe PTSD. Hospitals can set up nurses' personal health records to give timely warnings to nurses with health problems, and carry out support interventions to relieve occupational stress.

The place of philosophy in nursing

Philosophy adds humanness to nursing and facilitates holistic care. Philosophies like Ubuntu which purports that a person is only a person through other people and emphasises community cohesion and caring for each other can add humanness to nursing. Because Ubuntu validates subjective experience and its meaning in the lifeworld, it exemplifies the basis of holistic and individualised caring in nursing. Although nurses can make their own philosophy through critical reflexivity, the convergent point is the goal of meaningful caring that is, sustaining health and the well-being of patients and significant others. Philosophy transcends job description, it encompasses visceral experience, personal beliefs and goals, resulting in purpose and deeper meaning to the nursing profession of caring as emulated by Florence Nightingale. While contemporary philosophy has been met with criticism as being detached from human concern, narrowly focussed and technical, it evokes critical thinking and promotes sociality in nursing practice. The Covid-19 pandemic vividly brought philosophy to the fore as nurses sacrificially and vulnerably rose to the challenge of caring not only for the sick, but also for families who through infection control measures were deprived of sociality. This paper argues that philosophy adds humanness and substance to nursing in the context of COVID-19.

Resilience of first-line nurses during adaptation to the COVID-19 pandemic: A grounded theory study

AIM

Nurses are a vital resource in providing care to COVID-19 patients. During adaptation to the pandemic, the mental health of nurses was disturbed. The present study aimed to explain the resilience development process and adaptive strategies of first-line nurses during the COVID-19 pandemic.

METHODS

This study was conducted based on the grounded theory qualitative approach. Twenty-two Iranian first-line nurses, who were employed in one teaching hospital in Qazvin city, were included via purposive and theoretical sampling. The data were collected through semi-structured interviews and were analyzed based on the Corbin and Strauss approach 2015.

RESULTS

The resilience development process of nurses had three stages including initial confrontation with changes, managing conditions and reorganizing, developing resilience. Professional commitment was identified as a core category that affected all stages of resilience development. Negative emotions, nurses' characteristics, and caring challenges were identified as contextual factors which affected the adaptation of nurses to the COVID-19 pandemic and the development of resilience.

CONCLUSION

Regarding the importance of professional commitment in the nurses' resilience development and not leaving the profession in the COVID-19 pandemic, it is important to emphasize the ethical values and principles of the nursing profession in practice and especially in the education of nursing students. It is necessary to monitor mental health and provide professional psychological counseling by the healthcare systems; also, nursing managers should follow a supportive leadership style and consider first-line nurses' worries.

The experiences of nurses during the COVID-19 crisis in India and the role of the state: A qualitative analysis

OBJECTIVES

The study documents the lived experience of nurses coping with the double burden of external demands and internal stressors while providing care during the COVID-19 pandemic in India.

METHODS

This qualitative study interviewed 18 female nurses who worked in the COVID wards of a major hospital in India. The one-on-one telephonic interviews were conducted with respondents based on three broad open-ended questions. Thematic analysis was conducted.

RESULTS

Three themes were identified: (i) external demands such as availability, utilization, and management of resources; (ii) internal psychological stressors, such as emotional exhaustion, moral anguish, and social isolation; and (iii) promotive factors such as the roles of the state and society, and of patients and attendants CONCLUSIONS: Findings suggest that despite limited resources and facilities, nurses ploughed through the pandemic with their resilience and the state's and society's promotive factors. To improve health care delivery in this crisis, the role of the state and healthcare system has become important to prevent the workforce from crumbling. The sustained attention of the state and society is required to reinstate motivation among nurses by raising the collective value of their contribution and capability.

Vaccination, time lost from work, and COVID-19 infections: a Canadian healthcare worker retrospective cohort study

The COVID-19 pandemic highlighted hurdles for healthcare delivery and personnel globally. Vaccination has been an important tool for preventing severe illness and death in healthcare workers (HCWs) as well as the public at large. However, vaccination has resulted in some HCWs requiring time off work post-vaccination to recover from adverse events. We aimed to understand which HCWs needed to take time off work post-vaccination, for which vaccine types and sequence, and how post-vaccination absence impacted uptake of booster doses in a cohort of 26,267 Canadian HCWs. By March 31, 2022, more than 98% had received at least two doses of the approved COVID-19 vaccines, following a two-dose mandate. We found that recent vaccination and longer intervals between doses were associated with significantly higher odds of time-loss, whereas being a medical resident and receiving the BNT162b2 vaccine were associated with lower odds. A history of lab-confirmed SARS-CoV-2 infection was associated with lower odds of receiving a booster dose compared with no documented infection, aOR 0.61 (95% CI: 0.55, 0.68). Similarly, taking sick time following the first or second dose was associated with lower odds of receiving a booster dose, aOR 0.83 (95% CI: 0.75, 0.90). As SARS-CoV-2 becomes endemic, the number and timing of additional doses for HCWs requires consideration of prevention of illness as well as service disruption from post-vaccination time-loss. Care should be taken to ensure adequate staffing if many HCWs are being vaccinated, especially for coverage for those who are more likely to need time off to recover.

Beyond heroism: a qualitative study on the lived experiences of nurses caring for patients with COVID-19 in Pakistan

BACKGROUND

Healthcare professionals around the globe suffered severely during the COVID-19 pandemic. The present study aims to explore the lived experiences of nurses caring for COVID-19 patients in Pakistan.

METHODS

The study is a qualitative exploration of the lived experiences caring for patients with COVID-19 in Pakistan. This research was conducted in two government hospitals there. Face-to-face in-depth interviews were conducted amongst 30 nurses who had been selected using purposive sampling technique. Thematic analysis was applied to extract the themes from respondents' answers.

RESULTS

By using thematic analysis, social response, impacts on physical and mental health, and experience of handling COVID-19 patients were extracted as major themes.

CONCLUSIONS

The findings of this research are of immense importance in showing the impact of COVID-19 on mental and physical health, along with the social and personal consequences for nurses providing care to COVID-19 patients.

Exploring the Impacts of Caring for Hospitalized COVID-19 Patients on Nurses: A Qualitative Descriptive Study

Background

The impacts of caring for hospitalized COVID-19 patients on nurses are wide and varied and have not been comprehensively explained in the existing literature. The aim of this study was to explore the nurses' perception of the impacts of caring for hospitalized COVID-19 patients.

Materials and Methods

In this qualitative descriptive study, data were collected via semi-structured interviews with 20 nurses and head nurses of emergency/internal wards and Intensive Care Units (ICUs) of 2 hospitals in Tehran, Iran. The purposive sampling method was used, and data analysis was performed using a conventional content analysis approach.

Results

After data analysis, 12 subcategories, 3 main categories, and 1 theme (professional resilience) were extracted. The three main categories included "complex care," "professional development," and "caring self-efficacy." Caring for hospitalized COVID-19 patients was complex for nurses; however, the care provided to these patients could also lead to the nurses' professional development and caring self-efficacy.

Conclusions

Health organizations and nursing managers can better manage the COVID-19 pandemic and other similar future crises through strategies such as providing nurses with adequate and diverse resources and facilities, encouraging and supporting nurses in various dimensions, providing positive media advertisements for the nursing profession and nurses, and providing nurses with necessary and applicable knowledge and skills.

The Lived Experiences of Nurses Caring for Patients With COVID-19 in Arabian Gulf Countries: A Multisite Descriptive Phenomenological Study

Since the beginning of the COVID-19 pandemic, several studies worldwide have explored nurses' experiences of caring for COVID-19 patients in various healthcare settings. However, these studies were conducted in context, culture, and healthcare systems that differ greatly from the Arabian Gulf context. This descriptive phenomenological study aimed to understand nurses' lived experiences caring for patients diagnosed with COVID-19 in Arabian Gulf countries. Individual virtual interviews were conducted with 36 nurses from five countries and were analyzed using Giorgi's methodology. Four main themes were identified: (1) living with doubts, (2) living through the chaos of challenges, (3) moving toward professional resilience, and (4) reaching the maximum level of potential. The findings from this study hopefully will guide health organizations in this region in developing strategies and policies to support and prepare nurses for future outbreaks.

Frontline Nurses' Experiences of Patient Care in the COVID-19 Pandemic: A Phenomenological Study

Introduction: The COVID-19 pandemic is now a major public health crisis in the world. Nurses as key members of professional are exposed the most challenges caused by COVID19. Knowledgeable nurses' experiences can provide appropriate solutions to increase the quality of care and improve the health of the society. This study aimed to explore the lived experiences of nurses' caring for patients with COVID-19. Methods: 12 nurses participated in this phenomenological study. We performed purposeful sampling and in-depth face-to-face and semi-structured individual interviews for collecting data. Qualitative data, was analyzed by the 6-step Van Manen hermeneutic phenomenology. Results: After data analysis, the mean (SD) age of study participants was 32.25 (5.62) years and their mean work experience was 9.75 (5.39) years. From the analysis of data obtained from interviews with nurses working in COVID-19 wards, 1050 primary codes, 17 subthemes and 5 themes were extracted. Main themes include: sincere service, patient oppression, emotional instability, suspension and relaxation. Conclusion: Analysis of data in this study suggested that the nurses who care patients in COVID-19 pandemic, faced many professional and psychological challenges. Healthcare managers should plan for psychological support services for the nurses.

Ethical challenges faced by nurses during the COVID-19 pandemic: a scoping review protocol

OBJECTIVE

The aim of this scoping review is to describe the literature reporting on ethical challenges faced by nurses during the COVID-19 pandemic, including the contextual characteristics of ethical challenges, and strategies to address reported challenges.

INTRODUCTION

The COVID-19 pandemic presented many ethical challenges to nurses, ranging from allocating scarce resources, to balancing a duty of care with self-preservation and implementing visitation restrictions. Internationally, there has been a range of reported issues, but few studies describe strategies to overcome these challenges.

INCLUSION CRITERIA

Studies that report on ethical challenges faced by nurses while caring for patients during the COVID-19 pandemic will be included. Studies that report on strategies to address these challenges will also be considered for inclusion.

METHODS

This scoping review will be conducted in accordance with methods outlined by JBI and reported on using PRISMA-ScR guidance. The following databases will be searched for eligible studies from November 2019 to present day: PubMed, CINAHL, Ovid, PsycINFO, the Cochrane Library, and Scopus. No language restrictions will be applied. Studies will be reviewed for inclusion by 2 independent reviewers and a data extraction form developed specifically for this review will be used to extract data relevant to the review questions. Results will be analyzed and presented according to the concepts of interest, using tables, figures, images, and supporting narrative synthesis.

Facing the unknown COVID-19 pandemic: A qualitative study with nurses and nursing assistants in three European countries

Background

The coronavirus disease (COVID-19) is now a worldwide public health emergency. As essential and central parts of the COVID-19 patient care team, nurses and nurse assistants are facing all kinds of challenges caused by the disease and the pandemic. Understanding these challenges and the way nurses and nurse assistants handle and cope with them provides important knowledge on how to improve management of future pandemics and endemic situations. Thus, the present study explored the challenges faced by nurses and nurse asssitants who cared for COVID-19 patients in hospitals and long term care facilities in Italy, Austria and Germany.

Methods

The study employed a qualitative design. Purposive sampling was used to select the participants consisting on nurses (n = 30), nurse coordinators (n = 6) and nurse assistants (n = 5) from hospitals (n = 32) and long-term care facilities (n = 9) in Austria, Germany, and Italy. Data were collected between August and December 2020 through semi-structured interviews. The collected data were analyzed using qualitative content analysis.

Results

The analysis of the data revealed three main themes with twelve sub-categories: (i) Knowledge, skills, and training (lack of knowledge; skills; organizational issues; training); (ii) resources and risk (lack of protective equipment; difficulties with protective equipment; risk and infection; feelings and isolation); (iii) coping strategies (humor; adaption; team effort; self-care; family and friends).

Conclusion

Nurses and nurse assistants who participated in this study faced many personal and professional challenges, and used different coping strategies to manage the situation. Some of these strategies can be applied to reduce these challenges and create better working conditions for nurses and nurse assistants in similar events. Further research, training of staff, and adaptation of institutional policies may help develop new strategies to face future pandemics successfully.

Experiences and needs of front-line nurses during the COVID-19 pandemic: A systematic review and qualitative meta-synthesis

Background

Front-line nurses have played a critical role during the coronavirus disease 2019 (COVID-19) pandemic. A number of qualitative studies reported front-line nurses' experiences and needs in caring for patients with COVID-19. However, the application of evidence from a single qualitative study to guide clinical practice has limitations. This study aimed to explore front-line nurses' experiences and needs during the COVID-19 pandemic through a qualitative meta-synthesis.

Methods

Seven databases were searched from 1 December 2019 to 20 January 2022, including PubMed, Web of Science, Cochrane COVID-19 study register, CINAHL, PsycINFO, MedRxiv, and bioRxiv. The quality of included studies was appraised using the Critical Appraisal Skills Program (CASP) qualitative research appraisal tool. Meta-synthesis was used to synthesize the data from included studies.

Results

A total of 70 studies were included, and five synthesized findings were developed: (1) Although nurses actively devoted themselves to fighting against COVID-19, considering their professional responsibility and historical previous experience with mankind, they were not invulnerable; (2) There were various difficulties and challenges in caring for patients with COVID-19, including fear related to providing patients with care, shortage of protective equipment and manpower, and negative attitude of family members; (3) Facing difficulties and challenges, nurses could only partly cope by using mixed means to overcome those, including media, learning, gaining skills, responding together, and organizational assistance; (4) To better respond to the COVID-19 pandemic, nurses' needs should be paid attention to. Counseling, training, information, resources, and investment are pivotal; (5) Despite the hardships, nurses became stronger and gained gratitude, positivity, mental peace, and confidence.

Conclusions

This study reveals that the psychological experiences of front-line nurses varied, and they faced a variety of challenges. Although nurses had some coping strategies, they still needed multifaceted support to meet the challenges.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, PROSPERO: CRD42021255468.

The Experiences of Operating Room Nurses During COVID-19 Pandemic: A Qualitative Study

PURPOSE

The aim of this study was to determine the changes in the physical, mental, and social conditions of operating room nurses and their personal experiences during the COVID-19 pandemic.

DESIGN

The study applied a qualitative research design that included the content analysis method.

METHODS

Face-to-face interviews were conducted online with 26 operating room nurses. Analysis of the data was completed in six steps using the content analysis method.

FINDINGS

Four main themes emerged from the interviews: physical effect of the COVID-19 pandemic on operating room nurses, psychological effect of the COVID-19 pandemic on operating room nurses, operating room nurses' perceptions on the training given to them during the COVID-19 pandemic, and effects of the COVID-19 pandemic on health care worker and patient safety and nursing care.

CONCLUSIONS

This study contributes new findings on the experiences of operating nurses during the COVID-19 pandemic to the relevant literature. The results of the study indicated that the nurses were negatively affected both physically and psychologically during this period, and that this directly affected patient care.

Stress management in nurses caring for COVID-19 patients: a qualitative content analysis

BACKGROUND

Being in the frontline of the battle against COVID-19, nurses need to be capable of stress management to maintain their physical and psychological well-being in the face of a variety of stressors. The present study aims to explore the challenges, strategies, and outcomes of stress management in nurses who face and provide care to COVID-19 patients.

METHODS

The present study is a qualitative descriptive work that was conducted in teaching hospitals affiliated with Shiraz University of Medical Sciences, Iran, from June 2020 to March 2021. Sixteen nurses who were in practice in units assigned to COVID-19 patients were selected via purposeful sampling. Data were collected through semi-structured, individual interviews conducted online. The collected data were analyzed using MAXQDA 10 according to the conventional content analysis method suggested by Graneheim and Lundman.

RESULTS

The data collected in the interviews resulted in 14 subcategories under 4 main categories: providing care with uncertainty and anxiety, facing psychological and mental tension, creating a context for support, and experiencing personal-professional growth.

CONCLUSIONS

The nurses caring for COVID-19 patients needed the support of their authorities and families to stress management. Providing a supportive environment through crisis management training, providing adequate equipment and manpower, motivating nurses to achieve psychological growth during the pandemic can help them manage stress.

Common experiences and psychological difficulties during the pandemic: Insights from psychological support sessions

Due to identified mental health difficulties among populations worldwide, evidence-based mental health and psychosocial support interventions are recognized as a priority for the health response to the COVID-19 pandemic. The main aim of this study was to provide in-depth understanding of the common experiences and psychological difficulties among the people affected by COVID-19. The study included 32 persons (28 females), with the average age of 38.5 (SD 13.2), those with a confirmed or suspected COVID-19 diagnosis or those whose family or friends were infected with COVID-19, receiving online psychological support from December 2020 to June 2021. Protocols of the support sessions were analysed by relying on the principles of thematic analysis. The study results showed that anxiety, somatization, sadness over the loss of close ones and guilt were the most prominent psychological difficulties among the people seeking psychological help during the pandemic. The main factors which made coping with psychological difficulties more challenging include previous life circumstances, uncertainty and the lack of social support. The study enabled greater understanding of the common experiences and most prominent psychological difficulties, and provided evidence which can be used as a foundation for the creation of more focused psychological programs that could support people during the pandemic.