What support do frontline workers want? A qualitative study of health and social care workers' experiences and views of psychosocial support during the COVID-19 pandemic

Mechanisms Explaining the Longitudinal Effect of Psychosocial Safety Climate on Work Engagement and Emotional Exhaustion among Education and Healthcare Professionals during the COVID-19 Pandemic

During the COVID-19 pandemic, the education and healthcare sectors were severely affected. There is a need to investigate the ways in which these workers in at-risk sectors can be protected and through what mechanisms. The aims of this research are, therefore, (1) to assess the mediating role of job demands and resources in the relationship between psychosocial safety climate (PSC) and work engagement and emotional exhaustion, and (2) to test for sector-specific differences among education and healthcare professionals during the COVID-19 pandemic. In the study, which employed a longitudinal design including three measurement times, 70 education professionals and 69 healthcare professionals completed a questionnaire measuring PSC, psychological demands, social support, recognition, work engagement, and emotional exhaustion. The results show that PSC was significantly higher among education professionals than among healthcare professionals. When considering both job sectors together, mediation analyses show that social support mediates the PSC-work engagement relationship, while psychological demands mediate the PSC-emotional exhaustion relationship. Moderated mediation analyses show that job sector is a moderator: among education professionals, colleague support and recognition mediate the PSC-work engagement relationship, and psychological demands mediate the PSC-emotional exhaustion relationship. PSC is associated with more balanced job demands and resources, higher work engagement, and lower emotional exhaustion among education and healthcare professionals. The study of these two sectors, which are both vital to society but also more exposed to adverse work conditions, shows the importance that managers and executives must attach to their mental health by improving their respective working conditions.

Responding to the call of the NHS Nightingale, but at what cost? An auto-ethnography of a volunteer frontline mental health trainer's experiences during the COVID-19 pandemic

Healthcare workers, globally, volunteered time and skills to the COVID-19 pandemic frontline response. In March 2020, the predicted high demand for extra critical care beds led to the rapid construction of the UK National Health Service (NHS) Nightingale field hospital, London. I volunteered to develop and deliver psychological preparedness training - coined 'Psychological PPE' - to over 2300 frontline staff over an 8-week period. Existing research has identified broad themes of the impact working on the COVID-19 frontline has on healthcare workers but does not capture in-depth accounts of individuals' experiences. Using autoethnographic enquiry, this research explores my frontline experience at the NHS Nightingale during this time, and the personal impact this had on me. Reflexive thematic analysis explored themes of recognition and sacrifice, emotional lability and fragility, and the impact of transitions. Findings inform personal recovery, as well as future research and policy development pertaining to the sustainable recovery of our NHS people.

Exploring the needs and experiences of contact tracing staff during the COVID-19 pandemic in Ireland

BACKGROUND

Contact tracing is a key component in controlling the spread of COVID-19, however little research has focused on learning from the experiences of contact tracing staff. Harnessing learning from those in this role can provide valuable insights into the process of contact tracing and how best to support staff in this crucial role.

METHODS

Thematic analysis was used to analyse 47 semi-structured interviews conducted with contact tracing staff via telephone or Zoom at three time points in 2021: March, May and September-October.

RESULTS

Six themes related to the contact tracing role were identified, including training, workforce culture, systems issues, motivation and support. While initially nervous in the role, participants were motivated to contribute to the pandemic response and believed the role provided them with valuable transferable skills. Participants described the training as having improved over time while desiring more proactive training. Sources of frustration included a perceived lack of opportunity for feedback and involvement in process changes, feelings of low autonomy, and a perception of high staff turnover. Participants expressed a need for improved communication of formal emotional supports. Increased managerial support and provision of opportunities for career advancement may contribute to increased motivation among staff.

CONCLUSIONS

These findings identify the experiences of contact tracing staff working during the COVID-19 pandemic, and have important implications for the improvement of the contact tracing system. Recommendations based on learning from participants offer suggestions as to how best to support the needs of contact tracing staff during a pandemic response.

Nurses' perceptions of desired support from their employer during the COVID-19 pandemic: a qualitative survey study

BACKGROUND

Nurses play a crucial role in getting through the COVID-19 pandemic. However, the burden of the COVID-19 pandemic for nurses has been recognized, and thus, support for nurses is urgently needed. Support with various methods should help nurses' welfare and their ability to cope at work. Moreover, with appropriate support, it is possible to avoid anxiety, insomnia, or uncertainty caused by work. The aim of this study was to describe nurses' perceptions of desirable support from their employer during the COVID-19 pandemic.

METHODS

This qualitative survey study is a part of a follow-up study for the entire personnel of Helsinki University Hospital. This study focuses on one open-ended question answered by nurses (n = 579) at baseline of a follow-up study. Answers were analysed using qualitative content analysis with an inductive approach.

RESULTS

The findings reveal that various types of support desired from an employer. Qualitative content analysis raised six main categories, 39 categories, 167 sub-categories and 1235 codes from the original text. Main categories were as follows: Awarding personnel, Offering safety in working conditions, Showing appreciation to personnel, Offering a variety of support methods, Providing proper flow of information and Ensuring proper management in exceptional situations.

CONCLUSIONS

This study provides a better understanding of nurses´ perspectives on support from their employer during the COVID-19 pandemic. Results of this study suggest that employers, for example, should award personnel, ensure that working conditions are safe, show more appreciation to personnel. Employers should also pay attention to offer a variety method of support and make sure that the information is provided with a proper flow. In exceptional situations is important to ensure proper management too. With appropriate support methods, employers can avoid a shortage of nurses and maintain nursing as an attractive profession in the future.

Exploring how the design and provision of digital self-management technology can improve the uptake by older adults with chronic kidney disease, diabetes and dementia: A modified e-Delphi study

Objectives: As development and introduction of digital self-management technologies continues to increase, the gap between those who can benefit, and those who cannot correspondingly widens. This research aimed to explore the use of digital self-management technology by older adults with three highly-prevalent long-term conditions (chronic kidney disease, diabetes and dementia), and build expert consensus across the conditions on changes needed to improve effective usage. Method: This qualitative research involved a modified e-Delphi Study. The Delphi panel was comprised of experts with personal, academic or clinical expertise related to one of the long-term conditions and/or the development and use of digital self-management technology. The e-Delphi involved a round of online semi-structured interviews followed by two rounds of a structured online survey. Results: Fourteen experts participated in the study, with eleven of the fourteen completing all three rounds. Analysis of the interviews (round 1 of the Delphi) led to 7 main themes and 29 sub-themes. These were translated into 26 statements that formed the basis of the online survey questions. In the first administration of the survey (round 2) 19 statements reached consensus. After the second administration a further 6 statements reach consensus. Conclusion: The findings reflect expert consensus on barriers to the use of digital self-management by older adults with 3 different, but inter-related conditions, and identify ways in which the design and provision of such technologies could be improved to facilitate more effective use. It is concluded that both the design and the provision of technologies should consider a combination of individual, condition-specific and age-related requirements. By building a consensus on issues and potential strategies common across the three conditions, we aim to inform future research and practice and facilitate effective self-management by older adults.

COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria

Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.

Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance

Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.

Peer Support Programs to Reduce Organizational Stress and Trauma for Public Safety Workers: A Scoping Review

BACKGROUND

Public safety workers (PSWs), including correctional officers (COs), law enforcement, firefighters, emergency medical service, and military personnel, are at risk of organizational stress and burnout. Exposure to traumatic events, job hazards, injuries, fatalities, and work-related stressors such as work overload, irregular shift assignments, and lack of administrative support can negatively impact PSWs' mental health. Peer support programs (PSPs) have been cited as an intervention to address the mental health of PSWs.

PURPOSE

The purpose of this review is to explore the use, including facilitators and barriers, of PSPs to reduce organizational stress and trauma for PSWs. Implications for COs will be discussed.

METHOD

A scoping review was conducted using the Arksey and O'Malley methodology. A search was conducted for articles published between 1996 and 2021 using six databases. Selected articles described, implemented, or evaluated peer support as an intervention to reduce PSW organizational stress and trauma.

FINDINGS

Thirteen articles met eligibility criteria. Organizational support, including policies, practices, and peer leadership training, contributed to the sustainability of PSPs. Confidentiality, trust, and shared lived experience were also essential to PSP. Stigma was identified as the primary barrier to participation. Public safety workers found PSP helpful in normalizing experiences, increasing hope, and decreasing stigma. Peer support programs also serve to bridge the gap in mental health services use.

CONCLUSIONS

Peer support programs are a potential mental health intervention to reduce organizational stress and trauma for COs. Awareness of the facilitators and barriers to PSPs is the first step in developing such programs.

Workplace wellbeing among health care workers providing HIV services in primary care in Johannesburg: a mixed methods study

Background

Burnout among Health Care workers (HCWs) impacts on provider-patient relations and quality of care. Anova Health Institute (Anova) is a large South African non-profit organization and PEPFAR/USAID implementing partner. We conducted a study among HCWs providing HIV-related services in primary care settings in Johannesburg, South Africa, to examine levels of burnout, understand factors affecting workplace wellbeing, and explore strategies to prevent burnout.

Methods

We used a sequential mixed-method approach. Data were collected between February and April 2022. The first phase consisted of a survey using the Maslach Burnout Inventory Human Services Survey (MBI-HSS) to measure levels of burnout. We then interviewed a subset of survey participants to understand the experiences that may affect wellbeing. We used descriptive statistics to quantify burnout rates for each MBI dimension (emotional exhaustion, personal accomplishment, and depersonalization). Qualitative data analysis was guided by the Job Demands-Resources Framework that explores the interactions between demands and resources in the workplace.

Results

Survey findings (n = 194) revealed that although depersonalization rates were low at 6%, 21% of participants had high emotional exhaustion and 24% reported low professional accomplishment. Less than half (41%, n = 80) had scores in the high category for any one of the three MBI-HSS dimensions. The MBI-HSS dimensions differed significantly by type of work and job title. Roving positions (HCW working in more than one health facility) were more likely to experience higher emotional exhaustion and lower professional accomplishment. Qualitative findings (n = 25) indicate that a number of job demands, including high workload, inadequate mental health support, and challenging relationships with stakeholders, had a negative effect on HCWs' wellbeing. However, finding meaningfulness in their work, working as a team, and practicing autonomy were experienced as resources that reduced the negative effect of these demands.

Conclusion

While measured burnout syndrome rates were low, various experiences negatively impacted at least one in five HCW. We identified key resources that provided buffering against workplace stressors. We recommend that as well as addressing key drivers of burnout, access to these resources should be fostered, for example by strengthening interventions that offer recognition, and promoting team interactions through social activities and support groups.

'The phoenix that always rises from the ashes': an exploratory qualitative study of the experiences of an initiative informed by principles of psychological first aid following the Beirut blast

Background: On 4 August 2020, an explosion occurred in Beirut, Lebanon. Hundreds of people were killed, thousands injured and displaced. An initiative was rapidly initiated to provide remote support informed by psychological first aid for the mental health of Lebanese young adults affected by the blast. However, little is known about recipients' experiences of such initiatives.Objective: This study aimed to qualitatively explore the experiences of supporters and recipients in the community-led initiative following the blast.Method: We recruited a diverse sample of four supporters and four Lebanese recipients who took part in the Beirut initiative. Semi-structured interviews were conducted with participants. Reflexive thematic analysis was used to analyse the qualitative data.Results: We developed five themes from the qualitative interviews, which highlighted ideas around accessibility, alienation, the relationship, elements of the safe space created by the initiative, and unmet needs and areas for improvement. Recipients described the detrimental impact of the blast on their mental health within the Lebanese context and beyond. Recipients and supporters elucidated complex experiences of the support and its impact.Conclusions: Our findings suggest remote support has the potential to be acceptable for young adults in Lebanon. Further research into support informed by psychological first aid after similar crisis events is warranted.

Social Workers' Experiences of Support in the Workplace during the COVID-19 Pandemic

This qualitative study included in-depth semistructured interviews with 17 social workers from across the state of Texas that took place during the summer of 2021. The purpose of this study was to describe social workers' experiences of workplace support during the COVID-19 pandemic and provide implications for how to improve support in the workplace. The interviews were analyzed using a phenomenological approach to describe the main themes of the participants' experiences. The findings combined with current literature suggest that following the pandemic and in the case of similar prolonged disasters organizational leaders should consider supporting their social work staff by clearly communicating protocol changes, providing more autonomy and flexible work arrangements, increasing time off and financial support, and providing tangible assistance such as technological support. Leaders should also consider their social work staff's emotional well-being following the pandemic by providing therapeutic resources and bonding opportunities for staff to promote a more resilient team-like culture in the workplace.

An Assessment of Faculty Perceptions of Wellness Needs and Strategies to Optimize Engagement With Wellness Resources in Academic Medicine

OBJECTIVE

Faculty at academic medical institutions are at increased risk for burnout. This study aimed to assess faculty perceptions of wellness needs and identify strategies to optimize engagement with individualized wellness resources.

METHODS

Semistructured interviews were conducted with 37 faculty members in one US academic medical center.

RESULTS

Participants identified significant barriers to achieving emotional health and wellness goals. Areas where participants identified needing the most support included interpersonal relationships, accountability for wellness goals, career support, financial resources, and mentorship. Most participants were unaware of all wellness resources available at their institution. Participants recommended regular marketing and emphasizing confidentiality of employer-sponsored programs. They also provided feedback on specific dissemination and marketing methods.

CONCLUSIONS

This research underscores the need for wellness resources for faculty and the importance of intentional dissemination of these resources to optimize uptake.

Use it or lose it? Identifying reasons for the low use of psychosocial support by hospital staff

BACKGROUND

Psychosocial support programs are a way for hospitals to support the mental health of their staff. However, while support is needed, utilization of support by hospital staff remains low. This study aims to identify reasons for non-use and elements that are important to consider when offering psychosocial support.

METHODS

This mixed-method, multiple case study used survey data and in-depth interviews to assess the extent of psychosocial support use, reasons for non-use and perceived important elements regarding the offering of psychosocial support among Dutch hospital staff. The study focused on a time of especially high need, namely the COVID-19 pandemic. Descriptive statistics were used to assess frequency of use among 1514 staff. The constant comparative method was used to analyze answers provided to two open-ended survey questions (n = 274 respondents) and in-depth interviews (n = 37 interviewees).

RESULTS

The use of psychosocial support decreased from 8.4% in December 2020 to 3.6% by September 2021. We identified four main reasons for non-use of support: deeming support unnecessary, deeming support unsuitable, being unaware of the availability, or feeling undeserving of support. Furthermore, we uncovered four important elements: offer support structurally after the crisis, adjust support to diverse needs, ensure accessibility and awareness, and an active role for supervisors.

CONCLUSIONS

Our results show that the low use of psychosocial support by hospital staff is shaped by individual, organizational, and support-specific factors. These factors can be targeted to increase use of psychosocial support, whereby it is important to also focus on the wider hospital workforce in addition to frontline staff.

Self care and wellbeing in the face of COVID-19: Multidisciplinary perspectives and interprofessional experiences

The human toll which has resulted from the coronavirus disease 2019 pandemic is clearly recognised. No single event in recent times has had such profound effects on health services and their staff wellbeing around the world. Policy making has been led by the requirement for confinement and surveillance to limit spread of the disease, and in clinical settings the impact of the necessity for the use of personal protective measures has caused huge strains on practice clinically and professionally. In this paper we share experiences from the pandemic, explore the social and organisational factors at stake and make some suggestions for both personal wellbeing practice and a systems response to the ongoing staff wellbeing challenges of the pandemic.

Health and social care workers experiences of coping while working in the frontline during the COVID-19 pandemic: One year on

BACKGROUND

The unprecedented pressure of working on the frontline during the Covid-19 pandemic had a demonstrable impact on the mental health and wellbeing of health and social care workers in the early stages of the pandemic, however, less research has focused on workers' experiences over the longer course of the pandemic.

AIMS

We set out to develop an explanatory model of the processes that helped and hindered the coping of HSCWs working over the course of the Covid-19 pandemic.

METHOD

Twenty HSCWs based in the UK took part in the study. They completed semi-structured interviews 12-18 months after the peak of the first wave in the UK. Interviews were transcribed and analysed using grounded theory methodology.

RESULTS

The analysis identified eleven theoretical codes: personal context, organisational resources, organisational response, management, colleagues, decision-making and responsibilities, internal impacts, external impactors, safety, barriers to accessing support and temporal factors. The findings suggest that factors related to the individual themselves, their personal context, the organisation they work in, their managers, the support structures around them and their sense of safety impacted on HSCWs; ability to cope. Some factors changed over time throughout the first year of the pandemic, such as workload and staff illness, which further impacted HSCWs' coping. There were many barriers to accessing support that also impacted coping, including availability, awareness and time. The relationship between the factors that impacted coping are represented in an explanatory model.

CONCLUSIONS

The findings extend previous studies on the mental health impact on frontline HSCWs working during Covid-19, providing novel insight by developing an explanatory model illustrating the underlying factors that impacted their coping experiences over the course of the pandemic in the UK. The findings from this study may assist in the development of improved and more effective support for HSCWs going forwards.

A Qualitative Study on Frontline Nurses' Experiences and Challenges in Providing Care for COVID-19 Patients in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention

Since the outbreak of COVID-19, studies related to the COVID-19 pandemic have been published widely. However, there are limited qualitative studies in Ghana that explored and shed light on frontline nurses' experiences and challenges in caring for patients diagnosed with COVID-19. This study aimed to explore frontline nurses' experiences and challenges of providing care for COVID-19 patients in the Volta Region of Ghana. This study adopted a descriptive qualitative research design to collect data. We conducted the study among frontline nurses who provided nursing care for COVID-19 patients in the Treatment Centre for COVID-19 cases in the Volta Region of Ghana. A purposive sampling method was used to select fifteen (15) participants for this study. We collected data through individual in-depth interviews facilitated by a semi-structured interview guide. The content analysis approach was used to analyse the data. The results showed: frontline nurses received inadequate information and training during the initial stages of the pandemic; stress and burnout because of inadequate staffing; logistical challenges; stigmatisation by family members and friends; frontline nurses displeased with the decision to exclude other nurses as frontline workers; participants made some recommendations towards supporting frontline nurses for effective management of patients during pandemics. This study revealed an in-depth understanding of the experiences of frontline nurses who provided nursing care to COVID-19 patients during the pandemic. Our study concludes that the frontline nurses experienced both physical and psychological problems while caring for COVID-19 patients at the treatment centre. Some challenges frontline nurses encountered were inadequate information on COVID-19 prevention and management in the early stages of the pandemic, logistical inadequacies, and stigmatisation in providing care for COVID-19 patients during the pandemic, all of which affected the quality of nursing care, work productivity, and efficiency. Therefore, nurse managers need to provide support to frontline nurses providing care for patients with COVID-19.

Anti-Colonial Strategies in Cross-cultural Music Science Research

THIS PAPER PRESENTS A CRITICAL ANALYSIS OF ethical and methodological issues within cross-cultural music science research, including issues around community based research, participation, and data sovereignty. Although such issues have long been discussed in social science fields including anthropology and ethnomusicology, psychology and music cognition are only beginning to take them into serious consideration. This paper aims to fill that gap in the literature, and draw attention to the necessity of critically considering how implicit cultural biases and pure positivist approaches can mar scientific investigations of music, especially in a cross-cultural context. We focus initially on two previous papers (Jacoby et al., 2020; Savage et al., 2021) before broadening our discussion to critique and provide alternatives to scientific approaches that support assimilation, extractvism, and universalism. We then discuss methodological considerations around cross-cultural research ethics, data ownership, and open science and reproducibility. Throughout our critique, we offer many personal recommendations to cross-cultural music researchers, and suggest a few larger systemic changes.

Mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic in Luton, England

BACKGROUND

The COVID-19 pandemic intensified the risk factors for poor mental health among care workers in the UK. However, there is inadequate evidence on the mental health impact of COVID-19 on Black, Asian, and minority ethnic (BAME) care workers in particular. This study seeks to explore mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic.

METHOD

This is a qualitative study conducted between February and May, 2021 in Luton, England. A sample of n = 15 care workers from BAME background working in nursing and residential care homes were recruited purposively using the snowball sampling technique. In-depth interviews were conducted around topics such as views on COVID-19, the impact of the COVID-19 pandemic on mental health and coping during the COVID-19 pandemic. Data from the interviews was analysed using the Framework Analysis Approach.

RESULTS

The COVID-19 pandemic had a negative impact on the participants' mental health as they experienced stress, depression, anxiety, trauma and paranoia. The majority of the participants explained that they managed their mental health by belief in God and religious practices, by keeping themselves busy doing activities they were passionate about, following government guidelines on the prevention of COVID-19, seeing the service users happy and some participants managed through support that was offered by the government. However, some participants did not have any support for their mental health.

CONCLUSION

Issues such as increased workload associated with COVID-19 restrictions engendered mental health problems among BAME care workers, however, the workload only further increased during the pandemic, but the health and social care sector was already affected by heavy workload due to staff shortages and this needs to be addressed through increasing their wages to encourage more people to work in the health and social care sector. In addition, some BAME care workers never received any support for their mental health during the pandemic. Hence, integrating mental health services such as counselling, supportive psychotherapy and recreational therapies in care homes could help to support the mental health of care workers in the COVID-19 era.

Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis

BACKGROUND

Research has begun to draw attention to the challenges mental health professionals faced in delivering services during the COVID-19 pandemic response. However, few studies have examined the specific experiences of consultant psychiatrists.

AIMS

To examine the work-related experiences and psychosocial needs of consultant psychiatrists situated in the Republic of Ireland arising from the COVID-19 response.

METHOD

We interviewed 18 consultant psychiatrists and analysed data using inductive thematic analysis.

RESULTS

Work-related experience of participants was characterised by increased workload associated with assumption of guardianship of physical and mental health of vulnerable patients. Unintended consequences of public health restrictions increased case complexity, limited availability of alternative supports and hindered the practice of psychiatry, including inhibiting peer support systems for psychiatrists. Participants perceived available psychological supports as generally unsuitable for their needs given their specialty. Long-standing under-resourcing, mistrust in management and high levels of burnout exacerbated the psychological burden of the COVID-19 response.

CONCLUSIONS

The challenges of leading mental health services were evident in the increased complexity involved in caring for vulnerable patients during the pandemic, contributing to uncertainty, loss of control and moral distress among participants. These dynamics worked synergistically with pre-existing system-level failures, eroding capacity to mount an effective response. The longer-term psychological well-being of consultant psychiatrists - as well as the pandemic preparedness of healthcare systems - is contingent on implementation of policies addressing long-standing under-investment in the services vulnerable populations rely on, not least community mental health services.

Under pressure - The working situation of Swedish healthcare managers during the first wave of COVID-19

Introduction

The aim of this study is to provide insight into the psychosocial work situation of hospital managers during the first wave of the COVID-19 pandemic.

Methods

Mixed-effect modelling was used on survey data on job demands, job resources, job motivation, and work-life balance among over 500 managers working in 55 departments of a large Swedish university hospital in 2019 and 2020. Responses from 6011 employees were then used to stratify the analysis for COVID-19 exposure. Inductive content analysis was applied to open-ended questions on the managers' views on organisational prerequisites during the onset of the pandemic.

Results

The proportion of managers reporting difficulties with role clarity, quantitative demands, decision-making authority, and emotional support, time for recovery at work, motivation deficits, or problems with work-life balance clearly increased during the first wave of the pandemic. The proportion of managers reporting negative responses was higher in departments with high COVID-19 exposure. The qualitative analysis shows that overall governance in terms of clear, fair, and well-communicated routines, resource allocation, and division of responsibilities constituted an important framework for managerial during the crisis. First-line managers also require a mandate to re-organize their roles and their teams to successfully adapt to the situation. Organisational and social support was also important resources.

Discussion

This is the first study investigating healthcare managers' work situation during the first wave of the COVID-19 pandemic in a Swedish context. As expected, it indicates an increasingly strained work situation during the crisis, but it also provides findings on organisational prerequisites that allow healthcare managers to cope with stressful situations. In line with previous research on organisational resilience, the study provides suggestions for how higher-level managers can act in order to provide front-line managers with the organisational prerequisites they need to adapt, learn and develop successfully during times of unpredictability, insecurity, and rapid change in order to offer the best possible support to health care workers.

'You get looked at like you're failing': A reflexive thematic analysis of experiences of mental health and wellbeing support for NHS staff

Staff in the National Health Service (NHS) are under considerable strain, exacerbated by the COVID-19 pandemic; whilst NHS Trusts provide a variety of health and wellbeing support services, there has been little research investigating staff perceptions of these services. We interviewed 48 healthcare workers from 18 NHS Trusts in England about their experiences of workplace health and wellbeing support during the pandemic. Reflexive thematic analysis identified that perceived stigma around help-seeking, and staffing shortages due to wider socio-political contexts such as austerity, were barriers to using support services. Visible, caring leadership at all levels (CEO to line managers), peer support, easily accessible services, and clear communication about support offers were enablers. Our evidence suggests Trusts should have active strategies to improve help-seeking, such as manager training and peer support facilitated by building in time for this during working hours, but this will require long-term strategic planning to address workforce shortages.

Perceived workplace support and mental health, well-being and burnout among health care professionals during the COVID-19 pandemic: a cohort analysis

BACKGROUND

Little is known about the relationship between workplace support and mental health and burnout among health care professionals (HCPs) during the COVID-19 pandemic. In this cohort study, we sought to evaluate the association between perceived level of (and changes to) workplace support and mental health and burnout among HCPs, and to identify what constitutes perceived effective workplace support.

METHODS

Online surveys at baseline (July-September 2020) and follow-up 4 months later assessed the presence of generalized anxiety disorder (using the 7-item Generalized Anxiety Disorder scale [GAD-7]), clinical insomnia, major depressive disorder (using the 9-item Patient Health Questionnaire), burnout (emotional exhaustion and depersonalization) and mental well-being (using the Short Warwick-Edinburgh Mental Wellbeing Score). Both surveys assessed self-reported level of workplace support (single-item Likert scale). For baseline and follow-up, independently, we developed separate logistic regression models to evaluate the association of the level of workplace support (tricohotomized as unsupported, neither supported nor unsupported and supported) with mental health and burnout. We also developed linear regression models to evaluate the association between the change in perceived level of workplace support and the change in mental health scores from baseline and follow-up. We used thematic analyses on free-text entries of the baseline survey to evaluate what constitutes effective support.

RESULTS

At baseline (n = 1422) and follow-up (n = 681), HCPs who felt supported had reduced risk of anxiety, depression, clinical insomnia, emotional exhaustion and depersonalization, compared with those who felt unsupported. Among those who responded to both surveys (n = 681), improved perceived level of workplace support over time was associated with significantly improved scores on measures of anxiety (adjusted β -0.13, 95% confidence interval [CI] -0.25 to -0.01), depression (adjusted β -0.17, 95% CI -0.29 to -0.04) and mental well-being (adjusted β 0.19, 95% CI 0.10 to 0.29), independent of baseline level of support. We identified 5 themes constituting effective workplace support, namely concern or understanding for welfare, information, tangible qualities of the workplace, leadership and peer support.

INTERPRETATION

We found a significant association between perceived level of (and changes in) workplace support and mental health and burnout of HCPs, and identified potential themes that constitute perceived workplace support. Collectively, these findings can inform changes in guidance and national policies to improve mental health and burnout among HCPs. Trial registration: ClinicalTrials.gov, no. NCT04433260.

"Don't Just Study our Distress, Do Something": Implementing and Evaluating a Modified Stepped-Care Model for Health Care Worker Mental Health During the COVID-19 Pandemic

OBJECTIVE

Throughout the COVID-19 pandemic, there have been concerns about the mental health of health care workers (HCW). Although numerous studies have investigated the level of distress among HCW, few studies have explored programs to improve their mental well-being. In this paper, we describe the implementation and evaluation of a program to support the mental health of HCW at University Health Network (UHN), Canada's largest healthcare network.

METHODS

Using a quality improvement approach, we conducted a needs assessment and then created and evaluated a modified stepped-care model to address HCW mental health during the pandemic. This included: online resources focused on psychoeducation and self-management, access to online support and psychotherapeutic groups, and self-referral for individual care from a psychologist or psychiatrist. We used ongoing mixed-methods evaluation, combining quantitative and qualitative analysis, to improve program quality.

RESULTS

The program is ongoing, running continuously throughout the pandemic. We present data up to November 30, 2021. There were over 12,000 hits to the UHN's COVID mental health intranet web page, which included self-management resources and information on group support. One hundred and sixty-six people self-referred for individual psychological or psychiatric care. The mean wait time from referral to initial appointment was 5.4 days, with an average of seven appointments for each service user. The majority had moderate to severe symptoms of depression and anxiety at referral, with over 20% expressing thoughts of self-harm or suicide. Post-care user feedback, collected through self-report surveys and semistructured interviews, indicated that the program is effective and valued.

CONCLUSIONS

Development of a high-quality internal mental health support for HCW program is feasible, effective, and highly valued. By using early and frequent feedback from multiple perspectives and stakeholders to address demand and implement changes responsively, the program was adjusted to meet HCW mental health needs as the pandemic evolved.

Morning Connections: How do you support hospital staff working remotely during a global pandemic without providing 'staff support'?

When lockdown was announced in the United Kingdom, kitchen tables transformed into offices overnight, as many National Health Service (NHS) workers adapted to new ways of working from home. To respond to the developing situation, we established a programme of weekly 'Connections' meetings where staff could be together, remotely. This article describes the evolution of our Morning Connections and Oncology Connections virtual meetings, including the content of sessions, how they were evaluated and whether they met their intention to support colleagues during a particularly challenging time, both personally and professionally, for NHS staff.

Providing Housing First services for an underserved population during the early wave of the COVID-19 pandemic: A qualitative study

OBJECTIVE

We assessed the critical role of Housing First (HF) programs and frontline workers in responding to challenges faced during the first wave of the COVID-19 pandemic.

METHOD

Semi-structured interviews were conducted with nine HF frontline workers from three HF programs between May 2020 and July 2020, in Toronto, Canada. Information was collected on challenges and adjustments needed to provide services to HF clients (people experiencing homelessness and mental disorders). We applied the Analytical Framework method and thematic analysis to our data.

RESULTS

Inability to provide in-person support and socializing activities, barriers to appropriate mental health assessments, and limited virtual communication due to clients' lack of access to digital devices were among the most salient challenges that HF frontline workers reported during the COVID-19 pandemic. Implementing virtual support services, provision of urgent in-office or in-field support, distributing food aid, connecting clients with online healthcare services, increasing harm reduction education and referral, and meeting urgent housing needs were some of the strategies implemented by HF frontline workers to support the complex needs of their clients during the pandemic. HF frontline workers experienced workload burden, job insecurity and mental health problems (e.g. distress, worry, anxiety) as a consequence of their services during the first wave of the COVID-19 pandemic.

CONCLUSION

Despite the several work-, programming- and structural-related challenges experienced by HF frontline workers when responding to the needs of their clients during the first wave of the COVID-19 pandemic, they played a critical role in meeting the communication, food, housing and health needs of their clients during the pandemic, even when it negatively affected their well-being. A more coordinated, integrated, innovative, sustainable, effective and well-funded support response is required to meet the intersecting and complex social, housing, health and financial needs of underserved and socio-economically excluded groups during and beyond health emergencies.

Caring for Older People during and beyond the COVID-19 Pandemic: Experiences of Residential Health Care Workers

Older people and health care workers in residential care homes are particularly vulnerable to the adverse impacts of the COVID-19 pandemic. As COVID-19 has been spreading around the world for more than two years, the nature of care delivery has been substantially transformed. This study aims at understanding the long-term and ongoing impacts of COVID-19 on the delivery of care in residential care homes. It investigates how the delivery of care has been transformed by the COVID-19 pandemic and how health care workers adapted to these changes from the perspectives of frontline health care workers. Semi-structured interviews were conducted from February to December 2021 with a purposive sample of 30 health care workers from six residential care homes in Hong Kong. Thematic analysis identified three themes, including (1) enhancing infection prevention and control measures; (2) maintaining the psychosocial wellbeing of residents; and (3) developing resilience. Discussions and implications were drawn from these findings.

Prepared to Accompany the End of Life during Pandemics in Nursing Homes

BACKGROUND

The COVID-19 pandemic confronted nursing homes with a variety of challenges to ensure the provision of palliative care for residents. PallPan-Implement aimed to adapt the recommendations of the National Strategy for the Care of Seriously Ill, Dying Adults and their Families in Times of Pandemic (PALLPAN) in such a way that nursing facilities can use and implement them.

METHODS

Based on 33 PALLPAN recommendations, we developed a questionnaire, conducted a pilot implementation for selected nursing homes, and asked for qualitative feedback.

RESULTS

The developed questionnaire contains 22 main questions. A three-stage pilot implementation with an introductory event, processing phase, and evaluation event took place in seven facilities. The facilities evaluated the developed questionnaire as helpful. Feedback from the facilities identified three major categories: (a) requirements for facilities should be realistic to avoid frustration, (b) the creation of a pandemic plan for palliative care only is impractical, (c) measures for the psychosocial support of staff is particularly necessary, but was perceived as difficult to implement.

CONCLUSIONS

The practical implementation of recommendations requires a concept and material tailored to facilities and areas. The strategy of PallPan Implement developed in this project appears to be target-oriented, well-received, and can be recommended for further implementation.

How much are we worth? Experiences of nursing assistants in Swedish nursing homes during the first wave of COVID-19

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.

Frontline healthcare workers' experiences of providing care during the COVID-19 pandemic at a COVID-19 centre in Bulawayo, Zimbabwe: A phenomenological study

Background

The coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching, negative impact on healthcare systems worldwide. Healthcare workers play a critical role in the country’s healthcare delivery system, as they facilitate a continuum of care and containment of diseases such as the COVID-19 pandemic.

Objectives

The aim of this study was to explore and describe the experiences of healthcare workers who provided care to COVID-19 patients at a central hospital in Zimbabwe.

Method

The researchers used an interpretative phenomenological analysis design. In-depth interviews were conducted virtually with 10 frontline healthcare workers working at a COVID-19 centre in Zimbabwe. Data collection was guided by an interview guide. All audio-recorded interview data were transcribed verbatim into written text. Data analysis was conducted using an interpretative phenomenological analysis framework. An expert in qualitative research acted as an independent co-coder and conducted the open coding of each transcript.

Results

Findings reveal inadequate preparation and training of healthcare providers before the commencement of duty, resources-related challenges and a lack of support as significant experiences of healthcare providers. Moreover, healthcare providers have been subjected to stigma and discrimination attached to COVID-19, resulting in psychological effects on frontline healthcare providers.

Conclusion

The COVID-19 pandemic brings unique and challenging experiences for frontline healthcare workers, resulting in a physically and emotionally drained workforce. This study calls for comprehensive support in the form of counselling, reasonable work schedules, training and adequate provision of personal protective equipment.

Fear of contamination, perceived social support and physical health of health social workers in Hong Kong: A cross-sectional survey

Hong Kong experienced the SARS pandemic in 2003. Seventeen years later, the Covid-19 pandemic now challenges Hong Kong and the world. This study aims to unveil the impact of the pandemic on health social workers. One hundred and sixty-six health care social workers in Hong Kong were recruited to join a cross-sectional online survey from November 2020 to March 2021. This paper includes the analysis of the demographic information, fear of contamination, resilience, perceived social support and physical health only. Irrespective of the demographic background, the level of fear of contamination, resilience, perceived social support and physical health were similar. The mean scores of the two dimensions of fear of contamination (Harm avoidance: m = 7.49, s.d. = 3.25; Disgust avoidance: m = 7.75, s.d. = 2.90) were higher than those of general public and clinical samples with Obsessive-Compulsive Disorder. No moderation effects were found in resilience and perceived social support in the relationship of fear of contamination and physical health. Instead, direct effects were shown.The impact of the pandemic on health social workers was universal. Psychoeducational programs to alleviate the fear of contamination and organizational-level interventions to improve workplace social support are highly needed.

“Working in the Dark”: Experiences of Frontline Health Workers in Bangladesh During COVID-19 Pandemic

Introduction

Frontline health workers (FHW) are working relentlessly to combat the COVID-19 pandemic globally. This is particularly challenging for low- and middle-income countries such as Bangladesh because of resource scarcity. Therefore, it is critical to understand the challenges of healthcare providers to help shaping a contextual pandemic response plan address current and future similar crises.

Aim

This study aimed to describe the challenges faced by FHWs in Bangladesh in terms of information on COVID-19, managing patients with COVID-19, and what motivated them to continue providing service during the pandemic.

Methods

This qualitative study explored the experiences of 18 FHWs who were purposely recruited from different health interventions of a development organization in Bangladesh. In-depth interviews and focus group discussions were conducted during July–August 2020 using a semi-structured interview guide. The interviews were transcribed verbatim and content analysis was used to analyze the data which led to four categories.

Results

Four main categories and ten sub-categories emerged from the analysis. Categories derived from the analysis were as follows: i) experiences of the FHWs regarding information on COVID-19: “Working in the dark”, ii) experience of providing care: “Patients are grateful”, iii) impact on personal/family life: “Life is still in lockdown” and iv) motivation to carry on providing care.

Conclusion

FHWs desire a stable information source to prepare themselves for future health care crises. Organizational support is essential for them to overcome physical and mental struggles and keep themselves motivated to continue service provision during pandemics.

Challenges faced by healthcare workers at a central hospital in Zimbabwe after contracting COVID-19: An interpretive phenomenological analysis study

Background

Healthcare workers play a critical role in the delivery of healthcare services. Because of the high risk of exposure to healthcare workers, the emergence of coronavirus disease 2019 (COVID-19) has had a significant impact as they struggled to contain the pandemic. The purpose of this study was to explore and describe the challenges they faced after contracting COVID-19.

Methods

An interpretative phenomenological analysis (IPA) design was employed to gain insight into the lived experiences of healthcare workers who contracted COVID-19 in the course of their duties. This study involved participants who were healthcare workers based at a central hospital in Bulawayo, Zimbabwe. Data were collected through in-depth interviews that were audio recorded. A sample size of ten was reached based on data saturation.

Results

The study showed that healthcare workers lacked psychosocial support, experienced economic challenges as they incurred diagnostic and treatment costs. The study also found that the healthcare workers experienced stigma and discrimination both at work and in the community. Findings also indicate that healthcare workers did not receive institutional support. The study demonstrated lack of preparedness at the institution evidenced by inadequate testing for COVID-19 and shortage of personal protective equipment.

Conclusion

This study’s findings will be critical for health authorities, programmers and policymakers to facilitate planning and preparedness for pandemics. The researchers recommend setting up a differentiated service delivery support system for healthcare workers to cater for their mental health and well-being and that of their families.

Evolution of the Public-Health Response to COVID-19 Pandemic in Spain: A Descriptive Qualitative Study

The capacity of hospitals and primary care centres has, rightfully, been at the centre of public and political debate on resource availability and control measures during the outbreak of COVID-19 and lockdown. Thus, the aim of this study is to describe the public and professional perceptions towards the evolution of the COVID-19 public-health response, in order to analyse and learn lessons for future health policies in similar situations in the future. A descriptive qualitative study was conducted through 41 in-depth interviews between January and June 2021. Twenty-one healthcare professionals and twenty service users participated in our study. The participants were recruited using purposive sampling. After our data analysis, three main themes emerged: (i) experiences during an unprecedented public health threat: the impact and challenges of early control measures, and outcomes for the public image of nursing; (ii) overcoming the impact of the outbreak on the healthcare system: professional coping strategies in the context of the pandemic, and institutional considerations in hospitals and primary care; and (iii) the efficiency of resource management during the outbreak: perceptions of professionals and healthcare users. Health providers and service users demand structural and organisational changes, as well as resource-optimisation strategies for front-line workers. Nurses need to be involved in decision making in order to provide evidence-based guidelines and ensure well-resourced and supported care practice.

Support the frontliners – good initiatives during the COVID-19 pandemic for healthcare workers across the world: is this what we really need?

Healthcare workers have faced an unprecedented workload in overstretched health facilities during the COVID-19 pandemic, and we describe various initiatives to support them. Psychological, financial and peer support, accommodation and meal services, proper personal protective equipment, applause and gratitude in the community, spiritual and religious life, child care and volunteering were identified. The potential effects of the COVID-19 pandemic – permanent stress, burnout and other mental health problems among healthcare professionals – can be expected to grow. Continued monitoring is essential to bolster resilience among healthcare workers and prevent the possible consequences for their mental health.

Silver linings: will the COVID-19 pandemic instigate long overdue mental health support services for healthcare workers?

A study in this month’s journal adds to the growing body of evidence regarding the potential mental health impacts on frontline healthcare staff working during the COVID-19 pandemic. As clinical academics representing critical care, nursing, and medicine, and a psychologist guiding support for frontline health and social workers, we offer our perspectives on this study. We discuss the balance between pragmatic and rigorous data collection on this topic and offer perspectives on the observed differential impact on nurses. Finally, we suggest that the pandemic might have a positive effect by instigating more robust mental health support services for National Health Service workers.

The impact of an educational video about the role of an emergency nurse, viewed by emergency nurses' support systems, on emergency nurses' wellbeing

BACKGROUND

High stress daily events contribute to burnout in emergency nurses. Strong and informed support systems are essential in ensuring emergency nurses are actively dealing with their workplace-generated stress, through informal social support.

METHODS

A pre and post intervention design over a 6-month period in a single ED. A video was created by emergency nurses to orientate their support system to their role and work environment. Its impact on nurse well-being was assessed.

RESULTS

More than half of the participants considered their spouse/partner to be their main support system (n = 52, 58%). The majority of participants found their support system: (i) had a greater understanding of their everyday work (n = 79, 88%), (ii) were more engaged when talking about work (n = 72, 80%), (iii) asked more questions about work (n = 63, 70%), and (iv) reported they had an improved ability to debrief with their support system (n = 67, 74%). The median total World Health Organization wellbeing score improved by two points (7%, p < 0.001).

CONCLUSION

Emergency nurses' support systems had a greater understanding of the emergency nurse's role and work environment following exposure to the video. This in turn improved the emergency nurses' ability to debrief at home, experience of support, and ultimately their wellbeing.

Decreasing Wellbeing and Increasing Use of Negative Coping Strategies: The Effect of the COVID-19 Pandemic on the UK Health and Social Care Workforce

Many health and social care (HSC) professionals have faced overwhelming pressures throughout the COVID-19 pandemic. As the current situation is constantly changing, and some restrictions across the UK countries such as social distancing and mask wearing in this period (May-July 2021) began to ease, it is important to examine how this workforce has been affected and how employers can help rebuild their services. The aim of this study was to compare cross-sectional data collected from the HSC workforce in the UK at three time points during the COVID-19 pandemic: Phase 1 (May-July 2020), Phase 2 (November 2020-January 2021) and Phase 3 (May-July 2021). Respondents surveyed across the UK (England, Wales, Scotland, Northern Ireland) consisted of nurses, midwives, allied health professionals, social care workers and social workers. Wellbeing and work-related quality of life significantly declined from Phase 1 to 3 (p &lt; 0.001); however, no significant difference occurred between Phases 2 and 3 (p &gt; 0.05). Respondents increasingly used negative coping strategies between Phase 1 (May-July 2020) and Phase 3 (May-July 2021), suggesting that the HSC workforce has been negatively impacted by the pandemic. These results have the potential to inform HSC employers' policies, practices, and interventions as the workforce continues to respond to the COVID-19 virus and its legacy.

Associations among eHealth literacy, social support, individual resilience, and emotional status in primary care providers during the outbreak of the SARS-CoV-2 Delta variant

Objective

This study aimed to investigate eHealth literacy among primary care providers (PCPs) and explore its association with social support, individual resilience, anxiety, and depression during an outbreak of the SARS-CoV-2 Delta variant in Guangzhou, China.

Methods

A cross-sectional web-based survey was conducted in 18 community healthcare centers in Guangzhou, China. The responses of 600 PCPs were tagged as valid responses. Information pertaining to their background, eHealth literacy, anxiety, depression levels, social support, and individual resilience was also collected. Multilevel analysis was used to determine the association among the measures to account for the nested random effect of community health centers in different districts.

Results

Participants showed a moderate self-perceived level of eHealth literacy (M = 30, SD = 5.8). Participants who reported higher levels of eHealth literacy were more likely to exhibit lower levels of anxiety and depression, higher social support, and greater resilience. After adjusting for background characteristics, the results of the multilevel logistic analysis showed that eHealth literacy was significantly associated with anxiety and depression, social support, and individual resilience. Younger participants and those who were highly educated reported enhanced eHealth literacy.

Conclusions

This study presents a baseline reference for eHealth literacy among Chinese PCPs. Improving their ability to search for and use reliable web-based information was beneficial for facilitating perceived social support and raising resilience during the pandemic. Strategies to provide high-quality web-based information to PCPs to self-assess and identify psychological distress at an early stage should be encouraged.

Experiences and views of frontline healthcare workers' family members in the UK during the COVID-19 pandemic: a qualitative study

BACKGROUND

The COVID-19 pandemic has had a well-documented negative impact on the mental health and wellbeing of frontline healthcare workers (HCWs). Whilst no research has to date been carried out to explore the challenges experienced by the families of HCWs, some previous research has been conducted with military families, demonstrating that family members of deployed military personnel may also be affected seriously and negatively.

OBJECTIVES

This study aimed to explore the experiences, views, and mental health impact on frontline HCWs' families during the COVID-19 pandemic in the UK and what support the families of frontline HCWs may need.

METHOD

Close family members and friends of HCWs were interviewed. Transcripts were analysed in line with the principles of reflexive thematic analysis.

RESULTS

We completed fourteen interviews with three siblings, one mother, one friend, and nine spouses of HCWs. Family members were highly motivated to support healthcare workers and felt an intense sense of pride in their work. However, they also experienced increased domestic responsibilities and emotional burden due to anxiety about their loved ones' work. The fact that sacrifices made by family members were not noticed by society, the anxiety they felt about their family's physical health, the impact of hearing about traumatic experiences, and the failure of healthcare organisations to meet the needs of the HCWs all negatively affected the family members.

CONCLUSIONS

We have an ethical responsibility to attend to the experiences and needs of the families of healthcare professionals. This study emphasises the experiences and needs of family members of healthcare professionals, which have hitherto been missing from the literature. Further research is needed to hear from more parents, siblings and friends, partners in same sex relationships, as well as children of HCWs, to explore the variety of family members and supporters' experiences more fully.

HIGHLIGHTS

• COVID19 has impacted families of HCWs as well as workers themselves. They have experienced more anxiety, increased practical burden, significant physical health risks and been exposed vicariously to workers' traumatic experiences. We must ensure HCW families are better supported.

Resilience coaching for healthcare workers: Experiences of receiving collegial support during the COVID-19 pandemic

OBJECTIVE

To explore experiences of receiving collegial support from the department of psychiatry at an acute care hospital during the COVID-19 pandemic.

METHOD

The Resilience Coaching program launched in April 2020, with the aim of offering a timely response to supporting psychosocial needs of healthcare workers (HCWs), leveraging collegial relationships and mental health training to offer support. Twenty-four HCWs were interviewed about their experiences receiving support from resilience coaches.

RESULTS

Participants reported that Resilience Coaching offered hospital staff opportunities for connection, encouragement to attend to personal wellness, and avenues to learn practical skills to assist with coping. Coaching also assisted HCWs in accessing clinical mental health support when that was requested by staff.

CONCLUSIONS

Resilience Coaching is a model for supporting colleagues in an acute care hospital during a pandemic. It is generally regarded positively by participants. Further study is warranted to determine how best to engage some occupational subcultures within the hospital, and whether the model is feasible for other healthcare contexts.

Shared sources and mechanisms of healthcare worker distress in COVID-19: a comparative qualitative study in Canada and the UK

Background: COVID-19 has had a significant impact on the wellbeing of healthcare workers, with quantitative studies identifying increased stress, anxiety, depression, insomnia, and PTSD in a wide range of settings. Limited qualitative data so far has offered in-depth details concerning what underlies these challenges, but none provide comprehensive comparison across different healthcare systems. Objective: To explore qualitative findings relating to healthcare worker distress from two different countries to understand the nuanced similarities and differences with respect to the sources and impact of distress relating to COVID-19. Method: A comparative interpretive thematic analysis was carried out between two qualitative data sets examining healthcare workers' experiences of distress during the COVID-19 pandemic. Data from Canada and the UK were collected in parallel and analyzed in an iterative, collaborative process. Results: A number of sources of distress cut across both study settings including concerns about safety and patient care, challenges at home or in one's personal life, communication issues, work environment, media and public perception, and government responses to the pandemic. These sit on a spectrum from individual to institutional sources and were mutually reinforcing. Our analysis also suggested that common mechanisms such as exacerbations in uncertainty, hypervigilance, and moral injury underpinned these sources, which contributed to how they were experienced as distressing. Conclusion: This is the first international collaboration utilising qualitative data to examine this pressing issue. Despite differences in the political, social, health service, and pandemic-related context, the sources and mechanisms of distress experienced by healthcare workers in Canada and the UK were remarkably similar. HIGHLIGHTS This international comparative qualitative study explores how mechanisms that lead to distress are shared across different geographies and cultures, even as the local context shapes the sources of distress themselves.

A time for self-care? Frontline health workers' strategies for managing mental health during the COVID-19 pandemic

Frontline healthcare workers have experienced detrimental mental health impacts during the COVID-19 pandemic including anxiety, emotional distress, stress, fatigue, and burnout. But little is known about how these healthcare professionals take care of their own mental health in the midst of considerable personal, occupational and social disruption. In this article, we use qualitative data from an Australian national survey to examine the self-care strategies frontline healthcare professionals employed to manage their mental health and wellbeing during the crisis. Findings reveal how healthcare workers sought to adjust to disruption by adopting new self-care practices and mindsets, while encountering numerous personal and professional struggles that undermined their capacity for self-care. Feeling socially connected and valued were critical dimensions of caring for self, illustrating the importance of locating self-care in the social domain. These findings, we argue, highlight the need to expand conceptions of self-care away from those that focus primarily on the individual towards approaches that situate self care as collective and relational.