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Negarandeh R, Shahmari M, Zare L. Stigmatization experiences of healthcare workers in the context of the COVID-19 pandemic: a scoping review. BMC Health Serv Res 2024; 24:823. [PMID: 39020333 PMCID: PMC11253434 DOI: 10.1186/s12913-024-11300-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, healthcare workers face the stigmatization of those caring for COVID-19 patients, creating a significant social problem. Therefore, this study investigated the stigmatization of healthcare workers in the context of the COVID-19 pandemic. METHODS In this scoping review study, searches were conducted from December 2019 to August 2023 in Persian and English using various databases and search engines including PubMed (Medline), Embase, Scopus, ISI Web of Science, ProQuest, Science Direct, Springer, Cochrane Library, Google Scholar, and national databases. The study used English keywords such as Social Stigma, Health Personnel, Healthcare Worker, Medical Staff, Medical Personal, Physicians, doctors, Nurses, nursing staff, COVID-19, and coronavirus disease 2019, and their Persian equivalents, and their Persian equivalents to explore healthcare workers' experiences of COVID-19-related stigma. RESULTS From a total of 12,200 search results, 77 eligible studies were included in this study. stigmatization of healthcare workers caring for COVID-19 patients was evident from the literature because of fear, misinformation, and negative self-image. Manifestations were violence and deprivation of social rights, resulting in adverse biopsychosocial, occupational, and economic consequences. This condition can affect negatively health staff themselves, their families, and society as well. Anti-stigmatization measures include informing society about the realities faced by healthcare workers, presenting an accurate and empathetic image of health workers, providing psychosocial support to health workers, and encouraging them to turn to spirituality as a coping mechanism. There are notable research gaps in comprehending the phenomenon, exploring its variations across diverse healthcare roles and cultural contexts, examining its long-term effects, and monitoring shifts in stigma perceptions over time. CONCLUSION The COVID-19 pandemic has resulted in the stigmatization of healthcare workers, causing mistreatment and rights violations. This stigma persists even post-pandemic, posing a psychological dilemma for caregivers. Addressing this requires comprehensive strategies, including tailored stigma prevention programs and research to understand its psychological impact.
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Affiliation(s)
- Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehraban Shahmari
- Department of Medical-Surgical, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Leily Zare
- Department of Medical Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Maghsoodi E, Vanaki Z, Mohammadi E. Nurses' perception of work and life under COVID-19 pandemic conditions: a qualitative study. Front Public Health 2023; 11:1292664. [PMID: 38164452 PMCID: PMC10758251 DOI: 10.3389/fpubh.2023.1292664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives Although nurses work and live in special and stressful conditions due to the nature of their profession, in periods of crises and pandemics, when the work pressure on nurses and the public's need for professional services increases to extraordinary and incomparable levels compared to customary conditions, their work and life situation becomes entirely different. Therefore, what nurses experienced in the COVID-19 pandemic went beyond the typical challenges of their work environment. This study was conducted to discover nurses' perceptions of work and life during the COVID-19 pandemic. Methods This qualitative study was conducted with a conventional content analysis approach on 16 nurses working in the inpatient wards during the COVID-19 pandemic in Iran. Data were collected through unstructured, individual, and in-depth interviews between August 2020 and June 2023 and were analyzed using content analysis with the conventional (inductive) approach of Granheim and Lundman. Results Data analysis led to the extraction of 11 subcategories, namely, "feeling a lack of support and understanding from managers," "team cooperation and communication challenges in difficult work conditions," "shadow of burnout," "shortage inequity," "dissatisfaction with unfair wages and benefits," "not having their work and sacrifices appreciated," "suffering and fatigue of using personal protective equipment (PPE)," "deprivation of entertainment and rest," "fear of illness and imminent death," "low resilience," and "deteriorating life conditions" These 11 subcategories led to the following themes: "unsafe work environment" and "the shadow of suffering and death." Conclusion Nurses working in COVID-19 wards in Iran worked in an unsafe work environment during the COVID-19 pandemic and had to deal with suffering and fear of death. It is necessary to pay attention to the needs and problems of nurses, and healthcare organizations must provide the required support to maintain the physical and mental health of nurses during epidemics.
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Affiliation(s)
| | - Zohreh Vanaki
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Bakhsh LS, AlHazmi A, BaMohammed A, Binishaq E, Abdullah G, Bajal R, Al Ramamneh I. Emotions, Perceived Stressors, and Coping Strategies Among Nursing Staff in Saudi Arabia During the COVID-19 Pandemic. Cureus 2023; 15:e48284. [PMID: 38058321 PMCID: PMC10696279 DOI: 10.7759/cureus.48284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/08/2023] Open
Abstract
Objective The COVID-19 pandemic resulted in heightened stress for nurses and other healthcare workers, particularly during the initial phase of the crisis. Despite the adoption of various coping strategies, psychological distress persisted, affecting nurses' well-being and jeopardizing the overall resilience of the healthcare system. This study assessed the emotional response, perceived stressors, and coping strategies among nurses' staff who worked during the first wave of COVID-19 pandemic. Method A cross-sectional study was carried out among nurses who worked during the initial phase of the COVID-19 crisis (June - August 2020), at a tertiary care center in Western Saudi Arabia. The questionnaire explored five main sections. The first section (15 items) assessed emotions experienced during the initial wave of COVID-19, capturing both positive and negative sentiments, such as "joy" or "fear." The second section (20 items) examined the presence of stressors, like "lack of protective equipment" or "fear of infection." The third section (14 items) evaluated the perceived effectiveness of certain stress-reducing factors, including "peer support" or "training." In the fourth section (13 items), participants rated their usage frequency of various coping strategies, such as "meditation" or "seeking advice." Lastly, the fifth section assessed the hypothetical impact of 10 incentives, like "financial bonuses" or "additional training," in motivating nurses' involvement in future epidemic responses. The questionnaire was completed with demographic and professional data. A convenience sampling method was employed, and 315 nurses participated in the study. Descriptive statistics were carried out using SPSS version 24 for Windows (IBM Corp., Armonk, NY). Result The most commonly experienced emotion was a feeling of responsibility and ethical duty, reported by 97.5% of the participants, followed by nervousness and fear (83.8%), anger (73.3%), and stigma (70.2%). On the other hand, 86.7% were expecting a financial compensation. The most common stressors were related to the nurses' own safety, or the safety of their families and colleagues, reported by 92.4-95.2% of the participants. The perceived uncontrollability of COVID-19 was also a significant stressor. The improvement of the health status of infected colleagues (98.1%) or patients (97.5%) were the most common factors associated with the reduction in nurses' stress. Among the coping strategies, five were almost systematically deployed by the nurses (>95%), all consisting of cognitive and behavioral mechanisms to enhance own knowledge and safety and avoid being infected. The most crucial determinants for commitment in future pandemics are the availability of a cure or vaccine (93.3%), family support (91.4%), adequate personal protective equipment from the hospital (90.8%), and exemption from overtime (90.2%). Conclusion The first wave of COVID-19 exerted a tremendous psychological stress on nurses, due to concerns about safety, disease uncertainties, and social isolation. Analyzing these impacts offers insights for enhancing institutional and national crisis strategies, emphasizing staff safety and psychological well-being, especially for first responders like nurses. Policy implications include prioritizing mental health support and preparedness in future crisis plans. Additionally, ensuring continuous training and strategic workload management is crucial for maintaining frontline commitment.
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Affiliation(s)
- Lamees S Bakhsh
- Department of Nursing, King Abdulaziz University Hospital, Jeddah, SAU
| | - Abeer AlHazmi
- Department of Nursing, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Alla BaMohammed
- Department of Nursing, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Eiman Binishaq
- Department of Nursing, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ghadah Abdullah
- Department of Nursing, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Razaz Bajal
- Department of Nursing, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ibrahim Al Ramamneh
- Department of Nursing, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Huang F, Sun W, Li Y, Zhang L, Chen WT. Modification and validation of the COVID-19 stigma instrument in nurses: A cross-sectional survey. Front Psychol 2023; 14:1084152. [PMID: 37663322 PMCID: PMC10473103 DOI: 10.3389/fpsyg.2023.1084152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background Nurses taking care of patients with infectious diseases have suffered from noticeable societal stigma, however currently, there is no validated scale to measure such stigma. This study aimed to revise and validate the COVID-19 Stigma Instrument-Nurse-Version 3 (CSI-N-3) by using item response theory (IRT) as well as classical test theory analysis. Methods In phase I, the Chinese CSI-N-3 was modified from the English version of HIV/AIDS Stigma Instrument-Nurse based on standard cross-cultural procedures, including modifications, translation/back translations, pilot testing, and psychometric testing with classical test theory and Rasch analysis. In phase II, a cross-sectional study using cluster sampling was conducted among 249 eligible nurses who worked in a COVID-19-designed hospital in Shanghai, China. The influencing factors of COVID-19-associated stigma were analyzed through regression analysis. Results In phase I, the two-factor structure was verified by confirmatory factor analysis, which indicated a good model fit. The 15-item CSI-N-3 achieved Cronbach's α of 0.71-0.84, and composite reliability of 0.83-0.91. The concurrent validity was established by significant association with self-reported physical, psychological, and social support levels (r = -0.18, -0.20, and -0.21, p < 0.01). In IRT analysis, the CSI-N-3 has ordered response thresholds, with the Item Reliability and Separation Index of 0.95 and 4.15, respectively, and the Person Reliability and Separation Index of 0.20 and 0.50, respectively. The infit and outfit mean squares for each item ranged from 0.39 to 1.57. In phase II, the mean score for the CSI-N-3 in Chinese nurses was 2.80 ± 3.73. Regression analysis showed that social support was the only factor affecting nurses' COVID-19-associated stigma (standardized coefficients β = -0.21, 95% confidence interval: -0.73 ~ -0.19). Conclusion The instrument CSI-N-3 is equipped with rigorous psychometric properties that can be used to measure COVID-19-associated stigma during and after the COVID-19 pandemic among nurses. The use of this instrument may facilitate the evaluation of tailored stigma-reduction interventions.
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Affiliation(s)
- Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yonglin Li
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Wei-Ti Chen
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
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Nabavian M, Rahmani N, Seyed Nematollah Roshan F, Firouzbakht M. Nurses' experiences of the social stigma caused by the COVID-19 pandemic: a qualitative study. J Res Nurs 2023; 28:104-115. [PMID: 37152193 PMCID: PMC10140769 DOI: 10.1177/17449871231159604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Background One of the psychological issues that health personnel face when treating COVID-19 patients is the societal stigma. This issue has not been addressed due to the disease's devastating impact on numerous sectors of society. This study aimed to evaluate nurses' experiences of social stigma caused by the COVID-19 pandemic with a qualitative approach. Methods Inductive qualitative content analysis was used to conduct this qualitative research. COVID ward nurses who had been subjected to social stigma were chosen as the study sample. Data were collected through semi-structured and individual interviews and were concurrently analysed using the conventional content analysis approach recommended by Graneheim and Lundman. Results There are three categories and six sub-categories of social stigma experienced by nurses: (1) paradoxical emotions (psychological stress and positive attitude), (2) abandonment (all-round rejection and isolation) and (3) coping strategies (self-awareness over time and the influential role of the media). Conclusions The findings of this study can help healthcare managers to improve the quality of care by enhancing understanding of the psychological needs arising from social stigma. Based on these findings, designing psychosocial interventions related to stigma can promote the mental health of this group and their families.
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Affiliation(s)
- Majedeh Nabavian
- Assistant Professor, Department of Nursing and Midwifery, Comprehensive Health Research Center, Babol Branch, Islamic Azad University, Babol, Iran
| | - Narges Rahmani
- Narges Rahmani, Department of Nursing and Midwifery, Islamic Azad University, km 3 of Ghaemshahr road, University Complex of Islamic Azad University, Babol, 98111, Iran.
| | | | - Mojgan Firouzbakht
- Assistant Professor, Department of Nursing and Midwifery, Comprehensive Health Research Center, Babol Branch, Islamic Azad University, Babol, Iran
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Simeone S, Mercuri C, Cosco C, Bosco V, Pagliuso C, Doldo P. Enacted Stigma in Inflammatory Bowel Disease: An Italian Phenomenological Study. Healthcare (Basel) 2023; 11:healthcare11040474. [PMID: 36833009 PMCID: PMC9956300 DOI: 10.3390/healthcare11040474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/28/2023] [Accepted: 02/05/2023] [Indexed: 02/09/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic disease of the gastrointestinal tract that has a profound impact on the quality of life of those afflicted with it. The scientific literature shows how the quality of life of people with IBD influences and is influenced by the clinical manifestations of the disease. Strongly connected with excretory functions, which have always been taboo in society, these clinical manifestations can lead to stigmatizing behaviours. The purpose of this study was to understand the lived experiences of the enacted stigma of people with IBD through Cohen's phenomenological method. Two main themes (stigma in the workplace and stigma in social life) and one subtheme (stigma in love life) emerged from the data analysis. The data analysis revealed that stigma is associated with a multitude of negative health outcomes for the people targeted by it and can add to the already complex physical, psychological and social burdens endured by people with IBD. Having a better understanding of the stigma attached to IBD will facilitate the development of care and training interventions that can improve the quality of life of people suffering from IBD.
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Azman N, Nik Jaafar NR, Leong Bin Abdullah MFI, Abdul Taib NI, Mohamad Kamal NA, Abdullah MN, Dollah SN, Mohamed Said MS. Stigma and posttraumatic growth among COVID-19 survivors during the first wave of the COVID-19 pandemic in Malaysia: a multicenter cross-sectional study. Front Psychiatry 2023; 14:1152105. [PMID: 37168088 PMCID: PMC10164995 DOI: 10.3389/fpsyt.2023.1152105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/23/2023] [Indexed: 05/13/2023] Open
Abstract
Background Contracting COVID-19 can cause negative and distressing psychological sequelae, but traumatic stressors may also facilitate the development of positive psychological change beyond an individual's previous level of adaptation, known as posttraumatic growth (PTG). As a result, studies have investigated the negative effects of COVID-19 on mental health, but data on PTG among patients who have recovered from COVID-19 remains limited. This study aims to evaluate the level of PTG and its associations with stigma, psychological complications, and sociodemographic factors among COVID-19 patients 6 months post-hospitalization. Method A cross-sectional online survey of 152 COVID-19 patients was conducted after 6 months of being discharged from Hospital Canselor Tuanku Muhriz, MAEPS Quarantine Center, or Hospital Sungai Buloh, Malaysia. Patients completed a set of questionnaires on sociodemographic and clinical data. The Posttraumatic Growth Inventory (PTGI-SF) was used to assess the level of PTG, the Kessler Psychological Distress (K6) was used to measure the degree of psychological distress, the General Anxiety Disorder-7 (GAD-7) was used to evaluate the severity of anxiety symptoms, the Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression symptoms, and the Explanatory Model Interview Catalog Stigma Scale (EMIC-SS) was used to record the degree of perceived stigma toward COVID-19. Results The median PTGI SF score of the respondents was 40.0 (Interquartile range 16.0). Multivariable general linear model with bootstrapping (2,000 replications) revealed factors that significantly predicted PTG, which were at the higher level of the perceived stigma score, at 37 (B = 0.367, 95% CI = 0.041 to 0.691, p = 0.026), among the Malay ethnicity (B = 12.767, 95% CI 38 = 7.541 to 17.993, p < 0.001), retirees (B = -12.060, 95% CI = -21.310 to -2.811, p = 0.011), and those with a history of medical illness (B = 4.971, 95% CI = 0.096 to 9.845, p = 0.046). Conclusion Experiencing stigma contributed to patients' PTG in addition to psychosocial factors such as ethnicity, history of medical illness, and retirement.
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Affiliation(s)
- Nazirah Azman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz (HCTM), Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
- *Correspondence: Nik Ruzyanei Nik Jaafar,
| | | | - Nur Iwana Abdul Taib
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Nurul Ain Mohamad Kamal
- Hospital Canselor Tuanku Muhriz (HCTM), Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | | | - Siti Nordiana Dollah
- Department of Psychiatry Hospital Angkatan Tentera Tuanku Mizan, Kuala Lumpur, Malaysia
| | - Mohd Shahrir Mohamed Said
- Hospital Canselor Tuanku Muhriz (HCTM), Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Tran TTT, Nguyen QT, Nguyen NT, Vu ST, Kaewboonchoo O, Kawakami N, Nguyen HT. Psychometric properties and factor structure of the Vietnamese Copenhagen Burnout Inventory. J Occup Health 2023; 65:e12425. [PMID: 37775980 PMCID: PMC10541492 DOI: 10.1002/1348-9585.12425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/01/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVES This article examines the validity and reliability of the Vietnamese version of the Copenhagen Burnout Inventory (CBI-V) among hospital nurses in Vietnam in 2022. METHODS This article examined data from 587 nurses in two city hospitals in Vietnam in 2022. The reliability was determined via internal consistency (Cronbach's alpha coefficient) and test-retest reliability (Intraclass correlation coefficient). Factorial and construct validity of CBI-V were explored with confirmation factor analysis (CFA), exploratory factor analysis (EFA), and correlations with other mental health outcomes (measured by the depression, anxiety, and stress scale), job performance (Work Health Performance Questionnaires), work engagement (Utrecht work engagement), and quality of life (EQ-5D-5L). Statistical analyses were performed using SPSS 20.0 and AMOS 20.0. RESULTS Cronbach's alpha coefficients of CBI-V's three subscales showed good internal consistency (from 0.87 to 0.91). CFA showed a good fit of the three-factor model with the current data. EFA results showed that all items were loaded in accordance with the CBI's original three constructs, excluding work burnout item 7, forming the fourth factor with a single item. All of CBI-V's three subscales correlated with other constructs in expected directions. CONCLUSION The CBI-V showed good validity and reliability among hospital nurses. It can be a reliable tool to measure burnout among nurses in a low- and middle-income country in Vietnam during such a crisis as COVID-19. Future studies should examine the construct of the Copenhagen Burnout Inventory in different occupation groups.
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Affiliation(s)
- Thuy Thi Thu Tran
- Faculty of Environmental and Occupational HealthHanoi University of Public HealthHanoiVietnam
| | - Quynh Thuy Nguyen
- Faculty of Environmental and Occupational HealthHanoi University of Public HealthHanoiVietnam
| | - Nga Thi Nguyen
- Faculty of Social Sciences‐BehaviorHanoi University of Public HealthHanoiVietnam
| | - Son Thai Vu
- Faculty of Environmental and Occupational HealthHanoi University of Public HealthHanoiVietnam
| | | | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Huong Thanh Nguyen
- Faculty of Social Sciences‐BehaviorHanoi University of Public HealthHanoiVietnam
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Kealeboga KM, Ntsayagae EI, Tsima O. Psychological impact of COVID-19 on nurses caring for patients during COVID-19 pandemic in Gaborone. Nurs Open 2022; 10:3084-3093. [PMID: 36524453 PMCID: PMC9877726 DOI: 10.1002/nop2.1557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/18/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022] Open
Abstract
AIM Nurses as front liners have direct contact with COVID-19 patients during the pandemic. Carrying the heavy burden during the pandemic has a mental health toll on healthcare professionals. The study explored nurses' experiences of psychological distress during the COVID-19 pandemic in Botswana's two COVID-19 special care centres. DESIGN The study used qualitative case study research to solicit nurses' experiences caring for patients with COVID-19 in selected COVID-19 centres in Gaborone. METHOD Researchers purposively recruited nurses from two COVID-19 centres in Botswana. Data were collected using semi-structured telephone interviews and analysed through inductive thematic analysis. Various institutional review boards ethically cleared the study. RESULTS Six themes emerged from the thematic analysis: feelings of fear and anxiety, hopelessness and helplessness, loneliness, physical distress, support mechanism and commitment to care. PUBLIC CONTRIBUTION The results offer important insights into the nurses' experiences during the COVI-19 pandemic.
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Affiliation(s)
| | | | - Onalenna Tsima
- Faculty Health Sciences, School of NursingUniversity of BotswanaGaboroneBotswana
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Nikbakht Nasrabadi A, Abbasi S, Mardani A, Maleki M, Vlaisavljevic Z. Experiences of intensive care unit nurses working with COVID-19 patients: A systematic review and meta-synthesis of qualitative studies. Front Public Health 2022; 10:1034624. [PMID: 36466502 PMCID: PMC9710282 DOI: 10.3389/fpubh.2022.1034624] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives Intensive Care Unit (ICU) nurses are at the forefront of fighting and treating the Coronavirus 2019 (COVID-19) pandemic and are often directly exposed to this virus and at risk of disease, due to their direct care for infected patients. This study aims to synthesize the experiences of ICU nurses working with COVID-19 patients. Methods A systematic review and meta-synthesis of qualitative studies were undertaken. A systematic literature search in four databases, including Web of Sciences, Scopus, Embase, and PubMed (including Medline), was performed. Original qualitative studies and the qualitative section of mixed method studies, written in English, which focused on the experiences of only ICU nurses working with COVID-19 patients, were included. Results Seventeen qualitative studies and two mixed-method studies were included in the review. As a result of the inductive content analysis, six main categories were identified, as follows: "distance from holistic nursing," "psychosocial experiences," "efforts for self-protection and wellbeing," "organizational inefficiency," "job burnout," and "emerging new experiences in the workplace." Conclusions The findings from this study suggest that healthcare authorities and policymakers can facilitate the provision of high-quality patient care during the COVID-19 pandemic through appropriate planning to provide adequate support and training, prevent shortages of nursing staff and equipment, and provide adequate attention to the psychological needs and job satisfaction of ICU nurses. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256070, identifier: CRD42021256070.
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Affiliation(s)
| | - Soheila Abbasi
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran,*Correspondence: Maryam Maleki
| | - Zeljko Vlaisavljevic
- University Clinical Center of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia,Department of Nursing, Medical School of Vocational Studies Medika, Belgrade, Serbia
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Badrfam R, Qorbani M, Zandifar A. Status of stigma on the health care workers related to COVID-19 at the first wave of the pandemic in Iran: A qualitative study. Front Psychiatry 2022; 13:1045683. [PMID: 36405907 PMCID: PMC9668852 DOI: 10.3389/fpsyt.2022.1045683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Background Stigma can be seen as a mark of disgrace that can lead to the separation of one person from another. In this qualitative study, we assess the status of stigma among in front-line health care workers (HCWs) during the first wave of the COVID-19 pandemic in Iran. Subjects and methods The participants were selected from frontline HCWs related to COVID-19 in Imam Ali and Imam Hossein referral hospitals in Alborz province, Iran. Study was conducted between May and June 2020. The 32-item checklist Consolidated Criteria for Reporting Qualitative Research (COREQ) was used to report this qualitative study. Interview questions were prepared based on the grounded theory method. The thematic approach was used to analyze the data content. Data analysis was based on open and axial coding and after implementing the codes in MAXQDA software. Results The results of this study included 4 themes, 8 categories and 33 sub-categories. Themes included extrinsic and intrinsic elements of stigma, perplexity and stigma removal requirements. Extrinsic elements included "creating blame and shame" and "discrimination" categories. Intrinsic elements included "the desire to be avoidance," "feeling depressed and frustrated" and "feeling anxious and scared" categories. Perplexity included "feeling loss" category. Stigma removal requirements included "factors causing stigma" and "protective agents against stigma" categories. Conclusion Low public awareness on COVID-19 and inadequate public care, limited personal protective equipment and inadequate facilities for HCWs along with lack of appreciation for their efforts, lack of proper psychiatric/psychological counseling to identify and treat symptoms associated with mental health and the limitations of training to maintain mental health skills are considered to be factors in the formation of stigma among HCWs related to COVID-19. Health policymakers should implement coherent strategies related to increasing public awareness and providing personal protection needs and counseling care for HCWs in relation to COVID-19.
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Affiliation(s)
- Rahim Badrfam
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Zandifar
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Wu C, Liu T, Cheng C, Chang K. Relationship between nurses' resilience and depression, anxiety and stress during the 2021 COVID-19 outbreak in Taiwan. Nurs Open 2022; 10:1592-1600. [PMID: 36285646 PMCID: PMC9874739 DOI: 10.1002/nop2.1411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/31/2022] [Accepted: 10/02/2022] [Indexed: 01/27/2023] Open
Abstract
AIM The COVID-19 outbreak in Taiwan had a significant impact on medical services. These changes posed a threat to nurses' mental health. Resilience may protect nurses from the psychological impact of COVID-19. This study aimed to understand nurses' resilience and its relationship with nurses' characteristics (life and work situations) and mental health (depression, anxiety and stress) during the outbreak. DESIGN A cross-sectional study. METHODS This study surveyed the nurses at a hospital from 9 August 2021, to 20 August 2021. The content of the questionnaire included nurses' characteristics, resilience and mental health. RESULTS There was an association between higher resilience and lower mental health problems. We also found that some nurses' characteristics were positively correlated with mental health problems. CONCLUSION Some nurses' life and work situations predicted high levels of mental health problems during the pandemic. Additionally, higher levels of resilience were associated with lower levels of mental health problems.
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Affiliation(s)
- Chiu‐Feng Wu
- Department of NursingTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan
| | - Tzu‐Hung Liu
- Department of Family MedicineTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan,School of MedicineTzu Chi UniversityHualienTaiwan
| | - Chu‐Hsuan Cheng
- Department of NursingTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan
| | - Kai‐Yen Chang
- Department of NursingTaipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationNew Taipei CityTaiwan
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Fan Z, Chen H, Wu H, Zhang X. Patient Toward Physician Occupational Stigma Scale: Development of the Chinese Version. Psychol Res Behav Manag 2022; 15:2117-2127. [PMID: 35983020 PMCID: PMC9379113 DOI: 10.2147/prbm.s375032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/31/2022] [Indexed: 01/17/2023] Open
Abstract
Background/Objective Physicians’ occupational stigma could eradicate physician-patient trust, threatening physicians’ social status and occupational reputation. Hitherto, there has been no scale obtaining good psychometric properties to assess patients’ stigma toward physicians. The present study aimed to develop the Patient toward Physician Occupational Stigma Scale (PPOSS) and examine its reliability and validity. Methods The questionnaire comprising sociodemographic information and the PPOSS were employed to survey 645 Chinese patients in two phases. In Sample 2, the Wake Forest Physician Trust Scale (WFOTS), the Intolerance of Uncertainty Scale-12 (IUS-12), and the Brief Illness Perception Questionnaire (BIPQ) were tested. Results The PPOSS includes 19 items subsumed into three dimensions of stereotype, discrimination, and prejudice. According to the results of confirmatory factor analysis (CFA), the three-factor model fitted well (χ2/df=2.065, RMSEA=0.057, SRMR=0.045, RFI=0.904, CFI=0.956, IFI=0.956, PNFI=0.779, PCFI=0.811). The PPOSS was significantly negatively correlated with the WFOTS, and significantly positively correlated with the IUS-12 and the BIPQ. The Cronbach’s alpha coefficients for the total scale and each dimension were between 0.87 and 0.94, and the split-half reliability coefficients were between 0.84 and 0.93. Besides, the PPOSS had the measurement invariance across gender. Conclusion With its satisfactory psychometric properties, the PPOSS can be used as an effective instrument to assess patients’ stigma toward physicians.
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Affiliation(s)
- Zhiguang Fan
- Department of Education, Jilin International Studies University, Changchun City, Jilin Province, People's Republic of China.,Department of Marxism, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People's Republic of China
| | - Hongyan Chen
- Department of Chinese Medicine, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People's Republic of China
| | - Hanwei Wu
- Department of English, Jilin International Studies University, Changchun City, Jilin Province, People's Republic of China
| | - Xinghai Zhang
- Department of Marxism, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People's Republic of China
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Tolksdorf KH, Tischler U, Heinrichs K. Correlates of turnover intention among nursing staff in the COVID-19 pandemic: a systematic review. BMC Nurs 2022; 21:174. [PMID: 35787700 PMCID: PMC9252069 DOI: 10.1186/s12912-022-00949-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/22/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, shortage of nursing staff became even more evident. Nurses experienced great strain, putting them at risk to leave their jobs. Individual and organizational factors were known to be associated with nurses' turnover intention before the pandemic. The knowledge of factors associated with turnover intention during the pandemic could help to foster nurses' retention. Therefore, this review aims to identify factors associated with nurses' turnover intention during the COVID-19 pandemic. METHODS After a systematic search of six databases, the resulting records were screened in a two-step process based on pre-defined inclusion and exclusion criteria. The included quantitative studies were synthesized qualitatively due to their methodological heterogeneity. RESULTS A total of 19 articles were included in the analysis. Individual factors such as health factors or psychological symptoms and demographic characteristics were associated with nurses' turnover intention. Organizational factors associated with turnover intention were e.g., caring for COVID-19 patients, low job control or high job demands, and moral distress. Resilience and supporting leadership could mitigate adverse associations with turnover intention. CONCLUSIONS The results help to identify high-risk groups according to individual factors and to develop possible interventions, such as trainings for nurses and their superiors, addressing individual and organizational factors. Future research should focus on longitudinal designs applying carefully defined concepts of turnover intention.
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Affiliation(s)
- Katharina Herta Tolksdorf
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ulla Tischler
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Katherina Heinrichs
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
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