South Korean Nurses' Experiences with Patient Care at a COVID-19-Designated Hospital: Growth after the Frontline Battle against an Infectious Disease Pandemic

Post-traumatic growth experiences of emergency and critical care nurses after the COVID-19 pandemic: A qualitative meta-synthesis

Objective

The previous coronavirus disease 2019(COVID-19) epidemic inflicted significant psychological trauma on emergency and critical care nurses due to various factors, potentially leading to job burnout. Despite the rise of positive psychology, little is known about the post-traumatic growth experience of these nurses after the pandemic. The aim of this study was to assess the experience of post-traumatic growth among emergency and critical care nurses, in order to provide managerial insights for developing effective strategies and facilitating the transformation of nurses' negative emotions into positive ones.

Design

A qualitative review.

Data sources

PubMed, EBSCO, Medline, Elsvier, Cochrane Library, CINAHL, Web of Science, Embase, and Ovid and Chinese databases include the following: Chinese National Knowledge Infrastructure (CNKI), Wanfang Database (CECDB), VIP Database and China Biomedical Database (CBM).

Review methods

All articles about emergency and critical care nurses' post-traumatic growth after the COVID-19 pandemic were included after searching and screening 13 databases. The meta-synthesis method was used to integrate and evaluate the included literature in qualitative research. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used as a basis for reporting the review. The literature was selected and evaluated by two researchers, and then meta-integration was used for analysis.

Results

From a total of 11 articles, 90 main results were presented, eight new categories were integrated, and three themes were formed: stress period, adjustment period and growth period. These three themes include eight sub-themes: negative emotion, psychological gap, self adjusting, social support, improvement of personal ability, increased sense of professional belonging, spiritual awakening and extended thinking, look ahead.

Conclusion

Post-traumatic growth in emergency and critical care nurses is dynamic. Managers should monitor the psychological changes experienced by emergency and critical care nurses following traumatic events, offering targeted support at different stages, providing enhanced professional development opportunities, refining management strategies, guiding nurses in self-adjustment and active coping with trauma, and promoting their physical and mental well-being to ensure a positive mindset for effectively addressing future public health crises.

Social cohesion among healthcare workers during COVID-19: Qualitative research in Indonesia, Nepal, and Vietnam

Existing literature has portrayed numerous challenges that healthcare workers (HCWs) faced during the COVID-19 pandemic, such as heightened risks of transmission against the scarcity of protective equipment, burgeoning workload, and emotional distress, to name a few. However, most studies explored HCWs' experiences at the individual level rather than examining the collective responses. Exploring these experiences could reveal the social-cultural locality of the pandemic while identifying the system constraints in public health emergencies. As part of a mixed-method study on COVID-19 pandemic impacts, we analysed qualitative interview data with 129 HCWs and health-related staff to explore their experiences during the pandemic between 2020 and 2021 in Vietnam, Indonesia, and Nepal. Using Bahers' sociological framework, Community of Fate, we describe five themes reflecting the formation of a community of HCWs and the social cohesion underlying their efforts to survive hardship. The first three themes characterise the HCW community of fate, including (1) Recognition of extreme work-related danger, (2) physical and figurative closures where HCWs restrict themselves from the outside world, (3) chronic ordeals with overwhelming workload and responsibilities, encompassing recurrent mental health challenges. Against such extreme hardship, cohesive bonding and social resilience are reflected through two additional themes: (4) a mutual sense of moral and professional duty to protect communities, (5) the vertical and horizontal convergence among HCWs across levels and among government departments. We discuss these HCWs' challenges in relation to systemic vulnerabilities while advocating for increasing investment in public health and collaboration across government sectors to prepare for emergency situations.

Korean Hospital Nurses' Experiences with COVID-19: A Meta-Synthesis of Qualitative Findings

This study aims to provide a meta-synthesis of qualitative studies examining the perceptions and experiences of nurses who cared for patients in dedicated COVID-19 hospitals in South Korea. We searched key health databases (RISS, KISS, KMbase, NDSL, KoreaMed, DBpia, PubMed, CINAHL, and Cochrane) from September to November 2023. We reviewed and analyzed articles using a thematic synthesis approach. The quality of the studies was ascertained using the Critical Appraisal Skills Program checklist for qualitative research. Ultimately, 13 studies involving 219 nurses were included in the final review. Six major themes and thirteen subthemes emerged. During the unexpected COVID-19 pandemic, nurses were able to overcome difficult situations through their interactions with patients, sense of a professional mission, and commitment to nursing. Most importantly, they persevered through their collaboration and closeness with fellow nurses, despite confusion about their professional identity, the ethical dilemmas they faced in patient care, and the conflicting attitudes of their social support system. To prepare for future infectious disease outbreaks, a multifaceted support system should be established to enable nurses to have positive interactions with their families, colleagues, and patients, which have become central to their resilience.

Heterogeneity of the effect of the COVID-19 pandemic on the incidence of Metabolic Syndrome onset at a Japanese campus

Background

The coronavirus disease 2019 (COVID-19) outbreak began in China in December 2019, with the World Health Organization declaring a state of emergency in January 2020. Worldwide implementation of lockdown measures to slow the spread of the virus led to reduced physical activity, disrupted eating habits, mental health issues, and sleep disturbances, which increased the risk of lifestyle-related diseases such as metabolic syndrome (MetS). During the COVID-19 pandemic, healthcare workers, especially intensive care workers, experienced longer working hours and burnout, which further increased the risk of lifestyle-related diseases. Accordingly, it is important to identify individuals at a risk of new-onset MetS during a pandemic, which could direct preventive interventions. This study aimed to assess the heterogeneous impact of the COVID-19 pandemic on the incidence of new-onset MetS based on the conditional average treatment effect (CATE) and to identify at-risk populations.

Methods

This study analyzed health checkup data obtained from Okayama University Shikata Campus workers using paired baseline and follow-up years. Baseline data encompassed 2017 to 2019, with respective follow-up data from 2018 to 2020. Furthermore, as the COVID-19 pandemic in Japan began in January 2020, workers who underwent follow-up health checkups in 2018 to 2019 and 2020 were considered as "unexposed" and "exposed," respectively. As the Shikata campus has several departments, comparisons among departments were made. The primary outcome was new-onset MetS at follow-up. Predictor variables included baseline health checkup results, sex, age, and department (administrative, research, medical, or intensive care department). X-learner was used to calculate the CATE.

Results

This study included 3,572 eligible individuals (unexposed, n = 2,181; exposed, n = 1,391). Among them, 1,544 (70.8%) and 866 (62.3%) participants in the unexposed and exposed groups, respectively, were females. The mean age (±standard deviation) of the unexposed and exposed groups was 48.2 ± 8.2 and 47.8 ± 8.3 years, respectively. The COVID-19 pandemic increased the average probability of new-onset MetS by 4.4% in the overall population. According to the department, the intensive care department showed the highest CATE, with a 15.4% increase. Moreover, there was large heterogeneity according to the department. The high-CATE group was characterized by older age, urinary protein, elevated liver enzymes, higher triglyceride levels, and a history of hyperlipidemia treatment.

Conclusions

This study demonstrated that the COVID-19 pandemic increased the incidence of new-onset MetS, with this effect showing heterogeneity at a single Japanese campus. Regarding specific populations, workers in the intensive care department showed an increased risk of new-onset MetS. At-risk populations require specific preventive interventions in case the current COVID-19 pandemic persists or a new pandemic occurs.

The process through which nurses providing care to COVID-19 patients recognize professional growth: A Trajectory Equifinality Model

AIM

This study investigated the ways in which nurses caring for COVID-19 patients during the pandemic's early stages recognized professional growth through their experiences and continued working for several years, as well as the key experiences for identifying professional growth, external factors, and career intentions.

METHODS

We used a qualitative research method called the Trajectory Equifinality Model (TEM). The participants were nine nurses caring for COVID-19 patients during the pandemic's early stages and had already recognized professional growth through a series of experiences. We constructed a TEM diagram based on two interviews per participant (in February-March, and July-August 2022).

RESULTS

The process by which the participants recognized professional growth through a series of experiences was divided into Phases 1-4. The participants experienced adversity in Phases 1 and 3, and the following professional growth in Phases 2 and 4: gaining confidence as a nurse performing tasks of great social significance by acquiring the ability to fulfill my roles and realizing I could use the skills I had acquired by providing nursing care to COVID-19 patients in other situations, respectively. The key experiences for identifying professional growth as well as the inhibiting and facilitating factors of the process differed depending on the phase. The participants' career intention was wanting to continue to be involved in nursing by utilizing the skills and experience I have accumulated.

CONCLUSION

Managers and directors of nursing should provide appropriate support in each phase to help nurses recognize their professional growth during emerging epidemics.

Identifying and ranking of the main organizational resilience indicators in the hospital during the COVID-19 pandemic: A study using fuzzy Delphi technique (FDT) and fuzzy analytical hierarchy process (FAHP)

Resilience in a hospital is referred to as the capability to withstand and respond to disasters while maintaining critical functions. The current study aims to identify and prioritize the defining indicators of organizational resilience in dealing with the critical conditions of the COVID-19 pandemic. First, a literature review and semi-structured interviews with experts were performed for the identification of the primary indicators affecting the hospital's organizational resilience in critical conditions caused by the COVID-19 disease. Next, the fuzzy Delphi technique (FDT) was used to determine the effective and final indicators with a 70% agreement level. Finally, the indicators were weighted and prioritized using the FAHP method. The results shows that three indicators of leadership and management (NW = 0.092), preparedness (NW = 0.080), and learning from previous experiences (NW = 0.078) had the greatest impact on the organizational resilience of the hospital, respectively. Three indicators of logistics support, fallibility culture, creativity, and innovation with the final weights of 0.56, 0.054, and 0.053 gained the least importance, respectively. It can be concluded that a higher level of leadership and management, preparedness, and learning from previous experiences in the conditions of the COVID-19 pandemic can help control this crisis.

Posttraumatic growth of medical staff during COVID-19 pandemic: A scoping review

BACKGROUND

The COVID-19 pandemic has imposed unprecedented stress and challenges upon medical staff, potentially resulting in posttraumatic growth (PTG). This scoping review aims to synthesize the existing knowledge on PTG among medical staff during the pandemic by identifying its current status and potential influencing factors. The findings may provide a foundation for future research and interventions to enhance the medical staff's psychological resilience and well-being.

METHODS

Literature was systematically searched on PTG among medical staff during the COVID-19 pandemic from 01 January 2020 to 31 December 2022. The following databases were searched: PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Data. Eligibility criteria included: (1) medical staff as research subjects; (2) a focus on "posttraumatic growth" or "alternative posttraumatic growth" related to the COVID-19 outbreak and pandemic; (3) discussion of the situation and influencing factors of PTG; and (4) study types, such as qualitative, quantitative, and mixed methods. Two researchers independently selected and extracted study characteristics (study design, study population, region, measurement instruments, and primary outcomes) from the included literature. The data were synthesized qualitatively and descriptively.

RESULTS

Thirty-six papers from 12 countries met the inclusion criteria. Moderate PTG levels were observed among healthcare workers during the COVID-19 pandemic, with emphasis on "interpersonal relationships," "changes in life philosophy," and "growth in personal competence." Influencing factors included trauma exposure, sociodemographics, psychological characteristics (resilience and positive qualities), coping, and social support.

CONCLUSIONS

This review discovered moderate PTG levels among medical staff during the COVID-19 pandemic, with critical areas in interpersonal relationships, life philosophy, and personal competence. The identified influencing factors can inform future research and interventions to enhance healthcare workers' psychological resilience and well-being.

Work Experience of Intensive Care Nurses during the Period of the Pandemic: A Qualitative Study

This study was conducted to describe the working experiences, feelings, and thoughts of nurses working in the intensive care unit (ICU) during the COVID-19 pandemic from their perspective. Empirical phenomenological approach, one of the qualitative study methods, was used to obtain detailed descriptions of the experiences of nurses working in the ICU during the COVID-19 outbreak in providing patient care. The research design is an in-depth interview technique. The Colaizzi method was used in the analysis of the interviews. The data obtained from the research were categorized in six main themes. These themes are as follows: backbone of the health system-nursing, professional achievements, difficulties encountered, support needs and expectations, changes in emotions, and private life. In the process of fighting the pandemic, ICU nurses undertook important responsibilities, quickly adapted to the crisis, and displayed a strong stance, thus carrying a huge burden within the healthcare system.

Nurses' coping strategies caring for patients during severe viral pandemics: A mixed-methods systematic review

BACKGROUND

Nurses play an essential role in responding to severe viral disease which bring considerable challenges to their personal and professional well-being. This subsequently can affect the delivery of care and healthcare systems' organisational capacity to respond. Understanding nurses' experiences of these challenges will help inform healthcare policies.

AIM

To explore the experiences and coping strategies of nurses caring for patients during severe viral disease pandemics.

DESIGN

A mixed-methods systematic review informed by the Joanna Briggs Institute (JBI) methodology.

METHODS

A mixed-methods systematic review. Five electronic databases Medline, CINAHL, PsychInfo, ASSIA and Scopus were searched on 4th April 2021. Results were reported in accordance with PRISMA. The findings were analysed and reported in the context of the Self-Regulatory Common-Sense Model.

RESULTS

In total, 71 peer-review primary research articles describing nurses' experiences of caring for patients during SARS, MERS, Swine flu H1N1, Avian influenza or SARS-CoV-2 / COVID-19 published in English from 2003 to 2021 were included. We found links between nurses' perception of the health threats, their emotional reactions, and coping strategies. Perceived health threats were influenced by organisational factors including frequent changes in clinical guidelines and workplace protocols, onerous workloads and working hours, unavailability of PPE, and lack of knowledge and training in pandemic management. These impacted nurses' physical, psychological and social well-being. Nurses also reported helpful and unhelpful coping strategies to manage the health threats.

CONCLUSIONS

It is vital for stakeholders, policymakers, government and healthcare institutions to recognise and monitor the wider impact on healthcare workers from health emergencies. In addition, support to develop and implement effective systems and individual mechanisms to offset the anticipated impact pre and post pandemics/epidemics is needed. Our findings can inform those strategies for similar future health emergencies.

RELEVANCE TO CLINICAL PRACTICE

Nurses are often the first point of contact in providing direct care to patients, hence they are at high risk of being infected. The findings from this review can help managers and policymakers in developing programmes to enhance resilience in the nursing workforce.

NO PATIENT OR PUBLIC CONTRIBUTION

This was a literature review study.

The Impact of Resilience on Post-Traumatic Growth among Nurses in COVID-19-Designated Hospitals: The Mediating Effect of Meaning in Life

This study aimed to confirm the relationship between resilience, meaning in life, and post-traumatic growth (PTG) among nurses during the COVID-19 pandemic. In particular, the mediating effect of meaning in life on the relationship between resilience and PTG was examined. A cross-sectional descriptive research design was used. The participants were 220 nurses at COVID-19-designated hospitals in Seoul. Descriptive statistics, a t-test, ANOVA, Pearson's correlation coefficient analysis, hierarchical regression, and SPSS PROCESS macro (Model 4) were used for data analyses. As a result of the study, resilience and meaning in life each had a significant positive effect on PTG. In addition, the indirect effect of meaning in life was significant, suggesting that meaning in life partially mediated the relationship between resilience and PTG. The results indicate that nurses' resilience directly contributes to the improvement of PTG, and this relationship is further strengthened indirectly through the presence of meaning in life. Therefore, it is suggested that strategies should be developed to enhance resilience and promote a sense of meaning in the profession in order to support the mental health and foster growth among nurses.

Perceptions of Healthcare Safety Nets among Tertiary Hospital and Long-Term Care Hospital Nurses during the COVID-19 Pandemic: A Q-Methodological Approach

This study was conducted to identify the types of perceptions toward healthcare safety nets. This study applied a Q-methodology. From a Q-population of 91 samples that included a review of the related literature and interviews with five tertiary hospital nurses and five long-term care (LTC) hospital nurses, 33 Q-samples were selected. The data were analyzed with the PC-QUANL program. We recruited 32 nurses in a tertiary hospital and 33 nurses in an LTC hospital. The perceptions of the healthcare safety net of tertiary hospital nurses were categorized into four types: (1) systematic system request; (2) realistic work support; (3) government support; and (4) emotional support. The perceived subjectivity of the healthcare safety net of LTC hospital nurses were categorized into four types: (1) reward system and facility environmental support; (2) realistic work support; (3) social prevention infrastructure support; and (4) government support. This study provides basic data for these different hospital settings, as well as to inform future government policy and system improvements in an era characterized by infectious diseases. Specifically, this study presents the types of perceptions of healthcare safety nets of nurses in two hospital settings that deliver care for patients.

Ethical issues experienced by nurses during COVID-19 pandemic: Systematic review

BACKGROUND

Frontline nurses who care for patients with COVID-19 work in stressful environments, and many inevitably struggle with unanticipated ethical issues. Little is known about the unique, ethically sensitive issues that nurses faced when caring for patients with COVID-19.

AIM

To better understand how frontline nurses who care for patients with COVID-19 experience ethical issues towards others and themselves.

METHODS

Systematic review of qualitative evidence carried out according to the Preferred Reporting Items for Systematic reviews and Meta-analyses on ethical literature (PRISMA-Ethics). The electronic databases PubMed, Embase, Cinahl, Web of Science, Philosopher's Index, and Scopus were queried to identify candidate articles. Articles appearing from March 1, 2020 to December 31, 2022 were considered if they met the following inclusion criteria: (1) Published qualitative and mixed method studies and (2) ethical issues experienced by nurses caring for patients with COVID-19. We appraised the quality of included studies, and data analysis was guided by QUAGOL principles.

FINDINGS

Twenty-six studies meeting our inclusion criteria for how nurses experience ethical issues were characterised by two key themes: (1) the moral character of nurses as a willingness to respond to the vulnerability of human beings and (2) ethical issues nurses acted as barriers sometimes, impeding them from responding to requests of vulnerable human beings for dignified care.

CONCLUSION

Our review provides a deeper understanding of nurses' experiences of ethically sensitive issues, while also highlighting the critical need for adjustments to be made at organisational and societal levels. Ethical issues that emerged in situations where organisational and situational constraints impeded nurses' ethical responses to patients' appeals suggests that early practical support should be made available to resolve ethical issues recognised by nurses. Such support contributes to protecting and promoting not only the dignity of patients with COVID-19 but also of fellow humans in need during crisis.

Psychosocial status and risk perception among Iranian healthcare workers during the fifth wave of the COVID-19 pandemic

BACKGROUND

Healthcare workers (HCWs) are essential resources, and their health and wellbeing are key not only for offering constant and useful care facilities to clients, but also for maintaining the safety of the workforce and patients. The risk of severe mental health problems among HCWs may have increased during large outbreaks of COVID-19. To evaluate the psychosocial status and risk perception of HCWs who participated in treating COVID-19 patients in Northern Iran, we performed a web-based cross-sectional study.

METHODS

The web-based cross-sectional design was applied between June 27 and September 2, 2021. Using convenience sampling, 637 HCWs were recruited from hospitals in Northern Iran (Mazandaran). The HCWs completed self-report questionnaires that included a sociodemographic information form, the 12-item General Health Questionnaire, Impact of the Event Scale-Revised, Risk Perception Questionnaire, and Anxiety Stress Scale-21. The data were analyzed via descriptive and inferential statistics and univariate/multivariate logistic regression to assess the risk factors linked to each psychosocial consequence.

RESULTS

The results reveal that the COVID-19 pandemic had an adverse psychosocial influence on HCWs, which was already apparent 1.5 years after the crisis began. Based on the results, 71.6%, 55.6%, and 32.3% of HCWs reported having anxiety, depression, and stress symptoms, respectively, since the outbreak of this disease. The logistic regression models displayed that marital status, having children, and working hours with patients were all risk factors of psychosocial impairment.

CONCLUSIONS

The outbreak of COVID-19 can be considered an important experience of a bio-disaster resulting in a significant rate of psychiatric problems in HCWs. There is a need for designing and promoting supportive programs to help HCWs cope and to improve their psychosocial state, and the present study has detected for whom psychosocial support may be effective and practical 1.5 years after the primary outbreak. Moreover, detecting and managing concerns and reducing infection-related embarrassment/stigma are essential for improving HCWs' mental health.

Factors influencing nurses' post-traumatic growth during the COVID-19 pandemic: Bayesian network analysis

Objective

During the COVID-19 pandemic, nurses, especially if females and working in intensive care units or emergencies unit, were much more at risk than other health-workers categories to develop malaise and acute stress symptoms. This study aimed to examine the nurses' post-traumatic growth and associated influencing factors during the COVID-19 pandemic.

Methods

A cross-sectional study using an online survey was conducted at Henan Provincial People's Hospital to gather data from nurses. A set of questionnaires was used to measure the participants' professional identity, organizational support, psychological resilience and post-traumatic growth. Univariate, correlation, and multiple linear regression analyses were used to determine significant factors influencing post-traumatic growth. A theoretical framework based on the Bayesian network was constructed to understand post-traumatic growth and its associated factors comprehensively.

Results

In total, 1,512 nurses participated in the study, and a moderate-to-high level of post-traumatic growth was reported. After screening, the identified variables, including psychological counseling, average daily working hours, average daily sleep duration, professional identity, organizational support, and psychological resilience, were selected to build a Bayesian network model. The results of Bayesian network showed that professional identity and psychological resilience positively affected post-traumatic growth directly, which was particularly pronounced in low- and high-scoring groups. While organizational support positively affected post-traumatic growth indirectly.

Conclusion

Although this study identified a moderate-to-high level of nurses' post-traumatic growth, proactive measures to improve psychological resilience fostered by professional identity and organizational support should be prioritized by hospitals and nursing managers.

Experiences of health professionals in EU institutions during the Covid crisis

We performed a quantitative and a qualitative study, addressing the experiences of health services of 16 European Union institutions during the Covid-19 pandemic. Among the 165 eligible subjects, 114 (69%) participated in the survey. The biggest problem reported was limitation of social contacts (53%). At work, the biggest problems were workload (50%) and shortage of staff (37%). The majority were positive about teamwork. Teleworking was seen positively by 81%. Most participants felt better prepared for future situations by their recent experience (94%). Participants underlined the importance of strengthening the collaboration with the local health systems (80%), as well as with medical services and internal services within their own institution (75%). The qualitative analysis also reported participants' fear of becoming infected, and of their family members getting sick. Similarly reported were the sense of isolation and anxiety, the excessive workload and work complexity, shortage of staff, and the benefits of teleworking. Study findings highlight: i) the need to strengthen mental health support to health personnel, not only during crisis situations; ii) the need for sufficient health workers, with swift recruitment strategies in times of crisis; iii) the importance of clear protocols to ensure no shortages of personal protective equipment (PPE); iv) the importance of teleworking, which represents an opportunity for major reorganisation of work within EU medical services; v) the need to strengthen collaboration with local health systems and the medical services of EU institutions.

Experience of Pediatric Nurses in Parent-Child Isolation Units of COVID-19 Designated Hospitals: A Qualitative Study

Background

The omicron pandemic in Shanghai has created unprecedented challenges for pediatric medical institutions, and the work of pediatric nurses has changed rapidly due to the introduction of parent-child treatment. This study aimed to explore the experiences of pediatric nurses in the parent-child isolation unit of COVID-19-designated hospitals and provide a basis for developing feasible interventions as the next step.

Methods

Using phenomenological research methods, 12 nurses working in the parent-child isolation unit of Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine from April 1, 2022, to June 15, 2022, were selected by purposive sampling. Semi-structured interviews and data analysis were conducted using Colaizzi's 7-step analysis.

Results

Data analysis revealed three major themes and 11 subthemes. The main themes were "risk factors", "protection factors", and "resilience strategies". The sub-themes were "challenge of caring for both adults and children simultaneously", "lack of adult expertise leads to inadequate coping skills", "change in the care population increased communication difficulties", "physical and psychological distress", "social support", "social recognition", "awareness of responsibilities and roles", "team coming together", "hunger for knowledge", "health promotion", and "psychological adjustment strategies".

Conclusion

Hospital managers should optimize hospital management strategies, pay attention to multi-departmental and multidisciplinary team cooperation, reduce the burden on pediatric nurses, improve the work and rest environment, mobilize the hospital support system, and maintain nurse's physical and mental health, establish a warm parent-child isolation unit encourages nurses to listen to the patients' voices and adopt diversified communication methods, and strengthen the publicity of the nursing profession, improve social support and recognition, and enhance the sense of self-worth and mission.

COVID-19 Cases and Deaths among Healthcare Personnel with the Progression of the Pandemic in Korea from March 2020 to February 2022

Healthcare personnel (HCP) are vulnerable to COVID-19 infection due to their higher risk of contact with infected persons. The numbers of cases and deaths among HCP in Korea were divided into four periods associated with different major variants of SARS-CoV-2: GH clade, Alpha, Delta, and Omicron. To evaluate the implication of HCP infection in Korea, we overviewed the pandemic status in Korea and in other countries: the cases, deaths, excess mortality, and vaccination rates in Germany, Israel, Italy, Japan, the United Kingdom, and the United States. In about two years, there were 10,670 HCP cases among all COVID-19 cases (1.15% of 925,975 cases). HCP cases had a lower death rate (%) compared to that for all cases (0.14 versus 0.75). Nurses were the most infected (55.3%), followed by HCP of other categories (28.8%) and doctors (15.9%), while deaths were mostly reported among doctors (9 out of 15, 60%). Cases among HCP gradually increased, but the death rate decreased as the pandemic progressed. Compared to five of the other countries examined, Korea had a higher incidence of cases but a lower mortality, lower excess mortality, and a higher vaccination rate.

Use of interviewer-administered telephone surveys during infectious disease outbreaks, epidemics and pandemics: a scoping review

INTRODUCTION

During the COVID-19 crisis, researchers had to collect data remotely. Telephone surveys and interviews can quickly gather data from a distance without heavy expense. Although interviewer-administered telephone surveys (IATS) can accommodate the needs of international public health research, the literature on their use during infectious disease outbreaks is scarce. This scoping review aimed to map the characteristics of IATS during infectious disease outbreaks.

METHODS

IATS conducted principally during infectious disease outbreaks and answered by informants at least 18 years old were searched from PubMed and EBSCO. There was a manual addition of relevant documents identified during an initial search. Overall trends were reported using different groupings, including WHO regions, and study details were compared before and during the COVID-19 pandemic.

RESULTS

70 IATS published between 2003 and 2022 were identified. 57.1% were conducted during the COVID-19 pandemic. Among 30 IATS conducted before the COVID-19 pandemic in the world, only 3.3% were carried out in low-income and middle-income countries (LMICs). This percentage of studies in LMICs out of all the IATS rose to 32.5% during the pandemic. The share of qualitative studies grew from 6.7% before the COVID-19 outbreak to 32.5% during the outbreak. IATS performed during the COVID-19 pandemic focused on more diverse, specific population groups, such as patients and healthcare professionals. Mobile phones are increasingly used for IATS over time.

CONCLUSION

IATS are used globally with high frequency in the Western Pacific Region and high-income countries. Technical and financial challenges continue to exist, and assessments of inclusiveness and representativeness should be carefully conducted. A lack of details related to methods was observed, and this scoping review urges researchers using this data collection method in the future to specify how they executed IATS for better use and more efficient deployment.

Lessons Learned from the COVID-19 Outbreak as Experienced by ICU Nurses: Manifest Qualitative Content Analysis

From the moment the World Health Organization (WHO) declared the coronavirus (COVID-19) a global pandemic, intensive care unit (ICU) nurses struggled to care for the COVID-19 patients. As the pandemic became increasingly critical, the task of daily care for critically ill patients fell upon the shoulders of ICU nurses. Understanding the lived experience of ICU nurses, as well as their perception of the experience, is important to identify key lessons to further improve ICU nurses' psychological well-being and resilience. This study explored the lived experiences of ICU nurses who cared for COVID-19 patients using exploratory manifest qualitative content analysis. The findings of this study revealed that these ICU nurses offer important information concerning the crucial role of nurses' family support and religious-spiritual practices in helping them to maintain well-being and cope with the intense situations caused by the pandemic. The lessons emerging from the study findings show that family support and religious-spiritual practices are resources for coping and resilience in times of future pandemics. This implies that ICU nurses who provide care during stressful emergency surges require relief by nurses working in other areas to provide them the opportunity to rest, reconnect with family and become emotionally re-energized.

Frontline nurses experiences about human caring during pandemic of COVID-19: A directed content analysis study

AIM

This study aims to investigate experiences of frontline nurses about human caring during COVID-19 pandemic based on the Ten Caritas Processes® of Watson's Human Caring Theory.

DESIGN

A directed content analysis was performed.

METHODS

A total of 15 frontline nurses were recruited by purposive sampling from Razi hospital (north of Iran), in 2020 and semi-structured interviews were conducted.

RESULTS

Extracted categories based on Ten Caritas Processes® included feeling satisfied in providing care to patients, effective presence with patients, moving towards self-actualization (moving towards transcendence), care with trust and compassion, experience positive and negative emotions, creativity in providing care, self-directing learning experience in the field of care, unfavourable environment for providing care, feeling acceptance and worth, uncertainty (facing the unknown). This study showed that communication skills, self-sensitivity, patient dignity, teaching-learning and problem-solving skills, holistic attention to the patient, and the provision of a healing environment are necessary for patient care.

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.

Experiences of nurses providing care for patients with COVID-19 in acute care settings in the early stages of the pandemic: A thematic meta-synthesis study

AIM

The aim of this work is to synthesize and interpret qualitative research examining the experiences of nurses providing care for patients with COVID-19 in acute care settings in the early stages of the pandemic in different countries.

BACKGROUND

The prevalence of disasters, including the pandemic, is increasing globally. It is important to understand nurses' experiences in depth to effectively manage extraordinary events that may occur in the future.

DESIGN

This is a thematic meta-synthesis study.

METHODS

Electronic databases, including CINAHL, MEDLINE, PubMed, Web of Science, OVID, and Scopus, were searched for publications from December 2019 to October 2020. The search was updated for publications to 30 May 2022. The thematic synthesis method was used to analyse and interpret the data.

FINDINGS

The experiences of the nurses giving care to patients with COVID-19 were grouped under four themes: (1) Difficulties encountered in the care of patients with COVID-19; (2) mixed emotions experienced in the care of patients with COVID-19; (3) coping strategies that nurses used in the management of the pandemic; (4) the benefits of the COVID-19 to nurses.

CONCLUSION

Nurses faced many difficulties and experienced mixed emotions while providing care for patients with coronavirus disease. Perceived social support was seen as the most important strategy for coping with these difficult situations. It is important to be aware of the difficulties and emotions experienced by nurses and support them during the COVID-19 pandemic for the management of future pandemics.

Anxiety Levels and Coping Strategies to Deal with COVID-19: A Cross-Cultural Study among the Spanish and Latin American Healthcare Populations

Given its impact, COVID-19 has engendered great challenges in terms of health, highlighting the key role of health personnel. This study aims to analyze the level of anxiety, as well as coping strategies, among the health personnel in Latin American countries and Spain. An exploratory, descriptive, quantitative, cross-sectional study was conducted with 584 participants from the healthcare population. No significant differences were observed in anxiety levels due to COVID-19 between Latin American countries and Spain. In Spain, an active and passive coping style is used, while in Latin American countries, an avoidance coping style is employed; there is a direct correlation between anxiety levels and the avoidance coping style. There exists an inverse correlation between anxiety levels and the use of an active coping style; moreover, there are no significant differences in the anxiety level of health personnel depending on whether they have cared for patients with COVID-19. Low cognitive activity, use of the avoidance method and Spanish geography were the main predictive coping styles of anxiety. Effective measures are required for preserving the mental health of health professionals during pandemics.

Impact of, and mitigation measures for, burnout in frontline healthcare workers during disasters: A mixed-method systematic review

BACKGROUND

Burnout is a global concern for the healthcare community, especially following a disaster response. It is a major obstacle to providing safe and quality health care. Avoiding burnout is essential to ensuring adequate healthcare delivery and preventing psychological and physical health problems and errors among healthcare staff.

AIMS

This study aimed to determine the impact of burnout on healthcare staff working on the frontline in a disaster context, including pandemics, epidemics, natural disasters, and man-made disasters; and to identify interventions used to mitigate burnout among those healthcare professionals before, during, or after the disaster.

METHOD

A mixed methods systematic review was used and included a joint analysis and synthesis of data from qualitative and quantitative studies. The was guided by the preferred reporting items for systematic review and meta-analyses (PRISMA) of qualitative and quantitative evidence. Several databases were searched, for example, Medline, Embase, PsycINFO, Web of Science, Scopus, and CINAHL. The quality of included studies was assessed using the Mixed Method Appraisal Tool (MMAT), version 2018.

RESULTS

Twenty-seven studies met the inclusion criteria. Thirteen studies addressed the impact of burnout in relation to disasters and highlighted the association between burnout and the physical or mental well-being of healthcare workers, work performance, and workplace attitude and behavior. Fourteen studies focused on different burnout interventions including psychoeducational interventions, reflection and self-care activities, and administering a pharmacological product.

LINKING EVIDENCE TO ACTION

Stakeholders should consider reducing risk of burnout among healthcare staff as an approach to improving quality and optimizing patient care. The evidence points to reflective and self-care interventions having a more positive effect on reducing burnout than other interventions. However, most of these interventions did not report on long-term effects. Further research needs to be undertaken to assess not only the feasibility and effectiveness but also the sustainability of interventions targeted to mitigate burnout in healthcare workers.

Learning from critical care nurses' wartime experiences and their long-term impacts

BACKGROUND

The history of critical care nursing is intertwined with that of battlefield nursing, where for almost 200 years, nurses worked to save injured soldiers' lives, risking their own physical and emotional injuries. Today, with nurses increasingly deployed to provide critical care during natural, man-made and public health crises that can resemble battlefield situations, there is much to learn from battlefield nurses.

AIM

This qualitative study aims to explore the lessons of the experiences of civilian nurses deployed to Israeli battlefields in three wars between 1967 and 1982.

METHODS

Qualitative, semi-structured, in-depth interviews were conducted with twenty-two former military nurses who were deployed in three wars between 1967 and 1982. We analysed interview transcripts using a content analysis approach. COREQ, a 32-item checklist, guided method selection, data analysis and the findings' presentation.

FINDINGS

Data analysis revealed three main themes, with ten related subthemes: Field Service Challenges, Coping with Challenges, and Nurses' Need for Recognition.

CONCLUSION

The findings identify mental, emotional, and organizational issues resulting from nurses' wartime experiences, revealing numerous opportunities for better preparing and supporting critical care nurses before, during, and after crises.

RELEVANCE TO CLINICAL PRACTICE

Critical care nursing during crises, such as wartime, is unique but increasingly common. The memories and ongoing impact of those experiences offer invaluable information for nursing and health policy stakeholders planning for future deployments during wartime or other disasters such as the COVID-19 pandemic and the Russo-Ukrainian war.

Nurses' adaptations to changes on a COVID-19 ward in South Korea: A qualitative study

Background

Elucidating nurses' adaptation to changes in the early stage of an infectious disease epidemic is necessary to promote nurses' coping with and adapting to situations in which new infectious diseases are predicted periodically.

Aim

To explore nurses' adaptation to changes in COVID-19 wards in South Korea.

Methods

In-depth interviews were conducted with 20 nurses through purposive sampling from May to August 2020. The collected data were transcribed verbatim, and analysis was performed using conventional content analysis.

Findings

Three categories emerged from the interviews: (a) Disruption caused by an unforeseen pandemic outbreak, (b) perseverance through the turmoil of changes as a nurse, and (c) transition from feelings of fearfulness to those of accomplishment. While the nurses initially struggled to care for patients with COVID-19, they made conscious efforts to provide emotional nursing and maintain their professionalism.

Discussion

Nurses caring for patients with COVID-19 have faced a number of challenges but have adapted to new scenarios by endeavoring to fulfil their professional roles.

Conclusion

To overcome a national disaster situation such as COVID-19, the government and healthcare organizations should prepare strategies to support the efforts of nurses to strengthen their own professionalism.

Nurses' experiences of the social stigma caused by the COVID-19 pandemic: a qualitative study

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.

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

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

Experience of clinical nurses engaged in caring for patients with COVID-19: A qualitative systematic review and meta-synthesis

AIMS AND OBJECTIVE

This qualitative review summarises and synthesises the available evidence on subjective experiences of clinical nurses who cared for patients with COVID-19.

BACKGROUND

Nurses are first responders and play a vital role in emerging infectious disease epidemics such as the COVID-19 pandemic. In this context, they also face many difficulties and challenges related, for example to the imbalance between extensive demands and low control over work tasks.

DESIGN AND METHOD

A systematic review of qualitative studies and meta-synthesis focused on the experiences of clinical nurses caring for patients with COVID-19 during the pandemic was carried out.

RESULTS

A total of 279 findings were extracted, aggregated into 21 categories and combined into seven synthesised findings, namely (1) professional nursing practice during the pandemic, (2) support systems, (3) somatic sensations and psychological experiences, (4) difficulties and challenges, (5) coping strategies and behaviour, (6) impact on life, profession and values, and (7) needs and expectations for the future.

CONCLUSION

Nurses encountered considerable difficulties and challenges in caring for patients with COVID-19. Nurses caring for patients with COVID-19 need more support from organisations, families and society. It is essential to explore positive coping strategies suitable for working in different cultural backgrounds. Policymakers and decision-makers should pay attention to the experiences and voices of nurses.

RELEVANCE TO CLINICAL PRACTICE

It is critical for nurse managers to consider how to enhance the support system and help nurses develop adaptive coping strategies in response to COVID-19. Nurses' experiences and voices are valuable in improving health emergency response systems.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.

An analysis of the policy participation of field response nurses in South Korea: COVID-19 response guidelines and the infectious disease act revision

INTRODUCTION

The Republic of Korea's response to Coronavirus disease 2019 was divided before and after global vaccine development at the end of 2020. It also varied according to the size of confirmed patients in the non-pharmaceutical intervention. Therefore, this study aimed to analyze the contribution of frontline nurses to the policy and law revision on infectious diseases and suggest health and nursing policies for emerging infectious diseases in the future.

DESIGN

This case evaluation study analyzed the significant policy decisions that nurses' roles brought on changes in the infectious disease response system in the Republic of Korea and applying the health system model and those capacities on resilience under emerging infectious diseases.

METHODS

Objective data that contributed directly to the revision of infectious disease-related Acts and policies in 2020 were collected and analyzed through literature search and information disclosure claims from the first to third waves of Coronavirus disease 2019 in one city.

RESULTS

With the rapid outbreak of COVID-19 confirmed cases at the end of February 2020, a pan-government support group was formed and dispatched to D City. In addition, central quarantine officials worked with local quarantine officials to share real-time situations and find out on-site difficulties and support requests. As a result, inquiry of opinions to working staff before changing the "response guidelines to Coronavirus disease 2019" was reflected in major contents on the revision of "policy on infectious disease response" and "Infectious Disease Prevention and Management Act." With the establishment of an epidemiological investigation team in September 2020, the number of new nurses in 17 cities and provinces increased by 19.1% compared to the previous year, the most significant increase compared to doctors (-2.3), dentists (-1.6), and health workers (3.7).

CONCLUSION

The experience of responding to Coronavirus was a reminder that the curriculum needed to be improved so that nurses will be recognized to have leadership competencies and as field experts regarding social determinants of health for population groups in the decision-making process. In the initial COVID-19 response process, nurses showed excellence in analyzing patient interviews and various information as field epidemiological investigation response personnel, making comprehensive judgments, and solving problems in cooperation with related agencies and severe patients' bedside nursing care. Continuous primary care and management of infectious diseases for the vulnerable should be prepared on an ongoing basis to assure the quality of care.

CLINICAL RELEVANCE

Action strategies for developing leadership to enable nurses to have participated in the social determinants of health and the nursing policy formation for health equity should be applied in nursing education and practice, and global monitoring efforts were accelerated.

The psychological impact on frontline nurses in Spain of caring for people with COVID-19

AIM

To understand the perceptions of National Health System nurses who have been working on the frontline of the psychological impact of caring for people with COVID-19 during the first and second waves.

METHODS

A qualitative study, the design and analysis of which was based on phenomenology. For data collection, a semi-structured interview was administered to a sample of nurses who worked on the frontline in public hospitals in Extremadura and Madrid, Spain. The interviews, which followed a script including various topics, were conducted between May and November 2020 so as to include the experiences of the first and second waves of the pandemic. Sample collection continued until data saturation. The data were analysed following the phenomenological method of Giorgi with the help of the Atlas-Ti software.

RESULTS

Two main themes emerged from the data analysis that explained the nurses' perceptions: (i) the main psychological repercussions of being frontline carers (anxiety, fear, stress, impotence, frustration, and an increase in obsessions and obsessive behaviours) and (ii) psychological coping strategies (collapse in the face of the situation, dissociative amnesia, leaning on colleagues and working as a team, resigning oneself, perceiving the situation as a war, and being aware of psychological repercussions).

DISCUSSION

Caring as the first line causes great psychological repercussions for nurses. It is necessary to implement psychological and emotional support programmes to address the post-traumatic stress that nurses can suffer.

Lived Experiences of Female Nurses with COVID-19 Deaths on Their Watch

The COVID-19 pandemic has had a tremendous effect on health systems, leading to a spike in stress, anxiety, and depression conditions among healthcare workers worldwide. Considering the mental health status of nurses, a pillar of the health system, is crucial for assuring the quality of the healthcare provided during and after pandemics. This study aimed to explore the experiences of female nurses who witnessed their patients dying of COVID-19. Seven female COVID-19 nurses were interviewed in person. Thematic analysis of the respondents' verbatim answers was implemented. Six main themes were identified. Theme 1 illustrates nurses' experience of emotional and psychological trauma as they witnessed their patients with COVID-19 die under their care. Theme 2 reveals aftershock reactions, including somatization, isolation, and emotional disengagement. Theme 3 highlights the hindrances and difficult situations related to the in-hospital care of COVID-19 patients. Theme 4 demonstrates victorious feelings and celebration of the patient's survival. Theme 5 emphasizes the nurse's ability to be calm and recognize the takeaways or lessons they have learned from this phase for their careers and lives. Theme 6 sheds light on nurses' emerging abilities and competencies. This study will hopefully provide a basis for a debriefing program that might be beneficial to the nurses and the health system. This might affect nurses' ability to work closely with patients, cope emotionally with challenges, and fulfil their professional tasks.

Cross-cultural differences and similarities in nurses’ experiences during the early stages of COVID-19 in Korea and the United States: A qualitative descriptive study

Background

At the onset of the COVID-19 pandemic, governmental responses varied worldwide, which resulted in healthcare professionals and organizations having different experiences. As threats of global infectious disease and disasters increase, it is important to examine the collective experiences of nurses to leverage support across international settings and systems and to tailor specific policies to their local nursing workforce.

Objective

To compare and contrast nurses' experiences working in hospitals at the onset of COVID-19 in South Korea and the United States

Method

This was a qualitative descriptive study. Nurses in South Korea and the United States were recruited through social media using snowball sampling between April and May 2020. Semi-structured telephone interviews were audio-recorded, transcribed, and translated as needed. The transcripts were analyzed thematically, and each theme was compared and synthesized using NVivo 12.

Results

A total of 43 nurses from South Korea (n = 21) and the United States (n = 22) participated in the study. The majority of the participants were female and working as staff nurses in both countries. The work settings were similar between the participants from two countries. However, the participants in South Korea provided less direct care to patients with COVID-19 compared to the participants in the United States. Despite cultural and infrastructure differences, the nurses shared similar experiences.

Conclusion

The overlapping similarities of nurses’ experience highlight the need for national and global policies for a safe work environment and psychological well-being. The differences between the two countries also emphasize that specific policies and practice implications for the local contexts are needed in addition to global policies.

Providing End-of-Life Care to COVID-19 Patients: The Lived Experiences of ICU Nurses in the Philippines

In the midst of COVID-19, radical change in the work environment further exacerbated the detrimental effects of critical illness in the intensive care unit (ICU). This may be heightened if the patient experiences a lamentable end-of-life experience due to inadequate end-of-life care (EoLC). Anchoring on the theory of bureaucratic caring and the peaceful end-of-life theory, insights can be gained into the motivations and behaviors that support the delivery of palliative care during COVID-19. With this having been having said, the objective of this study was to use a narrative approach to examine the lived experience of 12 nurses who provided EoLC in the COVID-19 ward of several hospitals in the Western Philippines. Participants' narratives were transcribed, translated and analyzed. Among the themes that have emerged are: establishing a peaceful journey to death, holistic caring for the end of life, venturing into risky encounters in the call of duty, staying close amidst the reshaped work environment, and preparing the family life after a loved one's departure. The study identified the importance of assisting patients on their journey to a peaceful death, but this journey was also accompanied by a sense of self-preservation and safety for colleagues and families.

Lived Experience of Nurses in COVID-19 Units - A Phenomenological Study from Eastern India

Introduction: Nurses are the frontline workers who had to play multiple functions like in acute care, community, etc. but, it was stated that COVID-19 has caused immense trauma to nurses globally. Methods: A descriptive phenomenological study to explore the lived experience of nurses working in COVID-19 units was conducted among nine senior nursing officers recruited by purposive homogenous sampling and interviewed with an open-ended interview guide by ensuring data saturation. COREQ guideline were adopted for this qualitative study. Results: Qualitative data were analysed using Giorgi's framework, and themes and sub-themes were derived. The major themes that emerged in the present study were "Reactions and preparation", "Feelings and satisfaction in active duty", "Role of a helping hand", "Working experience in PPE", and "Pandemic and socialization". Each theme had further sub-themes to classify the verbatims. Conclusion: Most of the nurses had anxiety and prepared themselves to play with fire, had unrealistic hope, and mixed emotions, kept their family away and intentionally concealed information to reduce family's fear, were satisfied with training and preparation, and had unpleasant experiences with PPE, had to restrict their social activities and felt social stigma. It also concludes with the recommendation that warrants the need to improve their professional quality of life and working conditions by safeguarding nurses' physical and mental health.

Post COVID-19 mental health symptoms and quality of life among COVID-19 frontline clinicians: a comparative study using propensity score matching approach

BACKGROUND

The extent and severity of post-COVID-19 mental health symptoms among frontline clinicians are not clear. This study compared mental health symptoms (i.e., depression, anxiety, and insomnia symptoms) and global quality of life (QOL) after the first COVID-19 outbreak between the COVID-19 treating and non-COVID-19 treating frontline clinicians.

METHODS

This cross-sectional, comparative, convenient-sampling study was conducted between October 13 and 22, 2020, which was five months after the first COVID-19 outbreak in China was brought under control. The severity of depression, anxiety, insomnia symptoms, and global QOL of the clinicians were assessed using the Patient Health Questionnaire-9 items (PHQ-9), Generalized Anxiety Disorder Scale-7 items (GAD-7), Insomnia Severity Index (ISI), and the World Health Organization Quality of Life Questionnaire-brief version (WHOQOL-BREF), respectively. The propensity score matching (PSM) method was used to identify comparable COVID-19 treating and non-COVID-19 treating frontline clinicians. A generalized linear model (GLM) was used to assess the differences in PHQ-9, GAD-7, ISI, and QOL scores between the COVID-19 treating and non-COVID-19 treating frontline clinicians.

RESULTS

In total, 260 COVID-19 treating frontline clinicians and 260 matched non- COVID-19 treating frontline clinicians were included. Non-COVID-19 treating frontline clinicians experienced more frequent workplace violence (WPV) than the COVID-19 treating frontline clinicians (χ² = 7.6, p = 0.006). COVID-19 treating frontline clinicians reported higher QOL compared to their non-COVID-19 treating frontline counterparts (b = 0.3, p = 0.042), after adjusting for WPV experience. COVID-19 treating and non- COVID-19 treating frontline clinicians reported similar PHQ-9, GAD-7, and ISI total scores (all p values > 0.05).

CONCLUSION

This study did not reveal more severe post-COVID-19 mental health symptoms in COVID-19 treating frontline clinicians compared to non-COVID-19 treating frontline clinicians. It is possible that the implementation of timely and appropriate mental health, social and financial supports could have prevented the worsening of mental health symptoms among the COVID-19 treating frontline clinicians after the first COVID-19 outbreak in China.

Exploring the experiences of frontline nurses caring for COVID-19 patients

AIM

This study seeks to gain a comprehensive understanding of the experiences of frontline nurses who provided direct care for COVID-19 patients.

BACKGROUND

Due to the COVID-19 pandemic, the demands on healthcare systems have been higher than before. Although previous studies have explored the experiences of frontline nurses, these experiences could vary depending on each country's social, cultural, and historical contexts.

INTRODUCTION

In the midst of the global pandemic, sharing the experiences of COVID-19 frontline nurses could have implications for both nursing and nursing policies that could be applied to future pandemics.

METHODS

This descriptive qualitative study comprised 14 South Korean nurses with a minimum of one month of experience working within a COVID-19 department. Individual interviews were conducted on a virtual platform, and a thematic analysis was employed. The consolidated criteria for reporting qualitative studies were used to ensure a detailed reporting of the study.

RESULTS

Four themes and 12 subthemes were developed. The themes included: (1) feeling forced into a world of uncertainty; (2) providing unique care for COVID-19 patients; (3) perceiving barriers to providing quality care; and (4) seeking meaning in caring for COVID-19 patients.

DISCUSSION

Nurses recognized their unique roles in caring for COVID-19 patients and sought new meanings within their profession. However, the poor work environment exacerbated the physical and emotional burden among the nurses and compromised the provision of quality care.

CONCLUSION

This study highlighted the nursing policy issues that need to be improved to ensure better quality care and a stronger healthcare system.

IMPLICATIONS FOR NURSING POLICY

Governmental action is essential to ensure that nurses can maintain the quality of care they have provided during COVID-19 and any future pandemics.

Lived experience of Jordanian front-line healthcare workers amid the COVID-19 pandemic: a qualitative study

OBJECTIVES

This study aimed to explore the lived experience of Jordanian front-line healthcare workers (FHCWs), including their experienced challenges and adaptations amid the COVID-19 pandemic.

DESIGN

A phenomenological qualitative design was used to highlight the experiences of a sample Jordanian FHCWs during the COVID-19 pandemic. Qualitative interviews were conducted using a semistructured guide with open-ended questions, audiotaped and then transcribed verbatim. Thematic analysis of the transcribed narratives was conducted using an open coding line by line to develop themes and related subthemes.

SETTING

Mobile COVID-19 testing and contact tracing units during an active surge of cases in Jordan between May and September 2020.

PARTICIPANTS

Participants were recruited using purposive sampling method and consisted of 15 FHCWs (2 physicians, 10 nurses, 2 paramedics and 1 laboratory technician) who have worked in testing and contact tracing teams in the community and have dealt with suspected or confirmed cases of COVID-19 infection.

RESULTS

Participant narratives were classified into two main overarching themes; challenges and adaptation themes. The challenges theme was exhibited as follows: (1) an excruciating encounter with an invisible enemy, (2) distorted knowledge about COVID-19 and (3) organisational and administrative challenges. The adaptation theme was exhibited as follows: (1) seeking relevant knowledge about the disease and (2) seeking more connectedness.

CONCLUSIONS

The COVID-19 pandemic exerted many challenges for FHCWs at multiple levels; intrapersonal and interpersonal, organisational and societal levels. Nevertheless, a number of adaptation strategies within these levels have been reported. This study helps to provide the base on which healthcare officials and public health personnel can formulate preparedness plans that tackle challenges faced by front-line workers, which ultimately enhance the resilience of healthcare systems to withstand future pandemics.

Frontline nurses' burnout and its associated factors during the COVID-19 pandemic in South Korea

Background

The Coronavirus disease pandemic is a global health crisis with psychological consequences for healthcare workers.

Purpose

To identify the prevalence and potential factors influencing burnout among frontline nurses in South Korea.

Methods

This cross-sectional study comprised 161 nurses who voluntarily participated in the survey through advertisements at a general hospital. Data on sociodemographic and professional characteristics, insomnia, depression, anxiety, stress, and burnout were collected via an online questionnaire in 2021.

Results

Among the participants, 90 had a high level of burnout. Overall, 59.6 %, 23.0 %, 36.0 %, and 17.4 % of nurses experienced insomnia, depression, anxiety, and stress, respectively. The results showed that the assigned number of patients, insomnia, and depression were the major factors affecting burnout levels of nursing staff.

Conclusions

Frontline nurses were the main force in the fight against public health emergencies. The government and medical institutions must consider professional and psychological factors in ameliorating burnout and safety for nurses.

Exploring Nurses’ Working Experiences during the First Wave of COVID-19 Outbreak

During the COVID-19 outbreak, nurses employed in the clinical sector faced a number of difficulties associated with excessive workload, increased stress, and role ambiguity, which impacted nurses themselves and patient care. The aim of the present study was to investigate how Greek hospital nurses working in non-COVID units experienced the virus outbreak during the first wave of the pandemic. A descriptive qualitative research design was applied using a content analysis approach. To recruit the study participants a purposive sampling strategy was used. Ten nurses participated in the study. Data collection was conducted through semi-structured interviews. Content analysis revealed three themes namely, (a) emotional burden, (b) professional commitment, and (c) abrupt changes. Six subthemes were formulated and assimilated under each main theme respectively. Organizational changes, emotional burdens and feelings of fear and uncertainty, appeared to have a crucial effect on nurses and patient care. However, the professional commitment and the nurses’ effort to provide excellent nursing care remained high. Nurses demonstrated that despite the burdens caused by the COVID-19 outbreak, the pandemic era created opportunities for thoroughness and accuracy in nursing care.

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

Background

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

Methods

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

Results

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

Conclusions

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

Systematic review registration

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

Back to the Roots of Nursing: Qualitative Study on the Experience of Nurses in the Front Line During the COVID-19 Pandemic

The COVID-19 emergency has led many health facilities to reorganize themselves in a very short time to meet the urgent needs for intensive, semi-intensive or ordinary care of SARS-CoV-2 patients. In this pandemic, characterized by speed of transmission and severity of respiratory symptoms, care has been affected by the increase in volume and clinical complexity of patients, the sudden and unpredictable staff decrease and the lack of support from family members / caregivers. At the same time, experience in the field has shown how “informal” resources have been activated, which enabled to treat the highest possible number of patients above the real availability of resources. The purpose of this study was to explore the experiences of nurses involved in frontline care (COVID Centers) during the pandemic with a particular focus on professional motivation and on the development of technical-professional and personal skills. A study with a qualitative research design using focus group technique was conducted. Two focus groups were held with nine nurses. Data were analyzed with inductive content analysis. The findings can be summarized in five main categories: professional identity; motivation and sense of mission; development of professional and personal skills; spirituality; person-centered care; uniqueness of the lived experience. These findings shed new light on the correlation between motivation, professional identity and value, sense of duty and sense of belonging to the professional group. Moreover, the experience in the COVID Centers represented a valuable opportunity for participants to rediscover some specific issues related to nursing professional identity and to develop new personal and technical-professional skills in a very short time. Finally, nurses experienced once again how the nurse-patient relationship and basic care are essential to provide effective and excellent care, even and especially for patients in critical conditions. Nurses re-discovered, in a careful body care and basic care, irreplaceable elements to give back to patients, often dying, their own dignity, and all the needed closeness and attention necessary also to compensate the absence of the loved ones. These elements represent a way to concretely and deeply express the ethics of a job well done in nursing.

"Getting caught unprepared": A phenomenological study of Indonesian nurses dealing with difficulties when caring for patients with coronavirus disease (COVID-19)

The emergence of coronavirus disease 2019 (COVID‐19) has brought pressure and challenges to nurses worldwide. This study aims to understand the lived experiences of nurses in overcoming challenges when delivering care for patients with COVID‐19 in Indonesia. The study employed a phenomenological research design. The researchers purposely selected nine nurses who provided care for patients with COVID‐19 at an urban public hospital in Yogyakarta, Indonesia, between September and December 2020. The researchers conducted face‐to‐face interviews with participants. The interview data transcriptions were analyzed using Colaizzi's phenomenological analysis. The experiences of nurses in providing care for patients with COVID‐19 can be summarized into three themes: (1) getting caught unprepared, (2) understanding and adapting to a new working situation, and (3) finding new meaning in the nursing profession. This study suggested that nurses overcame difficulties in caring for patients with COVID‐19 by using multidimensional and culturally informed coping strategies. Hospital managers and policymakers need to consider culturally relevant coping strategies (i.e., religious‐based coping strategies) when supporting healthcare providers during public health emergencies.

The experience of anaesthesiology care providers in temporary intensive care units during the COVID-19 pandemic in France: a qualitative study

BACKGROUND

During the COVID-19 pandemic, care providers (CPs) worldwide grappled with the extraordinary number of severely ill patients with high fatality rates. The objective of this study is to explore the experience of anaesthesiology CPs in temporary intensive care units during the COVID-19 pandemic's first wave.

METHODS

CPs were interviewed at a university hospital in Paris, France. We conducted a qualitative study using interpretative phenomenological analysis.

RESULTS

Fifteen participants were included (five nurses, three nurse managers, and seven physicians). The analysis uncovered four themes: 1. Overworked care providers in an intensive care unit under pressure; 2. The disrupted relationship among patients, their families, and end-of-life care; 3. Short-term coping strategies; 4. A long-term transformative experience for care providers.

DISCUSSION

The COVID-19 pandemic has drained CPs physically and emotionally. Infection control protocols, lack of knowledge about this new disease, the establishment of open-space care settings, and the disruption of relationships have posed ethical dilemmas, leading CPs to question the meaning of their profession, and their future professional involvement. CPs at both an individual and institutional level employed numerous coping strategies, relying on a strong team spirit and a reinforced sense of duty. Nevertheless, after the end of the first wave, participants described the long-lasting psychological impact of this experience and frustration at the lack of recognition from their institutions and from policymakers. This study can inform institutional interventions and public health policy to support CPs during and after such a crisis to ensure their well-being and high standards of care.

Challenges faced by new nurses during the COVID-19 pandemic

INTRODUCTION

COVID-19 can be considered a unique and complex form of trauma with potentially devastating consequences for nurses in general and new nurses specifically. Few studies have been published that explain how relatively new nurses were prepared for COVID-19 in terms of knowledge and skill and how these nurses fared physically and emotionally.

DESIGN

A qualitative descriptive design utilizing purposive sampling to recruit a diverse group of nurses who were within 2 years post-graduation from nursing school.

METHODS

In-depth interviews of 29 nurses were conducted using a semi-structured interview guide to elicit data, which was coded and analyzed using thematic analysis.

RESULTS

Six main themes and multiple subthemes were identified in the data. The main themes were: "We were not prepared," "I was just thrown in," "Avoiding infection," "It was so sad," "We did the best we could," and "I learned so much."

CONCLUSION

The nurses who participated in this study expressed fear, weariness, exhaustion, isolation, and distress, observations echoed by studies from other countries. Retention of new nurses in acute care settings has always been a concern. In the recent Current Population Survey, a 4% reduction in nurses under 35 years of age has been reported, imperiling the retention of an effective workforce for decades to come.

CLINICAL RELEVANCE

A recent report suggests that a larger than expected number of young nurses have left the profession in the wake of the pandemic. Staff shortages threaten the ability of the remaining nurses to do their jobs. This is the time to listen to the needs of new nurses to retain them in the profession and to avoid an even greater shortage in the near future.

Experiences, Challenges, and Coping Strategies of Frontline Healthcare Providers in Response to the COVID-19 Pandemic in Kelantan, Malaysia

Introduction

In the fight against the COVID-19 pandemic, frontline healthcare providers who are engaged in the direct diagnosis, treatment, and care of patients face a high risk of infection and inadequate protection from contamination, overwork, frustration, and exhaustion. These impose significant psychological and mental health concerns for frontline healthcare providers.

Objectives

This study aimed to explore the experiences and challenges faced and coping strategies adopted by frontline healthcare providers in response to the COVID-19 pandemic in Kelantan, Malaysia.

Methodology

This phenomenological approach to qualitative study used a telephone-based in-depth interview that followed a semistructured interview guide. The number of frontline healthcare providers was based on saturation theory. All the participants recruited fulfilled the inclusion and exclusion criteria from May to July 2020 in Raja Perempuan Zainab II Hospital. All interviews were audio recorded and transcribed verbatim. Thematic data analysis using NVIVO version 10 was performed.

Result

The 10 respondents involved in this study consisted of doctors, medical assistants, and nurses. The findings were divided into four main themes: invaluable experiences during the pandemic, challenges, coping strategies, and future expectations. The providers responded well in facing the disease even though they felt psychologically disturbed at the initial phase of the COVID-19 pandemic.

Conclusion

Healthcare providers perceived themselves as being more resilient and less vulnerable to psychological impacts than they were before the pandemic.

Being A Hemodialysis Nurse During the COVID-19 Pandemic: A Phenomenological Approach

This study aimed to research the experiences of hemodialysis nurses during the COVID-19 pandemic. This study was designed with a descriptive phenomenological approach. The study was conducted with a total of 18 hemodialysis nurses. Content analysis method was used in the analysis of the data. As a result of the content analysis, six themes were determined. These were (I) encountering COVID-19, (II) social isolation, (III) difficulty maintaining nursing care, (IV) organizational issues, (V) professionalism, and (VI) coping methods. The research revealed that hemodialysis nurses experienced difficulties in their family lives, social lives, working environment and patient treatment during the pandemic. It was concluded that hemodialysis nurses need support physically and psychologically to cope with the fear of death, anxiety, exhaustion, and fatigue that they have experienced while working selflessly and vigorously with a small number of teams.

Lessons from the COVID-19 epidemic in Hubei, China: Perspectives on frontline nursing

Background

The emergence of COVID-19 has been an ordeal for nurses worldwide. It is crucial to understand their experiences at the frontline, attempt to allay their concerns, and help inform future pandemic response capabilities.

Aims

To explore nurses’ lived experiences at the frontline in order to identify and address their concerns and help enhance future responses to infectious disease outbreaks.

Methods

A qualitative study was carried out. Semi-structured interviews were conducted with 60 registered nurses who came to Hubei from different parts of China to care for patients with COVID-19. Interviews were audio-recorded and transcribed verbatim for thematic analysis.

Results

Six major themes emerged: emotional turmoil due to personal and professional concerns, quality issues with personal protective equipment and associated physical discomfort, witnessing and managing patient distress, readiness of emergency response mechanisms in the health system, collective community awareness and preparedness, and heightened professional pride and confidence in future epidemic control.

Discussion

Nurses were placed in challenging and unfamiliar situations to deal with unexpected and unpredictable events which caused considerable psychological and physical distress. Support in the form of government edicts, hospital management policies, community generosity and collegiality was highly welcomed by the nurses. Policy makers and managers should ensure that nurses are provided with the support and resources necessary for dealing with large-scale infectious disease outbreaks. Priority should be given to risk assessment, infection prevention and control, and patient and staff health and safety.