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Maben J, Taylor C, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-171. [PMID: 38662367 DOI: 10.3310/twdu4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. Aim To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Methods Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. Data sources First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. Results We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Conclusions Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future work Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. Limitations The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. Study registration This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Daniele Carrieri
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Simon Briscoe
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Karen Mattick
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Nash C. The Health Narratives Research Group (HeNReG): A self-direction process offered to help decrease burnout in public health nurse practitioners. AIMS Public Health 2024; 11:176-208. [PMID: 38617405 PMCID: PMC11007417 DOI: 10.3934/publichealth.2024009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 04/16/2024] Open
Abstract
Founded in accordance with 19th century sex roles and public health concerns, nursing evolved as other-directed, dependent on physician-focused diagnosis, prescription decisions, and public health advancements. The result of this other direction is that public health nurse practitioners have endured significant workplace stress resulting in burnout, especially during COVID-19. To help decrease their burnout, nurses require development of self-direction. The Health Narratives Research Group (HeNReG) has the potential to reduce burnout in nurse practitioners by encouraging the development of self-direction. The HeNReG process is presented through historically analyzed documents regarding reducing burnout in health researchers by developing self-direction including: (1) three years of archived year-end feedback results provided by participants, (2) archived participant responses to specific HeNReG-related writing prompts, and (3) a comparison of HeNReG results with the outcomes of resilience programs. The conclusion-the HeNReG offers an effective option for reducing burnout in health researchers that has the potential to decrease nurse practitioner burnout in a way that resilience programs do not. Tailoring the HeNReG process to public health nurses is discussed, inviting future research for reducing burnout in public health nurses.
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Affiliation(s)
- Carol Nash
- History of Medicine Program, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1
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Phillips G, Kendino M, Brolan CE, Herron LM, Kὃrver S, Motofaga S, Cox M. Women on the frontline: exploring the gendered experience for Pacific healthcare workers during the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100961. [PMID: 38022711 PMCID: PMC10658397 DOI: 10.1016/j.lanwpc.2023.100961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/24/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
Background Women comprise 90% of patient-facing global healthcare workers (HCWs), yet remain underpaid, undervalued, and under-represented in leadership and decision-making positions, particularly across the Pacific region. The COVID-19 pandemic has exacerbated these health workplace inequalities. We sought to understand Pacific women HCWs experience from the COVID-19 frontline to contribute to policies aimed at addressing gendered gaps in regional health systems. Methods Our interpretative phenomenological study used critical feminist and social theory, and a gendered health systems analytical framework. Data were collected using online focus groups and in-depth interviews with 36 Pacific regional participants between March 2020 and July 2021. Gender-specific content and women's voices were privileged for inductive analysis by Pacific and Australian women researchers with COVID-19 frontline lived experience. Findings Pacific women HCWs have authority and responsibility resulting from their familial, biological, and cultural status, but are often subordinate to men. They were emancipatory leaders during COVID-19, and as HCWs demonstrated compassion, situational awareness, and concern for staff welfare. Pacific women HCWs also faced ethical challenges to prioritise family or work responsibilities, safely negotiate childbearing, and maintain economic security. Interpretation Despite enhanced gendered power differentials during COVID-19, Pacific women HCWs used their symbolic capital to positively influence health system performance. Gender-transformative policies are urgently required to address disproportionate clinical and community care burdens and to protect and support the Pacific female health workforce. Funding Epidemic Ethics/World Health Organization (WHO), Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding: Australasian College for Emergency Medicine Foundation, International Development Fund Grant.
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Affiliation(s)
- Georgina Phillips
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia
| | | | - Claire E. Brolan
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Lisa-Maree Herron
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Kὃrver
- TB Elimination, and Implementation Science, Burnet Institute, Papua New Guinea and Australia
| | - Silina Motofaga
- Clinical Services Program, Public Health Division, Pacific Community, Suva, Fiji
| | - Megan Cox
- Faculty of Medicine and Health, The University of Sydney, Australia
- The Sutherland Hospital, NSW, Australia
- NSW Ambulance, Sydney, Australia
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Haq ZU, Sher ZF, Khattak FA, Zala, Hakim M, Ullah N, Rahim A, Hussain U, Afaq S. Healthcare workers safety in the COVID-19 era: the impact of pre-pandemic personal protective equipment (PPE) training in Pakistan. BMC Health Serv Res 2023; 23:1256. [PMID: 37968673 PMCID: PMC10647151 DOI: 10.1186/s12913-023-10048-y] [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: 07/10/2023] [Accepted: 09/20/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives. METHODS A cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22. RESULTS A total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn't receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn't receive training, labeled as "high risk" compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10-0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25-0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23-12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don't have skills to wear them. CONCLUSION Our findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.
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Affiliation(s)
- Zia Ul Haq
- Khyber Medical University, Peshawar, Pakistan
| | | | | | - Zala
- Khyber Medical University, Peshawar, Pakistan
| | | | | | | | | | - Saima Afaq
- Khyber Medical University, Peshawar, Pakistan.
- Deptt of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK.
- Department of Health Sciences, University of York, York, UK.
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Al-Qudimat AR, Singh K, Mustafa E, Nashwan AJ, Al-Zoubi RM, Yassin A, Aboumarzouk OM, Al-Ansari A. Psychosocial impact of COVID-19 pandemic: experience of healthcare workers in Qatar. Front Public Health 2023; 11:1283925. [PMID: 37927872 PMCID: PMC10620932 DOI: 10.3389/fpubh.2023.1283925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Background The COVID-19 pandemic has had a profound and global impact on healthcare systems worldwide, presenting unprecedented challenges for healthcare workers (HCWs) on the front. We aimed to evaluate the prevalence of anxiety and depression symptoms during the coronavirus pandemic among healthcare professionals in Qatar. Methods A cross-sectional study where an electronic questionnaire containing demographics, and psychosocial questions were made on Google Docs and Microsoft Team, and were sent through email and WhatsApp to healthcare workers, including doctors, nurses, allied health and others working at Hamad Medical Corporation in Qatar, from June 1, 2021, to January 1st 2023. ANOVA, t-test and multiple linear regression were used to see the association between the psychological factors and sociodemographic variables using STATA version 17 software. Results A total of 829 participants were included in this study (response rate: 55%). The average age of the participants is 36.0 ± 7.1; 65.9% were males; 2.3% were doctors and 53% were nurses, 38.7% were allied healthcare professionals and 6% were others. Psychological, social effects, and workplace were shown to significantly related to their marital status, career, and hospital setting (p < 0.01 for each). Similar to this, dealing with COVID-19 patients and their education level with the length of time working at the designated facility were all connected with the health professional safety score (p < 0.05). Conclusion During the COVID-19 epidemic, healthcare workers in Qatar experienced a high incidence of negative psychosocial symptoms. To alleviate these outcomes, it would be useful to implement screening procedures for such symptoms and to devise preventive measures accordingly.
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Affiliation(s)
- Ahmad R. Al-Qudimat
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Department of Public Health, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Kalpana Singh
- Department of Nursing Research, Hamad Medical Corporation, Doha, Qatar
| | - Emad Mustafa
- Department of Nursing Research, Hamad Medical Corporation, Doha, Qatar
| | | | - Raed M. Al-Zoubi
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Department of Biomedical Sciences, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
- Department of Chemistry, College of Science, Jordan University of Science and Technology, Irbid, Jordan
| | - Aksam Yassin
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany
| | - Omar M. Aboumarzouk
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- School of Medicine, Dentistry and Nursing, The University of Glasgow, Glasgow, United Kingdom
| | - Abdulla Al-Ansari
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
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O'Donnell S, Quigley E, Hayden J, Adamis D, Gavin B, McNicholas F. Psychological distress among healthcare workers post COVID-19 pandemic: from the resilience of individuals to healthcare systems. Ir J Psychol Med 2023; 40:508-512. [PMID: 35938227 DOI: 10.1017/ipm.2022.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Since the emergence of the COVID-19 pandemic, there has been increased interest in identifying ways of protecting the mental well-being of healthcare workers (HCWs). Much of this has been directed towards promoting and enhancing the resilience of those deemed as frontline workers. Based on a review of the extant literature, this paper seeks to problematise aspects of how 'frontline work' and 'resilience' are currently conceptualised. Firstly, frontline work is arbitrarily defined and often narrowly focused on acute, hospital-based settings, leading to the needs of HCWs in other sectors of the healthcare system being overlooked. Secondly, dominant narratives are often underpinned by a reductionist understanding of the concept of resilience, whereby solutions are built around addressing the perceived deficiencies of (frontline) HCWs rather than the structural antecedents of distress. The paper concludes by considering what interventions are appropriate to minimise the risk of burnout across all sectors of the healthcare system in a post-pandemic environment.
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Affiliation(s)
- S O'Donnell
- School of Medicine and Medical Science (SMMS), University College Dublin, Belfield, Dublin 4, Ireland
- School of Sociology, University College Dublin, Dublin 4, Ireland
| | - E Quigley
- National University of Ireland, Maynooth University, Department of Law, Maynooth, Ireland
| | - J Hayden
- RCSI School of Pharmacy and Biomolecular Sciences (PBS), Dublin, Ireland
| | - D Adamis
- HSE Sligo Mental Health Services, Sligo, Ireland
| | - B Gavin
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science (SMMS), University College Dublin, Dublin, Ireland
| | - F McNicholas
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science (SMMS), University College Dublin, Dublin, Ireland
- Children Health Ireland, Crumlin, Dublin 12, Ireland
- Lucena Clinic Rathgar, Dublin 6, Ireland
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Vera San Juan N, Martin S, Badley A, Maio L, Gronholm PC, Buck C, Flores EC, Vanderslott S, Syversen A, Symmons SM, Uddin I, Karia A, Iqbal S, Vindrola-Padros C. Frontline Health Care Workers' Mental Health and Well-Being During the First Year of the COVID-19 Pandemic: Analysis of Interviews and Social Media Data. J Med Internet Res 2023; 25:e43000. [PMID: 37402283 PMCID: PMC10426381 DOI: 10.2196/43000] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shed light on fractures in health care systems worldwide and continues to have a significant impact, particularly in relation to the health care workforce. Frontline staff have been exposed to unprecedented strain, and delivering care during the pandemic has affected their safety, mental health, and well-being. OBJECTIVE This study aimed to explore the experiences of health care workers (HCWs) delivering care in the United Kingdom during the COVID-19 pandemic to understand their well-being needs, experiences, and strategies used to maintain well-being (at individual and organizational levels). METHODS We analyzed 94 telephone interviews with HCWs and 2000 tweets about HCWs' mental health during the first year of the COVID-19 pandemic. RESULTS The results were grouped under 6 themes: redeployment, clinical work, and sense of duty; well-being support and HCW's coping strategies; negative mental health effects; organizational support; social network and support; and public and government support. CONCLUSIONS These findings demonstrate the need for open conversations, where staff's well-being needs and the strategies they adopted can be shared and encouraged, rather than implementing top-down psychological interventions alone. At the macro level, the findings also highlighted the impact on HCW's well-being of public and government support as well as the need to ensure protection through personal protective equipment, testing, and vaccines for frontline workers.
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Affiliation(s)
- Norha Vera San Juan
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
- Centre for Global Mental Health and Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sam Martin
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
- Ethox Centre, Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Anna Badley
- Academy Research and Improvement, Solent Trust, Southampton, United Kingdom
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Laura Maio
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
| | - Petra C Gronholm
- Centre for Global Mental Health and Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Caroline Buck
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Elaine C Flores
- Centre on Climate Change & Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Stanford Center for Innovation in Global Health, Stanford Woods Institute for the Environment,, Stanford University, Stanford, CA, United States
| | - Samantha Vanderslott
- Oxford Vaccine Group, Churchill Hospital, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Aron Syversen
- Institute of Epidemiology and Healthcare, University College London, London, United Kingdom
| | - Sophie Mulcahy Symmons
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Inayah Uddin
- Division of Psychiatry, Marie Curie Palliative Care Research Department, University College London, London, United Kingdom
| | - Amelia Karia
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
| | - Syka Iqbal
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
- Department of Psychology, University of Bradford, Bradford, United Kingdom
| | - Cecilia Vindrola-Padros
- Rapid Research Evaluation and Appraisal Lab (RREAL), Department of Targeted Intervention, University College London, London, United Kingdom
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Sangpoom S, Adesina F, Kaewchandee C, Sikanna K, Noppapak N, Maneerattanasak S, Shohaimi S, Suwanbamrung C. Levels and Predictors of Proactive Practical Experience to Solve COVID-19 among Public Health Officers in Primary Care Units in the Upper Southern Region, Thailand: An Explanatory Mixed Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6487. [PMID: 37569027 PMCID: PMC10419067 DOI: 10.3390/ijerph20156487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/10/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023]
Abstract
Public Health Officers (PHOs)' experiences in reaction to the COVID-19 pandemic can be based on whether the PHO is active or passive regarding five experience aspects, including knowledge, understanding, opinion, participation, and practice. Therefore, this study's objectives are to identify the types of experiences and analyse the predictors of proactive practical experiences in addressing the COVID-19 pandemic among PHOs in the southern region of Thailand. METHODS An explanatory mixed methods approach was used to collect data, through questionnaires and online in-depth interviews. This study was conducted from 4 August 2020 to 3 August 2021. RESULTS The results include 60 PHOs from 60 Primary Care Units in six provinces, with 41 (68.3%) females and an average age of 35.57 years (SD = 11.61). The PHOs' knowledge, understanding, and participation experience aspects were mostly proactive rather than passive. The factors that significantly predicted proactive practical experiences included sex (ORadj = 1.52, 95% CI = 1.04-2.21), age (ORadj = 1.69, 95% CI = 1.16-2.48), married status (ORadj = 1.69, 95% CI = 1.16-2.48), education level (ORadj = 1.50, 95% CI = 1.02-2.20), and position for work (ORadj = 1.69, 95% CI = 1.16-2.48). The results of quantitative method were confirmed by 12 sub-themes of 8 PHOs' experiences from qualitative method. CONCLUSIONS The PHOs' knowledge, understanding, opinion, and participation experiences were significant predictors of practical experience. Primary health care systems should promote proactive experiences in all four aspects to increase proactive practical experiences.
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Affiliation(s)
- Suttida Sangpoom
- Excellent Center for Dengue and Community Public Health: EC for DACH, School of Science, Walailak University, Thasala District, Nakhon Si Thammarat 80160, Thailand;
| | - Femi Adesina
- Department of Biology, Federal University of Technology Akure, Akura 340110, Nigeria;
| | - Chuthamat Kaewchandee
- Community Health Program, Faculty of Liberal Art and Science, Sisaket Rajabhat University, Muang 33000, Thailand;
| | - Kannika Sikanna
- School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand; (K.S.); (N.N.)
| | - Natchima Noppapak
- School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand; (K.S.); (N.N.)
| | - Sarunya Maneerattanasak
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia;
| | - Charuai Suwanbamrung
- Master and PhD. Program in Public Health Research, Excellent Center for Dengue and Community Public Health: EC for DACH, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand
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Meese KA, Boitet LM, Sweeney KL, Nassetta L, Mugavero M, Hidalgo B, Reamey R, Rogers DA. Still Exhausted: The Role of Residual Caregiving Fatigue on Women in Medicine and Science Across the Pipeline. J Med Internet Res 2023; 25:e47629. [PMID: 37314842 DOI: 10.2196/47629] [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: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/15/2023] Open
Abstract
Understanding the impact of caregiving responsibilities on women in medicine is crucial for ensuring a healthy and intact workforce, as caregiving responsibilities have the potential to affect the careers of women in health care along the entire pipeline, from students and trainees to physicians, physician-scientists, and biomedical researchers.
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Affiliation(s)
- Katherine A Meese
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Laurence M Boitet
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Medicine, Birmingham, AL, United States
| | - Katherine L Sweeney
- UAB Medicine, Birmingham, AL, United States
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lauren Nassetta
- UAB Medicine, Birmingham, AL, United States
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bertha Hidalgo
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rebecca Reamey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Wheater K, Montgomery C, Clark R, Nimmo G. Self care and wellbeing in the face of COVID-19: Multidisciplinary perspectives and interprofessional experiences. J R Coll Physicians Edinb 2023; 53:137-143. [PMID: 37114378 PMCID: PMC10140767 DOI: 10.1177/14782715231168208] [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] [Indexed: 04/29/2023] Open
Abstract
The human toll which has resulted from the coronavirus disease 2019 pandemic is clearly recognised. No single event in recent times has had such profound effects on health services and their staff wellbeing around the world. Policy making has been led by the requirement for confinement and surveillance to limit spread of the disease, and in clinical settings the impact of the necessity for the use of personal protective measures has caused huge strains on practice clinically and professionally. In this paper we share experiences from the pandemic, explore the social and organisational factors at stake and make some suggestions for both personal wellbeing practice and a systems response to the ongoing staff wellbeing challenges of the pandemic.
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Affiliation(s)
- Kitty Wheater
- Chaplaincy Centre, University of Edinburgh, Edinburgh, Scotland, UK
| | - Catherine Montgomery
- Chancellor’s Fellow in Sociology of Biomedicine, Science, Technology and Innovation Studies, University of Edinburgh, Edinburgh, Scotland, UK
| | - Rowena Clark
- Welfare Lead & Consultant in Anaesthetics and Intensive Care Medicine, NHS Lothian, Edinburgh, Scotland, UK
| | - Graham Nimmo
- Formerly MSc Critical Care, University of Edinburgh, Edinburgh, Scotland, UK
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11
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McNally S. Scarlett McNally: International Women's Day-and how institutions and individuals can reduce sexism in healthcare. BMJ 2023; 380:551. [PMID: 36889798 DOI: 10.1136/bmj.p551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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12
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Quiroga-Sánchez E, Calvo-Ayuso N, Liébana-Presa C, Trevissón-Redondo B, Marqués-Sánchez P, Arias-Ramos N. Life Habits of Healthcare Professionals during the Third Wave of COVID-19: A Cross-Sectional Study in a Spanish Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4126. [PMID: 36901137 PMCID: PMC10001878 DOI: 10.3390/ijerph20054126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: To describe sleep quality, eating behaviour and alcohol, tobacco and illicit drug use among healthcare staff in a Spanish public hospital. (2) Methods: Cross-sectional descriptive study examining sleep quality (Pittsburg Sleep Quality Index), eating behaviour (Three Factor Eating Questionnaire (R18)), tobacco and drug use (ESTUDES questionnaire) and alcohol use (Cut down, Annoyed, Guilty, Eye-opener). (3) Results: 178 people, of whom 87.1% (155) were women, with an average age of 41.59 ± 10.9 years. A total of 59.6% of the healthcare workers had sleep problems, to a greater or lesser degree. The average daily consumption was 10.56 ± 6.74 cigarettes. The most commonly used drugs included cannabis, occasionally used by 88.37%, cocaine (4.75%), ecstasy (4.65%) and amphetamines (2.33%). A total of 22.73% of participants had increased their drug use, and 22.73% had increased their consumption during the pandemic, with beer and wine accounting for 87.2% of drinks consumed during this period. (4) Conclusions: In addition to the psychological and emotional impact already demonstrated, the COVID-19 crisis has repercussions on sleep quality, eating behaviour and alcohol, tobacco and drug consumption. Psychological disturbances have repercussions on physical and functional aspects of healthcare workers. It is feasible that these alterations are due to stress, and it is necessary to act through treatment and prevention as well as promote healthy habits.
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Affiliation(s)
- Enedina Quiroga-Sánchez
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus of Ponferrada, University of León, 24400 Ponferrada, Spain
| | - Natalia Calvo-Ayuso
- Department of Nursing and Physiotherapy, Campus of Ponferrada, University of León, 24400 Ponferrada, Spain
| | - Cristina Liébana-Presa
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus of Ponferrada, University of León, 24400 Ponferrada, Spain
| | - Bibiana Trevissón-Redondo
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus of Ponferrada, University of León, 24400 Ponferrada, Spain
| | - Pilar Marqués-Sánchez
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus of Ponferrada, University of León, 24400 Ponferrada, Spain
| | - Natalia Arias-Ramos
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus of Ponferrada, University of León, 24400 Ponferrada, Spain
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13
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de Gennaro D, Piscopo G. Pinkwashing and mansplaining: individual and organizational experiences of gender inequality at work during the COVID-19 pandemic. CULTURE AND ORGANIZATION 2023. [DOI: 10.1080/14759551.2023.2176501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- Davide de Gennaro
- Department of Business Sciences – Management & Innovation Systems, University of Salerno (IT), Fisciano, Italy
| | - Gabriella Piscopo
- Business Organization at the Department of Business Sciences, Management & Innovation Systems of the University of Salerno (IT), Fisciano, Italy
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14
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Andina-Díaz E, Ventura-Miranda MI, Quiroga-Sánchez E, Ortega-Galán ÁM, Fernández-Medina IM, Ruiz-Fernández MD. Nursing Students' Perception about Gender Inequalities Presented on Social Networks: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1962. [PMID: 36767328 PMCID: PMC9916171 DOI: 10.3390/ijerph20031962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, gender inequalities in nurses have been exacerbated through the images shown on social networks. This study aimed to explore and describe nursing students' experiences and perceptions about gender inequalities in nurses during the COVID-19 pandemic. A descriptive qualitative study was carried out in two universities in 264 undergraduate nursing students. The photovoice method was used to guide the study. Results: Two main categories and four subcategories were described from the data: "gender-related stereotypes", with "male leadership in a female profession" and "sexualization of female nurses" and "women's vulnerability in the pandemic" with "the gender gap in the face of increased risk of contagion " and "women's emotional fragility". Over the years, care has been considered a female task, and nursing continues to be thought of in this way. The nurse has been discriminated against, poorly considered as a professional, and, as a woman, subjected to gender roles.
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Affiliation(s)
- Elena Andina-Díaz
- Department of Nursing and Physiotherapy, University of León, Vegazana Campus, 24170 Leon, Spain
- SALBIS Research Group, University of León, 24402 Leon, Spain
- EYCC Research Group, University of Alicante, 03690 Alicante, Spain
| | - María Isabel Ventura-Miranda
- Department of Nursing, Physiotherapy, and Medicine, University of Almeria, Carretera San Urbano, 04120 Almería, Spain
| | - Enedina Quiroga-Sánchez
- Department of Nursing and Physiotherapy, University of León, Vegazana Campus, 24170 Leon, Spain
- SALBIS Research Group, University of León, 24402 Leon, Spain
| | | | - Isabel María Fernández-Medina
- Department of Nursing, Physiotherapy, and Medicine, University of Almeria, Carretera San Urbano, 04120 Almería, Spain
| | - María Dolores Ruiz-Fernández
- Department of Nursing, Physiotherapy, and Medicine, University of Almeria, Carretera San Urbano, 04120 Almería, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia 4780000, Chile
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15
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Tawse J, Demou E. Qualitative study to explore UK medical students' and junior doctors' experiences of occupational stress and mental health during the COVID-19 pandemic. BMJ Open 2022; 12:e065639. [PMID: 36523252 PMCID: PMC9748513 DOI: 10.1136/bmjopen-2022-065639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This qualitative study aimed to explore the occupational experiences of medical students and junior doctors working during the COVID-19 pandemic. In particular, the research sought to identify factors which mediated work stress, barriers to disclosing mental health problems and levels of support medical students and junior doctors received during the pandemic. DESIGN This study was a form of thematic analysis and adopted an inductive, 'bottom-up' approach, in which coded categories were derived from rich, descriptive data. SETTING Semistructured interviews were conducted online with UK-based medical students and junior doctors. Interviews were recorded, and analysis was done by coding salient quotes into themes. PARTICIPANTS The final sample consisted of seven junior doctors and eight medical students, during the summer of 2021. RESULTS High levels of occupational stress were identified, which were exacerbated by COVID-19. A number of organisational difficulties associated with the pandemic compounded participants' experiences of work stress. Participants recognised progress towards promoting and managing mental health within the profession but may still be reluctant to access support services. Barriers to disclosure included fear of stigmatisation, concerns about adding to colleagues' workloads, lack of clarity about career implications and mistrust of occupational health services. CONCLUSIONS While attitudes towards mental health have improved, medical students and junior doctors may avoid seeking help. Given the immense pressures faced by health services, it is imperative that extra measures are implemented to minimise work-stress, encourage help-seeking behaviours and promote supportive work cultures.
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Affiliation(s)
- James Tawse
- University of Glasgow College of Social Sciences, Glasgow, UK
- Staff Advice and Liaison Service, Alder Hey Children's Hospital, Liverpool, UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, UK
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16
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Kulchar RJ, Haddad MB. Preventing burnout and substance use disorder among healthcare professionals through breathing exercises, emotion identification, and writing activities. JOURNAL OF INTERPROFESSIONAL EDUCATION & PRACTICE 2022; 29:100570. [PMID: 36349226 PMCID: PMC9633656 DOI: 10.1016/j.xjep.2022.100570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
The introduction of the COVID-19 pandemic has placed additional strain on healthcare workers, inducing immense levels of stress and workplace burnout. Health care professionals are acutely susceptible to COVID-19 exposure, ultimately leading to elevated levels of anxiety and mental illness. For example, dental professionals are at high risk due to their close work with the oral cavity. To provide temporary relief to the stress, some may turn toward substance use, especially if that individual has some form of mental illness. To curb the onset of burnout and its byproduct of substance use disorder, it is crucial to be equipped with proper tools and healthy habits that can counteract extreme levels of stress. In this article, a time-effective, 3-step method is introduced, with each activity proven to lessen the symptoms of burnout. When followed, an individual can navigate burnout's symptoms through a healthy mind and body approach. Additionally, resources to find resilience-building and mentorship programs are provided. Common substance use support groups and information regarding group meetings and contact information are listed.
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17
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Corbaz-Kurth S, Juvet TM, Benzakour L, Cereghetti S, Fournier CA, Moullec G, Nguyen A, Suard JC, Vieux L, Wozniak H, Pralong JA, Weissbrodt R, Roos P. How things changed during the COVID-19 pandemic's first year: A longitudinal, mixed-methods study of organisational resilience processes among healthcare workers. SAFETY SCIENCE 2022; 155:105879. [PMID: 35891964 PMCID: PMC9304155 DOI: 10.1016/j.ssci.2022.105879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/18/2022] [Indexed: 05/14/2023]
Abstract
COVID-19 had a huge impact on healthcare systems globally. Institutions, care teams and individuals made considerable efforts to adapt their practices. The present longitudinal, mixed-methods study examined a large sample of healthcare institution employees in Switzerland. Organisational resilience processes were assessed by identifying problematic real-world situations and evaluating how they were managed during three phases of the pandemic's first year. Results highlighted differences between resilience processes across the different types of problematic situations encountered by healthcare workers. Four configurations of organisational resilience were identified depending on teams' performance and ability to adapt over time: "learning from mistakes", "effective development", "new standards" and "hindered resilience". Resilience trajectories differed depending on professional categories, hierarchical status and the problematic situation's perceived severity. Factors promoting or impairing organisational resilience are discussed. Findings highlighted the importance of individuals', teams' and institutions' meso- and micro-level adaptations and macro-level actors' structural actions.
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Affiliation(s)
- Sandrine Corbaz-Kurth
- Haute École Arc Santé, University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont and Neuchâtel, Switzerland
- Geneva University Hospitals, Geneva, Switzerland
| | - Typhaine M Juvet
- Haute École Arc Santé, University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont and Neuchâtel, Switzerland
| | | | | | | | - Gregory Moullec
- School of Public Health, University of Montréal, Quebec, Canada
| | - Alice Nguyen
- School of Public Health, University of Montréal, Quebec, Canada
| | | | - Laure Vieux
- Geneva University Hospitals, Geneva, Switzerland
| | | | | | | | - Pauline Roos
- Haute École Arc Santé, University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont and Neuchâtel, Switzerland
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18
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Higham R, Pini S, Quyn A, Kowal M, Helliwell J, Saman R, Lewthwaite P, Young N, Rousseau N. Rapid qualitative analysis in a mixed-methods evaluation of an infection prevention intervention in a UK hospital setting during the COVID-19 pandemic: A discussion of the CLEAN study methodology. FRONTIERS IN SOCIOLOGY 2022; 7:958250. [PMID: 36386858 PMCID: PMC9640776 DOI: 10.3389/fsoc.2022.958250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/28/2022] [Indexed: 06/01/2023]
Abstract
The COVID-19 pandemic created an urgent need for high-quality rapid research. One clinical challenge was how to minimise the risk of transmission in the hospital setting. The CLEAN study conducted a rapid evaluation of the potential utility of a spray-based disinfectant in a hospital setting. The study was undertaken between December 2020 and March 2021 and involved the implementation of the spray in 10 different clinical areas in one UK teaching hospital. A mixed-methods approach was adopted (including observations, surveys, and qualitative interviews) informed by the theories for understanding the implementation of new healthcare technologies. The evaluation found that while the spray had a number of perceived benefits when added to existing disinfection processes, other factors limited its potential utility. These findings informed a number of recommendations for future adoption within hospital settings. This paper describes and reflects on the rapid methodology that allowed us to undertake the study and deliver results in a short space of time. We experienced a number of pressures during set-up and fieldwork due to the challenging conditions caused by the pandemic, and the methodological approach had to evolve throughout the study because of the changing clinical context. The involvement of clinicians from the research setting as full members of the research team was key to the rapid delivery of the research. They provided an essential link to the implementation environment, and their experiential knowledge of the setting added an important perspective to the analysis. Balancing their involvement with their clinical roles was challenging, however, as was coordinating a large and diverse team of interviewers in such a short space of time. Overall, the study highlighted the value of rapid research to inform urgent healthcare decisions in a pandemic. Although our experience suggests that conducting such research requires some practical and methodological trade-offs, we found that there were also numerous benefits of using rapid methods and identified various opportunities to ensure their robustness.
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Affiliation(s)
- Ruchi Higham
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - Simon Pini
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Aaron Quyn
- Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
- Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | - Mikolaj Kowal
- Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
- Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | | | - Razan Saman
- Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | | | - Nicola Young
- Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | - Nikki Rousseau
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
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19
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Fleming E, Neville P, Muirhead VE. Are there more women in the dentist workforce? Using an intersectionality lens to explore the feminization of the dentist workforce in the
UK
and
US. Community Dent Oral Epidemiol 2022; 51:365-372. [DOI: 10.1111/cdoe.12796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/26/2022] [Accepted: 09/21/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Eleanor Fleming
- University of Maryland School of Dentistry Baltimore Maryland USA
| | - Patricia Neville
- Bristol Dental School, Faculty of Health Sciences University of Bristol Bristol UK
| | - Vanessa Elaine Muirhead
- Institute of Dentistry, Faculty of Medicine and Dentistry Queen Mary University of London London UK
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20
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Lamb D, Wright L, Scott H, Croak B, Gnanapragasam S, Docherty M, Greenberg N, Hotopf M, Stevelink SAM, Raine R, Wessely S. Capturing the experiences of UK healthcare workers during the COVID-19 pandemic: A structural topic modelling analysis of 7,412 free-text survey responses. PLoS One 2022; 17:e0275720. [PMID: 36206241 PMCID: PMC9543686 DOI: 10.1371/journal.pone.0275720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/21/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Healthcare workers (HCWs) have provided vital services during the COVID-19 pandemic, but existing research consists of quantitative surveys (lacking in depth or context) or qualitative interviews (with limited generalisability). Structural Topic Modelling (STM) of large-scale free-text survey data offers a way of capturing the perspectives of a wide range of HCWs in their own words about their experiences of the pandemic. METHODS In an online survey distributed to all staff at 18 geographically dispersed NHS Trusts, we asked respondents, "Is there anything else you think we should know about your experiences of the COVID-19 pandemic?". We used STM on 7,412 responses to identify topics, and thematic analysis on the resultant topics and text excerpts. RESULTS We identified 33 topics, grouped into two domains, each containing four themes. Our findings emphasise: the deleterious effect of increased workloads, lack of PPE, inconsistent advice/guidance, and lack of autonomy; differing experiences of home working as negative/positive; and the benefits of supportive leadership and peers in ameliorating challenges. Themes varied by demographics and time: discussion of home working decreasing over time, while discussion of workplace challenges increased. Discussion of mental health was lowest between September-November 2020, between the first and second waves of COVID-19 in the UK. DISCUSSION Our findings represent the most salient experiences of HCWs through the pandemic. STM enabled statistical examination of how the qualitative themes raised differed according to participant characteristics. This relatively underutilised methodology in healthcare research can provide more nuanced, yet generalisable, evidence than that available via surveys or small interview studies, and should be used in future research.
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Affiliation(s)
| | | | | | | | | | - Mary Docherty
- South London and Maudsley NHS Trust, London, United Kingdom
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21
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Liang L, Yuan T, Guo X, Meng C, Lv J, Fei J, Mei S. The path of depression among frontline nurses during COVID-19 pandemic: A fuzzy-set qualitative comparative analysis. Int J Ment Health Nurs 2022; 31:1239-1248. [PMID: 35727700 PMCID: PMC9350022 DOI: 10.1111/inm.13033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 12/23/2022]
Abstract
This study aimed to explore the combination of different conditional variables that led to depressive symptoms among frontline nurses who were fought against COVID-19 during the outbreak in Wuhan City, Hubei Province of China. The study was conducted in August 2020, which included 331 frontline clinical nurses who supported Wuhan's fight against COVID-19. The age range was 21-57 years and included 315 female nurses and 16 male nurses. This study used the fuzzy-set qualitative comparative analysis research method to explore the path of depression among frontline nurses. This study generated nine different configurations for the path of depression among frontline nurses, and had a detailed demonstration for each configuration. Each configuration distinguishes the different effects of influencing factors. For example, in the first configuration, gender, sleep disorder and PTSD exist as core conditions, while social support exists as a core condition lack. This study was presented results which was different what linear regression model reports. It takes into consideration the combined effect of each conditional variable on the development of depression. Nurse managers should pay attention to the combination of multiple influencing factors, instead of focus on single factors.
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Affiliation(s)
- Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Tongshuang Yuan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xinmeng Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Cuicui Meng
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jianping Lv
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Songli Mei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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22
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Gillen P, Neill RD, Mallett J, Moriarty J, Manthorpe J, Schroder H, Currie D, McGrory S, Nicholl P, Ravalier J, McFadden P. Wellbeing and coping of UK nurses, midwives and allied health professionals during COVID-19-a cross-sectional study. PLoS One 2022; 17:e0274036. [PMID: 36129890 PMCID: PMC9491587 DOI: 10.1371/journal.pone.0274036] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/21/2022] [Indexed: 01/07/2023] Open
Abstract
Nurse, Midwives and Allied Health Professionals (AHPs), along with other health and social care colleagues are the backbone of healthcare services. They have played a key role in responding to the increased demands on healthcare during the COVID-19 pandemic. This paper compares cross-sectional data on quality of working life, wellbeing, coping and burnout of nurses, midwives and AHPs in the United Kingdom (UK) at two time points during the COVID-19 pandemic. An anonymous online repeated cross-sectional survey was conducted at two timepoints, Phase 1 (7th May 2020-3rd July 2020); Phase 2 (17th November 2020-1st February 2021). The survey consisted of the Short Warwick-Edinburgh Mental Wellbeing Scale, the Work-Related Quality of Life Scale, and the Copenhagen Burnout Inventory (Phase 2 only) to measure wellbeing, quality of working life and burnout. The Brief COPE scale and Strategies for Coping with Work and Family Stressors scale assessed coping strategies. Descriptive statistics and multiple linear regressions examined the effects of coping strategies and demographic and work-related variables on wellbeing and quality of working life. A total of 1839 nurses, midwives and AHPs responded to the first or second survey, with a final sample of 1410 respondents -586 from Phase 1; 824 from Phase 2, (422 nurses, 192 midwives and 796 AHPs). Wellbeing and quality of working life scores were significantly lower in the Phase 2 sample compared to respondents in Phase 1 (p<0.001). The COVID-19 pandemic had a significant effect on psychological wellbeing and quality of working life which decreased while the use of negative coping and burnout of these healthcare professionals increased. Health services are now trying to respond to the needs of patients with COVID-19 variants while rebuilding services and tackling the backlog of normal care provision. This workforce would benefit from additional support/services to prevent further deterioration in mental health and wellbeing and optimise workforce retention.
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Affiliation(s)
- Patricia Gillen
- School of Nursing Jordanstown Campus, Ulster University, Newtownabbey, Northern Ireland, United Kingdom
- Southern Health and Social Care Trust, Portadown, Northern Ireland, United Kingdom
- * E-mail:
| | - Ruth D. Neill
- School of Applied Social and Policy Sciences, Ulster University, Derry-Londonderry, Northern Ireland, United Kingdom
| | - John Mallett
- School of Psychology, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - John Moriarty
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London, London, United Kingdom
| | - Heike Schroder
- Queen’s Management School, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Denise Currie
- Queen’s Management School, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Susan McGrory
- School of Nursing Jordanstown Campus, Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | - Patricia Nicholl
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | | | - Paula McFadden
- School of Applied Social and Policy Sciences, Ulster University, Derry-Londonderry, Northern Ireland, United Kingdom
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23
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Hepp P, Rushwan S, Borisch B. Ways out of the crisis: how gender equality can help overcome COVID-19. J Public Health Policy 2022; 43:476-480. [PMID: 35760956 PMCID: PMC9244325 DOI: 10.1057/s41271-022-00352-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Paula Hepp
- Department of Obstetrics, Red Cross Hospital Munich, 80637, Munich, Germany.
| | - Sara Rushwan
- Research and Innovation, Concept Foundation, 1202, Geneva, Switzerland
| | - Bettina Borisch
- Institute of Global Health, University of Geneva, 1202, Geneva, Switzerland
- World Federation of Public Health Associations, 1202, Geneva, Switzerland
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24
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Yılmaz S, Ordu Y. The perceptions of nursing students regarding coronavirus and occupation according to gender: A qualitative study. Nurs Forum 2022; 57:393-402. [PMID: 35037715 DOI: 10.1111/nuf.12693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
Outbreaks are experienced differently based on gender. In the context of the Covid-19 epidemic, students' perceptions of the nursing profession, their feelings related to themselves, their social circle, nursing, and the appropriateness of nursing practices are important. This study aimed to determine the perceptions of nursing students of the Coronavirus and their occupation according to gender. Twenty nursing students were interviewed using the semi-structured interview method. Content analysis and MAXQDA were performed. Five categories were identified: Visual perceptions regarding the nursing occupation and Covid-19, future nurses' occupational perceptions according to gender of pandemics such as the Coronavirus, the effect of the pandemic on occupational perception, perceptions of the people around them of their profession in relation to the pandemic, and the approach toward any pandemic in the future in terms of their profession as a nurse. Pandemics such as Covid-19 can affect the occupational perceptions of nursing students.
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Affiliation(s)
- Sakine Yılmaz
- Faculty of Health Science, Karatekin University, Çankırı, Turkey
| | - Yadigar Ordu
- Eldivan Health Services Vocational School, Karatekin University, Çankırı, Turkey
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25
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Leap B, Stalp MC, Kelly K. Reorganizations of Gendered Labor During the COVID-19 Pandemic: A Review and Suggestions for Further Research. SOCIOLOGICAL INQUIRY 2022; 93:SOIN12488. [PMID: 35602467 PMCID: PMC9115508 DOI: 10.1111/soin.12488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Across a range of countries, analysts have found that adaptations to the COVID-19 pandemic often exacerbated previously existing labor inequalities between men and women in formal employment markets and households. This has been especially true for mothers with children in their households. Drawing on decades of sociological and feminist scholarship on labor, we suggest the following three strategies to strengthen ongoing research concerning pandemic-induced reorganizations of gendered labor. First, ongoing research should expand considerations of gendered labor to account for more types of work and workers. Second, initial findings should be extended through the continued utilization of diverse methodologies to better account for the ambivalent experiences and meanings associated with emergent reorganizations of gendered work during the pandemic. Finally, ongoing research should pursue intersectional analyses of gendered labor that are sensitive to the complex dynamics of place and time. By expanding and strengthening considerations of gendered labor in these manners, ongoing analyses could generate more comprehensive, precise findings that better guide policy interventions meant to address the gendered inequities being sharpened by the pandemic. Foundational theoretical understandings of gendered labor and its associated inequalities could also be extended.
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Psychological impact of the COVID-19 pandemic on primary care workers: a cross-sectional study. Br J Gen Pract 2022; 72:e501-e510. [PMID: 35440468 PMCID: PMC9037185 DOI: 10.3399/bjgp.2021.0691] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background The COVID-19 pandemic has had a major impact on the mental health of healthcare workers, yet studies in primary care workers are scarce. Aim To investigate the prevalence of and associated factors for psychological distress in primary care workers during the first COVID-19 outbreak. Design and setting This was a multicentre, cross-sectional, web-based survey conducted in primary healthcare workers in Spain, between May and September 2020. Method Healthcare workers were invited to complete a survey to evaluate sociodemographic and work-related characteristics, COVID-19 infection status, exposure to patients with COVID-19, and resilience (using the Connor–Davidson Resilience Scale), in addition to being screened for common mental disorders (depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder). Positive screening for any of these disorders was analysed globally using the term ‘any current mental disorder’. Results A total of 2928 primary care professionals participated in the survey. Of them, 43.7% (95% confidence interval [CI] = 41.9 to 45.4) tested positive for a current mental disorder. Female sex (odds ratio [OR] 1.61, 95% CI = 1.25 to 2.06), having previous mental disorders (OR 2.58, 95% CI = 2.15 to 3.10), greater occupational exposure to patients with COVID-19 (OR 2.63, 95% CI = 1.98 to 3.51), having children or dependents (OR 1.35, 95% CI = 1.04 to 1.76 and OR 1.59, 95% CI = 1.20 to 2.11, respectively), or having an administrative job (OR 2.24, 95% CI = 1.66 to 3.03) were associated with a higher risk of any current mental disorder. Personal resilience was shown to be a protective factor. Conclusion Almost half of primary care workers showed significant psychological distress. Strategies to support the mental health of primary care workers are necessary, including designing psychological support and resilience-building interventions based on risk factors identified.
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Côté J, Aita M, Chouinard MC, Houle J, Lavoie-Tremblay M, Lessard L, Rouleau G, Gélinas C. Psychological distress, depression symptoms and fatigue among Quebec nursing staff during the COVID-19 pandemic: A cross-sectional study. Nurs Open 2022; 9:1744-1756. [PMID: 35199497 PMCID: PMC8994967 DOI: 10.1002/nop2.1199] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 01/12/2022] [Accepted: 01/30/2022] [Indexed: 01/05/2023] Open
Abstract
Aim To describe the state of health of Quebec nursing staff during the pandemic according to their exposure to COVID‐19, work‐related characteristics and sociodemographic factors (gender, generational age group). State of health was captured essentially by assessing psychological distress, depression symptoms and fatigue. Design and methods A large‐scale cross‐sectional study was conducted with 1,708 nurses and licenced practical nurses in Quebec (87% women, mean age of 41 ± 11 years). The survey included several questionnaires and validated health‐related scales (psychological distress, depression symptoms and fatigue). The STROBE guidelines were followed in reporting the study's findings. Results Results showed that the prevalence of psychological distress and depression symptoms was moderate to severe. Women, generation Xers and Yers, nurses who cared for COVID‐19 patients and those with a colleague who was infected with COVID‐19 at work scored higher for fatigue, psychological distress and depression.
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Affiliation(s)
- José Côté
- Faculté des Sciences Infirmières, Université de Montréal, Montreal, QC, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Research Chair in Innovative Nursing Practices, Centre Hospitalier de l'Université de Montréal Centre de Recherche, Montreal, QC, Canada
| | - Marilyn Aita
- Faculté des Sciences Infirmières, Université de Montréal, Montreal, QC, Canada.,Sainte-Justine Hospital Pediatric Research Centre, Montreal, QC, Canada
| | | | - Julie Houle
- Nursing Department, Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada.,Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, Trois-Rivières, QC, Canada
| | - Mélanie Lavoie-Tremblay
- McGill University Ingram School of Nursing, Montreal, QC, Canada.,Centre of Research, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Lily Lessard
- Université du Québec à Rimouski - Sciences de la santé, Rimouski, QC, Canada.,Interdisciplinary Chair in Health and Social Services for Rural Populations, Université du Québec à Rimouski, Rimouski, QC, Canada.,Centre de recherche du CISSS de Chaudière-Appalaches, Sainte-Marie, QC, Canada
| | - Geneviève Rouleau
- Research Chair in Innovative Nursing Practices, Centre Hospitalier de l'Université de Montréal Centre de Recherche, Montreal, QC, Canada.,Women's College Hospital, Toronto, Ontario, Canada
| | - Céline Gélinas
- McGill University Ingram School of Nursing, Montreal, QC, Canada.,Centre intégré universitaire de santé et de services sociaux du l'Ouest-de-l'Île-de-Montréal du Québec, Centre for Nursing Research, Jewish General Hospital, Montreal, QC, Canada
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Vera San Juan N, Clark SE, Camilleri M, Jeans JP, Monkhouse A, Chisnall G, Vindrola-Padros C. Training and redeployment of healthcare workers to intensive care units (ICUs) during the COVID-19 pandemic: a systematic review. BMJ Open 2022; 12:e050038. [PMID: 34996785 PMCID: PMC8753114 DOI: 10.1136/bmjopen-2021-050038] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 12/09/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The rapid influx of patients with COVID-19 to intensive care at a rate that exceeds pre-existing staff capacity has required the rapid development of innovative redeployment and training strategies, which considered patient care and infection control. The aim of this study was to provide a detailed understanding of redeployment and training during the first year of the COVID-19 pandemic by capturing and considering the merit of the strategies enlisted and the experiences and needs of redeployed healthcare workers (HCWs). DESIGN The review involved a systematic search of key terms related to intensive care AND training AND redeployment AND healthcare workers within nine databases (Medline, CINAHL, PsychINFO, MedRxiv, Web of Science, The Health Management Consortium database, Social Science Research Network, OpenGrey and TRIP), which took place on 16 July 2021. Analysis consisted of a synthesis of quantitative study outputs and framework-based thematic analysis of qualitative study outputs and grey literature. These results were then combined applying an interpretative synthesis. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and the review protocol was available online. RESULTS Forty papers were analysed. These took place primarily in the UK (n=15, 37.5%) and USA (n=17, 42.5%). Themes presented in the results are redeployment: implementation strategies and learning; redeployed HCWs' experience and strategies to address their needs; redeployed HCWs' learning needs; training formats offered and training evaluations; and future redeployment and training delivery. Based on this, key principles for successful redeployment and training were proposed. CONCLUSIONS The COVID-19 pandemic presents unique challenges to develop flexible redeployment strategies and deliver training promptly while following infection control recommendations. This review synthesises original approaches to tackle these challenges, which are relevant to inform the development of targeted and adaptative training and redeployment plans considering the needs of HCWs.
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Affiliation(s)
- Norha Vera San Juan
- Rapid Research Evaluation and Appraisal Lab (RREAL), University College London, London, UK
- Health Service and Population Research, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | | | - Matthew Camilleri
- 33N Ltd, London, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - John Paul Jeans
- 33N Ltd, London, UK
- London North West University Healthcare NHS Trust, London, UK
| | - Alexandra Monkhouse
- 33N Ltd, London, UK
- Anaesthetics Department, St Bartholomew's Hospital, London, UK
| | - Georgia Chisnall
- Rapid Research Evaluation and Appraisal Lab (RREAL), University College London, London, UK
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Herten-Crabb A, Wenham C. "I Was Facilitating Everybody Else's Life. And Mine Had Just Ground to a Halt": The COVID-19 Pandemic and its Impact on Women in the United Kingdom. SOCIAL POLITICS 2022; 29:1213-1235. [PMID: 36533214 PMCID: PMC9755976 DOI: 10.1093/sp/jxac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A growing body of research has highlighted the disproportionately negative impact of the COVID-19 pandemic on women globally. This article contributes to this work by interrogating the lived realities of sixty-four women in the United Kingdom through semi-structured in-depth interviews, undertaken during the first and second periods of lockdown associated with COVID-19 in 2020. Categorizing the data by subgroup of women and then by theme, this article explores the normative and policy-imposed constraints experienced by women in 2020 with regard to paid and unpaid labor, mental health, access to healthcare services, and government representation and consideration of women. These findings highlight women's varied and gendered experiences of the COVID-19 pandemic and emphasizes the role that government can proactively play in attending to gender inequalities throughout its COVID-19 response.
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Affiliation(s)
- Asha Herten-Crabb
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
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30
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Mattsson J, Hedlund E, George-Svahn L, Scheers-Andersson E, Mazaheri M, Björling G. Nurses’ Experiences of Caring for Patients With Suspected or Confirmed COVID-19 in the Initial Stage of the Pandemic. SAGE Open Nurs 2022; 8:23779608221114981. [PMID: 35899037 PMCID: PMC9310289 DOI: 10.1177/23779608221114981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/26/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Nursing staff have faced various challenges during the global pandemic of
COVID-19 such as nursing shortages. The great number of COVID-19 patients
requiring hospitalization placed heavy demands on healthcare staff to
maintain patient safety and to work according to constantly changing
guidelines to prevent the spread of infection. Objective The objective was to describe nurses’ experiences of caring for patients with
suspected or confirmed COVID-19 in the initial phase of the pandemic. Methods The study has a qualitative design. Semi-structured interviews were conducted
with seven nurses in primary care and hospital care during the initial stage
of the pandemic. Qualitative content analysis with an inductive approach was
used. Results The nurses expressed that the working routines changed very quickly at the
onset of the pandemic. A triage system was implemented to care for patients
with symptoms of COVID-19 to prevent transmission between patients. A major
change was the constant use of personal protective equipment in patient
care. The nurses also experienced a sense of inadequacy regarding the care
of the patients and became emotionally affected and exhausted. Conclusion The nurses experienced that many patients worsened clinically, leading to
exhausting and difficult nursing care situations. They also experienced
increasing responsibility since new protective equipment and procedures
needed to be quickly implemented according to frequently changing
recommendations, causing the nurses to feel uncertain about how to maintain
patient safety. Support from colleagues was crucial to cope throughout the
initial stage of the pandemic.
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Affiliation(s)
- Janet Mattsson
- Swedish Red Cross University, Stockholm, Sweden
- Department of Learning, Informatics, Management and Education, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | - Monir Mazaheri
- Swedish Red Cross University, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Björling
- Swedish Red Cross University, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Mele BS, Holroyd-Leduc JM, Harasym P, Dumanski SM, Fiest K, Graham ID, Nerenberg K, Norris C, Parsons Leigh J, Pilote L, Pruden H, Raparelli V, Rabi D, Ruzycki SM, Somayaji R, Stelfox HT, Ahmed SB. Healthcare workers' perception of gender and work roles during the COVID-19 pandemic: a mixed-methods study. BMJ Open 2021; 11:e056434. [PMID: 35139035 PMCID: PMC8718936 DOI: 10.1136/bmjopen-2021-056434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES A high functioning healthcare workforce is a key priority during the COVID-19 pandemic. We sought to determine how work and mental health for healthcare workers changed during the COVID-19 pandemic in a universal healthcare system, stratified by gender factors. DESIGN A mixed-methods study was employed. Phase 1 was an anonymous, internet-based survey (7 May-15 July 2020). Phase 2 was semistructured interviews offered to all respondents upon survey completion to describe how experiences may have differed by gender identity, roles and relations. SETTING National universal healthcare system (Canada). PARTICIPANTS 2058 Canadian healthcare worker survey respondents (87% women, 11% men, 1% transgender or Two-Spirit), including 783 health professionals, 673 allied health professionals, 557 health support staff. Of the 63 unique healthcare worker types reported, registered nurses (11.5%), physicians (9.9%) and pharmacists (4.5%) were most common. Forty-six healthcare workers were interviewed. MAIN OUTCOME MEASURES Reported pandemic-induced changes to occupational leadership roles and responsibilities, household and caregiving responsibilities, and anxiety levels by gender identity. RESULTS Men (19.8%) were more likely to hold pandemic leadership roles compared with women (13.4%). Women (57.5%) were more likely to report increased domestic responsibilities than men (45%). Women and those with dependents under the age of 10 years reported the greatest levels of anxiety during the pandemic. Interviews with healthcare workers further revealed a perceived imbalance in leadership opportunities based on gender identity, a lack of workplace supports disproportionately affecting women and an increase in domestic responsibilities influenced by gender roles. CONCLUSIONS The COVID-19 pandemic response has important gendered effects on the healthcare workforce. Healthcare workers are central to effective pandemic control, highlighting an urgent need for a gender-transformative pandemic response strategy.
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Affiliation(s)
- Bria Scriven Mele
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jayna M Holroyd-Leduc
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Patricia Harasym
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sandra M Dumanski
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | - Kirsten Fiest
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, Calgary, Alberta, Canada
| | - Ian D Graham
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kara Nerenberg
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | - Colleen Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Louise Pilote
- Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Harlan Pruden
- Faculty of Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Valeria Raparelli
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Doreen Rabi
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, Calgary, Alberta, Canada
| | - Shannon M Ruzycki
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, Calgary, Alberta, Canada
| | - Ranjani Somayaji
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, Calgary, Alberta, Canada
| | - Henry Thomas Stelfox
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, Calgary, Alberta, Canada
| | - Sofia B Ahmed
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, Calgary, Alberta, Canada
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Usher K, Durkin J, Martin S, Vanderslott S, Vindrola-Padros C, Usher L, Jackson D. Public Sentiment and Discourse on Domestic Violence During the COVID-19 Pandemic in Australia: Analysis of Social Media Posts. J Med Internet Res 2021; 23:e29025. [PMID: 34519659 PMCID: PMC8489563 DOI: 10.2196/29025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/02/2021] [Accepted: 09/04/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Measuring public response during COVID-19 is an important way of ensuring the suitability and effectiveness of epidemic response efforts. An analysis of social media provides an approximation of public sentiment during an emergency like the current pandemic. The measures introduced across the globe to help curtail the spread of the coronavirus have led to the development of a situation labeled as a "perfect storm," triggering a wave of domestic violence. As people use social media to communicate their experiences, analyzing public discourse and sentiment on social platforms offers a way to understand concerns and issues related to domestic violence during the COVID-19 pandemic. OBJECTIVE This study was based on an analysis of public discourse and sentiment related to domestic violence during the stay-at-home periods of the COVID-19 pandemic in Australia in 2020. It aimed to understand the more personal self-reported experiences, emotions, and reactions toward domestic violence that were not always classified or collected by official public bodies during the pandemic. METHODS We searched social media and news posts in Australia using key terms related to domestic violence and COVID-19 during 2020 via digital analytics tools to determine sentiments related to domestic violence during this period. RESULTS The study showed that the use of sentiment and discourse analysis to assess social media data is useful in measuring the public expression of feelings and sharing of resources in relation to the otherwise personal experience of domestic violence. There were a total of 63,800 posts across social media and news media. Within these posts, our analysis found that domestic violence was mentioned an average of 179 times a day. There were 30,100 tweets, 31,700 news reports, 1500 blog posts, 548 forum posts, and 7 comments (posted on news and blog websites). Negative or neutral sentiment centered on the sharp rise in domestic violence during different lockdown periods of the 2020 pandemic, and neutral and positive sentiments centered on praise for efforts that raised awareness of domestic violence as well as the positive actions of domestic violence charities and support groups in their campaigns. There were calls for a positive and proactive handling (rather than a mishandling) of the pandemic, and results indicated a high level of public discontent related to the rising rates of domestic violence and the lack of services during the pandemic. CONCLUSIONS This study provided a timely understanding of public sentiment related to domestic violence during the COVID-19 lockdown periods in Australia using social media analysis. Social media represents an important avenue for the dissemination of information; posts can be widely dispersed and easily accessed by a range of different communities who are often difficult to reach. An improved understanding of these issues is important for future policy direction. Heightened awareness of this could help agencies tailor and target messaging to maximize impact.
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Affiliation(s)
- Kim Usher
- University of New England, Armidale, Australia
| | | | - Sam Martin
- Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
| | | | | | - Luke Usher
- Griffith University, Goldcoast, Australia
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The Impact of the COVID-19 Pandemic on ICU Healthcare Professionals: A Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179243. [PMID: 34501832 PMCID: PMC8431632 DOI: 10.3390/ijerph18179243] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 12/15/2022]
Abstract
The large numbers of patients admitted to intensive care units due to COVID-19 has had a major impact on healthcare professionals. The incidence of mental health disorders among these professionals has increased considerably and their professional quality of life has suffered during the pandemic. This study aims to explore the impact of the provision of COVID-19 patient care on ICU healthcare professionals. A mixed methods study with an exploratory concurrent design was conducted between June and November 2020 in the Balearic Islands, Spain. Data were collected using a self-report online survey (n = 122) based on three validated questionnaires, and individual semi-structured in-depth online interviews (n = 11). Respondents scored 2.5 out of 5 on the moral distress scale, moderate/high on the compassion satisfaction scale, and moderate on the burnout and compassion fatigue subscales. Age was significantly and negatively related to professional quality of life but was positively related to workload and unavailability of protective equipment. Three main groups of themes relating to the impact of the pandemic emerged from the in-depth interviews: (a) clinical, (b) professional, and (c) personal and family impacts in the two waves. ICU healthcare professionals should be viewed as second victims of the COVID-19 pandemic as they have suffered significant psychological, professional, and moral harm.
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Montgomery CM, Humphreys S, McCulloch C, Docherty AB, Sturdy S, Pattison N. Critical care work during COVID-19: a qualitative study of staff experiences in the UK. BMJ Open 2021; 11:e048124. [PMID: 34006556 PMCID: PMC8137198 DOI: 10.1136/bmjopen-2020-048124] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To understand National Health Service (NHS) staff experiences of working in critical care during the first wave of the COVID-19 pandemic in the UK. DESIGN Qualitative study using semistructured telephone interviews and rapid analysis, interpreted using Baehr's sociological lens of 'communities of fate'. PARTICIPANTS Forty NHS staff working in critical care, including 21 nurses, 10 doctors and advanced critical care practitioners, 4 allied health professionals, 3 operating department practitioners and 2 ward clerks. Participants were interviewed between August and October 2020; we purposefully sought the experiences of trained and experienced critical care staff and those who were redeployed. SETTING Four hospitals in the UK. RESULTS COVID-19 presented staff with a situation of extreme stress, duress and social emergency, leading to a shared set of experiences which we have characterised as a community of fate. This involved not only fear and dread of working in critical care, but also a collective sense of duty and vocation. Caring for patients and families involved changes to usual ways of working, revolving around: reorganisation of space and personnel, personal protective equipment, lack of evidence for treating COVID-19, inability for families to be physically present, and the trauma of witnessing extreme patient acuity and death on a large scale. The stress and isolation of working in critical care during COVID-19 was mitigated by strong teamwork, camaraderie, pride and fulfilment. CONCLUSION COVID-19 has changed working practices in critical care and profoundly affected staff physically, mentally and emotionally. Attention needs to be paid to the social and organisational conditions in which individuals work, addressing both practical resourcing and the interpersonal dynamics of critical care provision.
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Affiliation(s)
| | - Sally Humphreys
- Critical Care and Research & Development, West Suffolk NHS Foundation Trust, Suffolk, UK
| | | | - Annemarie B Docherty
- Anaesthetics, Theatres and Critical Care, NHS Lothian, Edinburgh, UK
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Steve Sturdy
- Centre for Biomedicine, Self and Society, University of Edinburgh, Edinburgh, UK
- Science, Technology and Innovation Studies, University of Edinburgh, Edinburgh, UK
| | - Natalie Pattison
- School of Health and Social Work, University of Hertfordshire, Hertfordshire, UK
- Nursing, East and North Hertfordshire NHS Trust, Stevenage, UK
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