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Collingridge Moore D, Garner A, Cotterell N, Harding AJE, Preston N. Long term care facilities in England during the COVID-19 pandemic-a scoping review of guidelines, policy and recommendations. BMC Geriatr 2024; 24:394. [PMID: 38702669 PMCID: PMC11069159 DOI: 10.1186/s12877-024-04867-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/04/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The disproportionate effect of COVID-19 on long term care facility (LTCF) residents has highlighted the need for clear, consistent guidance on the management of pandemics in such settings. As research exploring the experiences of LTCFs during the pandemic and the implications of mass hospital discharge, restricting staff movement, and limiting visitation from relatives are emerging, an in-depth review of policies, guidance and recommendations issued during this time could facilitate wider understanding in this area. AIMS To identify policies, guidance, and recommendations related to LTCF staff and residents, in England issued by the government during the COVID-19 pandemic, developing a timeline of key events and synthesizing the policy aims, recommendations, implementation and intended outcomes. METHOD A scoping review of publicly available policy documents, guidance, and recommendations related to COVID-19 in LTCFs in England, identified using systematic searches of UK government websites. The main aims, recommendations, implementation and intended outcomes reported in included documents were extracted. Data was analysed using thematic synthesis following a three-stage approach: coding the text, grouping codes into descriptive themes, and development of analytical themes. RESULTS Thirty-three key policy documents were included in the review. Six areas of recommendations were identified: infection prevention and control, hospital discharge, testing and vaccination, staffing, visitation and continuing routine care. Seven areas of implementation were identified: funding, collaborative working, monitoring and data collection, reducing workload, decision making and leadership, training and technology, and communication. DISCUSSION LTCFs remain complex settings, and it is imperative that lessons are learned from the experiences during COVID-19 to ensure that future pandemics are managed appropriately. This review has synthesized the policies issued during this time, however, the extent to which such guidance was communicated to LTCFs, and subsequently implemented, in addition to being effective, requires further research. In particular, understanding the secondary effects of such policies and how they can be introduced within the existing challenges inherent to adult social care, need addressing.
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Affiliation(s)
| | - Alex Garner
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | | | | | - Nancy Preston
- Division of Health Research, Lancaster University, Lancaster, UK
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Demir M, Håkansson E, Drott J. Nurses' experiences of moral distress and how it affects daily work in surgical care-a qualitative study. J Adv Nurs 2024; 80:2080-2090. [PMID: 37975326 DOI: 10.1111/jan.15966] [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: 06/25/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
AIM To describe nurses' and specialist nurses' experiences of moral distress and how it affects daily work in surgical care. DESIGN A qualitative descriptive study design was used. METHODS A qualitative study with 12 interviews with nurses and specialist nurses working in surgical care. All interviews were conducted during October and November 2022 in two hospitals in southeastern Sweden. Data were analysed using conventional qualitative content analysis. FINDINGS Three categories and seven subcategories generated from the data analysis. The three categories generated from the analysis were Experiences that lead to moral distress, Perceived consequences of moral distress and Strategies in case of moral distress. The results show that a lack of personnel in combination with people with complex surgical needs is the main source of moral distress. Both high demands on nurses as individuals and the teamwork are factors that generate moral distress and can have severe consequences for the safety of patients, individual nurses and future care. CONCLUSIONS The results show that moral distress is a problem for today's nurses and specialist nurses in surgical care. Action is necessary to prevent nurses from leaving surgical care. Prioritizing tasks is perceived as challenging for the profession, and moral distress can pose a patient safety risk. IMPACT Surgical care departments should design support structures for nurses, give nurses an authentic voice to express ethical concerns and allow them to practice surgical nursing in a way that does not violate their core professional values. Healthcare organizations should take this seriously and work strategically to make the nursing profession more attractive. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
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Affiliation(s)
- Maria Demir
- Department of Surgery, Department of Biomedicine and Clinical Sciences, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Elin Håkansson
- Department of Surgery, Regional Hospital of Växjö, Växjö, Sweden
| | - Jenny Drott
- Department of Surgery, Department of Biomedicine and Clinical Sciences, County Council of Östergötland, Linköping University, Linköping, Sweden
- Division of Nursing Science and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Vitorino C, Canavarro MC, Carona C. Six-month psychopathological symptom trajectories following the COVID-19 outbreak: Contrasting mental health outcomes between nurses and the general population. PLoS One 2024; 19:e0301527. [PMID: 38626159 PMCID: PMC11020497 DOI: 10.1371/journal.pone.0301527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 03/18/2024] [Indexed: 04/18/2024] Open
Abstract
The COVID-19 pandemic prompted a social, economic and health crisis that had a major impact on the mental health of the global community, particularly nurses. The objective of the current study is to conduct a longitudinal evaluation of the trajectory of depressive, anxiety, trauma, and fear of COVID-19 symptoms, comparing self-reports of nurses and the general population over a six-month period. Self-report questionnaires were administered online to a sample of 180 nurses and 158 individuals from the general population for the baseline assessment (T1) and follow-up at 6 months (T2). Levels of symptoms reported by nurses were generally greater and tended to worsen over time, as opposed to the levels of symptoms reported by the general population that tended to improve. Levels of depressive, anxiety, and trauma symptoms were significantly different between nurses and the general population over time. Levels of fear of COVID-19 declined significantly from T1 to T2 in both groups. These results suggest that it is crucial to monitor the longer-term effects of COVID-19 and to develop resilience-promoting interventions tailored to the unique needs of this vulnerable group.
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Affiliation(s)
- Catarina Vitorino
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Carlos Carona
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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Parmar J, L’Heureux T, Lobchuk M, Penner J, Charles L, St. Amant O, Ward-Griffin C, Anderson S. Double-duty caregivers enduring COVID-19 pandemic to endemic: "It's just wearing me down". PLoS One 2024; 19:e0298584. [PMID: 38626216 PMCID: PMC11020535 DOI: 10.1371/journal.pone.0298584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/28/2024] [Indexed: 04/18/2024] Open
Abstract
The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative interviews, aimed to comprehensively understand the experiences of these Canadian double-duty caregivers amidst the pandemic and the transition to the endemic phase. The multi-section survey included standardized assessments such as the Double-duty Caregiver Scale and the State Anxiety Scale, along with demographic, employment-related, and care work questions. Data analysis employed descriptive and linear regression modeling statistics, and content analysis of the qualitative data. Out of the 415 respondents, the majority were female (92.5%) and married (77.3%), with 54.9% aged 35 to 54 years and 29.2% 55 to 64 years. 68.9% reported mental health decline over the past year, while 60.7% noted physical health deteriorated. 75.9% of participants self-rated their anxiety as moderate to high. The final regression model explained 36.8% of the variance in participants' anxiety levels. Factors contributing to lower anxiety included more personal supports, awareness of limits, younger age, and fewer weekly employment hours. Increased anxiety was linked to poorer self-rated health, and both perceptions and consequences of blurred boundaries. The eighteen interviewees highlighted the stress of managing additional work and home care during the pandemic. They highlighted the difficulty navigating systems and coordinating care. Double-duty caregivers form a significant portion of the healthcare workforce. Despite the spotlight on care and caregiving during the COVID-19 pandemic, the vital contributions and well-being of double-duty caregivers and family caregivers have remained unnoticed. Prioritizing their welfare is crucial for health systems as they make up the largest care workforce, particularly evident during the ongoing healthcare workforce shortage.
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Affiliation(s)
- Jasneet Parmar
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tanya L’Heureux
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Lobchuk
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jamie Penner
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lesley Charles
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Oona St. Amant
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Catherine Ward-Griffin
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada
| | - Sharon Anderson
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Seyffert M, Wu C, Özkan-Seely GF. Insights into the Impact of Organizational Factors and Burnout on the Employees of a For-Profit Psychiatric Hospital during the Third Wave of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:484. [PMID: 38673395 PMCID: PMC11050685 DOI: 10.3390/ijerph21040484] [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: 01/11/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
In this paper, we provide insights into the interplay among the organizational, job, and attitudinal factors and employees' intentions to resign during the third wave of the COVID-19 pandemic at a mental health hospital. We point out shortcomings in the relationship dynamics between executive administration and operational staff and propose a pathway to develop more effective leadership frameworks to increase job satisfaction. We integrate qualitative data from case information and open-ended questions posed to employees at a mental health hospital and quantitative data from a small-scale survey (n = 19). We highlight that the ability to achieve objectives, work autonomy, burnout, affective commitment, distributive and procedural justice, and job satisfaction are critical in determining individuals' intentions to resign. Individuals identified disconnectedness and moral distress as critical aspects, while highlighting empathy, compassion, satisfaction, and confidence as pivotal elements. Mental healthcare settings could benefit from enhancing the staff's ability to achieve objectives, work autonomy, affective commitment, and both distributive and procedural justice. Addressing burnout and implementing measures to increase job satisfaction are equally vital. Efficiently restructuring dynamics between various leadership levels and staff can significantly improve employee retention.
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Affiliation(s)
- Michael Seyffert
- School of Business, University of Washington Bothell, Bothell, WA 98195, USA;
| | - Chunyi Wu
- Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA;
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Anderson H, Scantlebury A, Galdas P, Adamson J. The well-being of nurses working in general practice during the COVID-19 pandemic: A qualitative study (The GenCo Study). J Adv Nurs 2024; 80:1574-1591. [PMID: 37902132 DOI: 10.1111/jan.15919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 10/31/2023]
Abstract
AIM Exploration of experiences of nurses working in general practice during the COVID-19 pandemic to evaluate the impact on nurses' professional well-being. DESIGN An exploratory qualitative study comprised of case studies of three general practice sites in England and a nationwide interview study of nurses working in general practice and nurse leaders. The study was funded by The General Nursing Council for England and Wales Trust. University of York ethics approval (HSRGC/2021/458/I) and Health Research Authority approval was obtained (IRAS: 30353, Protocol number: R23982, Ref 21/HRA/5132, CPMS: 51834). METHODS Forty participants took part. Case site data consisted of interviews/focus groups and national data consisted of semi-structured interviews. Data collection took place between April and August 2022. Analysis was underpinned by West et al.'s The courage of compassion. Supporting nurses and midwives to deliver high-quality care, The King's fund, 2020 ABC framework of nurses' core work well-being needs. FINDINGS The majority of participants experienced challenges to their professional well-being contributed to by lack of recognition, feeling undervalued and lack of involvement in higher-level decision-making. Some participants displayed burnout and stress. Structural and cultural issues contributed to this and many experiences pre-dated, but were exacerbated by, the COVID-19 pandemic. CONCLUSIONS By mapping findings to the ABC framework, we highlight the impact of the COVID-19 pandemic on the well-being of nurses working in general practice and contributing workplace factors. The issues identified have implications for retention and for the future of nursing in general practice. The study highlights how this professional group can be supported in the future. IMPACT The study contributes to our understanding of the experiences of nurses working in general practice during the COVID-19 pandemic and beyond. Findings have implications for this skilled and experienced workforce, for retention of nurses in general practice, the sustainability of the profession more broadly and care quality and patient safety. REPORTING METHOD Standards for Reporting Qualitative Research (O'Brien et al. in Journal of the Association of American Medical Colleges, 89(9), 1245-1251, 2014). PATIENT OR PUBLIC CONTRIBUTION As this was a workforce study there was no patient or public contribution.
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Affiliation(s)
- Helen Anderson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Paul Galdas
- Department of Health Sciences, University of York, York, UK
| | - Joy Adamson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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Stewart C, Bench S, Malone M. Interventions to support critical care nurse wellbeing: A scoping review. Intensive Crit Care Nurs 2024; 81:103613. [PMID: 38199182 DOI: 10.1016/j.iccn.2023.103613] [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: 04/12/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Recruitment and retention of qualified nurses in critical care is challenging and has been further exacerbated by the COVID-19 pandemic. Poor staff wellbeing, including sickness absence and burnout contribute to a high staff turnover and staff shortages. This scoping review charts wellbeing interventions targeting nurses who work in adult critical care. METHODS Following the Joanna Briggs Institute scoping review methodology, five databases were searched: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Embase, Ovid PsycINFO, and the Cochrane Library alongside a search for grey literature targeting national and international critical care nurse organisations. Primary research studies (qualitative, quantitative and mixed methods), as well as quality improvement studies and policy frameworks published from January 1997 to September 2022 were included. Studies conducted outside an adult critical care setting or not including adult critical nurses were excluded. Extracted data were charted using a series of tables. RESULTS 26 studies met the inclusion criteria. Most of the interventions targeted personal rather than organisational strategies, focusing on resilience training, mindfulness-based interventions, and other psychological approaches. One intervention was not evaluated. Most of the rest of the studies reported their interventions to improve wellbeing. However, only one study evaluated the intervention for longer than six months. CONCLUSION Current evidence identified that critical care nurse wellbeing is an international concern affecting recruitment and retention. Most available wellbeing interventions take a psychological, personal approach. However, these may not address the complex interaction of organisational factors which impact adult critical care nurses. IMPLICATIONS FOR CLINICAL PRACTICE Further work is needed to identify and evaluate organisational approaches to improving wellbeing and to evaluate wellbeing interventions over a longer period of time. Critical care nurses should be included in the design of future wellbeing interventions.
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Affiliation(s)
- Carolyne Stewart
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.
| | - Suzanne Bench
- Nurse and Midwife Led Research and Academic Leadership, ACORN -A Centre Of Research for Nurses & Midwives, St Thomas Hospital, UK; Director of Nurse and Midwife led Research: Guys and St Thomas NHS Foundation Trust and Professor of critical care nursing, London South Bank University, UK.
| | - Mary Malone
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.
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Riley R, Causer H, Patrick L, Rogowsky R. Why are dominant suicidology approaches failing nurses? A call for a feminist critical suicidology perspective. J Adv Nurs 2024; 80:1245-1247. [PMID: 37828683 DOI: 10.1111/jan.15899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Ruth Riley
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Hilary Causer
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Leanne Patrick
- Health Development Team Lead, Sexual Health Department, Whytemans Brae Hospital, Kirkcaldy, UK
| | - Rayna Rogowsky
- School of Health Sciences, University of Dundee, Dundee, UK
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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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Whybrow D, Jones B, Temeng E, Dale C, Bundy C, Watts T. The perceived helpfulness and acceptability of a bespoke psychological therapy service for registered nurses experiencing psychological distress: A qualitative study. J Adv Nurs 2024. [PMID: 38504145 DOI: 10.1111/jan.16160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/07/2024] [Accepted: 03/05/2024] [Indexed: 03/21/2024]
Abstract
AIM To understand the perceived helpfulness and acceptability of a bespoke psychological therapy service for registered nurses. The service provided a free and confidential specialist mental health service to all healthcare professionals, including nurses and nursing students. DESIGN An exploratory study using a descriptive qualitative approach. METHODS A purposive sample of 20 registered nurses accessing a bespoke psychological therapy service in Wales participated in audio-recorded semi-structured interviews in January 2022. Transcribed data were analysed using reflexive thematic analysis. RESULTS Four interrelated themes were identified from the data analysis: COVID [SARS-CoV-2] changed things; You're a nurse, you're human; I've got 'me' back; and pretty close to miracle workers. CONCLUSION Participants attempted to live up to an idealized image of a nurse, generating self-stigmatizing beliefs that negatively affected their mental health. The psychological therapy service enabled participants to put their roles into perspective, that is, separate themselves from their role, be vulnerable, and develop confidence and adaptive coping strategies. Participants valued the minimal barriers and ease of access to support. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The complex relationship between nurse identity and the challenges of the workplace needs to be central to nurse education. Nurses can benefit from rapid access to a timely, confidential, and independent self-referring psychological therapy service. IMPACT This qualitative study explored the helpfulness and accessibility of psychological support for nurses. The main themes were that COVID changed things; You're a nurse, you're human; I've got 'me' back; and pretty close to miracle workers. The findings will impact how nurses are supported in the United Kingdom and worldwide. REPORTING METHOD This report adheres to the standards for reporting qualitative research (SRQR). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Yao A, Zhu M, Li L. Psychological experience of university students during prolonged quarantine in China: a qualitative study. BMJ Open 2024; 14:e077483. [PMID: 38471689 DOI: 10.1136/bmjopen-2023-077483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE To explore the psychological experiences of university students in prolonged quarantine during the COVID-19 pandemic. DESIGN A qualitative descriptive study based on semistructured interviews; data were analysed using a thematic topic analysis approach. SETTING Interviews were conducted via WeChat video. PARTICIPANTS 20 full-time undergraduate students from seven districts in Shanghai Province who experienced prolonged quarantine were interviewed from June to August 2022. RESULTS The data analysis revealed three themes with corresponding subthemes related to the psychological experiences of university students during prolonged quarantine: (1) dynamic and complex psychological experiences, encompassing the feelings of relief, confusion, anxiety, insecurity, loneliness, craving for catharsis and emotional numbness; (2) desire for diverse support; and (3) self-reflection and growth, mainly including learning to be grateful, self-efficacy enhancement, reconsideration of the meaning of life and restructuring of future planning. CONCLUSION This study explored the psychological experiences of university students in prolonged quarantine through qualitative interviews, which contributed to our understanding of their emotions, needs and conceptual changes during quarantine. Combined with the experiences of university students in quarantine, they reported complex emotional changes and diverse needs, as well as the impact of prolonged quarantine on their outlook on life. These findings can serve as a reference and basis for the development of future psychological intervention measures in line with national conditions.
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Affiliation(s)
- Anling Yao
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Mingling Zhu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ling Li
- School of Nursing, Zhejiang Shuren University, Hangzhou, China
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Schilling S, Armaou M, Morrison Z, Carding P, Bricknell M, Connelly V. "Trust people you've never worked with" - A social network visualization of teamwork, cohesion, social support, and mental health in NHS Covid personnel. Front Psychol 2024; 15:1293171. [PMID: 38445057 PMCID: PMC10913897 DOI: 10.3389/fpsyg.2024.1293171] [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: 09/12/2023] [Accepted: 01/16/2024] [Indexed: 03/07/2024] Open
Abstract
Background The unprecedented rapid re-deployment of healthcare workers from different care pathways into newly created and fluid COVID-19 teams provides a unique opportunity to examine the interaction of many of the established non-technical factors for successful delivery of clinical care and teamwork in healthcare settings. This research paper therefore aims to address these gaps by qualitatively exploring the impact of COVID work throughout the pandemic on permanent and deployed personnel's experiences, their ability to effectively work together, and the effect of social dynamics (e.g., cohesion, social support) on teamwork and mental health. Methods Seventy-five interviews were conducted across the UK between March and December 2021 during wave 2 and 3 of COVID-19 with 75 healthcare workers who were either permanent staff on Intensive Care/High Dependency Units used as COVID wards, had been rapidly deployed to such a ward, or had managed such wards. Work Life Balance was measured using the WLB Scale. Interview transcripts were qualitatively coded and thematic codes were compared using network graph modeling. Results Using thematic network analysis, four overarching thematic clusters were found, (1) teamwork, (2) organizational support and management, (3) cohesion and social support, and (4) psychological strain. The study has three main findings. First, the importance of social factors for teamwork and mental health, whereby team identity may influence perceptions of preparedness, collaboration and communication, and impact on the collective appraisal of stressful events and work stressors. Secondly, it demonstrates the positive and negative impact of professional roles and skills on the development of teamwork and team identity. Lastly the study identifies the more pronounced negative impact of COVID work on deployed personnel's workload, mental health, and career intentions, exacerbated by reduced levels of social support during, and after, their deployment. Conclusion The thematic network analysis was able to highlight that many of the traditional factors associated with the successful delivery of patient care were impeded by pandemic constraints, markedly influencing personnel's ability to work together and cope with pandemic work stressors. In this environment teamwork, delivery of care and staff well-being appear to depend on relational and organizational context, social group membership, and psycho-social skills related to managing team identity. While results hold lessons for personnel selection, training, co-location, and organizational support during and after a pandemic, further research is needed into the differential impact of pandemic deployment on HCWs mental health and teamwork.
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Affiliation(s)
- Stefan Schilling
- Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
- Department of Psychology, Health and Professional Development, Oxford Brookes University, Oxford, United Kingdom
| | - Maria Armaou
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Zoe Morrison
- Aberdeen Business School, Robert Gordon University, Aberdeen, United Kingdom
| | - Paul Carding
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Martin Bricknell
- King’s College London, School of Security Studies, London, United Kingdom
| | - Vincent Connelly
- Department of Psychology, Health and Professional Development, Oxford Brookes University, Oxford, United Kingdom
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Alexiou E, Wijk H, Åkerström M, Jonsdottir IH, Degl' Innocenti A, Ahlstrom L. Worry perception and its association with work conditions among healthcare workers during the first wave of the COVID-19 pandemic: a web-based multimethod survey at a university hospital in Sweden. BMJ Open 2024; 14:e080248. [PMID: 38382952 PMCID: PMC10882285 DOI: 10.1136/bmjopen-2023-080248] [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: 02/23/2024] Open
Abstract
OBJECTIVES In this study, we explored healthcare workers' (HCWs) worry perception and its association with their work situation during the first wave of the COVID-19 pandemic. DESIGN A web-based multimethods survey including multiple choice and open-ended questions was used. SETTING The study was conducted at a university hospital in Sweden. PARTICIPANTS All HCWs who were working during the first wave of the COVID-19 pandemic in March-June 2020 were eligible. HCWs (n=6484, response rate=41%) from 69 departments fulfilled the study inclusion criteria and responded to the survey. Of them, we analysed data from the 3532 participants who replied to the open-ended questions (54% of the respondents). MAIN OUTCOMES MEASURES Worry perception and its association with work conditions among HCWs. RESULTS 29% (n=1822) and 35% (n=2235) of the responding HCWs experienced a daily or more than daily strong worry of being infected or infecting others with SARS-CoV-2. This finding could be further confirmed and explored with themes from the qualitative results: 'ambiguity of feeling safe and secure', 'being obliged to adapt to a new reality' and 'into the unknown'. The themes consisted of 6 main categories and 15 subcategories. The findings revealed that the two main drivers of worry perceived by HCWs were lack of personal protective equipment and fear of bringing the virus home to their families and friends. CONCLUSIONS Worries of getting infected are common among HCWs during crises such as the COVID-19 pandemic. Several factors are raised that plausibly could minimise the negative effects of worry among HCWs. Thus, effective preventive work plans should be created, promoted and communicated in order to minimise the effects of such crises and support HCWs. By focusing on effective communication and preparedness, including access to relevant protective equipment and providing general support to HCWs, the work environment and patient care could be sustained during a crisis such as the COVID-19 pandemic.
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Affiliation(s)
- Eirini Alexiou
- Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Magnus Åkerström
- Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl' Innocenti
- Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regionhälsan, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Sperling D. "They choke to death in front of your very eyes": nurses' lived experiences and perspectives on end-of-life care during COVID-19. BMC Palliat Care 2024; 23:35. [PMID: 38331781 PMCID: PMC10854065 DOI: 10.1186/s12904-024-01352-3] [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: 04/22/2023] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic led to an intensified fear and threat of dying, combined with dying and grieving in isolation, in turn significantly impacting nursing in end-of-life situations. The study aims (1) to understand the lived experiences of nurses who provided care to end-of-life patients during COVID-19; and (2) to explore whether providing care under such circumstances altered the perspectives of these nurses regarding end-of-life care. METHODS Applying the phenomenological-interpretive qualitative approach, 34 in-depth semi-structured interviews were conducted between March 2020-May 2021 with nurses from eight hospitals in Israel who were recruited through purposive and snowball sampling. Thematic analysis was applied to identify major themes from the interviews. RESULTS Five main themes emerged from the analysis, including: (1) a different death; (2) difficulties in caring for the body after death; (3) the need for family at end-of-life; (4) weaker enforcement of advance care directives; and (5) prolonging the dying process. DISCUSSION During the pandemic, nurses encountered numerous cases of death and dying, while facing ethical and professional issues regarding end-of-life care. They were required to administer more aggressive care than usual and even necessary, leading to their increased moral distress. The nurses' ethical concerns were also triggered by the requirement to wrap the corpse in black garbage-like bags to prevent contagion, which they felt was abusing the dead. The findings also demonstrate how family presence at end-of-life is important for the nursing staff as well as the patient. Finally, end-of-life situations during the pandemic in Israel were managed in an individual and personal manner, rather than as a collective mission, as seen in other countries. CONCLUSIONS The study offers insights into the nurses' attitudes towards death, dying, and end-of-life care. An emphasis should be placed on the key elements that emerged in this study, to assist nurses in overcoming these difficulties during and after medical crises, to enhance end-of-life care and professionalism and decrease burnout.
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O'Malley M, O'Mahony J, Happell B, Mulcahy H. The nurse bombarded, consumed and vulnerable: An interpretative phenomenological analysis of mental health nurses' self-care at work. J Psychiatr Ment Health Nurs 2024; 31:66-76. [PMID: 37534379 DOI: 10.1111/jpm.12956] [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] [Received: 10/08/2022] [Revised: 05/16/2023] [Accepted: 06/28/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Self-care is essential for nurses' wellbeing, with stress posing a major barrier. Research into self-care is often absorbed into studies of burnout or resilience. Understanding lived experiences of influences on nurses' self-care practices is essential. There is currently a paucity of literature on this topic. AIM To explore mental health nurses' views about what influences their ability to self-care in relation to workplace stress and the impact on their practice and work environment. METHODS An Interpretative Phenomenological Analysis approach was utilized. In-depth interviews explored how nurses perceived the influence of environment and relationships on self-care practices in the workplace. RESULTS Participants' perceptions and experiences are embodied by the theme: the nurse bombarded, comprising two subordinate themes-the nurse consumed by the intensity of work and therapeutic relationships; and feeling vulnerable from colleague relationships and feeling undervalued. Participants described conflict between workload demands and expectations and the desire to provide optimal care. CONCLUSIONS Stressful working environments pose major barriers to effective self-care. Feeling bombarded and vulnerable, impacts nurses' lives personally and professionally. IMPLICATIONS FOR PRACTICE Mental health nurses' self-care is crucial for quality practice. Strategies to address relational, personal and environmental barriers to self-care are therefore necessary.
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Affiliation(s)
- Maria O'Malley
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - James O'Mahony
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - Brenda Happell
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Helen Mulcahy
- Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
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Shipp HG, Hall KC. Analyzing the concept of toxic positivity for nursing: A dimensional analysis approach. J Adv Nurs 2024. [PMID: 38243659 DOI: 10.1111/jan.16057] [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: 10/13/2023] [Revised: 11/30/2023] [Accepted: 12/30/2023] [Indexed: 01/21/2024]
Abstract
AIM To analyze toxic positivity and its relevance to nursing. DESIGN Concept analysis using Schatzman's dimensional analysis approach. DATA SOURCES Two searches were conducted using Google Scholar, JSTOR, ProQuest and CINAHL (1990-2023). Keywords included "toxic positivity" (Phase 1) and "emotional suppression," "unrealistic optimism"; "disingenuous happiness," "forced gratitude" and "logical fallacy" (Phase 2). Retained sources (1) were in English (Phases 1 and 2); (2) used 'toxic positivity' as a construct reflecting the purpose of analysis (Phase 1); and (3) demonstrated relevance towards analytical findings (Phase 2). Total analytic sources were 35. METHODS The analytic phase, identification, elucidated conceptual dimensions and contexts. The analytic phase, logistics, examined relationships among dimensions and contexts through an iterative process resulting in a dimensional matrix/conceptual model. RESULTS Salient dimension is Emotional Suppression with two sub-dimensions, Logical Fallacy and Forced Gratitude. Other dimensions include Unrealistic Optimism and Disingenuous Happiness. Contexts include intra- and post-paradigmatic societal shifts and intra- and post-traumatic experiences. Analysis reveals toxic positivity as an exchange between a giver and receiver with the receiver experiencing negative outcomes. CONCLUSION The concept appears consistent in its application and use across contexts and is emerging in nursing literature. IMPLICATIONS FOR THE PROFESSION Acknowledging toxic positivity in nursing may inform theoretical and future research related to improving nursing burnout, bolstering retention, and enhancing well-being. Nurses across work environments may encounter toxic positivity. Leaders should consider policy adoption and inclusion of trauma-informed practices. IMPACT Nursing workforce issues require deeper examination of potential contributing factors. Findings suggest toxic positivity may be encountered in work environments impacting nursing at individual and system levels. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Hannah G Shipp
- College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
| | - Katherine C Hall
- College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
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op ‘t Hoog SAJJ, de Vos AJBM. Lessons learned from nursing crisis meetings: Qualitative study to evaluate nurses' experiences and needs. Nurs Open 2024; 11:e2037. [PMID: 38268247 PMCID: PMC10724613 DOI: 10.1002/nop2.2037] [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: 11/02/2022] [Revised: 05/25/2023] [Accepted: 10/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIMS The aim of this study is to evaluate the nurses' experiences with the Nursing Crisis Meetings and to identify nurses' needs regarding the future governance structure. DESIGN Qualitative study. METHODS Two focus groups were conducted in February 2022 with participants of the Nursing Crisis Meetings (N = 15). We used thematic analysis to describe themes. RESULTS We identified five themes: opportunity to speak up, call for nursing leadership, call for control over practice and autonomy, development of a governance infrastructure and development of the professional nurse role. CONCLUSION Nurses experienced the Nursing Crisis Meetings to be a positive and empowering infrastructure, which facilitates the unique opportunity to speak up and share experiences and concerns. This new infrastructure is a promising strategy to engage nurses during a pandemic and to build on a professional governance structure. IMPACT This paper highlights the need for nurses to speak up and be engaged during the COVID-19 pandemic and gives a practical example of how to put this infrastructure into practice.
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Affiliation(s)
| | - Annemarie Johanna Burgje Maria de Vos
- Academy of Nursing Science and EducationElisabeth‐TweeSteden HospitalTilburgThe Netherlands
- School of People & Healthcare StudiesFontys University of Applied SciencesTilburgThe Netherlands
- Centre of Expertise Health, Care & WellbeingAvans University of Applied SciencesBredaThe Netherlands
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18
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Miller J, Young B, Mccallum L, Rattray J, Ramsay P, Salisbury L, Scott T, Hull A, Cole S, Pollard B, Dixon D. "Like fighting a fire with a water pistol": A qualitative study of the work experiences of critical care nurses during the COVID-19 pandemic. J Adv Nurs 2024; 80:237-251. [PMID: 37515348 DOI: 10.1111/jan.15773] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/19/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023]
Abstract
AIM To understand the experience of critical care nurses during the COVID-19 pandemic, through the application of the Job-Demand-Resource model of occupational stress. DESIGN Qualitative interview study. METHODS Twenty-eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID-19 pandemic took part in semi-structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job-Demand Resource model. Data were analysed using framework analysis. RESULTS The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post-traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well-being had negative organizational consequences with CCN expressing increased intention to leave their role. CONCLUSIONS The combination of high demands and reduced resources had negative impacts on the psychological well-being of nurses which is translating into increased consideration of leaving their profession. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions. IMPACT Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention. REPORTING METHOD We used the COREQ guidelines for reporting qualitative studies. PATIENT AND PUBLIC CONTRIBUTION Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic.
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Affiliation(s)
- Jordan Miller
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Ben Young
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Louise Mccallum
- Nursing & Health Care School, University of Glasgow, Glasgow, UK
| | - Janice Rattray
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Pam Ramsay
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Lisa Salisbury
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Teresa Scott
- Critical Care Unit, NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Alastair Hull
- Institute of Medical Sciences, University of Dundee, Dundee, UK
| | - Stephen Cole
- Anaesthesia & Intensive Care Medicine, NHS Tayside, Ninewells Hospital, Dundee, UK
| | - Beth Pollard
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Diane Dixon
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
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Morley G, Sankary LR. Nurturing moral community: A novel moral distress peer support navigator tool. Nurs Ethics 2023:9697330231221220. [PMID: 38149497 DOI: 10.1177/09697330231221220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Moral distress is a pervasive phenomenon in healthcare for which there is no straightforward "solution." Rhetoric surrounding moral distress has shifted over time, with some scholars arguing that moral distress needs to be remedied, resolved, and eradicated, while others recognize that moral distress can have some positive value. The authors of this paper recognize that moral distress has value in its function as a warning sign, signaling the presence of an ethical issue related to patient care that requires deeper exploration, rather than evidencing identification of the "right" course of action. Once the experience of moral distress is identified, steps ought to be taken to clarify the moral issue, and, if possible and reasonable, the patient's values ought to be prioritized. This paper offers concrete actions steps, drawn from theory, which can be used in clinical practice to provide peer support or to facilitate self-reflection for morally distressed individuals. This approach empowers morally distressed individuals to explore ethical issues, identify concrete steps that can be taken, and mitigate feelings of powerlessness that are often associated with moral-constraint distress. The questions guide individuals and peers to reflect first on the micro-space and then more broadly on the institutional culture, facilitating meso- and macro-reflection and action.
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Affiliation(s)
- Georgina Morley
- Nursing Ethics Program, Center for Bioethics, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Health System
| | - Lauren R Sankary
- Neuroethics Program, Center for Bioethics, Neurological Institute, Cleveland Clinic Health System
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20
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Littzen-Brown C, Dolan H, Norton A, Bethel C, May J, Rainbow J. Unbearable suffering while working as a nurse during the COVID-19 pandemic: A qualitative descriptive study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023; 5:100127. [PMID: 37082653 PMCID: PMC10091725 DOI: 10.1016/j.ijnsa.2023.100127] [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: 11/08/2022] [Revised: 04/03/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023] Open
Abstract
Background The COVID-19 pandemic resulted in negative consequences for nurse well-being, patient care delivery and outcomes, and organizational outcomes. Objective The purpose of this study was to explore the experiences of nurses working during the COVID-19 Pandemic in the United States. Design This study used a qualitative descriptive design. Settings The setting for this study was a national sample of nurses working during the COVID-19 pandemic in the United States over a period of 18 months. Participants Convenience and snowball sampling were used to recruit 81 nurses via social media and both national and state listservs. Methods Using a single question prompt, voicemail and emails were used for nurses to share their experiences anonymously working as a nurse during the COVID-19 pandemic. Voicemails were transcribed and each transcript was analyzed using content analysis with both deductive and inductive coding. Results The overarching theme identified was Unbearable Suffering. Three additional themes were identified: 1) Facilitators to Nursing Practice During the COVID-19 Pandemic, 2) Barriers to Nursing Practice During the COVID-19 pandemic, with the sub-themes of Barriers Within the Work Environment, Suboptimal Care Delivery, and Negative Consequences for the Nurses; and lastly, 3) the Transitionary Nature of the Pandemic.. Conclusions The primary finding of this study was that nurses experienced and witnessed unbearable suffering while working during the COVID-19 pandemic that was transitionary in nature. Future research should consider the long-term impacts of this unbearable suffering on nurses. Intervention research should be considered to support nurses who have worked during the COVID-19 pandemic, and mitigate the potential long-term effects. Tweetable abstract A study on nurses experiences during the pandemic reveals their unbearable suffering. Read here about the reasons nurses are leaving.
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Affiliation(s)
- Chloé Littzen-Brown
- The University of Portland, School of Nursing and Health Innovations, Portland, Oregon, United States of America
| | - Hanne Dolan
- Arizona State University, Edson College of Nursing and Health Innovation, Tempe, Arizona, United States of America
| | - Angie Norton
- The University of Arizona, College of Nursing, Tucson, Arizona, United States of America
| | - Claire Bethel
- University of Pittsburgh Medical - Community Osteopathic Hospital, Pittsburgh, Pennsylvania, United States of America
| | - Jennifer May
- Duke University, School of Nursing, Durham, North Carolina, United States of America
| | - Jessica Rainbow
- The University of Arizona, College of Nursing, Tucson, Arizona, United States of America
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21
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Morley G, Copley DJ, Field RB, Zelinsky M, Albert NM. A divided community: A descriptive qualitative study of the impact of the COVID-19 pandemic on nurses and their relationships. J Adv Nurs 2023; 79:4635-4647. [PMID: 37358047 DOI: 10.1111/jan.15747] [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: 02/06/2023] [Revised: 05/16/2023] [Accepted: 06/10/2023] [Indexed: 06/27/2023]
Abstract
AIMS To identify the personal and professional impact of the COVID-19 pandemic on clinical nurses with regard to personal and workplace safety, personal and professional relationships and perceptions of their team, organization and community, and to understand lessons learned to inform future responses to pandemics or global emergencies. DESIGN Qualitative, descriptive free-text surveys, informed by appreciative inquiry. METHODS Nurses working in adult COVID- and non-COVID cohort medical-surgical and intensive care units, outpatient cancer and general surgery centres were invited to participate. Data were collected between April and October 2021 and analysed using summative content analysis. RESULTS In total, 77 participants completed free-text surveys. Five themes were identified: (1) Constraints on nursing: barriers in communication and diminished patient safety and quality of care; (2) Navigating uncertainty: the emotional toll of the pandemic; (3) Team solidarity, renewed appreciation and reaffirming purpose in nursing work; (4) Enhanced trust versus feeling expendable; and (5) Increased isolation and polarization within communities. Nurses described a perceived negative impact on a number of their relationships, including with patients, employer and community. They described a huge emotional toll that included feelings of isolation and polarization. While some nurses described feeling supported by their team and employer, others described feeling expendable. CONCLUSION Nurses' responses provided insights into negative emotional experiences during the pandemic due to heightened uncertainty and fear, and also the importance of support received from peers, colleagues and their employer. Nurses experienced feelings of isolation and polarization within their communities. The varied responses reflect the importance of societal solidarity when faced with global emergencies, and the need for nurses to feel valued by their patients and employer. IMPACT Effective responses to public health emergencies require individuals and communities to work together to achieve collective goals. Efforts to retain nurses are critical during global emergencies. PATIENT OR PUBLIC CONTRIBUTION No patient and public involvement.
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Affiliation(s)
- Georgina Morley
- Center for Bioethics, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic, Cleveland, Ohio, USA
| | - Dianna Jo Copley
- Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic, Cleveland, Ohio, USA
- Nursing Ethics Faculty Fellow, Center for Bioethics, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rosemary B Field
- Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Marymount Hospital, Garfield Heights, Ohio, USA
| | - Megan Zelinsky
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nancy M Albert
- Office of Nursing Research and Innovation, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Health System, Cleveland, Ohio, USA
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Conolly A, Rowland E, Abrams R, Harris R, Kelly D, Kent B, Maben J. 'Pretty cathartic actually': Reflections on the attempt to reduce re-traumatization of researchers and nurses taking part in a longitudinal interview study. J Adv Nurs 2023; 79:4196-4206. [PMID: 37415315 DOI: 10.1111/jan.15764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/02/2023] [Accepted: 06/16/2023] [Indexed: 07/08/2023]
Abstract
AIM To critically evaluate the concepts of harm and re-traumatization in the research process and to explore the ethical implications of conducting research on distressing topics using our research on the experiences of nurses working during the COVID-19 pandemic as an exemplar. DESIGN Longitudinal qualitative interview study. METHODS Using qualitative narrative interviews, we explored the impacts of the COVID-19 pandemic on nurses' psychological well-being in the UK. RESULTS To reduce the potential for harm to both research participants and researchers, the members of the research team were keen to establish ways to reduce the power differential between the researcher and participants. We found that our collaborative and team-based approach, with participant autonomy and researcher reflexivity embedded into the research framework, enabled the sensitive generation of data. CONCLUSION Reduction of potential harm for both participants and researchers in the generation of at times highly distressing data with a traumatized population was achieved through a respectful, honest and empathetic approach within a team that met frequently for reflection. IMPACT The research participants were not harmed by our research, instead they expressed gratitude at being given space and time to tell their stories in a supportive environment. Our work advances nursing knowledge through accentuating the value of giving autonomy to research participants to control their stories whilst working within a supportive research team with emphasis placed on reflexivity and debriefing. PATIENT AND PUBLIC CONTRIBUTION Nurses working clinically during COVID-19 were involved in the development of this study. Nurse participants were given autonomy over how and when they participated in the research process.
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Affiliation(s)
- Anna Conolly
- School of Health Sciences, University of Surrey, Faculty of Health and Medical Sciences, Guildford, Surrey, UK
| | | | - Ruth Abrams
- School of Health Sciences, University of Surrey, Faculty of Health and Medical Sciences, Guildford, Surrey, UK
| | | | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Bridie Kent
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Faculty of Health and Medical Sciences, Guildford, Surrey, UK
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23
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Conolly A. Commentary: Factors associated with the presence of fear of contagion and burnout syndrome in nursing personnel during the COVID-19 pandemic. J Res Nurs 2023; 28:432-433. [PMID: 38144958 PMCID: PMC10741271 DOI: 10.1177/17449871231207645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Affiliation(s)
- Anna Conolly
- Lecturer, School of Health Sciences, University of Surrey, Guildford, UK
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24
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Dobrowolski J, Chreim S, Yaya S, Ramlawi S, Dingwall-Harvey ALJ, El-Chaâr D. Occupational stressors and coping mechanisms among obstetrical nursing staff during the COVID-19 pandemic: a qualitative study. BMC Nurs 2023; 22:384. [PMID: 37845635 PMCID: PMC10577898 DOI: 10.1186/s12912-023-01557-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/08/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Due to heightened occupational stress throughout the COVID-19 pandemic, hospital nurses have experienced high rates of depression, anxiety, and burnout. Nurses in obstetrical departments faced unique challenges, such as the management of COVID-19 infection in pregnancy with limited evidence-based protocols and the unknown risks of the virus on pregnancy and fetal development. Despite evidence that obstetrical nurses have experienced high levels of job stress and a decrease in job satisfaction during the COVID-19 pandemic, there is less known about the working conditions resulting in these changes. Using the Job Demands-Resources (JD-R) model, this study aims to offer insight into the COVID-19 working environment of obstetrical nurses and shed light on their COVID-19 working experiences. METHODS The study was conducted using a qualitative approach, with data collection occurring through semi-structured interviews from December 2021 to June 2022. A total of 20 obstetrical nurses recruited from the obstetrical departments of a tertiary hospital located in Ontario, Canada, participated in the study. Interviews were audio-recorded, transcribed verbatim, and coded using NVivo. Data was analyzed using a theoretical thematic approach based on the JD-R model. RESULTS Four themes were identified: (1) Job stressors, (2) Consequences of working during COVID-19, (3) Personal resources, and (4) Constructive feedback surrounding job resources. The findings show that obstetrical nurses faced several unique job stressors during the COVID-19 pandemic but were often left feeling inadequately supported and undervalued by hospital upper management. However, participants offered several suggestions on how they believe support could have been improved and shared insight on resources they personally used to cope with job stress during the pandemic. A model was created to demonstrate the clear linkage between the four main themes. CONCLUSIONS This qualitative study can help inform hospital management and public policy on how to better support and meet the needs of nurses working in obstetrical care during pandemics. Moreover, applying the JD-R model offers both a novel and comprehensive look at how the COVID-19 hospital work environment has influenced obstetrical nurses' well-being and performance.
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Affiliation(s)
- Julia Dobrowolski
- Telfer School of Management, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Samia Chreim
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
| | - Serine Ramlawi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Alysha L J Dingwall-Harvey
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Darine El-Chaâr
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
- Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, Canada.
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
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Lawton R, Murray J, Baxter R, Richardson G, Cockayne S, Baird K, Mandefield L, Brealey S, O'Hara J, Foy R, Sheard L, Cracknell A, Breckin E, Hewitt C. Evaluating an intervention to improve the safety and experience of transitions from hospital to home for older people (Your Care Needs You): a protocol for a cluster randomised controlled trial and process evaluation. Trials 2023; 24:671. [PMID: 37838678 PMCID: PMC10576890 DOI: 10.1186/s13063-023-07716-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/07/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Older patients often experience safety issues when transitioning from hospital to home. The 'Your Care Needs You' (YCNY) intervention aims to support older people to 'know more' and 'do more' whilst in hospital so that they are better prepared for managing at home. METHODS A multi-centre cluster randomised controlled trial (cRCT) will evaluate the effectiveness and cost-effectiveness of the YCNY intervention. Forty acute hospital wards (clusters) in England from varying medical specialities will be randomised to deliver YCNY or care-as-usual on a 1:1 basis. The primary outcome will be unplanned hospital readmission rates within 30 days of discharge. This will be extracted from routinely collected data of at least 5440 patients (aged 75 years and older) discharged to their own homes during the 4- to 5-month YCNY intervention period. A nested cohort of up to 1000 patients will be recruited to the study to collect secondary outcomes via follow-up questionnaires at 5-, 30- and 90-day post-discharge. These will include measures of patient experience of transitions, patient-reported safety events, quality of life and healthcare resource use. Unplanned hospital readmission rates at 60 and 90 days of discharge will be collected from routine data. A process evaluation (primarily interviews and observations with patients, carers and staff) will be conducted to understand the implementation of the intervention and the contextual factors that shape this, as well as the intervention's underlying mechanisms of action. Fidelity of intervention delivery will also be assessed across all intervention wards. DISCUSSION This study will establish the effectiveness and cost-effectiveness of the YCNY intervention which aims to improve patient safety and experience for older people during transitions of care. The process evaluation will generate insights about how the YCNY intervention was implemented, what elements of the intervention work and for whom, and how to optimise its implementation so that it can be delivered with high fidelity in routine service contexts. TRIAL REGISTRATION UK Clinical Research Network Portfolio: 44559; ISTCRN: ISRCTN17062524. Registered on 11/02/2020.
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Affiliation(s)
- Rebecca Lawton
- Yorkshire Quality and Safety Research group, Bradford Institute for Health Research, Bradford, UK.
- School of Psychology, University of Leeds, Leeds, UK.
| | - Jenni Murray
- Yorkshire Quality and Safety Research group, Bradford Institute for Health Research, Bradford, UK
| | - Ruth Baxter
- Yorkshire Quality and Safety Research group, Bradford Institute for Health Research, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
| | | | | | | | | | | | - Jane O'Hara
- School of Healthcare, University of Leeds, Leeds, UK
| | - Robbie Foy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Alison Cracknell
- Leeds Centre for Older People's Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Edmund Breckin
- Yorkshire Quality and Safety Research group, Bradford Institute for Health Research, Bradford, UK
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Zhu P, Qian M, Lee A, Hayter M, Wang W, Shi G, Wu Q, Ji Q, Gu X, Zhang H, Ding Y. Trajectory analysis of the work and life experience of healthcare workers during the COVID-19 pandemic: a longitudinal qualitative study. BMC Nurs 2023; 22:333. [PMID: 37759182 PMCID: PMC10523727 DOI: 10.1186/s12912-023-01520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has posed a global health threat and has had a profoundly negative impact on the work and lives of healthcare workers. However, few people know how their experiences have evolved over time. AIMS To describe healthcare workers' experiences during clinical responses to COVID-19 and how they changed over time. DESIGN A longitudinal qualitative study. METHODS We undertook a series of four semi-structured qualitative interviews of 14 healthcare workers called as 1st responders to the COVID-19 pandemic. Participants were recruited through purposive snowball sampling. Interviews were undertaken between May 2020 and May 2022 and trajectory approach was used to reveal individual experiences over time. This paper follows the COREQ (Consolidated criteria for Reporting Qualitative Research) guidance. RESULTS Data analysis yielded the following four themes: (1) Changes in emotions; (2) Changes in organization and management of care; (3) Changes in knowledge and capabilities; and (4) Changes in outlook on life and career. CONCLUSION Healthcare workers have become stronger in the pandemic and have demonstrated a high degree of professional loyalty and responsibility. However, there is a need to focus on the issue of jealousy and create a harmonious and safe work environment to reduce harm to healthcare workers. Additionally, human resource management strategies must support well-being of healthcare workers and maximize the efficiency of human resource utilization to enable them to respond to current and future needs and emergencies.
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Affiliation(s)
- Pingting Zhu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China.
- Jiangsu Key Laboratory of Zoonosis, Yangzhou, China.
| | - Meiyan Qian
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Amanda Lee
- Manchester Metropolitan University, Manchester, England
| | - Mark Hayter
- Manchester Metropolitan University, Manchester, England.
| | - Wen Wang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Guanghui Shi
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Qiwei Wu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Qiaoying Ji
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Xinyue Gu
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Hui Zhang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Yinwen Ding
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
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Ystaas LMK, Nikitara M, Ghobrial S, Latzourakis E, Polychronis G, Constantinou CS. The Impact of Transformational Leadership in the Nursing Work Environment and Patients' Outcomes: A Systematic Review. NURSING REPORTS 2023; 13:1271-1290. [PMID: 37755351 PMCID: PMC10537672 DOI: 10.3390/nursrep13030108] [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: 07/11/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND With the increasingly demanding healthcare environment, patient safety issues are only becoming more complex. This urges nursing leaders to adapt and master effective leadership; particularly, transformational leadership (TFL) is shown to scientifically be the most successfully recognized leadership style in healthcare, focusing on relationship building while putting followers in power and emphasizing values and vision. AIM To examine how transformational leadership affects nurses' job environment and nursing care provided to the patients and patients' outcomes. DESIGN A systematic literature review was conducted. From 71 reviewed, 23 studies were included (studies included questionnaire surveys and one interview, extracting barriers and facilitators, and analyzing using qualitative synthesis). RESULT TFL indirectly and directly positively affects nurses' work environment through mediators, including structural empowerment, organizational commitment, and job satisfaction. Nurses perceived that managers' TFL behavior did not attain excellence in any of the included organizations, highlighting the necessity for additional leadership training to enhance the patient safety culture related to the non-reporting of errors and to mitigate the blame culture within the nursing environment. CONCLUSION Bringing more focus to leadership education in nursing can make future nursing leaders more effective, which will cultivate efficient teamwork, a quality nursing work environment, and, ultimately, safe and efficient patient outcomes. This study was not registered.
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Affiliation(s)
- Line Miray Kazin Ystaas
- Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia 1700, Cyprus
| | - Monica Nikitara
- Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia 1700, Cyprus
| | - Savoula Ghobrial
- Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia 1700, Cyprus
| | - Evangelos Latzourakis
- Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia 1700, Cyprus
| | - Giannis Polychronis
- Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia 1700, Cyprus
| | - Costas S. Constantinou
- Department of Basic and Clinical Sciences, Medical School, University of Nicosia, Nicosia 1700, Cyprus
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Falcó-Pegueroles A, Viola E, Poveda-Moral S, Rodríguez-Martín D, Via-Clavero G, Barello S, Bosch-Alcaraz A, Bonetti L. Protective factors of ethical conflict during a pandemic-Quali-Ethics-COVID-19 research part 2: An international qualitative study. J Clin Nurs 2023; 32:6677-6689. [PMID: 37190669 DOI: 10.1111/jocn.16754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/10/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023]
Abstract
AIMS AND OBJECTIVES To determine which factors can be considered protective of ethical conflicts in intensive care unit healthcare professionals during a pandemic. BACKGROUND The COVID-19 pandemic gave rise to new ethical concerns in relation to the management of public health and the limitations on personal freedom. Continued exposure to ethical conflict can have a range of psychological consequences. DESIGN A qualitative design based on phenomenological approach. METHODS A total of 38 nurses and physicians who were regular staff members of Barcelona and Milan's public tertiary university hospitals and working in intensive care units during the first wave of the COVID-19 pandemic. Semi-structured online in-depth interviews were conducted. A thematic analysis was performed by two independent researchers following the seven steps of Colaizzi's methods. We adhere COREQ guidelines. RESULTS One theme 'Protective factors of ethical conflict in sanitary crisis' and four subthemes emerged from the data: (1) knowledge of the infectious disease, (2) good communication environment, (3) psychological support and (4) keeping the same work team together. CONCLUSIONS Four elements can be considered protective factors of ethical conflict for healthcare professionals during a sanitary crisis. While some of these factors have already been described, the joint identification of this set of four factors as a single element is, in itself, novel. This should help in ensuring the right mechanisms are in place to face future pandemics and should serve to improve institutional organisation and guarantee safe and high-quality patient care in times of healthcare crisis. RELEVANCE TO CLINICAL PRACTICE Future strategies for the prevention of ethical conflict during sanitary crises, pandemics or other catastrophes need to consider a set of four factors as a single element. These factors are the knowledge of the infectious disease, a good communication environment, psychological support and keeping the same work team together into joint consideration.
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Affiliation(s)
- Anna Falcó-Pegueroles
- Faculty of Nursing, University of Barcelona, Barcelona, Spain
- Consolidated Research Group 325 Bioethics, Law and Society (BIOELSi), University of Barcelona, Barcelona, Spain
| | - Elena Viola
- Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Nursing and Health Doctoral Program, University of Barcelona, Barcelona, Spain
| | - Silvia Poveda-Moral
- University School of Nursing and Occupational Therapy, Terrassa, Barcelona, Spain
| | | | - Gemma Via-Clavero
- Faculty of Nursing, University of Barcelona, Barcelona, Spain
- Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Loris Bonetti
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- University of Applied Sciences and Arts of Southerm Switzerland, Manno, Switzerland
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29
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Portillo-Van Diest A, Vilagut G, Alayo I, Ferrer M, Amigo F, Amann BL, Aragón-Peña A, Aragonès E, Asúnsolo Del Barco Á, Campos M, Del Cura-González I, Espuga M, González-Pinto A, Haro JM, Larrauri A, López-Fresneña N, Martínez de Salázar A, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Zapata A, Pijoan JI, Plana N, Puig T, Rius C, Rodríguez-Blázquez C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Mortier P. Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study. Epidemiol Psychiatr Sci 2023; 32:e50. [PMID: 37555258 PMCID: PMC10465320 DOI: 10.1017/s2045796023000628] [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] [Received: 09/02/2022] [Revised: 03/06/2023] [Accepted: 06/24/2023] [Indexed: 08/10/2023] Open
Abstract
AIM To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. METHODS This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). RESULTS Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. CONCLUSIONS TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Asociación instituto de investigación en sistemas de salud Biosistemak, Barakaldo, País Vasco, España
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Benedikt L. Amann
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Centre Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Department of Health Services Research Group, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department for Psychiatry and Psychotherapy, Hospital of the Ludwig-Maximilians-University Munich, Germany
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Enric Aragonès
- Department of Atenció Primària Camp de Tarragona, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Isabel Del Cura-González
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain
| | - Meritxell Espuga
- Occupational Health Service, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- BIOARABA, UPV-EHU, Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain
| | - Josep M. Haro
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Department Facultat de Medicina y Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Amparo Larrauri
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Nieves López-Fresneña
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Juan D. Molina
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M. Ortí-Lucas
- Department of Preventive MedicineDepartment, Hospital Clínic Universitari, Valencia, Spain
| | - Mara Parellada
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José M. Pelayo-Terán
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Psiquiatría y Salud Mental, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
- Area de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Aurora Pérez-Zapata
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - José I. Pijoan
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Clinical Epidemiology Unit, Hospital Universitario Cruces/OSI EEC, Bilbao, Spain
| | - Nieves Plana
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Teresa Puig
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Rius
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ferran Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Instituto Nacional de Bioinformatica – ELIXIR-ES (IMPaCT-Data-ISCIII), Barcelona, Spain
| | - Consol Serra
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
- CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- Clinical Epidemiology, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Víctor Pérez-Solá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Sillero Sillero A, Ayuso Margañon R, Gil Poisa M, Buil N, Padrosa E, Insa Calderón E, Marques-Sule E, Alcover Van de Walle C. Moral Breakdowns and Ethical Dilemmas of Perioperative Nurses during COVID-19: COREQ-Compliant Study. Healthcare (Basel) 2023; 11:1937. [PMID: 37444771 DOI: 10.3390/healthcare11131937] [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: 06/09/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: The COVID-19 pandemic has led to an increase in the complexity of caregiving, resulting in challenging situations for perioperative nurses. These situations have prompted nurses to assess their personal and professional lives. The aim of this study was to explore the experiences of perioperative nurses during the first wave of the COVID-19 pandemic, with a specific focus on analyzing moral breakdowns and ethical dilemmas triggered by this situation. (2) Methods: A qualitative design guided by a hermeneutical approach was employed. Semi-structured interviews were conducted with 24 perioperative nurses. The interviews were transcribed and thematically analysed following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. (3) Results: The findings revealed three main categories and ten subcategories. These categories included the context in which moral breakdowns emerged, the ethical dilemmas triggered by these breakdowns, and the consequences of facing these dilemmas. (4) Conclusions: During the first wave of COVID-19, perioperative nurses encountered moral and ethical challenges, referred to as moral breakdowns, in critical settings. These challenges presented significant obstacles and negatively impacted professional responsibility and well-being. Future studies should focus on identifying ethical dilemmas during critical periods and developing strategies to enhance collaboration among colleagues and provide comprehensive support.
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Affiliation(s)
- Amalia Sillero Sillero
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra Affiliated, 08003 Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Raquel Ayuso Margañon
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra Affiliated, 08003 Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Maria Gil Poisa
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra Affiliated, 08003 Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Neus Buil
- Nursing Care Research, IIBSANT PAU, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Eva Padrosa
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra Affiliated, 08003 Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Esther Insa Calderón
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra Affiliated, 08003 Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Faculty of Physiotherapy, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Carlota Alcover Van de Walle
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra Affiliated, 08003 Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
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Mauk KL. Cultivating Resilience-Building Relationships. J Christ Nurs 2023; 40:144. [PMID: 37271900 DOI: 10.1097/cnj.0000000000001076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Affiliation(s)
- Kristen L Mauk
- Kristen L. Mauk, PhD, DNP, RN, CRRN, GCNS-BC, GNP-BC, FARN, FAAN , is the Senior Editor of the Journal of Christian Nursing . She is also a professor of nursing and the graduate program director at Colorado Christian University, Lakewood, CO. Kris is passionate about rehabilitation and gerontological nursing, and helping developing countries in these areas
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Byrne JP, Humphries N, McMurray R, Scotter C. COVID-19 and healthcare worker mental well-being: Comparative case studies on interventions in six countries. Health Policy 2023; 135:104863. [PMID: 37399678 PMCID: PMC10292916 DOI: 10.1016/j.healthpol.2023.104863] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Abstract
Healthcare worker (HCW) mental well-being has become a global public health priority as health systems seek to strengthen their resilience in the face of the COVID-19 pandemic. Analysing data from the Health System Response Monitor, we present six case studies (Denmark, Italy, Kyrgyzstan, Lithuania, Romania, and the United Kingdom) as a comparative review of policy interventions supporting HCW mental health during the pandemic. The results illustrate a wide range of interventions. While Denmark and the United Kingdom built on pre-existing structures to support HCW mental wellbeing during the pandemic, the other countries required new interventions. Across all cases, there was a reliance on self-care resources, online training tools, and remote professional support. Based on our analysis, we develop four policy recommendations for the future of HCW mental health supports. First, HCW mental health should be seen as a core facet of health workforce capacity. Second, effective mental health supports requires an integrated psychosocial approach that acknowledges the importance of harm prevention strategies and organisational resources (psychological first aid) alongside targeted professional interventions. Third, personal, professional and practical obstacles to take-up of mental health supports should be addressed. Fourth, any specific support or intervention targeting HCW's mental health is connected to, and dependent on, wider structural and employment factors (e.g. system resourcing and organisation) that determine the working conditions of HCWs.
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Affiliation(s)
- John-Paul Byrne
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland.
| | - Niamh Humphries
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland
| | - Robert McMurray
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland
| | - Cris Scotter
- Graduate School of Healthcare Management (GSM), RCSI University of Medicine and Health Sciences, RCSI, Ballymoss Road, Sandyford Industrial Est. Dublin 18, Ireland
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He S, Zhao H, Wang H, Chen F, Lv T, Li L, Zhang H. The mediating effects of attitude toward death and meaning of life on the relationship between perception of death and coping with death competence among Chinese nurses: a cross-sectional study. BMC Nurs 2023; 22:87. [PMID: 36997960 PMCID: PMC10060942 DOI: 10.1186/s12912-023-01245-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/11/2023] [Indexed: 03/31/2023] Open
Abstract
Abstract
Background
It is important to understand how the perception of death affects the competence to cope with death.
Objectives
To explore whether the perception of death has an indirect effect on competence to cope with death through the mediation of attitude toward death and meaning of life.
Methods
A total of 786 nurses from Hunan Province, China, selected by random sampling method and asked to complete an online electronic questionnaire between October and November 2021 were included in the study.
Results
The nurses’ scored 125.39 ± 23.88 on the competence to cope with death. There was a positive correlation among perception of death, competence to cope with death, the meaning of life, and attitude toward death. There were three mediating pathways: the separate mediating effect of natural acceptance and meaning of life, and the chain mediating effect of natural acceptance and meaning of life.
Conclusion
The nurses’ competence to cope with death was moderate. Perception of death could indirectly and positively predict nurses’ competence to cope with death by enhancing natural acceptance or sense of meaning in life. In addition, perception of death could improve natural acceptance and then enhance the sense of meaning in life to positively predict nurses’ competence to cope with death.
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Grant A, Maciver E, Adams N, Teodorowski P, Kennedy C. 'A journey of self-discovery and transformation': A theoretical and comprehensive evaluation of the Queen's nursing institute Scotland community development programme. J Adv Nurs 2023; 79:2200-2210. [PMID: 36645111 DOI: 10.1111/jan.15552] [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: 05/23/2022] [Revised: 11/29/2022] [Accepted: 12/11/2022] [Indexed: 01/17/2023]
Abstract
AIM To evaluate adoption, implementation and maintenance of the Queen's Nursing Institute Scotland development programme. DESIGN A comprehensive, longitudinal, qualitative evaluation. METHOD Participants from the first two cohorts were interviewed at different stages to explore adoption, implementation and maintenance. Managers of participants engaged in interviews to explore service changes. Facilitators took part in a focus group exploring delivery. A member-checking event was held. Data collection was between March 2017 and October 2019. Data analysis was thematically followed by the application of Normalization Process Theory. RESULT Ninety-four interviews, two focus groups and a member-checking event were conducted. Prior to the programme most participants were burnt-out and considering leaving. Engaging led to a journey of self-discovery and transformation. The programme was perceived to change their way of thinking, personally and professionally, unlike any training and development previously experienced. Participants were rejuvenated and reinvigorated, sharing their learning with colleagues, service users and family, implementing new working practices and furthering their careers. They developed communities of practice amongst their cohorts with strong bonds; enabling them to build and sustain learnings. CONCLUSION Participants experienced a journey of self-discovery and transformation unlike anything before due to the personal investment in them. Participants were rejuvenated and reinvigorated with many moving into new roles. The programme equipped them with a range of leadership and resilience skills. IMPACT The Queen's Nursing Institute Scotland Development Programme had a profound impact on participants, personally and professionally, which was perceived as lifelong. These findings and programmes are transferable beyond Scotland and to different professions.
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Affiliation(s)
- Aileen Grant
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, UK
| | - Emma Maciver
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, UK
| | - Nick Adams
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, UK
| | - Piotr Teodorowski
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Catriona Kennedy
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, UK
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Abrams R, Conolly A, Rowland E, Harris R, Kent B, Kelly D, Couper K, Maben J. Speaking up during the COVID-19 pandemic: Nurses' experiences of organizational disregard and silence. J Adv Nurs 2023; 79:2189-2199. [PMID: 36645162 DOI: 10.1111/jan.15526] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 01/17/2023]
Abstract
AIM To critically examine nurses' experiences of speaking up during COVID-19 and the consequences of doing so. DESIGN Longitudinal qualitative study. METHODS Participants were purposively sampled to represent differing geographical locations, specialities, settings and redeployment experiences. They were interviewed (remotely) between July 2020 and April 2022 using a semi-structured interview topic guide. RESULTS Three key themes were identified inductively from our analysis including: (1) Under threat: The ability to speak up or not; (2) Risk tolerance and avoidance: Consequences of speaking up; and (3) Deafness and hostility: Responses to speaking up. Nurses reported that their attempts to speak up typically focused on PPE, patient safety and redeployment. Findings indicate that when NHS Trusts and community services initiated their pandemic response policies, nurses' opportunities to speak up were frequently thwarted. CONCLUSION Accounts presented in this article include nurses' feeling a sense of futility or of suffering in silence in relation to speaking up. Nurses also fear the consequences of speaking up. Those who did speak up encountered a 'deaf' or hostile response, leaving nurses feeling disregarded by their organization. This points to missed opportunities to learn from those on the front line. IMPACT Speaking up interventions need to focus on enhancing the skills to both speak up, and respond appropriately, particularly when power, hierarchy, fear and threat might be concerned. PATIENT OR PUBLIC CONTRIBUTION Nurses working clinically during COVID-19 were involved in the development of this study. Participants were also involved in the development of our interview topic guide and comments obtained from the initial survey helped to shape the study design.
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Affiliation(s)
| | | | | | | | | | | | - Keith Couper
- University of Warwick and University Hospitals Birmingham NHS Foundation Trust, Coventry, UK
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Ocean N, Meyer C. Satisfaction and attrition in the UK healthcare sector over the past decade. PLoS One 2023; 18:e0284516. [PMID: 37053234 PMCID: PMC10101409 DOI: 10.1371/journal.pone.0284516] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Existing literature has highlighted concerns over working conditions in the UK National Health Service (NHS), with healthcare workers frequently citing work-life balance issues and stress as being drivers of attrition and burnout. However, we do not know whether these problems have become worse over time, particularly over the past decade, during which there have been multiple shocks to the UK healthcare system. To investigate this, we analysed data from NHS monthly workforce statistics and the UK Household Longitudinal Study. Three times as many workers left the NHS in 2021 for work-life balance reasons than in 2011, while estimated satisfaction with one's amount of leisure time for healthcare workers fell by three times the amount that it fell for non-healthcare workers. Both satisfaction with amount of leisure time and satisfaction with income have remained lower for healthcare workers than for other public sector workers. By 2020, a worker that had low satisfaction with their amount of leisure time was as much as 22 percentage points less likely than in 2010 to remain in healthcare in the following year. Overall, working conditions in UK healthcare have deteriorated between 2010 and 2020, especially relative to the private sector. However, overall job satisfaction has fallen faster in other areas of the public sector than it has in healthcare, which may indicate wider issues within the UK public sector as a whole.
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Affiliation(s)
- Neel Ocean
- WMG, University of Warwick, Coventry, United Kingdom
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Hinzmann D, Schütte-Nütgen K, Büssing A, Boenisch O, Busch HJ, Dodt C, Friederich P, Kochanek M, Michels G, Frick E. Critical Care Providers' Moral Distress: Frequency, Burden, and Potential Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:333. [PMID: 36612657 PMCID: PMC9819312 DOI: 10.3390/ijerph20010333] [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: 09/24/2022] [Revised: 10/25/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Critical Care Providers (CCPs) experience situations that challenge their ethics and professional standards and may entail moral distress (MD). AIM To analyze MD perceived by CCPs in intensive care units (ICUs) or emergency departments (EDs) and further clarify whether CCPs who rely on spiritual resources differ in their perception of MD from those who do not utilize these resources. METHODS A cross-sectional anonymous survey was administered using a modified version of the German language version of the Moral Distress Scale (MDS) with 2 × 12 items to assess the frequency and the respective perceived burden of specific situations by applying a 5-point Likert scale. Explorative factor analysis was performed and the sub-constructs of the respective items regarding MD frequency and burden were identified. Job burden and professional satisfaction were measured using visual analogue scales (VAS) and a four-point Likert scale, respectively. The 15-item SpREUK questionnaire was applied to measure spiritual attitudes and behaviours and to differentiate between religious and spiritual persons. Data from 385 German-speaking CCPs were included (55% physicians, 45% nurses). RESULTS Conflict situations are similar for physicians and nurses although they are perceived as more burdensome by nurses. Among physicians, the MDS factor Looking away/Resignation scores highest for assistant physician residents, whereas distress caused by looking away is more often perceived by specialist physicians without a managerial position. Work satisfaction is inversely associated with MD and emotional exhaustion is positively associated with it. Participants' spirituality is marginally associated with MD. The best predictors of both MD frequency and burden are emotional exhaustion with further influences of work satisfaction, being a nurse, and being a non-believer on the frequency of MD perception. Being a nurse, participants' experience in ICU/ED, and being of the male gender are further predictors of MD burden. CONCLUSIONS MD is experienced differently by different groups of CCPs depending on their place in the hierarchy of responsibility. As MD perception is best predicted by emotional exhaustion, these situations should be avoided. Although some CCPs may rely on spiritual resources, all need individual and team support to cope with MD.
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Affiliation(s)
- Dominik Hinzmann
- Department of Anaesthesiology and Intensive Care, University Hospital Rechts der Isar, 81675 Munich, Germany
- School of Medicine, Technical University of Munich, 80333 München, Germany
| | | | - Arndt Büssing
- Quality of Life, Spirituality and Coping, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Olaf Boenisch
- Department of Intensive Care, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Hans-Jörg Busch
- Department of Emergency Medicine, University Hospital Freiburg, 79106 Freiburg, Germany
| | - Christoph Dodt
- Emergency Department, München Klinik, 81925 Munich, Germany
| | | | - Matthias Kochanek
- Department of Intensive Care, University Hospital Cologne, 50937 Cologne, Germany
| | - Guido Michels
- Emergency Department, Sankt Antonius Hospital, 52249 Eschweiler, Germany
| | - Eckhard Frick
- School of Medicine, Technical University of Munich, 80333 München, Germany
- Spiritual Care and Psychosomatic Health, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, 80539 Munich, Germany
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Nagel C, Nilsson K. Nurses' Work-Related Mental Health in 2017 and 2020-A Comparative Follow-Up Study before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15569. [PMID: 36497643 PMCID: PMC9738150 DOI: 10.3390/ijerph192315569] [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: 09/30/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic put a lot of strain on healthcare organizations. Nurses account for over 50% of healthcare staff, and how nurses perform in their work is influenced by a number of human and work environmental factors. However, to our knowledge, there has not been a previous study with the intention to look at all areas that affect a sustainable working life and how these impact nurses' mental well-being. The aim of this study is to investigate the association between, and the effect of, different factors in nurses' work situations associated with nurses' work-related mental-health diagnoses, before and during the COVID-19 pandemic. A questionnaire was sent out to all 9219 nurses in the Swedish county of Skane in the spring of 2017 and during wave two of the COVID-19 pandemic in the fall of 2020. The data were analyzed through logistic regression analysis. The results showed that lack of joy in the daily work, an increased workload and lack of support from co-workers had an increased association with work-related mental-health diagnoses. Future research regarding the long-term impact of COVID-19 on all areas of nurses' professional and personal lives is needed.
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Affiliation(s)
- Cicilia Nagel
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22184 Lund, Sweden
- Division of Public Health, Kristianstad University, 29128 Kristianstad, Sweden
| | - Kerstin Nilsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22184 Lund, Sweden
- Division of Public Health, Kristianstad University, 29128 Kristianstad, Sweden
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Asimakopoulou E, Paoullis P, Shegani A, Argyriadis A, Argyriadi A, Patelarou E, Patelarou A. Translation, Adaptation and Validation of the Pandemic Fatigue Scale (PFS) in the Greek Language. Healthcare (Basel) 2022; 10:healthcare10112118. [PMID: 36360459 PMCID: PMC9690820 DOI: 10.3390/healthcare10112118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 11/04/2022] Open
Abstract
The growing fatigue of citizens due to the COVID-19 pandemic has already been addressed and its results are visible and threatens citizen compliance. The aim of this study was to translate and validate the Pandemic Fatigue Scale (PFS) in the Greek language. A cross-sectional study was conducted between October 2021 to March 2022. The translation and cultural adaptation process was developed according to the research protocols among the university student population in Cyprus and tested the psychometric properties of PFS. Three hundred thirty-four subjects participated in the study through a web survey, which included general information and the study process. The internal consistency for the total PFS showed good reliability (six items, a = 0.88). A weak statistically significant positive correlation was found between the PFS and the Greek versions of Generalised Anxiety Disorder Assessment—GAD-7 (r = 0.1.96; p < 0.001) and the PFS and Patient Health Questionnaire—PHQ-9 (r = 0.173; p = 0.002) demonstrating good concurrent validity. Recovering from the pandemic, it is necessary to build systems to detect and respond to future healthcare crises. The results suggest that the psychometric properties of the Greek PFS are satisfactory. The measure of pandemic fatigue allows for identifying fatigue groups for targeted interventions and testing how pandemic fatigue might be reduced in such situations.
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Affiliation(s)
- Evanthia Asimakopoulou
- Department of Nursing, School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
- Correspondence: ; Tel.: +357-22394394; Fax: +357-22438234
| | - Panagiotis Paoullis
- Department of Nursing, School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
| | - Antonio Shegani
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, UK
| | - Alexandros Argyriadis
- Department of Nursing, School of Health Sciences, Frederick University, Nicosia 1036, Cyprus
| | - Agathi Argyriadi
- Department of Psychology and Social Sciences, Frederick University, Nicosia 1036, Cyprus
| | - Evridiki Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Crete, Greece
| | - Athina Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71410 Crete, Greece
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Vincent JL, Boulanger C, van Mol MMC, Hawryluck L, Azoulay E. Ten areas for ICU clinicians to be aware of to help retain nurses in the ICU. Crit Care 2022; 26:310. [PMID: 36229859 PMCID: PMC9559151 DOI: 10.1186/s13054-022-04182-y] [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: 08/10/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Shortage of nurses on the ICU is not a new phenomenon, but has been exacerbated by the COVID-19 pandemic. The underlying reasons are relatively well-recognized, and include excessive workload, moral distress, and perception of inappropriate care, leading to burnout and increased intent to leave, setting up a vicious circle whereby fewer nurses result in increased pressure and stress on those remaining. Nursing shortages impact patient care and quality-of-work life for all ICU staff and efforts should be made by management, nurse leaders, and ICU clinicians to understand and ameliorate the factors that lead nurses to leave. Here, we highlight 10 broad areas that ICU clinicians should be aware of that may improve quality of work-life and thus potentially help with critical care nurse retention.
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Affiliation(s)
- Jean-Louis Vincent
- grid.4989.c0000 0001 2348 0746Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Carole Boulanger
- Department of Intensive Care, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Margo M. C. van Mol
- grid.5645.2000000040459992XDepartment of Intensive Care Adults, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Laura Hawryluck
- grid.17063.330000 0001 2157 2938Critical Care Medicine, University Health Network, University of Toronto, Toronto, ON Canada
| | - Elie Azoulay
- Medical Intensive Care Unit, Famirea Study Group, Paris, France
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Rossettini G, Peressutti V, Visintini E, Fontanini R, Caruzzo D, Longhini J, Palese A. Italian nurses' experiences of the COVID-19 pandemic through social media: A longitudinal mixed methods study of Internet posts. Digit Health 2022; 8:20552076221129082. [PMID: 36211800 PMCID: PMC9536097 DOI: 10.1177/20552076221129082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/12/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To examine the experience of Italian nurses posted on social media and discover changes, if any, over the waves. Methods A mixed methods study reported according to the Good Reporting of a Mixed Methods Study criteria. All narratives (texts, letters and interviews) posted by Italian nurses from February 2020 to May 2020 (first wave) and from October 2020 to May 2021 (second/third wave) on the five most famous Italian professional social media platforms. The data were analysed qualitatively (first wave) and then quantitatively (second/third wave). Results A total of 380 narratives (202,626 words, 2510 quotes) were posted in the first wave, and 161 (68,388 words, 835 quotes) in the second/third wave. In the first wave, the following five themes emerged: (a) ‘sharing what is happening within myself’ (891; 35.5%); (b) ‘experiencing unprecedented working conditions’ (749; 29.8%); (c) ‘failing to rehabilitate the image of nurses in society’ (376; 15%); (d) ‘experiencing a deep change’ (253; 10.1%) and (e) ‘do not abandon us’ (241; 9.6%). The same themes and subthemes also emerged in the second/third wave with some significant differences, indicating changes in the lived experience of nurses. Moreover, in the second/third wave, a new theme emerged: ‘experiencing the mixed emotions towards jabs’. Conclusions By analysing their posts, Italian nurses continue to face challenges during the COVID-19 pandemic, with changes in their lived experiences across the waves. Governments, nursing associations and health care organizations should consider these changes to design policies to prevent the further loss of nurses.
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Affiliation(s)
- Giacomo Rossettini
- Clinical PT, School of Physiotherapy, University of Verona, Verona, Italy
| | | | | | | | | | | | - Alvisa Palese
- Udine University, Udine, Italy,Jessica Longhini, Udine University, Viale Ungheria, 20, 33100, Udine, Italy.
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Ball J, Anstee S, Couper K, Maben J, Blake H, Anderson JE, Kelly D, Harris R, Conolly A. The impact of COVID-19 on nurses (ICON) survey: Nurses' accounts of what would have helped to improve their working lives. J Adv Nurs 2022; 79:343-357. [PMID: 36177495 PMCID: PMC9538551 DOI: 10.1111/jan.15442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/19/2022] [Accepted: 08/31/2022] [Indexed: 12/15/2022]
Abstract
AIMS To use nurses' descriptions of what would have improved their working lives during the first peak of the COVID-19 pandemic in the UK. DESIGN Analysis of free-text responses from a cross-sectional survey of the UK nursing and midwifery workforce. METHODS Between 2 and 14 April 2020, 3299 nurses and midwives completed an online survey, as part of the 'Impact of COVID-19 on Nurses' (ICON) study. 2205 (67%) gave answers to a question asking for the top three things that the government or their employer could do to improve their working lives. Each participants' response was coded using thematic and content analysis. Multiple response analysis quantified the frequency of different issues and themes and examined variation by employer. RESULTS Most (77%) were employed by the National Health Service (77%) and worked at staff or senior staff nurse levels (55%). 5938 codable responses were generated. Personal protective equipment/staff safety (60.0%), support to workforce (28.6%) and better communication (21.9%) were the most cited themes. Within 'personal protective equipment', responses focussed most on available supply. Only 2.8% stated that nothing further could be done. Patterns were similar in both NHS and non-NHS settings. CONCLUSIONS The analysis provided valuable insight into key changes required to improve the work lives of nurses during a pandemic. Urgent improvements in provision and quality of personal protective equipment were needed for the safety of both workforce and patients. IMPACT Failure to meet nurses needs to be safe at work appears to have damaged morale in this vital workforce. We identified key strategies that, if implemented by the Government and employers, could have improved the working lives of the nursing and midwifery workforce during the early stages of the COVID-19 pandemic and could prevent the pandemic from having a longer-term negative impact on the retention of this vital workforce. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution, due to the COVID-19 Pandemic, urgency of the work and the target population being health and social care staff.
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Affiliation(s)
- Jane Ball
- University of SouthamptonSouthamptonUK,NIHR ARC WessexSouthamptonUK
| | | | - Keith Couper
- Warwick Medical SchoolUniversity of WarwickCoventryUK,Critical Care UnitUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Jill Maben
- School of Health SciencesUniversity of SurreyGuildfordUK
| | - Holly Blake
- School of Health SciencesUniversity of NottinghamNottinghamUK,NIHR Nottingham Biomedical Research CentreNottinghamUK
| | | | | | | | - Anna Conolly
- School of Health SciencesUniversity of SurreyGuildfordUK
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Morley G, Copley DJ, Field R, Zelinsky M, Albert NM. RESPONDER: A Qualitative Study of Ethical Issues Faced by Critical Care Nurses during the COVID-19 Pandemic. J Nurs Manag 2022; 30:2403-2415. [PMID: 36064194 PMCID: PMC9537935 DOI: 10.1111/jonm.13792] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/26/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
AIMS To identify and understand ethical challenges arising during COVID-19 in intensive care; nurses' perceptions of how they made 'good' decisions and provided 'good' care when faced with ethical challenges, and use of moral resilience. BACKGROUND Little is known about the ethical challenges that nurses faced during the COVID-19 pandemic and ways they responded. Design Qualitative, descriptive free-text surveys and semi-structured interviews, underpinned by appreciative inquiry. METHODS Nurses working in intensive care in one academic quaternary care center and three community hospitals in Midwest United States were invited to participate. In total, 49 participants completed free-text surveys and 7 participants completed interviews. Data were analyzed using content analysis. RESULTS Five themes captured ethical challenges: implementation of the visitation policy; patients dying alone; surrogate decision-making; diminished safety and quality of care; and imbalance and injustice between professionals. Four themes captured nurses' responses: personal strength and values, problem-solving, teamwork and peer support, and resources. CONCLUSIONS Ethical challenges were not novel but were amplified due to repeated occurrence and duration. Some nurses' demonstrated capacities for moral resilience, but none described drawing on all four capacities. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers would benefit from greater ethics training to support their nursing teams.
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Affiliation(s)
- Georgina Morley
- Center for Bioethics, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic, Cleveland, Ohio, USA
| | - Dianna Jo Copley
- Stanley S. Zielony Institute for Nursing Excellence; and Nursing Ethics Faculty Fellow, Center for Bioethics, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rosemary Field
- Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Marymount Hospital, Ohio, USA
| | - Megan Zelinsky
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nancy M Albert
- Office of Nursing Research and Innovation, Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Health System, Cleveland, OH, USA
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Karanikola M, Mpouzika M, Papathanassoglou E, Kaikoushi K, Hatzioannou A, Leontiou I, Livadiotis C, Christophorou N, Chatzittofis A. Work-Related Traumatic Stress Response in Nurses Employed in COVID-19 Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711049. [PMID: 36078761 PMCID: PMC9518142 DOI: 10.3390/ijerph191711049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 05/27/2023]
Abstract
Nurses may be at a higher risk of experiencing work-related traumatic stress response during the COVID-19 pandemic compared to other clinicians. This study aimed to investigate the correlations between work-related trauma symptoms and demographic factors, psychosocial hazards and stress response in a census sample of nurses working in COVID-19 settings in Cyprus. In this nationwide descriptive and cross-sectional study, data were collected between April and May 2020 using a questionnaire that included sociodemographic, educational and employment and work-related variables, as well as a modified version of the Secondary Traumatic Stress Scale (STSS) for the assessment of work-related trauma symptoms during the pandemic. Overall, 233 nurses participated (with a response rate of 61.3%) and 25.7% of them reported clinical work-related trauma symptoms (STSS-M > 55; actual scale range: 17-85). The mean value for emotional exhaustion was 7.3 (SD: 2.29; visual scale range: 1-10), while the value for distress that was caused by being avoided due to work in COVID-19 units was 6.98 (SD: 2.69; visual scale range: 1-10). Positive associations were noted between trauma symptoms and both emotional exhaustion and distress from being avoided by others due to work in a COVID-19 setting and a negative association was also found between trauma symptoms and satisfaction from organizational support variables (all p < 0.002). Working in COVID-19 settings during the pandemic is a stressful experience that has been linked to psychologically traumatic symptoms Thus, supportive measures are proposed for healthcare personnel, even in countries with low COVID-19 burden.
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Affiliation(s)
- Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Meropi Mpouzika
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | | | - Anna Hatzioannou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Ioannis Leontiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | - Chris Livadiotis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus
| | | | - Andreas Chatzittofis
- Medical School, University of Cyprus, Nicosia 1065, Cyprus
- Department of Clinical Sciences/Psychiatry, Umeå University, 901 85 Umeå, Sweden
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Mizumoto J, Mitsuyama T, Kumagaya S, Eto M, Izumiya M, Horita S. Primary care nurses during the coronavirus disaster and their struggle: Qualitative research. J Gen Fam Med 2022; 23:343-350. [PMID: 36093220 PMCID: PMC9444012 DOI: 10.1002/jgf2.566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/15/2022] [Accepted: 06/21/2022] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID‐19) has substantially affected the health and lives of medical professionals. However, the experiences of nurses engaged in primary care remain unclear. We explored how nurses working in primary care were psychologically and socially affected by the COVID‐19 disaster and how they overcame the difficulties experienced. Methods We conducted a qualitative study of seven Japanese nurses working in primary care. Data collection was performed before, during, and after a workshop based on the Tojisha‐Kenkyu (user‐led research) framework to explore how the COVID‐19 disaster affected the nurses and how they coped. Data were analyzed using inductive thematic analysis. Results Three themes emerged from the analysis: effects of the COVID‐19 disaster on nurses, nurses' newly found strength during the pandemic, and their changes and achievements through the Tojisha‐Kenkyu framework. The first theme comprised four subthemes: fear of the unknown; difficulty in adaptation; dysfunction in patient care; and defilement and oppression. The second theme involved feeling in control and professionalism. The third theme, which was based on participants' discovery of “same and different” fellowships, showed work reconstruction and self‐understanding, which alleviated their difficulties. Conclusions The effect of the pandemic on nurses working in primary care ranges from work‐related frustration to daily life issues. The Tojisha‐Kenkyu method can help nurses to alleviate difficulties. Further research should be conducted to elucidate the constant burden on primary care professionals and establish appropriate occupational and daily life support during pandemics.
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Affiliation(s)
- Junki Mizumoto
- Department of Medical Education Studies, Graduate School of Medicine, International Research Center for Medical Education The University of Tokyo Tokyo Japan
| | - Toshichika Mitsuyama
- Department of Medical Education Studies, Graduate School of Medicine, International Research Center for Medical Education The University of Tokyo Tokyo Japan
| | - Shinichiro Kumagaya
- Tojisha‐Kenkyu Department, Research Center for Advanced Science and Technology The University of Tokyo Tokyo Japan
| | - Masato Eto
- Department of Medical Education Studies, Graduate School of Medicine, International Research Center for Medical Education The University of Tokyo Tokyo Japan
| | - Masashi Izumiya
- Department of Medical Education Studies, Graduate School of Medicine, International Research Center for Medical Education The University of Tokyo Tokyo Japan
| | - Shoko Horita
- Department of Medical Education Studies, Graduate School of Medicine, International Research Center for Medical Education The University of Tokyo Tokyo Japan
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Healthcare provider experiences during COVID-19 redeployment. Curr Opin Support Palliat Care 2022; 16:144-150. [DOI: 10.1097/spc.0000000000000609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Conolly A, Abrams R, Rowland E, Harris R, Couper K, Kelly D, Kent B, Maben J. "What Is the Matter With Me?" or a "Badge of Honor": Nurses' Constructions of Resilience During Covid-19. Glob Qual Nurs Res 2022; 9:23333936221094862. [PMID: 35528859 PMCID: PMC9073120 DOI: 10.1177/23333936221094862] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 12/23/2022] Open
Abstract
It has long been known that nursing work is challenging and has the potential for negative impacts. During the COVID-19 pandemic most nurses' working landscapes altered dramatically and many faced unprecedented challenges. Resilience is a contested term that has been used with increasing prevalence in healthcare with health professionals encouraging a "tool-box" of stress management techniques and resilience-building skills. Drawing on narrative interview data (n = 27) from the Impact of Covid on Nurses (ICON) qualitative study we examine how nurses conceptualized resilience during COVID-19 and the impacts this had on their mental wellbeing. We argue here that it is paramount that nurses are not blamed for experiencing workplace stress when perceived not to be resilient "enough," particularly when expressing what may be deemed to be normal and appropriate reactions given the extreme circumstances and context of the COVID-19 pandemic.
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Affiliation(s)
| | - Ruth Abrams
- University of Surrey, Guildford, United Kingdom
| | | | - Ruth Harris
- King’s College London, London, United Kingdom
| | - Keith Couper
- University of Warwick and University Hospitals Birmingham NHS Foundation Trust, United Kingdom
| | | | - Bridie Kent
- University of Plymouth, Plymouth, United Kingdom
| | - Jill Maben
- University of Surrey, Guildford, United Kingdom
- Jill Maben, School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Kate Granger Building, 30 Priestley Road, Surrey Research Park, Guildford, Surrey GU2 7YH, UK.
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