Coping strategies that motivated frontline nurses while caring for the covid-19 patients during the pandemic: A Scoping Review

"Patient dignity can be ensured by providing adequate health care": A phenomenological analysis on survival strategies of military nurses

Background

The devastating COVID-19 outbreak has considerably influenced basic human healthcare needs. Due to healthcare organizational limitations, workload, and a shortage of healthcare professionals, particularly military nurses in developing countries, faced critical situations in dealing with COVID-19 patients. However, little is known about the survival strategies military nurses used while caring for coronavirus-infected patients.

Aims

This study aimed to investigate the survival strategies that inspired military nurses to manage COVID-19 patients in Bangladesh.

Methods

This study employed the phenomenology of practice framework developed by Max van Manen. Fourteen military nurses were purposefully selected to participate in this study. Semi-structured online interviews were conducted individually from January to February 2023 in three divisional (Dhaka, Chittagong, and Sylhet) COVID-19 dedicated military hospitals in Bangladesh. The study was reported using the COREQ checklist. Audio-video sessions of discussions were recorded, analyzed, and transcribed verbatim. Dataset analysis was performed using thematic analysis.

Results

Eight themes were developed: (i) Nurses' self-strategies; (ii) colleagues' strategies; (iii) Nurse managers' strategies; (iv) Feelings about nursing ethical values; (v) Employers' strategies; (vi) Government strategies; (vii) Family members' strategies; (viii) Strategies of social people.

Conclusions

The study's findings would inspire healthcare professionals to use various survival strategies when facing critical clinical situations. Additionally, this study encourages nurses to develop survival skills to avoid depression, fear, and anxiety and to learn how to deal with work-related stress situations.

Enhancing Nurses' Disaster Management and Preparedness: Evaluating the Effectiveness of an Online Educational Program Through a Quasi-Experimental Study

Background

Disaster management is an ongoing international concern, and nurses play essential roles in minimizing negative impacts on the health of communities. However, many nurses have limited knowledge and skills on how to respond to disasters effectively. Therefore, this study was conducted to determine the effectiveness of a newly developed educational program on improving nurses' disaster management and preparedness.

Methods and Design

A quasi-experimental study was conducted on 88 nurses working at a public hospital. The educational program included six modules covering various aspects of disaster management. Pre-and post-tests were administered to evaluate changes in perceptions of disaster management competencies. Independent sample t-test, Pearson coefficient correlation, and One-way ANOVA tests were all run using SPSS.

Results

A significant proportion of nurses (78.4%) reported ongoing training in disaster management, while a smaller percentage (21.6%) expressed a contrary opinion. Nurses also had a moderate level of agreement with the disaster preparedness program (Pretest: 2.26 ± 0.34; post-test: 2.29 ± 0.31). Further, the results showed small improvements in nursing perceptions of the operational plan after the educational program (Pretest: M=2.76, SD=0.63; Post-test: M=2.89, SD=0.44), although the differences between pre-and-post assessments were not significant (P > 0.05). The mean values for overall familiarity in the pre-test were 3.16 ± 1.39, while in the post-test, they slightly increased to 3.26 ± 1.18. The findings also showed no statistically significant differences reported in nurses' attitudes and familiarity towards disaster preparedness based on the gender, marital status, nationality, working shifts, and working hours variables (P > 0.05).

Conclusion

This study demonstrated the significance of providing nurses with the essential knowledge that helps respond to disasters. Online educational programs can help improve nurses' preparedness to better manage disasters. Future research should investigate additional variables that could enhance nurses' knowledge and skills related to disaster response.

Emotions, action strategies and expectations of health professionals and people with dementia regarding COVID-19 in different care settings in Switzerland: a mixed methods study

BACKGROUND

More than 55 million people are currently affected by dementia worldwide and over 144 thousand in Switzerland. In Swiss nursing homes, 47.6% of the residents had a medical diagnosis of dementia in 2014. Due to cognitive impairment, they have difficulties remembering hygiene measures or placing them in the epidemic context. This results in a higher infection risk. There are COVID-19-associated recommendations focused on dementia care management but studies simultaneously surveying and correlating perspectives of health professionals as well as people with dementia across care settings are largely lacking. This study is focused on COVID-19-associated perspectives and needs of health professionals and people with dementia across different care settings. Lessons learned from the pandemic shall be pointed out.

METHODS

We conducted a mixed-methods approach based on an exploratory sequential design. Two qualitative interview rounds (n = 15 participants) and a quantitative online survey (n = 148 participants) with people with dementia, caring relatives, Advanced Practice Nurses and nursing home managers (health professionals) were performed. Data collected was performed in nursing home and home-care settings. The SQRQ checklist was used.

RESULTS

Fear and uncertainty were highest at the beginning of the pandemic among the interviewed nursing professionals and nursing home managers. As a positive side effect of the pandemic, increased cohesion in care teams was reported. Some people with dementia experienced the decelerated outside world as pleasant and less challenging to master. Particularly during the first wave, nursing home managers rated political decision-making processes as being too slow, partly non-transparent, inconsistent, and sometimes inappropriate for people with dementia.

CONCLUSIONS

Although the identified emotional and physical consequences of the COVID-19 pandemic are mostly negative for health professionals and people with dementia, research should also investigate potential positive side effects. Furthermore, political decisions should be passed on to care institutions as promptly, transparently, and comprehensibly as possible. The results provide guidance on dementia-focused COVID-19 management interventions incorporating lessons learned and considering the emotional impact of the pandemic in Switzerland and beyond.

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

BACKGROUND

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

AIM

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

METHODS

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

FINDINGS

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

CONCLUSION

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

Understanding early experiences of Chinese frontline nurses during the COVID-19 pandemic: A text mining and thematic analysis of social media information

This study aims to explore the early experiences of frontline nurses at the beginning of the COVID-19 pandemic in China as expressed through social media posts. This study used an explanatory sequential mixed-method design. Text mining was used for sentiment analysis. The chi-square test was used to compare the differences in the composition ratio of sentiment classification of posts in different months. Word frequency was statistically analyzed. Further thematic analysis was also performed. The primary sentiments of the posts were discovered to be positive and neutral. The number of posts containing positive emotions was the lowest in January, peaked in March, and gradually declined in April 2020. The following nurse-oriented narrative themes were developed: "To see and be seen," "Moving forward amid adversity and support," and "Returning to everyday life and constructing meaning." The sentiments of Chinese nurses in response to the pandemic fluctuated, with positive emotions in the early stage, but it could not be sustained. This study recommends nurses could be encouraged to engage in expressive writing while adhering to ethical guidelines.

Coping strategies adopted by frontline nurses in dealing with COVID-19 patients in a developing country during the pandemic: A qualitative study

AIM

This study aimed to explore the coping strategies adopted by frontline nurses in dealing with COVID-19 patients during the pandemic in Bangladesh.

DESIGN

A qualitative descriptive study.

METHODS

Purposive sampling was used to recruit seventeen frontline nurses from three COVID-19-specific hospitals in Dhaka City. In-depth online interviews and semi-structured questionnaires were used to collect data through the Google Meet platform. Interview sessions audio-video were recorded, interpreted, analysed, verbatim transcribed and quotes of the participants were verified by member checking. Thematic analysis was used in this research. The study's reporting guidelines were based on the consolidated criteria for reporting qualitative research.

RESULTS

Seven themes were identified after careful data analysis: (i) A positive attitude in dealing with challenging situation, (ii) Intimate partner's influence, (iii) Self-emotional regulation, (iv) The tendency to avoid negativity, (v) Motivated by professional obligations, (vi) Religious influence, (vii) Recreational activities.

NO PATIENT OR PUBLIC CONTRIBUTION

This study explored various coping strategies employed by frontline nurses in caring for COVID-19 patients. No patient or public contribution was investigated.

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

AIMS AND OBJECTIVE

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

BACKGROUND

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

DESIGN AND METHOD

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

RESULTS

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

CONCLUSION

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

RELEVANCE TO CLINICAL PRACTICE

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

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.

Facing the unknown COVID-19 pandemic: A qualitative study with nurses and nursing assistants in three European countries

Background

The coronavirus disease (COVID-19) is now a worldwide public health emergency. As essential and central parts of the COVID-19 patient care team, nurses and nurse assistants are facing all kinds of challenges caused by the disease and the pandemic. Understanding these challenges and the way nurses and nurse assistants handle and cope with them provides important knowledge on how to improve management of future pandemics and endemic situations. Thus, the present study explored the challenges faced by nurses and nurse asssitants who cared for COVID-19 patients in hospitals and long term care facilities in Italy, Austria and Germany.

Methods

The study employed a qualitative design. Purposive sampling was used to select the participants consisting on nurses (n = 30), nurse coordinators (n = 6) and nurse assistants (n = 5) from hospitals (n = 32) and long-term care facilities (n = 9) in Austria, Germany, and Italy. Data were collected between August and December 2020 through semi-structured interviews. The collected data were analyzed using qualitative content analysis.

Results

The analysis of the data revealed three main themes with twelve sub-categories: (i) Knowledge, skills, and training (lack of knowledge; skills; organizational issues; training); (ii) resources and risk (lack of protective equipment; difficulties with protective equipment; risk and infection; feelings and isolation); (iii) coping strategies (humor; adaption; team effort; self-care; family and friends).

Conclusion

Nurses and nurse assistants who participated in this study faced many personal and professional challenges, and used different coping strategies to manage the situation. Some of these strategies can be applied to reduce these challenges and create better working conditions for nurses and nurse assistants in similar events. Further research, training of staff, and adaptation of institutional policies may help develop new strategies to face future pandemics successfully.

Stressors, coping strategies and intention to leave the nursing profession: A cross-sectional nationwide study in China

AIMS

This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses.

BACKGROUND

Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large-scale study has been conducted on these associations in China yet.

METHOD

A cross-sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported.

RESULTS

Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse-patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on-the-job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect.

CONCLUSIONS

Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China.

IMPLICATIONS FOR NURSING MANAGEMENT

Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress.