Recovered but Constrained: Narratives of Ghanaian COVID-19 Survivors Experiences and Coping Pathways of Stigma, Discrimination, Social Exclusion and Their Sequels

A Qualitative Study on Frontline Nurses' Experiences and Challenges in Providing Care for COVID-19 Patients in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention

Since the outbreak of COVID-19, studies related to the COVID-19 pandemic have been published widely. However, there are limited qualitative studies in Ghana that explored and shed light on frontline nurses' experiences and challenges in caring for patients diagnosed with COVID-19. This study aimed to explore frontline nurses' experiences and challenges of providing care for COVID-19 patients in the Volta Region of Ghana. This study adopted a descriptive qualitative research design to collect data. We conducted the study among frontline nurses who provided nursing care for COVID-19 patients in the Treatment Centre for COVID-19 cases in the Volta Region of Ghana. A purposive sampling method was used to select fifteen (15) participants for this study. We collected data through individual in-depth interviews facilitated by a semi-structured interview guide. The content analysis approach was used to analyse the data. The results showed: frontline nurses received inadequate information and training during the initial stages of the pandemic; stress and burnout because of inadequate staffing; logistical challenges; stigmatisation by family members and friends; frontline nurses displeased with the decision to exclude other nurses as frontline workers; participants made some recommendations towards supporting frontline nurses for effective management of patients during pandemics. This study revealed an in-depth understanding of the experiences of frontline nurses who provided nursing care to COVID-19 patients during the pandemic. Our study concludes that the frontline nurses experienced both physical and psychological problems while caring for COVID-19 patients at the treatment centre. Some challenges frontline nurses encountered were inadequate information on COVID-19 prevention and management in the early stages of the pandemic, logistical inadequacies, and stigmatisation in providing care for COVID-19 patients during the pandemic, all of which affected the quality of nursing care, work productivity, and efficiency. Therefore, nurse managers need to provide support to frontline nurses providing care for patients with COVID-19.

Lessons from the stigma of COVID-19 survivors: A Marxist criticism appraisal

Stigma refers to devalued stereotypes that create barriers for stigmatized individuals. During the COVID-19 pandemic, the stigmatization of survivors worsened existing inequalities and triggered mass hysteria. The paper delves into the stigmatization experienced by COVID-19 survivors and the role of Marxist criticism in analyzing this issue. The main findings from the empiricist tradition approach suggest that the perception of COVID-19 stigma is higher among those who are older, belong to ethnic minorities, lack social support, have manual occupations, and possess lower levels of education. The proposed destigmatization pathways include psychological counseling services, social support, and health education. Employing a Marxist perspective can aid in illuminating how economic practices and material conditions influence prevalent ideologies related to stigma. The stigmatization of COVID-19 survivors may be perceived as a consequence of social power inequality, although the current emphasis on individual characteristics as triggers for stigma may neglect the wider systemic forces in operation. Thus, it’s crucial to establish improved social care policies to combat exploitation and oppression due to power imbalances. The ultimate objective of such an examination is to identify effective approaches to tackle and eradicate stigma regarding health-related concerns. An interdisciplinary approach integrating a pluralistic perspective would benefit investigating how social systems and individual attributes contribute to the exacerbation of social inequality and stigmatization.

Psychosocial experiences of patients diagnosed with COVID-19 at a teaching hospital in Ghana

Objectives

The number of people affected with COVID-19 keeps rising globally resulting in increasing fear and anxiety among patients and their families. However, literature on the psychosocial experiences of these patients with COVID-19 in Africa is limited. Hence, this research explored the psychosocial experiences of patients infected with COVID-19 and undergoing treatment.

Methods

The study employed a qualitative phenomenological approach. The sampling technique chosen for this study was purposive with a sample size of 34 determined by data saturation. Participants were selected from Korle-Bu Teaching Hospital, Ghana, and were interviewed face-face using a semi-structured interview guide. Data were analyzed using Interpretive Phenomenological Analysis.

Results

Two main themes and seven sub-themes were generated from this study. The two themes included emotional burden of COVID-19 patients and effects of COVID-19 on patients and relatives. Sub-themes formulated under the emotional burden were reactions to COVID-19 diagnosis, suicidal thoughts, and sadness by fear of the unknown. Social restriction/isolation, stigmatization and disclosure, effect of COVID-19, and positive attitudes of staff emerged under the effect of COVID-19 on patients and relatives.

Conclusion

Even though the recovery rate of COVID-19 has improved since the introduction of the COVID-19 vaccine, there is generally a global surge with respect to the incidence of the condition and an increasing number of patients on admission. Most interventions are targeted at the prevention of the disease than the effect of the psychosocial experience on the quality of life of the individuals affected which is equally essential. It is therefore recommended that current studies focus on improving the quality of life of those affected.

The scar that takes time to heal: A systematic review of COVID-19-related stigma targets, antecedents, and outcomes

COVID-19, as a crucial public health crisis, has affected our lives in nearly every aspect. Besides its major health threats, COVID-19 brings severe secondary impacts, one of which is the rise of social stigma. Although numerous studies have examined the antecedents and outcomes of COVID-19-related stigma, we still lack a systematic understanding of who is being stigmatized during the COVID-19 pandemic, what exacerbates COVID-19-related stigma, and what impacts COVID-19-related stigma has on victims. Therefore, this review aims to provide a systematic overview of COVID-19-related stigma. With 93 papers conducted with 126,371 individuals in more than 150 countries and territories spanning five continents, we identify three targets that have received the most research: Chinese/Asian people, (suspected) patients and survivors, and healthcare workers. Furthermore, we find that for each stigma target, characteristics of the stigmatized, stigmatizer, and context contribute to COVID-19-related stigma and that this stigma negatively influences victims' health and non-health outcomes. We call for future research to provide a more integrative, balanced, and rigorous picture of COVID-19-related stigma via conducting research on neglected topics (e.g., contextual factors that contribute to stigma toward HCWs) and stigma interventions and using a longitudinal design. In practice, we urge governments and institutions (e.g., ministries of public health, hospitals) to pay close attention to stigma issues and to promote safe and inclusive societies.

Life orientation and psychological distress in COVID recovered patients-the role of coping as a mediator

The coronavirus disease (COVID-19) pandemic has not only brought the risk of death but has brought unbearable psychological pressures to the people. Mental health of COVID patients is expected to be affected by the continuous spread of the pandemic. This study aims to find the mediating role of coping styles in the relationship between life orientation and psychological distress among COVID recovered patients. It was hypothesized that: life orientation is likely to have a relationship with coping; coping is likely to have a relationship with psychological distress and coping is likely to mediate the relationship between life orientation and psychological distress among patients recovered from COVID. For this purpose, 378 COVID-10 recovered patients’ men (190) and women (188). Urdu translations of the Life Orientation scale revised, Brief Coping Orientation to Problem Experienced (COPE) and Impact of event scales were used to collect data. Results show that emotion-focused and avoidant coping mediate the relationship between life orientation and psychological distress. The research has implications for mental health practitioners and individuals dealing with health-related issues.

Understanding the policy dynamics of COVID-19 vaccination in Ghana through the lens of a policy analytical framework

Background

Ghana became the first African country to take delivery of the first wave of the AstraZeneca/Oxford vaccine from the COVAX facility. But why has this promising start of the vaccination rollout not translated into an accelerated full vaccination of the population? To answer this question, we drew on the tenets of a policy analytical framework and analysed the diverse interpretations, issue characteristics, actor power dynamics and political context of the COVID-19 vaccination process in Ghana.

Methods

We conducted a rapid online review of media reports, journal articles and other documents on debates and discussions of issues related to framing of the vaccination rollout, social constructions generated around vaccines, stakeholder power dynamics and political contentions linked to the vaccination rollout. These were complemented by desk reviews of parliamentary reports.

Results

The COVID-19 vaccination was mainly framed along the lines of public health, gender-centredness and universal health coverage. Vaccine acquisition and procurement were riddled with politics between the ruling government and the largest main opposition party. While the latter persistently blamed the former for engaging in political rhetoric rather than a tactical response to vaccine supply issues, the former attributed vaccine shortages to vaccine nationalism that crowded out fair distribution. The government’s efforts to increase vaccination coverage to target levels were stifled when a deal with a private supplier to procure 3.4 million doses of the Sputnik V vaccine collapsed due to procurement breaches. Amidst the vaccine scarcity, the government developed a working proposal to produce vaccines locally which attracted considerable interest among pharmaceutical manufacturers, political constituents and donor partners. Regarding issue characteristics of the vaccination, hesitancy for vaccination linked to misperceptions of vaccine safety provoked politically led vaccination campaigns to induce vaccine acceptance.

Conclusions

Scaling up vaccination requires political unity, cohesive frames, management of stakeholder interests and influence, and tackling contextual factors promoting vaccination hesitancy.

COVID-19 Testing: A Qualitative Study Exploring Enablers and Barriers in the Greater Accra Region, Ghana

Introduction

The COVID-19 pandemic is a global crisis and has reaffirmed that extensive testing along with effective tracing is still crucial to slowing transmission of the COVID-19 virus despite the rolling out of vaccines. This study explored enablers and barriers to COVID-19 testing in the Greater Accra region of Ghana. We envision lessons learned from this study could serve as a road map to strengthen the current response to COVID-19 and preparedness for future outbreaks, particularly in low- and middle-income countries.

Methods

A qualitative design was undertaken to explore the phenomenon. Data collection methods included in-depth interviews with key informants with a purposively selected sample of 20 participants. Interviews were conducted using flexible semi-structured interview guides. Depending on the participant's position and involvement in COVID-19 testing, the guides were modified, and key elements were drawn from a tailored version of the WHO Health System Framework, incorporating the Essential Public Health Functions (EPHF). The interview findings were augmented by reviewing published literature.

Results

Better health governance through political leadership, community participation, multisectoral collaboration, effective resource management, and information systems played a crucial role in catalyzing COVID-19 testing. The primary barriers to testing were mainly COVID-19 infodemic, inadequacy of material resources to meet growing health needs, and a lack of opportunities to have equal and easy access to testing services. Furthermore, although human resources were adequate, they were unevenly distributed across settings.

Conclusion

Despite rolling out vaccines against COVID-19, testing remains an important measure to control the virus. To effectively be prepared for extensive COVID-19 testing and respond to future outbreaks, the following are recommended: there should be improved political commitments, coordination, and communication with diverse actors to ensure even distribution of all resources across the country; empowerment of community members should be encouraged to develop community-oriented pandemic preparedness and management of COVID-19 infodemic; investment in strengthening capacity of Good Manufacturing Practice (GMP); incorporation of health policy and systems research (HPSR) into the post-COVID-19 pandemic recovery process and future pandemic preparedness.

The Moderating Effect of Resilience on Mental Health Deterioration among COVID-19 Survivors in a Mexican Sample

Resilience has been reported to be a protective psychological variable of mental health; however, little is known about its role in COVID-19 survivors. Thus, in this study, we aimed to evaluate the levels of depression, anxiety, stress, traumatic impact, and resilience associated with COVID-19, as well as to investigate the role of resilience as a moderating variable. A sample of 253 participants responded to an online survey; all were previously diagnosed with COVID-19 by a nasopharyngeal swab RT-PCR test, were older than 18 years, and signed an informed consent form. Significant negative correlations were found between resilience and the mental health variables. Higher resilience was significantly related to a lower impact of the event, stress, anxiety, and depression when the number of symptoms was low. Only when the duration of COVID-19 was short and resilience levels were medium or high was psychological distress reduced. Moreover, resilience moderated the effects of COVID-19 on mental health, even if a relapse occurred. The results emphasize the need for interdisciplinary interventions aimed at providing COVID-19 patients with psychological and social resources to cope with the disease, as well as with probable relapses.