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Several studies described staff gaining new knowledge and skills which they felt would equip them in their future work, especially if they ever worked in a pandemic situation again. For example, Liu and Liehr [33] in their study of nurses caring for SARS patients in China describe: Another source of pressure for the nurse was the demise of patients and the coexisting feeling that they could not do enough. However, colleagues could also be a source of tension, so peer support interventions in this workforce warrant careful evaluation. Disclaimer. Google Scholar. Of these, 665 were agreed to be irrelevant, resulting in 143 studies which were read in full by the two reviewers. In some ways these workers will be our most skilled and productive employees but in others the most vulnerable. Restructuring the system is a massive step for the industry, that will bring ease and comfort for retirees and their families in choosing the best care options for their loved ones. The results of this review also suggest that healthcare workers mental health needs may change over time. [16] describe the experiences of US healthcare volunteers after returning from the Ebola crisis in West Africa: Participants reported feelings of grief, mourning, sadness, depression, remorse, and regret upon their return. Brooks S, Amlt R, Rubin GJ, Greenberg N. Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature. Anxiety, guilt, and moral injury may be mitigated by reducing lone working, encouraging buddying systems, facilitating ethical forums which allow workers to discuss difficult decisions and focusing on the meaningfulness of the work. Article We and the nurses are now working with one voice: How community leaders and health committee members describe their role in Sierra Leones Ebola response. [21] describe nurses experiences of treating colleagues affected by SARS in Hong Kong: All of the participants described being particularly vulnerable when caring for patients who were healthcare workers, whether doctors, nurses or support staff who had contracted the disease at work. Sarikaya O, Erbaydar T. Avian influenza outbreak in Turkey through health personnel's views: a qualitative study. and transmitted securely. They cited increased hours and weekend shifts, additional time taken to manage PPE and increased paperwork as frequent sources of stress [24]. We resolved any discrepancies about papers to be included at any stage through discussion between the two reviewers and the first author. For example, Moore et al. This puts caregivers at risk for poorer health and worsening health conditions they may already have. Comments such as I couldnt do anything to stop it [32] p. 107 and we could not do enough [33] (p. 2884) pervaded many narratives. Psychotherapy and older adults resource guide JB is a Consultant Clinical Psychologist and Associate Clinical Professor, specialising in trauma, PTSD and the mental health and wellbeing of high-risk occupational groups. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. 2020;19(2):12930. Journal of International Women's Studies, 18(2), 59-73. Concurrent to the pressures noted above, many healthcare workers described aspects of the work as enjoyable and rewarding and appeared to derive job satisfaction from work that they felt was important and meaningful [36] p. 648. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Mental health care for medical staff in China during the COVID-19 outbreak. All studies were published between 1999 and 2020. https://doi.org/10.1111/j.1365-2702.2009.02857.x. Workers perceptions of their organisations preparedness varied with workers in several studies reporting a lack of established protocols. Local preparedness for infectious disease outbreaks: a qualitative exploration of willingness and ability to respond. This was compounded by staff shortages (due to inadequate staffing or staff absences because of ill health or caring responsibilities) resulting in requirements for staff to work overtime. Int Emerg Nurs. Understanding Moral Distress among Eldercare Workers: A Scoping Review. (See supplementary material for our full list of search terms). The feeling of not being able to do enough occurred partly because of the limited resources of the environment. Six databases were searched. (p. 7). CASP UK. We need to ensure that we maintain a psychologically healthy workforce, not just for the wellbeing of the workers, but also for the sustainability of healthcare services globally. PLoS med. What is the aged care crisis? Before International Portuguese Nurse Leaders' Insights for Multicultural Nursing. We have an opportunity to mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce across the world. JAMA Netw Open. Int J Hum Caring. This was not unique to developing countries, with similar challenges reported in Canada [23] and Australia [22]. Family caregiving and other sources of role conflict among nurses during large-scale outbreaks. [19] reported that: Some participants were not concerned about themselves, rather they were concerned that they would, because of their exposure to infected patients, colleagues or visitors to the organization, inadvertently infect their family. Canadian Journal on Aging, 29(1), 109-118. FOIA Nurse roles in the advance directive system in Korea. J Infect Dis 1999; 179(Supplement_1), S268-73. For example, Guimard et al. Preventing the next 'SARS' - European healthcare workers' attitudes towards monitoring their health for the surveillance of newly emerging infections: qualitative study. Front Psychiatry. However, the mental health and psychological wellbeing of this group prior to the current COVID-19 pandemic was already being identified as a major healthcare issue, evidenced by the growing incidence of stress, burnout, depression, drug and alcohol dependence and suicide across all groups of health professionals, in many countries [4]. Nevertheless, they expected a degree of support in return for the sacrifices they made that not all felt was met. The results of this review also highlight potential protective factors. BMJ Open. Having physical, sensory, or cognitive impairments does not lessen the maturity of an adult patient. This information was exported into NVivo Pro version 12 and analysed thematically [15]. Interventions to prevent and treat mental health distress in healthcare workers need to be developed and their timing, effectiveness and acceptability carefully evaluated. We conducted a meta-synthesis for the reader to highlight overarching themes in relation to healthcare workers experiences of working on the frontline during a pandemic and their views about support. Things we did for patients, such as cleaning patients, were not enoughthe thought that I didnt try my best for patients could not disappear. (p. 2884). Also, be sure to check in regularly with your physician to make sure you are maintaining your own health. 2006;23(3):26772. Experiences of frontline healthcare workers and their views about Lancet Psychiatry. 5.4 The committee has heard that the aged care workforce will need to grow by two per cent per year to accommodate demand for services, yet there is no clear plan in place as to how this will be achieved. The predominant concern across most staff groups, across all pandemics, was becoming infected with the virus themselves. 2023 Apr 14. doi: 10.1007/s12124-023-09761-4. 2023 Jan 18;11(3):291. doi: 10.3390/healthcare11030291. eCollection 2022. Hewlett BL, Hewlett BS. Experiences of front-line nurses combating coronavirus disease-2019 in China: A qualitative analysis. CAS PubMed [11] in their commentary on medical staff in China in the early stages COVID-19 described: The implementation of psychological intervention services encountered obstacles, as medical staff were reluctant to participate in the group or individual psychology interventions provided to them. BMC Public Health. Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. The facilities will be required to strictly implement reporting of daily staffing hours, specifying necessary details to maintain balanced working conditions for the care workers and reviewing the service given to the residents. Other studies pointed to the hypocrisy that some healthcare workers experienced when they were publicly commended for their work but privately discriminated against [26]. Several accounts during the hearings have opened a lot of issues and dissatisfaction regarding the certain issues within the aged care sector: limited information of local services and support for transitioning into residential care, long waiting lists for funding or home care packages (up to 34 months!) . The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Many have been redeployed into new roles, teams or newly purposed wards so have been working in unfamiliar settings and without established social support from colleagues. Background: High-income countries have an increasingly culturally diverse aged care workforce. However, meta-synthesis revealed eight key themes which largely transcended temporal and geographical boundaries. How to support staff deploying on overseas humanitarian work: a qualitative analysis of responder views about the 2014/15 west African Ebola outbreak. National Library of Medicine 2020;7(6):46871. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. I read it on the plane, showed up, but I had no real idea of what I was doing. (p. 7). 2013). Have you or your loved one been experiencing any of the following? Please see our lists of support organizations, resources and factsheets related to cancer, end of life care, stroke, dementia, neurological disorders and other health conditions. Relations between immigrant care workers and older persons in home and long-term care. The felt valued by their organisations when they prioritised their safety and supported them with manageable workloads and time out from work. BMC Health Serv Res 21, 923 (2021). Even though some participants described feeling unprepared, there was a sense in some studies of limited or superficial engagement with training. 2021 Nov-Dec;28(7-8):1194-1209. doi: 10.1177/0969733020981761. Training seemed better received when it was deemed as relevant, realistic and timely. This led to significant financial hardship and a motivation for some to work even when unwell [27]. Acta Otorhinolaryngol Ital. Chiang HH, Chen MB, Sue IL. New Zealand nurses perceptions of caring for patients with influenza a (H1N1). Bergeron SM, Cameron S, Armstrong-Stassen M, Pare K. Diverse implications of a national health crisis: A qualitative exploration of community nurses' SARS experiences. von Strauss E, Paillard-Borg S, Holmgren J, Saaristo P. Global nursing in an Ebola viral haemorrhagic fever outbreak: before, during and after deployment. Wong EL, Wong SY, Lee N, Cheung A, Griffiths S. Healthcare workers duty concerns of working in the isolation ward during the novel H1N1 pandemic. Im afraid to go home and havent seen my mom and dad for a long time. (p. 3). Ethical issues in geriatrics: a guide for clinicians - PubMed However, there is also currently a lack of evidence about what interventions are most helpful for staff working in such high-risk occupational roles, with what evidence there is about effectiveness being mixed, and often demonstrating that well intentioned interventions (i.e. Bethesda, MD 20894, Web Policies There was real division created amongst staff. They engaged well with training when it was practical and specific. This review has highlighted a dearth of research exploring healthcare workers own views, needs and preferences. Knowledge was key in decreasing uncertainty and many participants sought information, clarity and consensus with the purpose of achieving greater certainty. Mental and neurological disorders among older adults account for 6.6% of the total disability (DALYs) for this age group. Challenges faced by employees in the home care of elderly people Methods: The literature on aging and work was reviewed, including demographic trends, physical and cognitive changes, safety and . [16] describe US healthcare workers struggling to readjust on returning from volunteering in West Africa: Others mentioned feeling isolated because the only people that they felt they could really talk to and who understood what they were feeling were the people who had deployed with them. A qualitative study on the psychological experience of caregivers of COVID-19 patients. J Clin Nurs. How Social Workers Demonstrate Respect for Elderly Clients This type of fraud can be devastating not only to the individual stolen from, but to their entire family. Prisma Group. https://doi.org/10.1089/hs.2016.0068. The 'lot' of workers is linked to the often casual and insecure terms of employment and industrial powerlessness5. Workshops on coping and emotional support were also described positively in some studies. Google Scholar. sharing sensitive information, make sure youre on a federal Please enable it to take advantage of the complete set of features! Federal government websites often end in .gov or .mil. Raven J, Baral S, Wurie H, Witter S, Samai M, Paudel P, et al. JBI Database System Rev Implement Rep. 2015. Im proud of what I did. For example, Gershon et al. Pearson A, Srivastava R, Craig D, Tucker D, Grinspun D, Bajnok I, Griffin P, Long L, Porritt K, Han T, Gi AA. Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia. https://doi.org/10.20467/1091-5710.13.4.26. Aged care workers are facing a 'crisis level of exhaustion' as the AAOHN J. This review also demonstrates that psychological growth was possible. Doctors often do what is called a social history to help them and other members of the health care team evaluate a person's care needs and social support. When I got back, the problems were still thereReforming a new life has been tough. Ive just lost my way. Of note, these ratings reflect what is included in the available report of the study and may not necessarily reflect detail that was attended to in the research process but not necessarily written up in the presented paper. This is an additional area that warrants exploration in order to better understand workers ambivalence and to ensure that they feel able to engage with appropriate mental health support when needed. https://doi.org/10.1002/wps.20768. Aims: Clearly visible posters and information cascaded through team leaders at shift handovers were cited as helpful. This review identified 111 findings that were aggregated into 15 categories and five themes. 2020;3(5):e2010185. Some studies commented on the pay off between staff safety and patient care. At the core of the issues is funding At the core of nearly all of the issues highlighted in the Royal Commission report is funding. By using this website, you agree to our This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. An official website of the United States government. Google Scholar. For some, fear was constant. We have adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [12] guidance throughout this review. https://doi.org/10.1136/bmjopen-2017-017476. https://doi.org/10.1016/j.apnr.2018.01.009. The impact of these dilemmas appeared to continue after the crisis had passed. This may leave them . We excluded studies where less than 50% of the participants were frontline healthcare workers or where we could not extract data for healthcare workers alone. 2017;31(13):449. The authors declare that they have no competing interests. Ghebreyesus TA. Mental health follow-up will be imperative for the early detection and treatment of emerging mental health problems and to ensure staff feel supported by their organisations. https://doi.org/10.1177/0894318417741119. Nikunlaakso R, Selander K, Weiste E, Korkiakangas E, Paavolainen M, Koivisto T, Laitinen J. Int J Environ Res Public Health. Qualitative Research Checklist. According to the Royal Commissions report, at least 1 in 3 people accessing residential aged care and home care services have experienced substandard care, often due to overworked providers. JBI Database System Rev Implement Rep. 2016 Apr;14(4):96-137. doi: 10.11124/JBISRIR-2016-1843. https://doi.org/10.1016/j.ajic.2018.01.012. The report also brought out primary and acute care issues, staffing issue and the systems lack of coordination and integration with the medical care sector. As COVID-19 has progressed around the world, we have heard repeatedly about the mental health burden faced by frontline healthcare workers globally as they have worked to treat patients affected by the virus. An official website of the United States government. Springer Nature. Even in some of the most challenging moments, many healthcare workers found meaning in their work, for example, Erland and Dahl [28] describe midwives caring from pregnant women dying from Ebola in Sierra Leone who found it meaningful to be there and care for the women in their last moment of life. (p. 25). Epub 2021 Feb 3. Buddying systems, whereby more experienced staff supported newer staff, seemed appreciated, as were opportunities for informal group reflection. We have an opportunity to learn from the lessons of previous pandemics and provide better support for frontline healthcare workers. This was reported to bring them comfort as well as allay the worries of their loved ones. 5. We assessed the quality of the studies included in the meta-synthesis using the Critical Appraisal Skills Programme (CASP) [13] qualitative research checklist (see Table2). This stigma extended to the families of healthcare workers with some reporting their children being discriminated against [30]. Studies were heterogenous in their sample sizes, locations and samples. Keywords: 910). The recommendations also addressed the extremely long wait times for home care packages. Many of these issues are inter-related as caregiving can encompass a range of challenges, but there are resources to help you through this. Available from: https://doi.org/10.1101/2020.10.21.20216804. Glob Health Action. The results of this review show that the current experiences of frontline healthcare workers are not without precedent. BCFC and VG completed the literature searches, screening, data extraction and quality appraisal under supervision of JB. COVID-19 has placed extreme demands on healthcare workers. The review highlighted that older adults faced a range of physical, social and psychological challenges due to living with chronic conditions and required care and support in three main areas: 1) social activities and relationships; 2) psychological health; and 3) activities related to mobility, self-care and domestic life. All searches took place from inception, with final searches taking place on September 28, 2020. (p. 8). Issues of accessibility to health services by older Australians: a [23] described her experiences: I work 12-hour shifts in emergency, rarely got a break, we were not permitted to have fluids at the desk. PDF Challenges to the provision of community aged care services across