Document Type : Original Article
Authors
Department of Community Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
BACKGROUND: The mental health of health‑care workers with their unique role in responding
to the COVID‑19 pandemic is strictly essential. Hence, to react effectively to the pandemic, it is
essential to collect further data on the stressors and adaptation strategies. The aim of this study is
to explain the health‑care workers’ experiences of stressors and adaptation strategies used during
the COVID‑19 pandemic outbreak.
MATERIALS AND METHODS: A qualitative content analysis approach was employed in this
study, with semi‑structured in‑depth interviews. Nineteen health‑care workers participated in the
study by purposeful sampling method. The study setting included selective educational hospitals
that admitting patients infected with COVID‑19. The data were analyzed using content analysis
method.
RESULTS: Stressors were classified under four major categories: idiopathic, i.e., arising from
unknown causes, individual and familial, stressful work environment, and socially imposed stressors.
The adaptation strategies were classified under inactive and active adaptation strategies.
CONCLUSIONS: The stressors include the stresses arising from the unknown nature of the disease,
stressful work environment, individual and familial stresses, and the socially imposed stresses. The
adaptation strategies include inactive and active adaptation strategies. Identification of these factors
can help workers and management to effectively react to the pandemic.
Keywords
China. Glob Health Res Policy 2020;5:1-3.
2. Zangrillo A, Beretta L, Silvani P, Colombo S, Scandroglio AM,
Dell’Acqua A, et al. Fast reshaping of intensive care unit facilities
in a large metropolitan hospital in Milan, Italy: Facing the
COVID-19 pandemic emergency Crit Care Resusc 2020;22:91-4.
3. Remuzzi A, Remuzzi G. COVID-19 and Italy: What next? Lancet
2020; 395 (10231):1225-8. [doi: 10.1016/S0140-6736(20)30627-9].
4. Nikpouraghdam M, Farahani AJ, Alishiri G, Heydari S,
Ebrahimnia M, Samadinia H, et al. Epidemiological characteristics
of coronavirus disease 2019 (COVID-19) patients in IRAN:
A single center study. J Clin Virol 2020;127:104378.
5. INSPIRATION Investigators; Sadeghipour P, Talasaz AH,
Rashidi F, Sharif-Kashani B, Beigmohammadi MT, et al. Effect of
intermediate-dose vs standard-dose prophylactic anticoagulation
on thrombotic events, extracorporeal membrane oxygenation
treatment, or mortality among patients with COVID-19 admitted
to the intensive care unit: The INSPIRATION randomized clinical
trial. JAMA 2021;325:1620-30.
6. Chughtai AA, Seale H, Islam MS, Owais M, Macintyre CR. Policies
on the use of respiratory protection for hospital health workers
to protect from coronavirus disease (COVID-19). Int J Nurs Stud
2020;105:103567.
7. Adams JG, Walls RM. Supporting the health care workforce
during the COVID-19 global epidemic. JAMA 2020;323:1439-40.
8. Liu Y, Wang H, Chen J, Zhang X, Yue X, Ke J, et al. Emergency
management of nursing human resources and supplies to respond
to coronavirus disease 2019 epidemic. Int J Nurs Sci 2020;7:135-8.
9. Wu Z, McGoogan JM. Characteristics of and important lessons
from the coronavirus disease 2019 (COVID-19) outbreak in China:
Summary of a report of 72 314 cases from the Chinese Center for
Disease Control and Prevention. JAMA 2020;323:1239-42.
10. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: Address
mental health care to empower society. Lancet 2020;395:e37-8.
11. Ryu S, Chun BC, of Epidemiology KS. An interim review of
the epidemiological characteristics of 2019 novel coronavirus.
Epidemiol Health 2020;42:e2020006.
12. Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health
care for medical staff in China during the COVID-19 outbreak.
Lancet Psychiatry 2020;7:e15-6.
13. Li L, Wan C, Ding R, Liu Y, Chen J, Wu Z, et al. Mental distress
among Liberian medical staff working at the China Ebola
Treatment Unit: A cross sectional study. Health Qual Life
Outcomes 2015;13:1-6.
14. Huang L, Rong Liu H. Emotional responses and coping strategies
of nurses and nursing college students during COVID-19
outbreak. MedRxiv 2020; Jan 1. [doi: 10.1371/journal.pone.
0237303].
15. Huang J, Han M, Luo T, Ren A, Zhou X. Mental health survey
of 230 medical staff in a tertiary infectious disease hospital for
COVID-19. J Indust Hyg Occup Dis 2020;38:E001-E.
16. Liu CY, Yang YZ, Zhang XM, Xu X, Dou QL, Zhang WW, et al. The
prevalence and influencing factors in anxiety in medical workers
fighting COVID-19 in China: A cross-sectional survey. Epidemiol
Infect 2020;148:1-7.
17. Meena SP, Jhirwal M, Puranik AK, Sharma N, Rodha MS,
Lodha M, et al. Awareness and experience of health-care workers
during coronavirus disease 2019 pandemic. J Edu Health Promot
2021;10:110.
18. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated
with mental health outcomes among health care workers exposed
to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.
19. Mohammadi F, Farjam M, Gholampour Y, Tehranineshat B,
Oshvandi K, Bijani M. Health professionals’ perception of
psychological safety in patients with coronavirus (COVID-19).
Risk Manag Healthc Policy 2020;13:785-94.
20. Maben J, Bridges J. Covid-19: Supporting nurses’ psychological
and mental health. J Clin Nurs 2020;29:2742-50.
21. Graneheim UH, Lundman B. Qualitative content analysis in
nursing research: Concepts, procedures and measures to achieve
trustworthiness. Nurse Educ Today 2004;24:105-12.
22. Denzin NK, Lincoln YS, editors. The Sage handbook of qualitative
research. Sage; 2011 Apr 27.
23. Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S,
et al. Psychological distress, coping behaviors, and preferences
for support among New York healthcare workers during the
COVID-19 pandemic. Gen Hosp Psychiatry 2020;66:1-8.
24. Shanafelt T, Ripp J, Trockel M. Understanding and addressing
sources of anxiety among health care professionals during the
COVID-19 pandemic. JAMA 2020;323:2133-4.
25. Alizadeh A, Khankeh HR, Barati M, Ahmadi Y, Hadian A,
Azizi M. Psychological distress among Iranian health-care
providers exposed to coronavirus disease 2019 (COVID-19):
A qualitative study. BMC psychiatry. 2020 Dec; 20(1):1-10.
[doi: 10.21203/rs. 3.rs-29738/v2].
26. Ministry of Health and Medical Education. Available from:
http://behdasht.gov.ir. [Last accessed on 2020 Sep 21].
27. Lam KK, Hung SY. Perceptions of emergency nurses during the
human swine influenza outbreak: A qualitative study. Int Emerg
Nurs 2013;21:240-6.
28. Liu Q, Luo D, Haase JE, Guo Q, Wang XQ, Liu S, et al. The
experiences of health-care providers during the COVID-19
pandemic in China: A qualitative study. Lancet Glob Health
2020;8:e790-8.
29. Javed S, Parveen H. Adaptive coping strategies used by people
during coronavirus. J Edu Health Promot 2021;10:122.
30. Bruns DP, Kraguljac NV, Bruns TR. COVID-19: Facts, cultural
considerations, and risk of stigmatization. J Transcult Nurs
2020;31:326-32.
31. Glanz K, Rimer BK, Viswanath K. Theory, Research, and Practice
in Health Behavior and Health Education. Jossey-Bass; 2008.
32. Busby S. Engaging faith for spiritual fitness: Helping new nurses
avoid burnout. J Christ Nurs 2019;36:E54-8.
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