Abstract
This study aimed to develop empirically grounded recommendations and a coherent model of psychological care derived from the experiences and psychological care needs of COVID-19 frontline doctors, using semi-structured interviews and thematic analysis. Participants were UK frontline doctors specialising in Emergency Medicine, Anaesthetics, or Intensive Care (n = 31) purposively sampled for maximum variation on gender, specialty, ethnicity, and trauma-related distress; most worked in ICU during the pandemic (71%). Four themes were derived: (1) ‘coping strategies’, participants used many, including exercise, mindfulness, and “wait until it gets really bad”; (2) ‘sources of support’, participants valued embedded psychological support, digital services, and informal conversations with colleagues or family, though there was little opportunity; (3) ‘organisational influences on wellbeing’, participants reported a love–hate relationship for concepts like ‘wellbeing’, seen as important but insulting when basic workplace needs were unmet; (4) ‘improving engagement with support’, analysis suggests we must reduce physical and psychological barriers to access and encourage leaders to model psychologically supportive behaviours. Doctors’ frontline COVID-19 working experiences shine a ‘spotlight’ on pre-existing problems such as lack of physical resources and access to psychological care. Empirically grounded recommendations and a model of incremental psychological care are presented for use in clinical services.
Highlights
Guidelines to address the psychological needs of healthcare workers (HCW) amidst the COVID-19 pandemic have been developed and advocated by national professional bodies and Royal Colleges [8,9,10,11,12]; these resources were written at the outset of the pandemic when little was known about the impact and likely trajectory, and were not
The aims of this study were to develop an empirically-grounded set of recommendations and model of future-facing psychological care de-rived from the experiences of psychologically distressed doctors working on the frontline during the COVID-19 pandemic
This study aimed to develop empirically grounded recommendations and a future This study aimed to develop empirically grounded recommendations and a future facing model of psychological care for frontline doctors, derived from the experiences of facing model of psychological care for frontline doctors, derived from the experiences of those most psychological distressed in the EM, An, and intensive care unit (ICU) specialties
Summary
The psychological impact of Coronavirus Infectious Disease 2019 (COVID-19) on frontline doctors has been well documented. With up to 54% experiencing clinical levels of psychological distress [1], many report being affected by trauma symptoms, fears of contamination, moral injury, disruption of normal supportive structures, and work pressure [2,3,4,5]. These factors are associated with long-term psychological sequelae [6,7].
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