Frontline Healthcare Research Articles

Enduring the unseen burden: a qualitative analysis on long-term emotional impact of COVID-19 on long-term care workers

IntroductionLong-term care facilities, such as nursing homes and other assisted living facilities, have been hit particularly hard by the COVID-19. The overall pandemic created an enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. However, most of the existing evidence regarding the well-being of care professionals has predominantly focused on frontline healthcare workers.ObjectivesThis study aimed to identify long-term psychological needs of LTCWs derived from the COVID-19 pandemic, as part of a project that is developing an intervention to reduce psychological distress in this population group.MethodsWe performed a qualitative study with a rapid research approach. Participants were recruited from long-term care facilities located in Catalonia, Spain. Between April and September 2022, we conducted semi-structured interviews inquiring about the most psychologically challenging stages of the pandemic, perceived emotions during those stages, main determinants of those emotions, and their emotional state at the time of the interview. We used a qualitative content analysis method with an inductive-deductive approach.ResultsThirty LTCWs participated in the study. Mean age was 44 (SD=11,4), 87% were females and one third were from foreign nationalities. The period of the pandemic with highest mental health burden was the outbreak, with almost every worker having experienced some form of emotional distress. Emotional distress persisted over time in more than half of participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, feeling that pandemic times are not over and poor working conditions that have remained since then, have been the most frequently expressed determinants of such emotions.ConclusionsLong after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees’ wellbeing.Disclosure of InterestNone Declared

The influence of COVID-19 pandemic on the mental health of pharmacists as frontline health care providers in Nepal

BackgroundDue to COVID-19, pharmacists have been exposed to a variety of dangers that have an impact on their mental health. The study highlights that impact of COVID-19 and work led to burnout among them. Thus, it is necessary to offer mental health services. AimsTo assess the impact of COVID-19 on the work of pharmacy professionals and ascertain the extent of the influence of burnout on mental health among pharmacists working as frontline health providers in Nepal. MethodsPharmacists from Province 2, 3, and 5 in Nepal participated in a self-administered questionnaire that assessed mental health and wellbeing and burnout using 16-item OLBI. Data was collected from January 2023–March 2023. Independent sample t-test, one-way ANOVA, Pearson's correlation, and linear regression were employed to identify any significant connections between burnout and mental health and wellbeing. ResultsOut of 243 participants, COVID-19 pandemic and work was found to have a negative impact on the mental health and wellbeing of a 33.7% of pharmacists. Participants reported having financial issues in 41.6% of cases and 9.5% considered leaving the profession and were concerned about the provision of service quality and making mistakes at work. A strong and meaningful positive relationship and linear regression were observed between exhaustion, disengagement, burnout, mental health and wellbeing. Pharmacists working part-time (p < 0.050) in hospital settings experienced burnout as a result of insufficient training, extended working hours, and stress both on and off the job. ConclusionsPharmacists are to prioritize a healthy work-life balance, which includes avoiding prolonged shifts >8 h, regular physical exercise and promote open communication among colleagues to address workplace concerns.

Does Professional Self-Efficacy Provide a Shield in Troubling Situations? Evidence of Performance and Thriving Through Perceived Strength Use

The COVID-19 pandemic has created a more stressful and uncertain work environments, disrupting personal and organizational lives, and particularly the impact of this crises on health care professionals (i.e., doctors and nurses) is unprecedented. COVID-19 has increased the workload and job risks for frontline health care professionals, causing them significant emotional stress. In such testing times, individual’s personal effectiveness ensued by the utilization of one’s personal energy may be helpful in not only ensuring wellbeing but also providing other desired results, for example, enhanced performance. Based on this notion, we conducted a study (amidst the third wave in mid-2021) using a multi-wave design to investigate the role of professional self-efficacy of health care professionals in well-being and behavioral outcomes during crises of COVID-19. The hypothesized relationships were tested by collecting data from 361 frontline healthcare professionals dealing with COVID-19 patients in hospitals in Northern part of Pakistan. The study results verified our assumed relationships and revealed that health care workers’ professional self-efficacy was positively related to their well-being, in terms of workplace thriving, and it also showed positive association with work role performance. In addition, the results of the study also revealed that perceived strengths use mediated the relationship between professional self-efficacy and outcomes. This study discusses implications, limitations, and future directions in detail, including how the findings can be used to inform interventions and support healthcare professionals dealing with the emotional and professional stresses brought on by the pandemic.

Impact of the COVID-19 pandemic on pharmacists practicing in community pharmacies in the state of Nebraska

BackgroundThe rapid increase in COVID-19 combined with uncertainty surrounding transmission and treatment protocols resulted in unprecedented burnout amongst health care workers. As other health care workers scrambled to support patients, community pharmacists quickly responded to the pandemic by extending their services. This constantly changing environment amongst other factors created a high degree of psychological burden associated with COVID-19 for pharmacists. Although studies have examined the psychological impact of the pandemic on frontline health care workers, pharmacists are rarely included in these studies. ObjectiveTo examine the impact of COVID-19 on work and personal well-being from the perspective of pharmacists practicing in community pharmacies in Nebraska. MethodsA cross-sectional online survey collected data from pharmacists with an active Nebraska Pharmacist license (N=2763) from November 2022 to January 2023. The survey was a hybrid of researcher-developed items and the validated abbreviated Maslach Burnout Inventory (aMBI). The aMBI is a 9-item Likert-scale scored instrument, which captures three domains of burnout: Personal Accomplishment; Emotional Exhaustion; and Depersonalization. Data was analyzed using IBM SPSS Statistics version 27. ResultsThe response rate to the survey was 12.3% (n=339). Mean age of the respondents was 44.8 years with an average of 18.7 years in practice. Most respondents (n = 113, 50.7%) practiced in a community pharmacy followed by hospital (n = 72, 32.3%). 55.8% of community pharmacists reported that they considered leaving their current employer. Chi-square analysis confirmed that community pharmacists are more burned out than noncommunity pharmacists. ConclusionsPharmacists realized they had not been recognized for their contributions as frontline health care workers, which motivated them to consider leaving their employer and even the profession of pharmacy. This study found community pharmacists are burned out more than non-community pharmacists. Within community pharmacies, it was found that pharmacists practicing at corporate-owned community pharmacies had increased burnout compared to those practicing in independent community pharmacies.

Frontline Providers’ and Patients’ Perspectives on Improving Diagnostic Safety in the Emergency Department: A Qualitative Study

Few studies have described the insights of frontline health care providers and patients on how the diagnostic process can be improved in the emergency department (ED), a setting at high risk for diagnostic errors. The authors aimed to identify the perspectives of providers and patients on the diagnostic process and identify potential interventions to improve diagnostic safety. Semistructured interviews were conducted with 10 ED physicians, 15 ED nurses, and 9 patients/caregivers at two separate health systems. Interview questions were guided by the ED-Adapted National Academies of Sciences, Engineering, and Medicine Diagnostic Process Framework and explored participant perspectives on the ED diagnostic process, identified vulnerabilities, and solicited interventions to improve diagnostic safety. The authors performed qualitative thematic analysis on transcribed interviews. The research team categorized vulnerabilities in the diagnostic process and intervention opportunities based on the ED-Adapted Framework into five domains: (1) team dynamics and communication (for example, suboptimal communication between referring physicians and the ED team); (2) information gathering related to patient presentation (for example, obtaining the history from the patients or their caregivers; (3) ED organization, system, and processes (for example, staff schedules and handoffs); (4) patient education and self-management (for example, patient education at discharge from the ED); and (5) electronic health record and patient portal use (for example, automatic release of test results into the patient portal). The authors identified 33 potential interventions, of which 17 were provider focused and 16 were patient focused. Frontline providers and patients identified several vulnerabilities and potential interventions to improve ED diagnostic safety. Refining, implementing, and evaluating the efficacy of these interventions are required.

Perceptions and Experiences of Midwives During the COVID-19 Pandemic in Iran: A Qualitative Exploration

Background: The COVID-19 pandemic affected both the maternity care and services provided by healthcare providers. Midwives are among the health professionals who are fighting on the frontlines of the COVID-19 pandemic. Objective: This study aimed to explore Iranian midwives' perceptions and experiences of the COVID19 pandemic. Methods: This qualitative description was carried out between March and May 2020 in Mashhad, Northeast Iran. Through purposive sampling, 15 midwives were selected from Corona Centers. Semistructured face-to-face interviews were used for data collection. Graneheim &amp; Lundman's conventional content analysis approach was used to analyze the data. The data organization was performed using MAXQDA 12 software. Guba and Lincoln's elements of rigor, including credibility, dependability, confirmability, and transferability were considered Results: Four overarching categories emerged based on the analysis of midwives' perceptions and experiences including "Facing challenges in confrontation with pregnant women", "Inefficiency of crisis management", "providing solutions and strategies to improve the current situation ", and "being affected by the pandemic in all aspects of life". Conclusion: Midwives faced different challenges since all aspects of pregnancy and childbirth care were influenced by the COVID-19 outbreak. Like other medical staff, midwives were on the frontline of health care during the COVID-19 pandemic, and it made problems for their personal feelings and professional responsibilities. Comprehensive support, promoting working status, and motivating midwives are vital in maintaining high-quality midwifery care.

Closing the Educational Gap on Human Trafficking: There’s No Better Time Than Now!

IntroductionHuman trafficking is a heinous crime and violation of human rights affecting between 25 and 27 million adults and children globally each year. Current immigration and refugee policy could exacerbate the human trafficking public health crisis. Health care providers working in emergency department and urgent care settings interact with human trafficking victims and provide life-changing care. Research identifies a significant need for coordinated, consistent, and standardized education on human trafficking. The purpose of this study was to determine the effectiveness of online educational training in human trafficking on the knowledge and self-confidence of registered nurses and nurse practitioners working in the emergency department and urgent care settings in New York. MethodsAn asynchronous, online education module was designed for emergency department and urgent care registered nurses and nurse practitioners to address key components of human trafficking identification, assessment, and treatment. Using a 1-group pretest/posttest design, participants completed an existing published survey tool before and 6 weeks after education. ResultsFindings revealed statistically significant improvement (P < .05) in knowledge and confidence regarding components of identifying, assessing, and treating victims of human trafficking. Data demonstrated 63.8% of participants had never received human trafficking training, and 80% reported no history of contact with patients known or suspected of being trafficked. DiscussionResults in this study demonstrate the need for increased standardized education regarding HT for frontline health care workers.

Impact of Yoga on anxiety, stress and sleep quality among health care professionals during a public health crisis.

Health care professionals (HCPs) working on the frontlines of health care emergencies/pandemics often experience elevated anxiety, stress and reduced quality of sleep. Yoga is a mind-body practice that has been proven to effective in improving physical and mental health. To evaluate the effectiveness of integrated Yoga intervention on mental health measures and sleep quality among HCPs working during the COVID-19 pandemic. This quasi-experimental study was conducted on 110 HCPs, including Doctors and nursing staff, with an age range of 20 to 65 years who were recruited through a convenience sampling method and assigned to a Yoga group (n = 55) or a control group (n = 55). The Yoga group received a weekly one-hour Yoga session followed by a 30-minute self-practice three times a week at home for one month. The control group followed routine activity. Heart rate (HR), Blood Pressure, stress measures (Perceived Stress and visual analogue Scale for Stress), COVID-related anxiety, Sleep Quality, Quality of life and Preservative Thinking were assessed before and after the intervention. A significant decrease in stress measures, COVID-19-related anxiety and fear, and perseverative thinking was noticed in the Yoga group. Sleep quality and quality of life also improved significantly. The control group showed no significant change. At one month, the Yoga group showed significantly greater improvement in stress measures, COVID-19-related anxiety and fear, perseverative thinking, sleep quality and quality of life compared to the control group. Yoga practice during the public health crisis would help reduce anxiety and stress and improve sleep among HCPs. Further randomized controlled trials are warranted.

Overcoming walls and voids: Responsive practices that enable frontline workers to feel heard.

There is increasing recognition that beyond frontline workers' ability to speak up, their feeling heard is also vital, both for improving work processes and reducing burnout. However, little is known about the conditions under which frontline workers feel heard. This inductive qualitative study identifies barriers and facilitators to feeling heard among nurses in hospitals. We conducted in-depth semistructured interviews with registered nurses, nurse managers, and nurse practitioners across four hospitals ( N = 24) in a U.S. health system between July 2021 and March 2022. We coded with the aim of developing new theory, generating initial codes by studying fragments of data (lines and segments), examining and refining codes across transcripts, and finally engaging in focused coding across all data collected. Frontline nurses who spoke up confronted two types of challenges that prevented feeling heard: (a) walls, which describe organizational barriers that lead ideas to be rejected outright (e.g., empty solicitation), and (b) voids, which describe organizational gaps that lead ideas to be lost in the system (e.g., structural mazes). We identified categories of responsive practices that promoted feeling heard over walls (boundary framing, unscripting, priority enhancing) and voids (procedural transparency, identifying a navigator). These practices appeared more effective when conducted collectively over time. Both walls and voids can prevent frontline workers from feeling heard, and these barriers may call for distinct managerial practices to address them. Future efforts to measure responsive practices and explore them in broader samples are needed. Encouraging responsive practices may help ensure that frontline health care workers feel heard.

Nurses’ Attitudes and Perceptions Regarding Suicidal Patients: A Quasi-Experimental Study of Depression Management Training

Suicide prevention is a priority globally. Community nurses are on the frontline of healthcare, and thus well placed to identify those at risk of suicide and act to prevent it. However, they are often ill-equipped to do so. This study examines whether depression management training for nurses may also help them manage suicide-risk patients. Method: This quasi-experimental study used a questionnaire that included a randomly assigned textual case vignette, measures related to patient descriptions portrayed in the vignette, and demographic and clinical/training information. The participants were 139 Israeli nurses who were mostly Jewish, Israeli-born, and married women working as community nurses. Almost half had completed depression management training (DMT) in their routine work. Results: Nurses who completed depression management training were more likely than non-trainees to query the patient regarding mental status and suicide plans and were more likely to refer them to appropriate further treatment. The graduate nurses also reported higher self-competence and more positive attitudes regarding their ability to assess depression and suicide risk than nurses who had not received depression management training. Discussion: The results highlight the importance of depression management training, as suicide assessment and referral are among the major steps to suicide prevention.

How to Support Health Care Professionals in Emergencies

ABSTRACT In recurring emergencies, frontline health care professionals (HCPs) have taken on a dual responsibility of not only serving as medical professionals for patients but also disseminating medical knowledge online for the public to alleviate their anxiety. They are expected to perform both online and offline organizational citizenship behavior (OCB). However, HCPs carry out their duties with high risks, inhibiting their OCB. This study aims to understand how to effectively and efficiently integrate online and offline support to facilitate HCP’s online and offline OCB in recurring emergencies. Data was collected from a survey among HCPs amid the second wave of the COVID-19 pandemic from March to April 2021. It was found that perceived support helps promote HCPs’ OCB through increasing optimism and resilience. Moreover, offline problem-focused support is more helpful than online emotion-focused support for HCPs with more knowledge of the emergency.

COVID-19 and Challenging Working Environments: Experiences of Black Sub-Saharan African (BSSA) Front-Line Health Care Professionals Amid of COVID-19 Pandemic in the English Midlands Region.

The impact of COVID-19 is challenging for many health and social care workers. The impact has been more felt by all ethnic groups, but during the course of its tenure, it has become more apparent that the black community has been affected more than others. They have been reported to suffer more fatalities from the pandemic compared to their white counterparts. Blacks are reported to make a significant percentage of health care workers. They are sometimes undervalued, lowly paid, with many on insecure contracts and experiencing professional inequality. This study sought to explore the challenges experienced by Black Sub-Saharan African (BSSA) front-line workers in health care during COVID-19 pandemic. The study utilised an explorative qualitative approach (EQA). Forty research participants were recruited for the study. Semi-structured interviews were used to collect data through online platforms which included Zoom, WhatsApp and Teams. A thematic approach was used to analyse data. Following data analysis, the research found that the research participants experienced undermining of expertise, lack of appreciation and unfair allocation of tasks and were overlooked for promotion and perceived as carriers of COVID-19. This group was over-represented in agency and self-employed roles. There is need for a strong government commitment to prevent discrimination through enacting a comprehensive legislation to support tackling the problem. Race equality training awareness needs to be rolled out into healthcare organisations and empower managers to deal with equality issues at work.

Understanding factors associated with COVID-19 vaccination among health care workers using the Diffusion of Innovation Theory

The COVID-19 vaccine was initially offered to frontline health care workers (HCWs), due to the high risk of contracting COVID-19 through occupational exposure to patients. Low HCW vaccine uptake can impact overall community-level vaccine uptake. This study used the Diffusion of Innovation (DOI) Theory to understand factors related to COVID-19 vaccine uptake in HCWs. We surveyed Pennsylvanian HCWs (excluding Philadelphia) from August 2022 to February 2023. Survey questions inquired about demographics, COVID-19 vaccination status, reasons for receiving/declining the COVID-19 vaccine, and sources of information about the vaccine. Participants (n=3,490) were 85% female, 89% White, and 93% (n=3,255) reported receiving at least one dose of a COVID-19 vaccine. HCWs were categorized into adopter categories of the DOI Theory: innovators (56%), early adopters (9%), early majority (11%), late majority (7%), and laggards (17%). The major reason that prompted participants to get the vaccine was to protect them against COVID-19 infection (78%), while the major reason for declining the vaccine was due to concern about possible side effects from the vaccine (78%). We applied the DOI Theory to characterize adopters and identify factors related to COVID-19 vaccine uptake in HCWs. As updated COVID-19 vaccines are approved for the United States market, our findings may be used to improve vaccine education and communication among HCWs to support vaccine uptake.

Digital Interventions for Stress Among Frontline Health Care Workers: Results From a Pilot Feasibility Cohort Trial.

The COVID-19 pandemic has challenged the mental health of health care workers, increasing the rates of stress, moral distress (MD), and moral injury (MI). Virtual reality (VR) is a useful tool for studying MD and MI because it can effectively elicit psychophysiological responses, is customizable, and permits the controlled study of participants in real time. This study aims to investigate the feasibility of using an intervention comprising a VR scenario and an educational video to examine MD among health care workers during the COVID-19 pandemic and to use our mobile app for longitudinal monitoring of stress, MD, and MI after the intervention. We recruited 15 participants for a compound intervention consisting of a VR scenario followed by an educational video and a repetition of the VR scenario. The scenario portrayed a morally challenging situation related to a shortage of life-saving equipment. Physiological signals and scores of the Moral Injury Outcome Scale (MIOS) and Perceived Stress Scale (PSS) were collected. Participants underwent a debriefing session to provide their impressions of the intervention, and content analysis was performed on the sessions. Participants were also instructed to use a mobile app for 8 weeks after the intervention to monitor stress, MD, and mental health symptoms. We conducted Wilcoxon signed rank tests on the PSS and MIOS scores to investigate whether the VR scenario could induce stress and MD. We also evaluated user experience and the sense of presence after the intervention through semi-open-ended feedback and the Igroup Presence Questionnaire, respectively. Qualitative feedback was summarized and categorized to offer an experiential perspective. All participants completed the intervention. Mean pre- and postintervention scores were respectively 10.4 (SD 9.9) and 13.5 (SD 9.1) for the MIOS and 17.3 (SD 7.5) and 19.1 (SD 8.1) for the PSS. Statistical analyses revealed no significant pre- to postintervention difference in the MIOS and PSS scores (P=.11 and P=.22, respectively), suggesting that the experiment did not acutely induce significant levels of stress or MD. However, content analysis revealed feelings of guilt, shame, and betrayal, which relate to the experience of MD. On the basis of the Igroup Presence Questionnaire results, the VR scenario achieved an above-average degree of overall presence, spatial presence, and involvement, and slightly below-average realism. Of the 15 participants, 8 (53%) did not answer symptom surveys on the mobile app. Our study demonstrated VR to be a feasible method to simulate morally challenging situations and elicit genuine responses associated with MD with high acceptability and tolerability. Future research could better define the efficacy of VR in examining stress, MD, and MI both acutely and in the longer term. An improved participant strategy for mobile data capture is needed for future studies. ClinicalTrails.gov NCT05001542; https://clinicaltrials.gov/study/NCT05001542. RR2-10.2196/32240.

A survey of Australian public opinion on using comorbidity to triage intensive care patients in a pandemic.

Objectives This study aimed to determine which method to triage intensive care patients using chronic comorbidity in a pandemic was perceived to be the fairest by the general public. Secondary objectives were to determine whether the public perceived it fair to provide preferential intensive care triage to vulnerable or disadvantaged people, and frontline healthcare workers. Methods A postal survey of 2000 registered voters randomly selected from the Australian Electoral Commission electoral roll was performed. The main outcome measures were respondents' fairness rating of four hypothetical intensive care triage methods that assess comorbidity (chronic medical conditions, long-term survival, function and frailty); and respondents' fairness rating of providing preferential triage to vulnerable or disadvantaged people, and frontline healthcare workers. Results The proportion of respondents who considered it fair to triage based on chronic medical conditions, long-term survival, function and frailty, was 52.1, 56.1, 65.0 and 62.4%, respectively. The proportion of respondents who considered it unfair to triage based on these four comorbidities was 31.9, 30.9, 23.8 and 23.2%, respectively. More respondents considered it unfair to preferentially triage vulnerable or disadvantaged people, than fair (41.8% versus 21.2%). More respondents considered it fair to preferentially triage frontline healthcare workers, than unfair (44.2% versus 30.0%). Conclusion Respondents in this survey perceived all four hypothetical methods to triage intensive care patients based on comorbidity in a pandemic disaster to be fair. However, the sizable minority who consider this to be unfair indicates that these triage methods could encounter significant opposition if they were to be enacted in health policy.

Perception of Health Professionals on the National Health Act, 2014, in University College Hospital, Ibadan

Abstract Background: The National Health Bill was the most debated bill from the legislative arm of government since 1999 and yet, many health professionals are largely unaware of its details. There had been insufficient health legislation establishing a unified national health system in Nigeria, such as provided for in the National Health Act (NHA), 2014, leading to duplication of functions and laws. Health professionals, being key policy actors and at the front line of healthcare, easily notice the impact of policies set by actors in the health-care system. Therefore, their knowledge and perception of the NHA as legitimate, will compel obedience with the provisions of the act, and also create a basis for stronger advocacy for its implementation for the overall strengthening of the health-care system that the act intends to provide a legal framework for. Methodology: This is a descriptive cross-sectional study to assess the perception of health professionals at the University College Hospital, Ibadan, on the NHA, 2014. Participants were selected by a multistage (stratified and then systematic) random sampling technique. Data were collected quantitatively using a self-administered semi-structured questionnaire. The quantitative data were entered and analysed using IBM SPSS version 23. Results: Awareness of the respondents about the Act was good, with up to 75% of respondents being aware of the existence of the NHA Act. However, the knowledge of the content of the Act was poor among all the cadres of health professionals. The differences in awareness among the different cadres of health professionals were statistically significant with the doctors being more aware and the nurses least aware, P = 0.001. The majority of health professionals perceive that the NHA is sufficient to regulate health care and set the appropriate standards in Nigeria. However, the health-care professionals also perceive that Nigerian government is incapable of diligently implementing the provisions of the Act. Conclusion: There is a need for sustained remedial action by health-care professional bodies, organised media, and relevant government ministries and agencies, to ensure that stakeholders, including health professionals, are abreast with the provisions of the NHA, through prioritising health laws as key areas in undergraduate school curricula and continuing medical education on health laws for the practicing health professionals. Good knowledge of the Act will increase the advocacy efforts by the health professionals and other stakeholders towards the implementation of the provisions of the Act by the government and other relevant stakeholders. There is also a need for the government to show more commitment in publicising its effort at the implementation of the Act to improve the poor perception by the health professionals on the government’s ability to implement the provisions of the Act, as seen in this study.

Addressing the health human resources crisis: Strategies for retaining women health care professionals in organizations.

Globally, healthcare systems are contending with a pronounced health human resource crisis marked by elevated rates of burnout, heightened job transitions, and an escalating demand for the limited supply of the existing health workforce. This crisis detrimentally affects the quality of patient care, contributing to long wait times, decreased patient satisfaction, and a heightened frequency of patient safety incidents and medical errors. In response to the heightened demand, healthcare organizations are proactively exploring solutions to retain their workforce. With women comprising over 70% of health human resources, this study seeks to gain insight into the unique experiences of women health professionals on the frontlines of healthcare and develop a conceptual framework aimed at facilitating organizations in effectively supporting the retention and advancement of women in healthcare frontline roles. We used grounded theory in this qualitative study. From January 2023 to May 2023, we conducted individual semi-structured interviews with 27 frontline HCWs working in Canada and representing diverse backgrounds. The data underwent thematic analysis, which involved identifying and comprehending recurring patterns across the information to elucidate emerging themes. Our analysis found that organizational, professional, and personal factors shape women's intentions to leave the frontline workforce. Reevaluating organizational strategies related to workforce, fostering a positive work culture, and building the capacity of management to create supportive work environment can collectively transform the work environment. By creating conditions that enable women to perform effectively and find satisfaction in their professional roles, organizations can enhance their ability to retain valuable talent.

The experiences of public health nurses during the COVID-19 in Taiwan: A qualitative study.

The coronavirus disease 2019 (COVID-19) pandemic has had a substantial effect on frontline health care workers and caused public health nurses (PHNs) to come under various forms of pressure. PHNs face high-risk challenges in their work environment, and their professional commitment and adaptability are key concerns. The aim of this qualitative study was to describe the experiences of PHNs during the COVID-19 outbreak. Twenty PHNs who worked during the COVID-19 outbreak were recruited from seven public health centres through posters. Data were collected through in-depth interviews that comprised semi-structured and open-ended questions; subsequently, the data were analysed through content analysis. Three themes emerged from the study findings, namely (1) the disorderliness of COVID-19 pandemic prevention work, (2) managing stress and fear, and (3) the establishment of a new normal. Because of the severity of the pandemic, the workload and stress associated with epidemic prevention policies continue to increase. PHNs may infect their family members and experience a sense of alienation and distance. They must also deal with irrationality and reactions in the people within their community. Health department directors and policymakers should provide the necessary support and assistance to frontline pandemic prevention workers to increase the efficiency of pandemic prevention efforts. The participants agreed to participate in the qualitative study during the study period.

Challenges and Counteracting Strategies Including Optimum Health Service Practices for Frontline Nurses During the Mpox Outbreak and Futuristic Vision.

Monkeypox (mpox) is an evolving infectious disease caused by the monkeypox virus (MPXV). On July 23, 2022, the WHO declared the recent mpox outbreaks a public health emergency of international concern (PHEIC), which terminated on May 11, 2023. As of July 11, 2023, 88,288 confirmed cases and 149 deaths have been reported from 112 countries and territories. Currently, mpox is not a PHEIC, as the outbreak and its impacts are nearly over. Nurses played significant roles during the mpox 2022 outbreak as frontline workers. In light of the impending mpox global outbreak in 2022, this brief report provides an update on the enormous difficulties faced by frontline nurses while playing a crucial role in handling the mpox outbreak and some potential solutions to these difficulties. The methodological framework employed in this narrative brief report involves conducting a comprehensive analysis and synthesis of relevant literature and hypothetical scenarios. The aim is to put forth practical strategies that can effectively tackle the difficulties encountered by frontline nurses in the context of the mpox outbreak. Additionally, the report seeks to envision a healthcare system that is more resilient in the face of future challenges. It is important to understand the challenges the nurses face from their perspective. As frontline health care workers, the various health issues of nurses and their concerns must be taken care of appropriately by adopting optimum health service practices, adequate safety measures, recommended precautionary measures, and boosting them mentally while handling mpox patients. Counseling and the arrangement of workshops are required. Appropriate care should be taken to address the various health issues concerning nurses by adopting health service practices at optimum levels. Side by side, recommended safety and precautionary measures should be followed.

Side effects of AZD 1222 COVISHIELD vaccine among front-line health care workers in a tertiary care hospital: A descriptive cross-sectional study

Introduction: Coronavirus disease vaccination has been accepted as a global health measure to prevent severity,transmission and mortality. Vaccine frequently cause adverse effects which is supposed to be due to protective immune response induced by the vaccine. The study aimed to find out the prevalence of side effects of first dose of AZD 1222 COVISHIELD vaccine among front line health care workers receiving vaccination in a tertiary care hospital. Methods: This was a descriptive cross-sectional study among front line health workers who received the first dose of COVISHIELD vaccine. The study was conducted from February 2021 to March 2021 in a tertiary care hospital after receiving ethical approval from the Institutional Review Committee. Convenience sampling was used for data collection and data was analyzed using SPSS version 17 was used for analysis. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 629 participants, 344(54.7%) participants reported one or other side effects following vaccination. The major side effects reported were fever 152(19.6%), myalgia 144(22.9%), pain at injection site 123(19.6%), headache 75(11.9%) and in one reactivation of Herpes Zoster. Conclusions: After the first dose of COVISHIELD vaccine, mild symptoms were seen which resolved within few days. Some cases of reactivation of Herpes Zoster was found. The adverse effects were seen more in patients who had history of COVID-19 infection.