scholarly journals Critical care work during COVID-19: a qualitative study of staff experiences in the UK

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048124
Author(s):  
Catherine M Montgomery ◽  
Sally Humphreys ◽  
Corrienne McCulloch ◽  
Annemarie B Docherty ◽  
Steve Sturdy ◽  
...  
Keyword(s):  
Critical Care ◽  
Qualitative Study ◽  
Large Scale ◽  
Care Staff ◽  
Patient Acuity ◽  
Allied Health Professionals ◽  
Telephone Interviews ◽  
Extreme Stress ◽  
The Uk ◽  
Staff Experiences

ObjectiveTo understand National Health Service (NHS) staff experiences of working in critical care during the first wave of the COVID-19 pandemic in the UK.DesignQualitative study using semistructured telephone interviews and rapid analysis, interpreted using Baehr’s sociological lens of ‘communities of fate’.ParticipantsForty NHS staff working in critical care, including 21 nurses, 10 doctors and advanced critical care practitioners, 4 allied health professionals, 3 operating department practitioners and 2 ward clerks. Participants were interviewed between August and October 2020; we purposefully sought the experiences of trained and experienced critical care staff and those who were redeployed.SettingFour hospitals in the UK.ResultsCOVID-19 presented staff with a situation of extreme stress, duress and social emergency, leading to a shared set of experiences which we have characterised as a community of fate. This involved not only fear and dread of working in critical care, but also a collective sense of duty and vocation. Caring for patients and families involved changes to usual ways of working, revolving around: reorganisation of space and personnel, personal protective equipment, lack of evidence for treating COVID-19, inability for families to be physically present, and the trauma of witnessing extreme patient acuity and death on a large scale. The stress and isolation of working in critical care during COVID-19 was mitigated by strong teamwork, camaraderie, pride and fulfilment.ConclusionCOVID-19 has changed working practices in critical care and profoundly affected staff physically, mentally and emotionally. Attention needs to be paid to the social and organisational conditions in which individuals work, addressing both practical resourcing and the interpersonal dynamics of critical care provision.

scholarly journals Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 767
Author(s):  
Connie Lethin ◽  
Andrea Kenkmann ◽  
Carlos Chiatti ◽  
Jonas Christensen ◽  
Tamara Backhouse ◽  
...  
Keyword(s):  
United Kingdom ◽  
Organizational Support ◽  
Care Home ◽  
External Support ◽  
Care Staff ◽  
Care Organization ◽  
Online Questionnaire ◽  
The United Kingdom ◽  
The Uk ◽  
Staff Experiences

The COVID-19 pandemic has affected care workers all over the globe, as older and more vulnerable people face a high risk of developing severe symptoms and dying from the virus infection. The aim of this study was to compare staff experiences of stress and anxiety as well as internal and external organizational support in Sweden, Italy, Germany, and the United Kingdom (UK) in order to determine how care staff were affected by the pandemic. A 29-item online questionnaire was used to collect data from care staff respondents: management (n = 136), nurses (n = 132), nursing assistants (n = 195), and other healthcare staff working in these organizations (n = 132). Stress and anxiety levels were highest in the UK and Germany, with Swedish staff showing the least stress. Internal and external support only partially explain the outcomes. Striking discrepancies between different staff groups’ assessment of organizational support as well as a lack of staff voice in the UK and Germany could be key factors in understanding staff’s stress levels during the pandemic. Structural, political, cultural, and economic factors play a significant role, not only factors within the care organization or in the immediate context.

scholarly journals Long COVID and the role of physical activity: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047632
Author(s):  
Helen Humphreys ◽  
Laura Kilby ◽  
Nik Kudiersky ◽  
Robert Copeland
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Lived Experience ◽  
Well Being ◽  
Telephone Interviews ◽  
Semistructured Interviews ◽  
The Usa ◽  
The Uk ◽  
Insight Into

ObjectivesTo explore the lived experience of long COVID with particular focus on the role of physical activity.DesignQualitative study using semistructured interviews.Participants18 people living with long COVID (9 men, 9 women; aged between 18–74 years; 10 white British, 3 white Other, 3 Asian, 1 black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with long COVID.SettingTelephone interviews with 17 participants living in the UK and 1 participant living in the USA.ResultsFour themes were generated. Theme 1 describes how participants struggled with drastically reduced physical function, compounded by the cognitive and psychological effects of long COVID. Theme 2 highlights challenges associated with finding and interpreting advice about physical activity that was appropriately tailored. Theme 3 describes individual approaches to managing symptoms including fatigue and ‘brain fog’ while trying to resume and maintain activities of daily living and other forms of exercise. Theme 4 illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability.ConclusionsThis study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with long COVID. Findings highlight the need for greater clarity and tailoring of physical activity-related advice for people with long COVID and improved support to resume activities important to individual well-being.

Moving Past the Loss: A Longitudinal Qualitative Study of Health Care Staff Experiences of Disinvestment

2020 ◽  
pp. 107755872097258
Author(s):  
Deb Mitchell ◽  
Lisa O’Brien ◽  
Anne Bardoel ◽  
Terry Haines
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Services ◽  
Management Strategies ◽  
Care Staff ◽  
Health Care Staff ◽  
Modifying Factors ◽  
Big Picture ◽  
Staff Experiences ◽  
The Impact

This longitudinal qualitative study examines staff experience of disinvestment from a service they are accustomed to providing to their patients. It took place alongside a disinvestment trial that measured the impact of the removal of weekend allied health services from acute wards at two hospitals. Data were gathered from repeated interviews and focus groups with 450 health care staff. We developed a grounded theory, which explains changes in staff perceptions over time and the key modifying factors. Staff appeared to experience disinvestment as loss; a key difference to other operational changes. Early staff experiences of disinvestment were primarily negative, but evolved with time and change-management strategies such as the provision of data, clear and persistent communication approaches, and forums where the big picture context of the disinvestment was robustly discussed. These allowed the disinvestment trial to be successfully implemented at two health services, with high compliance with the research protocol.

scholarly journals Long Covid and the role of physical activity: a qualitative study

2020 ◽  
Author(s):  
Helen Humphreys ◽  
Laura Kilby ◽  
Nik Kudiersky ◽  
Robert Copeland
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Lived Experience ◽  
Research Interest ◽  
List Type ◽  
Structured Interviews ◽  
Telephone Interviews ◽  
On Line ◽  
The Uk

ABSTRACTObjectivesTo explore the lived experience of Long Covid with particular focus on the role of physical activityDesignQualitative study using semi-structured interviewsParticipants18 people living with Long Covid (9 male, 9 female; aged between 18-74; 10 White British, 3 White Other, 3 Asian, 1 Black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with Long CovidSettingTelephone interviews with 17 participants living in the UK and 1 participant living in the USResultsFour themes were generated. Theme one highlights the physical and social isolation experienced by people with Long Covid, compounded by a lack of support and advice from medical professionals. Theme two describes how participants sought information and validation through online sources and communities. Theme three captures the challenges associated with managing physical and cognitive effects of Long Covid including fatigue and ‘brain fog’ whilst trying to resume and maintain activities of daily living and other forms of exercise. Theme four illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability.ConclusionsThis study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with Long Covid. Findings highlight the need for greater consensus around physical activity-related advice for people with Long Covid and improved support to resume activities considered important for wellbeing.Article SummaryStrengths and limitations of this studyTo our knowledge, this paper is the first to explore the role of physical activity in the lived experience of Long Covid using a qualitative approachThe study design enabled in-depth inquiry of lived experiences in a diverse sampleInductive thematic analysis ensured descriptions and interpretations of the lived experience were tested and found to be grounded in the dataParticipants were recruited from members of a Long Covid research interest database who registered via an on-line form, meaning study findings might not capture the views of digitally excluded populationsFunding statementThis work was supported by Sheffield Hallam University.Competing interestsAll authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

scholarly journals Is my cough a cold or covid? A qualitative study of COVID-19 symptom recognition and attitudes towards testing in the UK

2021 ◽  
Author(s):  
Fiona Mowbray ◽  
Lisa Woodland ◽  
Louise E Smith ◽  
Richard Amlot ◽  
G James Rubin
Keyword(s):  
Qualitative Study ◽  
Perceived Risk ◽  
Test Methods ◽  
Test Accuracy ◽  
Telephone Interviews ◽  
Testing Uptake ◽  
Mixed Feelings ◽  
Previous Contact ◽  
The Uk ◽  
Equal Split

Objective Key to reducing the spread of COVID-19 in the UK is increased use of the NHS Test and Trace (NHSTT) system. This study explored one of the main issues that determine whether people engage with NHSTT, how people understand symptoms that may indicate the presence of COVID-19 and that should trigger a request for a test. Methods In this qualitative study, a series of semi-structured telephone interviews were conducted with 40 people (21 members of the general population, 19 students). There was nearly an equal split between male and female participants in both populations. Data were collected between 30 November and 11 December 2020 and explored using thematic analysis. There was substantial similarity in responses for both populations so we combined our results and highlighted where differences were present. Results Participants generally had good knowledge of the main symptoms of COVID-19 (high temperature, new, persistent cough, anosmia) but had low confidence in their ability to differentiate them from symptoms of other illnesses. Attribution of symptoms to COVID-19 was most likely where the symptoms were severe, many symptoms were present, symptoms had lasted for some time and when perceived risk of exposure to infection was high due to previous contact with others. Participants felt encouraged to engage in testing where symptoms were present and had persisted for several days, though many had concerns about the safety of testing centres and the accuracy of test results. Students had mixed feelings about mass asymptomatic testing, seeing it as a way to access a more normal student experience, but also a potential waste of resources. Conclusions This study offers novel insights into how people attribute symptoms to COVID-19 and barriers and facilitators to engaging with testing. Participants had positive views of testing, but there is a need to improve not just recognition of each main symptom, but also understanding that even single, mild symptoms may necessitate a test rather than a wait and see approach, and to address concerns around test accuracy to increase testing uptake.

scholarly journals Paediatric Intensive Care Staff Experiences of Debriefing Post Critical Incident; a Qualitative Study of the Leeds ‘time Out’ Method

2020 ◽  
Author(s):  
Mark Winton ◽  
Sian Cooper ◽  
Gary Latchford
Keyword(s):  
Intensive Care ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Critical Incidents ◽  
Local Politics ◽  
Paediatric Intensive Care ◽  
Care Staff ◽  
Structured Interviews ◽  
Time Out ◽  
Staff Experiences

Abstract BackgroundHow intensive care teams respond to critical incidents is important for maintaining effective patient care, staff education and morale(1). We investigated Paediatric Intensive Care (PIC) staff experiences of participating in novel 20 minute group ‘time outs’ held after critical incidents.MethodA qualitative study using semi-structured interviews with staff attendees of ‘time outs’. Interviews transcribed and analysed using thematic analysis. Results shared with interviewees for participant validation. Ethical approval granted by the University of Leeds School of Medicine Research Ethics Committee (approval number SOMREC17-020).Results8 semi-structured interviews lasted on average 45 minutes each. Participant roles; 1 Consultant, 1 PIC grid trainee, ST3 Paediatrician, 1 Advanced Nurse Practitioner, 2 Band 6 Nurses and 2 Band 7 Nurses. Thematic analysis generated 1,060 initial codes, subsequently revised until a thematic map emerged, containing five main themes: 1. Context and culture in which critical incidents and ‘time outs’ are embedded, including hierarchy and local politics.2. Pragmatics of organising and evaluating ‘time outs’.3. Position of valued clinical psychologists, who were removed from the ‘time outs’.4. Reflections on coping and resilience, notably blame and fear.5. Process of attending a time out and its impact – both positive (clinical knowledge and the ability to cope) and negative (damaging if inappropriately run).ConclusionThe data contextualised the time outs within the complex PIC environment, with politics, communication challenges and hierarchies affecting how staff respond and how they are supported following critical incidents. Though practical challenges of time outs were noted, this intervention has potential to improve the understanding and well-being of PIC staff after critical incidents.

scholarly journals Hospital Staff Report It Is Not Burnout, but a Normal Stress Reaction to an Uncongenial Work Environment: Findings from a Qualitative Study

2020 ◽  
Vol 17 (11) ◽  
pp. 4107
Author(s):  
Madeleine Kendrick ◽  
Kevin Kendrick ◽  
Peter Morton ◽  
Nicholas F. Taylor ◽  
Sandra G. Leggat
Keyword(s):  
Public Health ◽  
Occupational Health ◽  
Hospital Staff ◽  
Social Determinant ◽  
Care Staff ◽  
Health Care Staff ◽  
Healthcare Staff ◽  
Public Health Services ◽  
Allied Health Professionals ◽  
Staff Experiences

(1) Background: The issue of burnout in healthcare staff is frequently discussed in relation to occupational health. In this paper, we report healthcare staff experiences of stress and burnout. (2) Methods: In total, 72 healthcare staff were interviewed from psychiatry, surgery, and emergency departments at an Australian public health service. The sample included doctors, nurses, allied health professionals, administrators, and front-line managers. Interview transcripts were thematically analyzed, with participant experiences interpreted against descriptors of burnout in Maslach’s Burnout Inventory and the International Statistical Classification of Diseases and Related Health Problems (ICD-11). (3) Results: Staff experiences closely matched the ICD-11 description of stress associated with working in an uncongenial workplace, with few reported experiences which matched the ICD-11 descriptors of burnout. (4) Conclusion: Uncongenial workplaces in public health services contribute to healthcare staff stress. While previous approaches have focused on biomedical assistance for individuals, our findings suggest that occupational health approaches to addressing health care staff stress need greater focus on the workplace as a social determinant of health. This finding is significant as organizational remedies to uncongenial stress are quite different from remedies to burnout.

scholarly journals Morita Therapy for depression (Morita Trial): an embedded qualitative study of acceptability

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e023873
Author(s):  
Holly Victoria Rose Sugg ◽  
Julia Frost ◽  
David A Richards
Keyword(s):  
Qualitative Study ◽  
Large Scale ◽  
Controlled Trial ◽  
Future Research ◽  
Treatment As Usual ◽  
Morita Therapy ◽  
Semistructured Interviews ◽  
Framework Approach ◽  
Randomised Controlled ◽  
The Uk

ObjectiveTo explore the views of UK-based recipients of Morita Therapy (MT) on the acceptability of MT.DesignQualitative study nested within a pilot randomised controlled trial of MT (a Japanese psychological therapy largely unknown in the UK) versus treatment as usual, using post-treatment semistructured interviews analysed with a framework approach.Setting and participantsParticipants who received MT as part of the Morita Trial, recruited for the trial from General Practice record searches in Devon, UK. Data from 16 participants were purposively sampled for analysis.ResultsWe identified five themes which, together, form a model of how different participants viewed and experienced MT. Overall, MT was perceived as acceptable by many participants who emphasised the value of the approach, often in comparison to other treatments they had tried. These participants highlighted how accepting and allowing difficulties as natural phenomena and shifting attention from symptoms to external factors had facilitated symptom reduction and a sense of empowerment. We found that how participants understood and related to the principles of MT, in light of their expectations of treatment, was significantly tied to the extent to which MT was perceived as acceptable. Our findings also highlighted the distinction between MT in principle and practice, with participants noting challenges of engaging with the process of therapy such as fear and discomfort around rest, needing sufficient support from the therapist and others, and the commitment of treatment.ConclusionsPeople in the UK can accept the premise of MT, and consider the approach beneficial and novel. Therefore, proceeding to a large-scale trial of MT is appropriate with minor modifications to our clinical protocol. Participants’ expectations and understandings of treatment play a key role in acceptability, and future research may investigate these potential moderators of acceptability in MT.Trial registration numberCISRCTN17544090; Pre-results.

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