Journal of Qualitative Research in Health Sciences

Document Type : Original Article

Authors

1 Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran

2 Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

3 Education Development Center, Sirjan School of Medical Sciences, Sirjan, Iran

4 Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, Texas, USA

10.34172/jqr.2023.30

Abstract

Background: The large-scale spread of COVID-19 affected communities with many deaths worldwide causing significant concerns. Due to being on the front line of fighting against this disease, a great number of healthcare providers lost their lives. Accordingly, this study aimed to explore the changes in nurses’ behavior and practice while taking care of COVID-19 patients.
Methods: The present study was conducted using a qualitative conventional content analysis approach in 2020-2021. The participants were 14 nurses taking care of COVID-19 patients in the infectious diseases wards of a teaching hospital affiliated with Kerman University of Medical Sciences. The data were collected through interviews with the nurses, and data collection continued until data saturation. The collected data were analyzed based on the steps proposed by Graneheim and Lundman. After recording and transcribing the interviews, the participants’ statements were categorized into semantic units. Data analysis was performed using MAXQDA-10 software.
Results: The majority of nurses reported significant behavioral changes that were categorized into five main themes including intensification of protective measures and increase in concentration, emergence of mental and psychological symptoms, increase in the sense of responsibility towards the family, recourse to prayer and religious rituals, and increased empathy with patients.
Conclusion: The most important behavioral changes of nurses as a result of the COVID-19 crisis were the intensification of personal protective measures, the emergence of mental and emotional symptoms, the increase in the sense of responsibility towards the family, resorting to prayer and religious rituals, and increased empathy with patients. Providing material and spiritual incentives as well as support to personnel to increase their motivation and work productivity should be taken into consideration by officials during epidemics. Moreover, actions such as providing free psychological counseling are suggested to calm the personnel.

Highlights

Arezoo Sarani (Google Scholar) (PubMed)

Seyed Mostafa Seyed Askari (Google Scholar) (PubMed)

Amin Beigzadeh (Google Scholar) (PubMed)

Minoo Mohammadkhani (Google Scholar) (PubMed)

Mohammadsadegh Tavakolisani (Google Scholar) (PubMed)

Narges Khanjani (Google Scholar) (PubMed)

 

Keywords

  1. Balkhi F, Nasir A, Zehra A, Riaz R. Psychological and behavioral response to the coronavirus (COVID-19) pandemic. Cureus. 2020;12(5):e7923. doi: 10.7759/cureus.7923.
  2. Heidarijamebozorgi M, Jafari H, Sadeghi R, Sheikhbardsiri H, Kargar M, Amiri Gharghani M. The prevalence of depression, anxiety, and stress among nurses during the coronavirus disease 2019: a comparison between nurses in the frontline and the second line of care delivery. Nurs Midwifery Stud. 2021;10(3):188-93. doi: 10.4103/nms.nms_103_20.
  3. Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3. doi: 10.1016/s0140- 6736(20)30185-9.
  4. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/s0140-6736(20)30211-7.
  5. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi: 10.1016/j.jaut.2020.102433.
  6. Liu X, Na RS, Bi ZQ. [Challenges to prevent and control the outbreak of COVID-19]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(7):994-7. doi: 10.3760/ cma.j.cn112338-20200216-00108. [Chinese].
  7. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;395(10228):931-4. doi: 10.1016/s0140- 6736(20)30567-5.
  8. Allahtavakoli M. Coping with stress of COVID-19 epidemic. J Jiroft Univ Med Sci. 2020;7(1):253-4. [Persian].
  9. Saadatzadeh M, Fazel R, Madani S, Sabouri Khosroshahi H. Arak city governmental employees’ life span experiences of weakness of culture of work: a qualitative study. J Qual Res Health Sci. 2020;8(4):68-76. doi: 10.22062/jqr.2020.90992.
  10. Vahdaninya Z, Nasiri A, Zainali Z. Initial reactions of novice nurses in facing death in patients. J Qual Res Health Sci. 2016;5(3):240-9. [Persian].
  11. Li S, Wang Y, Xue J, Zhao N, Zhu T. The impact of COVID-19 epidemic declaration on psychological consequences: a study on active Weibo users. Int J Environ Res Public Health. 2020;17(6):2032. doi: 10.3390/ijerph17062032.
  12. Shahyad S, Mohammadi MT. Psychological impacts of COVID-19 outbreak on mental health status of society individuals: a narrative review. J Mil Med. 2020;22(2):184- 92. [Persian].
  13. Aminizadeh M, Saberinia A, Salahi S, Sarhadi M, Jangipour Afshar P, Sheikhbardsiri H. Quality of working life and organizational commitment of Iranian pre-hospital paramedic employees during the 2019 novel coronavirus outbreak. Int J Healthc Manag. 2022;15(1):36-44. doi: 10.1080/20479700.2020.1836734.
  14. Carter EJ, Pouch SM, Larson EL. Common infection control practices in the emergency department: a literature review. Am J Infect Control. 2014;42(9):957-62. doi: 10.1016/j. ajic.2014.01.026.
  15. Haghanizemeydani M, Ahmadi S, Ashouri F, Showani E, Monavari Roozbahani L. Qualitative study of spiritual experiences in nurses of psychiatry wards. J Qual Res Health Sci. 2020;8(4):59-67. doi: 10.22062/jqr.2020.90991.
  16. Lam SK, Kwong EW, Hung MS, Chien WT. Emergency nurses’ perceptions regarding the risks appraisal of the threat of the emerging infectious disease situation in emergency departments. Int J Qual Stud Health Well-being. 2020;15(1):e1718468. doi: 10.1080/17482631.2020.1718468.
  17. Lam SK, Kwong EW, Hung MS, Pang SM. Bridging the gap between guidelines and practice in the management of emerging infectious diseases: a qualitative study of emergency nurses. J Clin Nurs. 2016;25(19-20):2895-905. doi: 10.1111/ jocn.13343.
  18. Mohammadnahal L, Mirzaei A, Khezeli MJ. The effect of caring for COVID-19 patients on nurses’ productivity and burnout. Nurs Midwifery J. 2021;18(11):859-72. [Persian].
  19. Mansurnejad Z, Malekpour M, Ghamarani A. Explanation of self-determination experiences in students with externalized behavior disorders: a phenomenological approach. J Qual Res Health Sci. 2020;8(2):183-91. [Persian].
  20. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. doi: 10.3390/ ijerph17051729.
  21. Koh D, Lim MK, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn? Med Care. 2005;43(7):676-82. doi: 10.1097/01.mlr.0000167181.36730.cc.
  22. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105- 12. doi: 10.1016/j.nedt.2003.10.001.
  23. Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. Lippincott Williams & Wilkins; 2008.
  24. Neuwirth MM, Mattner F, Otchwemah R. Adherence to personal protective equipment use among healthcare workers caring for confirmed COVID-19 and alleged non-COVID-19 patients. Antimicrob Resist Infect Control. 2020;9(1):199. doi: 10.1186/s13756-020-00864-w.
  25. Eftekhar Ardebili M, Naserbakht M, Bernstein C, Alazmani- Noodeh F, Hakimi H, Ranjbar H. Healthcare providers experience of working during the COVID-19 pandemic: a qualitative study. Am J Infect Control. 2021;49(5):547-54. doi: 10.1016/j.ajic.2020.10.001.
  26. Torkian S, Akhlaghi E, Khosravi V, Etesami R, Ahmadi A, Khanjani N, et al. Depression symptoms and sleep quality during COVID-19 outbreak in Iran: a national cross-sectional study. Iran J Psychiatry Behav Sci. 2021;15(1):e108500. doi: 10.5812/ijpbs.108500.
  27. Yang S, Kwak SG, Chang MC. Psychological impact of COVID-19 on hospital workers in nursing care hospitals. Nurs Open. 2021;8(1):284-9. doi: 10.1002/nop2.628.
  28. Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N, Leszcz M, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ. 2003;168(10):1245-51.
  29. Heidari M, Yoosefee S, Heidari A. COVID-19 pandemic and the necessity of spiritual care. Iran J Psychiatry. 2020;15(3):262-3. doi: 10.18502/ijps.v15i3.3823.
  30. Almaghrabi RH, Alfaraidi HA, Al Hebshi WA, Albaadani MM. Healthcare workers experience in dealing with coronavirus (COVID-19) pandemic. Saudi Med J. 2020;41(6):657-60. doi: 10.15537/smj.2020.6.25101.
  31. Alshmemri MS, Ramaiah P. Nurses experiences and challenges during COVID-19: mixed method approach. J Pharm Res Int. 2020;32(31):81-7.
  32. Araghian-Mojarad F, Sanagoo A, Jouybari L. Nurses’ experiences of intimacy with the patient in pediatric wards affiliated to Mazandaran and Golestan Universities of Medical Sciences, Iran, 2016. J Qual Res Health Sci. 2017;6(2):147- 56. [Persian].
  33. Kim JS, Choi JS. Factors influencing emergency nurses’ burnout during an outbreak of Middle East respiratory syndrome coronavirus in Korea. Asian Nurs Res (Korean Soc Nurs Sci). 2016;10(4):295-9. doi: 10.1016/j.anr.2016.10.002.
  34. Beigzadeh A, Yamani N, Sharifpoor E, Bahaadinbeigy K, Adibi P. Teaching and learning in clinical rounds: a qualitative meta-analysis. J Emerg Pract Trauma. 2021;7(1):46-55. doi: 10.34172/jept.2020.32.