https://www.mdu.se/

mdu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Struggling in the dehumanized world of COVID—An exploratory mixed‐methods study of frontline healthcare workers' experiences
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-6512-849x
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0001-6292-7010
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. The Arctic University of Norway Narvik Norway.ORCID iD: 0000-0002-9714-577X
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-3965-1666
Show others and affiliations
2024 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, p. 1-15Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim

To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden.DesignAn online fully mixed-methods design.MethodsA web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.

Results

Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.

Conclusions

Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis.

Place, publisher, year, edition, pages
2024. p. 1-15
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-65889DOI: 10.1111/jan.16083ISI: 001155994100001Scopus ID: 2-s2.0-85184195479OAI: oai:DiVA.org:mdh-65889DiVA, id: diva2:1834751
Available from: 2024-02-05 Created: 2024-02-05 Last updated: 2024-04-10Bibliographically approved
In thesis
1. Nurses' caring struggle: Stress in caring within hospital emergency care during the COVID-19 pandemic
Open this publication in new window or tab >>Nurses' caring struggle: Stress in caring within hospital emergency care during the COVID-19 pandemic
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Nurses took a frontline caregiving role during the COVID-19 pandemic in pervasively altered conditions in Swedish hospital emergency healthcare. Little is known about nurses’ experiences of the stress they were subjected to. In this thesis, findings from individual in-depth interviews with both newly graduated registered nurses (NGRNs) and experienced nurses (ERNs), as well as a web-based questionnaire, illuminate nurses’ lived experiences of stress in caring during the COVID-19 pandemic. Three studies employed qualitative methods (I, II, IV), and one a mixed methods approach (III). Study I aimed to describe NGRNs’ experiences of encountering stress in EDs during the COVID-19 pandemic. Findings illuminate how dedicated NGRNs struggle to develop into the nurse they want to be whilst battling extraordinary situations and conflicting emotions. Loss of control and experiences of shortcomings caused by work overload in combination with understaffing force NGRNs into an independent role at an early point in their career. Study II aimed to illuminate the meaning of NGRNs' experiences of caring for patients in EDs during the COVID-19 pandemic. Findings comprise caring being bestowed through spatial, emotional, and temporal barriers. NGRNs want to be present, relieve suffering yet describe caring during the pandemic as being a hidden activity, less acknowledged and left to the recognition of each nurse. Study III aimed to explore healthcare workers’ (HCWs’) experiences of the changed caring reality of the COVID-19 pandemic. Findings disclose traumatic experiences and having to sacrifice moral values and harbour dilemmas in isolation. Experiencing stress was significantly correlated to lower sense of coherence (SOC). Study IV aimed to explore nurses’ lived experiences of stress in the transformed caring reality during the COVID-19 pandemic. The interpreted meaning comprises the dilemma of enduring the unbearable, meaning having to silence one’s inner ethical, caring compass. In conclusion, stress in caring during the COVID-19 pandemic from a nurse perspective, can be understood as a caring struggle entailing bodily, knowledge, and ethical stress in a search for meaning that might be found in togetherness with patients, with colleagues, with dear ones and in nature.

Abstract [sv]

Covid-19-pandemin innebar genomgripande förändrade förhållanden inom svensk akutsjukvård och lite är känt om sjuksköterskors erfarenheter av den stress de utsattes för. Den här avhandlingens övergripande syfte var att utforska sjuksköterskors erfarenheter av stress i vårdandet i akutmiljöer på sjukhus under Covid-19-pandemin. Det empiriska materialet bestod av individuella djupintervjuer och en webbaserad enkät. Guidad av ett livsvärldsperspektiv på sjuksköterskors erfarenheter genomfördes tre studier med kvalitativa metoder (I, II, IV) och en med mixad metod (III). Avhandlings resultat belyser nyutexaminerade och erfarna sjuksköterskors erfarenheter av stress i vårdandet under Covid-19-pandemin. Studie I som syftar till att beskriva nyutexaminerade sjuksköterskors erfarenheter av stress på akutmottagning under pandemin visar att dedikerade sjuksköterskor kämpar för att utvecklas till den sjuksköterska de vill vara i extraordinära situationer och med motstridiga känslor under pandemin. Förlust av kontroll och upplevelser av brister på grund av överbelastning i arbetet i kombination med underbemanning tvingar nyblivna sjuksköterskor in i en självständig roll tidigt i karriären. I studie II som syftar till att belysa innebörden av nyutexaminerade sjuksköterskors erfarenheter av att vårda patienter på akutmottagning under Covid-19-pandemin visar resultatet att sjuksköterskor vårdar genom rumsliga, emotionella och tidsmässiga barriärer. Sjuksköterskor vill vara närvarande, lindra lidande men beskriver omvårdnaden under pandemin som en dold aktivitet, mindre omtalad och lämnad till varje sjuksköterska att genomföra i mån av tid. I studie III som syftar till att utforska vårdpersonals (sjuksköterskors, läkares och undersköterskors) erfarenheter av den förändrade vårdverkligheten av Covid-19-pandemin avslöjar traumatiska upplevelser som tvingar dem att offra moraliska värderingar och bära dilemman inom sig. Erfarenhet av stress var signifikant korrelerad till lägre meningsfullhet och svåra minnen stannar kvar. I studie IV, som syftar till att utforska sjuksköterskors levda erfarenheter av stress i den förändrade vårdverkligheten under Covid-19-pandemin, pekar fynden mot att sjuksköterskor ställdes inför dilemmat att uthärda det outhärdliga och tysta sin inre etiska kompass om vad som utgör god vård. Sammanfattningsvis från sjuksköterskors perspektiv kan stress i vården under Covid-19-pandemin förstås som en vårdandets kamp som innebär kroppslig (fysisk, psykisk och andlig), kunskaps- och etisk stress i sökandet efter mening. Mening finns i gemenskap, med patienter, med kollegor, med nära och kära och i naturen.

Place, publisher, year, edition, pages
Eskilstuna: Mälardalens universitet, 2024
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 406
Keywords
Compassion; Ethical stress; Lifeworld; Moral stress; Newly graduated registered nurses; Recovery; Stress of conscience; Stress-related ill health; Suffering
National Category
Nursing
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-66373 (URN)978-91-7485-644-6 (ISBN)
Public defence
2024-05-24, C3-003, Mälardalens universitet, Eskilstuna, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2024-04-05 Created: 2024-04-05 Last updated: 2024-05-03Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textScopus

Authority records

Carnesten, Hillewivon Heideken Wågert, PetraWiklund Gustin, LenaToivanen, SusannaSkoglund, KarinAndreae, Christina

Search in DiVA

By author/editor
Carnesten, Hillewivon Heideken Wågert, PetraWiklund Gustin, LenaToivanen, SusannaSkoglund, KarinJaarsma, TinyAndreae, Christina
By organisation
Health and Welfare
In the same journal
Journal of Advanced Nursing
Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 59 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf