Frontline healthcare workers experiences and challenges with in-person and remote work during the COVID-19 pandemic: A qualitative study.

The COVID-19 pandemic created new and exacerbated existing stressors for frontline healthcare workers. Despite being disproportionately affected by COVID-19, little is known about the experiences of frontline healthcare workers serving marginalized populations in community settings. We used qualitative descriptive methods to understand the experiences of 12 frontline healthcare workers (HCWs) supporting primarily underserved populations in outpatient settings during COVID-19. Interviews were conducted from March to April 2021. Interviews were held virtually via Zoom using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and uploaded into NVivo 12 qualitative data analysis software. The transcripts were dually coded by members of the research team and a thematic analysis was conducted. Four major themes from the interviews were identified: stressors and burnout, coping strategies, organizational support, and recommendations. HCWs described how the early adjustment period to the pandemic created new challenges as they attempted to navigate changes in the workplace and altered responsibilities at home. HCWs felt largely unsupported by their organizations as they attempted to cope with stressors. Organizational support programs and resources often did not meet frontline workers' needs, and sentiments of unappreciation from leadership contributed to feelings of burnout and frustration as pandemic-related challenges persisted and evolved. Despite encountering numerous stressors at work and home, resulting from pandemic-related disruptions, frontline HCWs continued to provide care for their clients while navigating emerging challenges. Health organizations should include HCWs in decision-making processes when implementing support systems for workers during times of crisis.

Sims H ，Alvarez C ，Grant K ，Walczak J ，Cooper LA ，Ibe CA ... -  《Frontiers in Public Health》

Perceived barriers to the process of COVID-19 control among frontline healthcare workers in South Korea: a qualitative study.

This study aimed to explore barriers to disease control perceived by frontline healthcare workers (HCWs) working in community settings during the COVID-19 pandemic in South Korea. A qualitative study was conducted using semistructured focus group interviews. All interviews were conducted in Korean on Zoom between October and November 2020, audio-recorded and transcribed for reflexive thematic analysis. All participants were working in Gyeonggi-do, the most populous province in South Korea. The province had the second-highest COVID-19 infection rates at the time of the interview. Participants serving as HCWs in Gyeonggi Province were eligible to participate in the study. A total of 20 HCWs comprised of public health doctors and professional epidemiologists agreed to participate in the study. Four themes were generated. Each theme described how these barriers affected a disease control process: (1) 'uncooperative public and unprepared community health centre' delayed the investigation of newly diagnosed COVID-19 cases; (2) 'uncoordinated disease control system' impeded the collection and analysis of digital data; (3) 'the gap between responsibilities and capabilities' hindered the classification of close and casual contacts; and (4) 'conflicts with persons who have different interests and priorities' hampered epidemiological decision-making. Our study found that frontline HCWs experienced various challenges disrupting their work performance to control COVID-19. We provide several recommendations, such as providing HCWs with systematic interview skill training, strengthening patient information security systems, providing sufficient resources, securing a regular workforce, collecting the field experiences of HCWs, implementing task-shifting, and having regular stakeholder meetings. These strategies may promote work capacity among the frontline HCWs and subsequently strengthen emergency preparedness.

Kwon S ，Kang BA ，You M ，Lee H ... -  《BMJ Open》

"Why Am I Even Here If I Can't Save the Patients?": The Frontline Healthcare Workers' Experience of Burnout during COVID-19 Pandemic in Mthatha, South Africa.

Fathuse N ，Hlongwana KW ，Ginindza TG 《-》

Experiences and views of frontline healthcare workers' family members in the UK during the COVID-19 pandemic: a qualitative study.

The COVID-19 pandemic has had a well-documented negative impact on the mental health and wellbeing of frontline healthcare workers (HCWs). Whilst no research has to date been carried out to explore the challenges experienced by the families of HCWs, some previous research has been conducted with military families, demonstrating that family members of deployed military personnel may also be affected seriously and negatively. This study aimed to explore the experiences, views, and mental health impact on frontline HCWs' families during the COVID-19 pandemic in the UK and what support the families of frontline HCWs may need. Close family members and friends of HCWs were interviewed. Transcripts were analysed in line with the principles of reflexive thematic analysis. We completed fourteen interviews with three siblings, one mother, one friend, and nine spouses of HCWs. Family members were highly motivated to support healthcare workers and felt an intense sense of pride in their work. However, they also experienced increased domestic responsibilities and emotional burden due to anxiety about their loved ones' work. The fact that sacrifices made by family members were not noticed by society, the anxiety they felt about their family's physical health, the impact of hearing about traumatic experiences, and the failure of healthcare organisations to meet the needs of the HCWs all negatively affected the family members. We have an ethical responsibility to attend to the experiences and needs of the families of healthcare professionals. This study emphasises the experiences and needs of family members of healthcare professionals, which have hitherto been missing from the literature. Further research is needed to hear from more parents, siblings and friends, partners in same sex relationships, as well as children of HCWs, to explore the variety of family members and supporters' experiences more fully. • COVID19 has impacted families of HCWs as well as workers themselves. They have experienced more anxiety, increased practical burden, significant physical health risks and been exposed vicariously to workers' traumatic experiences. We must ensure HCW families are better supported.

Tekin S ，Glover N ，Greene T ，Lamb D ，Murphy D ，Billings J ... -  《European Journal of Psychotraumatology》

Puerto Rican healthcare workers' perspectives on the impact of COVID-19 pandemic on their role, patient care, and mental health.

To explore the personal and work-related stressors of healthcare workers in Puerto Rico and the organizational support they received during the pandemic. We used a qualitative descriptive design and from April - November, 2021, conducted semi-structured individual interviews with Puerto Rican frontline healthcare workers (n = 12) and supervisors (n = 5). Thematic analysis revealed five major themes: (a) Organizations' response to COVID-19; (b) increased complexity of patients; (c) intensified work and psychological demand for nurses; (d) overwhelmed and overworked; and (e) recommendations for healthcare leadership. Participants explained that their organizations' responses to COVID-19 were insufficient for  meeting the demands and acuity of the patients. Closure of outpatient services contributed to people presenting to hospitals with exacerbated chronic conditions - especially the elderly. With COVID-19 precautions prohibiting family visitation, nurses became responsible for total care, including emotional support of patients. In addition, the shortage of staff contributed to nurses assuming greater workloads, feeling overwhelmed and overworked, and healthcare worker resignations. Given their experiences, healthcare workers recommended that healthcare leadership show more appreciation for staff, demonstrate empathy, include frontline workers in decision-making, and provide mental health resources for staff. This study with Puerto Rican frontline workers and supervisors uncovers the multiple stressors experienced during the COVID-19 pandemic. Our findings underscore the need for prioritizing the well-being of healthcare workers, preparing healthcare leadership on how to support staff, and mandating nurse-to-patient ratios. Healthcare workers explained the barriers they experienced for providing quality care to their patients. They also presented recommendations for healthcare leadership to facilitate supporting frontline workers, which ultimately contributes to optimal patient care.

Alvarez C ，Diaz-Ramos N ，Quiles R ，Sanchez-Roman MJ ，Weeks K ，Cooper LA ... -  《-》