A longitudinal qualitative exploration of victorian healthcare workers' and organisations' evolving views and experiences during COVID-19.

The COVID-19 pandemic has profoundly impacted individuals, society, and healthcare organisations worldwide. Recent international research suggests that concerns, needs, and experiences of healthcare workers (HCWs) have evolved throughout the pandemic. This longitudinal qualitative study explored the evolving views and experiences of Victorian healthcare workers (HCWs) and organisational key personnel during the coronavirus disease (COVID-19) pandemic. We recruited participants from the Coronavirus in Victorian Health and Aged care workers (COVIC-HA) study cohort. We conducted two rounds of semi-structured interviews with HCWs and organisational key personnel from three different healthcare settings (hospital, aged care and primary care) in Victoria, Australia, in May-July 2021 and May-July 2022. Data were analysed thematically using trajectory and recurrent cross-sectional approaches, guided by a temporal change framework. Twelve HCWs and five key personnel from various professional roles participated in interviews at both timepoints. Expected themes derived from mid-2021 interviews (navigating uncertainty, maintaining service delivery, and addressing staff needs) evolved over time. Concerns shifted from personal health and safety to workforce pressures, contributing to HCW burnout and fatigue and ongoing mental health support needs. New themes emerged from mid-2022 interviews, including managing ongoing COVID-19 impacts and supporting the healthcare workforce into the future. Clear and consistent communication, stable guidelines and forward-looking organisational responses were considered crucial. Our longitudinal qualitative study highlighted the evolving impact of the COVID-19 pandemic on HCWs' perceptions, health and wellbeing and uncovered long-term sector vulnerabilities. Analysing HCW experiences and key personnel insights over time and across different pandemic phases provided crucial insights for policymakers to protect the healthcare workforce. Findings emphasise the need for proactive strategies that prioritise HCWs' wellbeing and workforce sustainability. Policy makers must invest in HCW health and wellbeing initiatives alongside healthcare system improvements to ensure resilience and capacity to meet future challenges. This study was approved through the Victorian Streamlined Ethical Review Process (SERP: Project Number 68,086) and registered with ANZCTR (ACTRN12621000533897) on 6 May 2021.

McGuinness SL ，Eades O ，Zhong S ，Clifford S ，Fisher J ，Kelsall HL ，Kirkman M ，Russell G ，Skouteris H ，Leder K ，COVIC-HA investigator group ... -  《BMC HEALTH SERVICES RESEARCH》

Organizational responses to the COVID-19 pandemic in Victoria, Australia: A qualitative study across four healthcare settings.

Organizational responses that support healthcare workers (HCWs) and mitigate health risks are necessary to offset the impact of the COVID-19 pandemic. We aimed to understand how HCWs and key personnel working in healthcare settings in Melbourne, Australia perceived their employing organizations' responses to the COVID-19 pandemic. In this qualitative study, conducted May-July 2021 as part of the longitudinal Coronavirus in Victorian Healthcare and Aged Care Workers (COVIC-HA) study, we purposively sampled and interviewed HCWs and key personnel from healthcare organizations across hospital, ambulance, aged care and primary care (general practice) settings. We also examined HCWs' free-text responses to a question about organizational resources and/or supports from the COVIC-HA Study's baseline survey. We thematically analyzed data using an iterative process. We analyzed data from interviews with 28 HCWs and 21 key personnel and free-text responses from 365 HCWs, yielding three major themes: navigating a changing and uncertain environment, maintaining service delivery during a pandemic, and meeting the safety and psychological needs of staff . HCWs valued organizational efforts to engage openly and honesty with staff, and proactive responses such as strategies to enhance workplace safety (e.g., personal protective equipment spotters). Suggestions for improvement identified in the themes included streamlined information processes, greater involvement of HCWs in decision-making, increased investment in staff wellbeing initiatives and sustainable approaches to strengthen the healthcare workforce. This study provides in-depth insights into the challenges and successes of organizational responses across four healthcare settings in the uncertain environment of a pandemic. Future efforts to mitigate the impact of acute stressors on HCWs should include a strong focus on bidirectional communication, effective and realistic strategies to strengthen and sustain the healthcare workforce, and greater investment in flexible and meaningful psychological support and wellbeing initiatives for HCWs.

McGuinness SL ，Josphin J ，Eades O ，Clifford S ，Fisher J ，Kirkman M ，Russell G ，Hodgson CL ，Kelsall HL ，Lane R ，Skouteris H ，Smith KL ，Leder K ... -  《Frontiers in Public Health》

Mental Health Outcomes in Australian Healthcare and Aged-Care Workers during the Second Year of the COVID-19 Pandemic.

McGuinness SL ，Johnson J ，Eades O ，Cameron PA ，Forbes A ，Fisher J ，Grantham K ，Hodgson C ，Hunter P ，Kasza J ，Kelsall HL ，Kirkman M ，Russell G ，Russo PL ，Sim MR ，Singh KP ，Skouteris H ，Smith KL ，Stuart RL ，Teede HJ ，Trauer JM ，Udy A ，Zoungas S ，Leder K ... -  《-》

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》

Health care workers' experiences during the COVID-19 pandemic: a scoping review.

COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers' (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs' experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included. 161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs' well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs' personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs' experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs' experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries. This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs' experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs' circumstances. Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.

Chemali S ，Mari-Sáez A ，El Bcheraoui C ，Weishaar H ... -  《Human Resources for Health》