Healthcare staff experiences on the impact of COVID-19 on emergency departments: a qualitative study.

The COVID-19 pandemic has had a major impact on the access and delivery of healthcare services, posing unprecedented challenges to healthcare staff worldwide. Frontline healthcare staff faced unique stressors and challenges that impact their well-being and patient care. This qualitative study aimed to explore the experiences and perspectives of frontline ED healthcare staff on emergency care services during the COVID-19 pandemic, providing valuable insights into the challenges, adaptations, and lessons learned in delivering emergency care. This study utilized a qualitative approach. In-depth semi-structured interviews were conducted with 30 ED healthcare staff from three different hospitals located in Turkey between 15/03/2022 and 30/04/2022. Convenience sampling was used to recruit participants. The duration of the interviews ranged from 28 to 37 min. Data saturation was reached as no new information was gathered. The data were analyzed using the thematic analysis method. NVivo software was used to manage the data analysis process. Member check was carried out to ensure that the generated themes conformed to the participants' views. 15 sub-themes under three themes emerged: (1) the impact of COVID-19 on emergency care services, including sub-themes of "introducing a COVID-19 unit in the ED", "changes in the routine functioning of EDs", "changes in the number of ED visits", "quality of care", "resources", and "increased workload"; (2) the psychological effects of COVID-19 on ED healthcare staff, including sub-themes of "staying away from family", "fear", "society's perspective on healthcare professionals", "morale-staff burnout", "psychological and emotional effects", and "unable to receive sufficient support"; and (3) the difficulties faced by ED healthcare staff, including sub-themes of "difficult working conditions", "community-based effects difficulties", and "COVID-19 is an unknown situation". Staff burnout threatens the quality of patient care and staff retention, and therefore this should be addressed by ED directors and leaders. This study could inform appropriate stakeholders regarding lessons learned from COVID-19 to better manage future pandemics. Learning from such lived experiences and developing appropriate interventions to minimize the difficulties faced during COVID-19 would allow better management of future pandemics. This study calls for a reform to address the challenges faced by healthcare staff, improve the overall response to public health crises, and enhance the resilience of healthcare systems for future crises.

Butun A 《BMC HEALTH SERVICES RESEARCH》

The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff.

Conlon C ，McDonnell T ，Barrett M ，Cummins F ，Deasy C ，Hensey C ，McAuliffe E ，Nicholson E ... -  《BMC HEALTH SERVICES RESEARCH》

Documenting response to COVID-individual and systems successes and challenges: a longitudinal qualitative study.

This study aimed to document the evolution of perceptions of frontline healthcare workers (FHCW) regarding their well-being and the quality of health systems' response to the COVID-19 pandemic over four months in Pakistan. We conducted this prospective longitudinal qualitative study during the four months (June-September 2020) coinciding with the peak and trough of the first wave of Pakistan's COVID-19 pandemic. We approached frontline healthcare workers (physicians and nurses) working in emergency departments (ED) in two hospitals using the WhatsApp group of the Pakistan Society of Emergency Physicians (PSEM). Participants were asked to self-record their perception of their wellness and their level of satisfaction with the quality of their hospitals' response to the pandemic. We transcribed, translated, and analysed manually using MAXQDA 2020 software and conducted the thematic analysis to identify themes and sub-themes. We invited approximately 200 FHCWs associated with PSEM to participate in the study. Of the 61 who agreed to participate, 27 completed the study. A total of 149 audio recordings were received and transcribed. Three themes and eight sub-themes have emerged from the data. The themes were individual-level challenges, health system-level challenges, and hope for the future. Sub-themes for individual-level challenges were: fear of getting or transmitting infection, feeling demotivated and unappreciated, disappointment due to people's lack of compliance with COVID-19 protocols, physical exhaustion, and fatigue. For the healthcare system, sub-themes were: Infrastructure, logistics, management, and communications response of the hospital/healthcare system and financial stressors. For sub-themes under hope for the future were the improved disease knowledge and vaccine development. The overall perceptions and experiences of FHCWs evolved from fear, grief, and negativity to hope and positivity as the curve of COVID-19 went down. This study shows that the individuals and systems were not prepared to deal with the challenges of the COVID-19 pandemic. The findings highlight the challenges faced by individuals and health systems during the wake of the Covid-19 pandemic. The healthcare workers were emotionally and physically taxed, while the health systems were overwhelmed by COVID-19. The overall perceptions of FHCWs evolved with time and became negative to positive as the curve of COVID-19 went down during the first wave of COVID-19 in Pakistan.

Shaukat N ，Ali DM ，Barolia R ，Hisam B ，Hassan S ，Afzal B ，Khan AS ，Angez M ，Razzak J ... -  《BMC HEALTH SERVICES RESEARCH》

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》

Perceptions, challenges and experiences of frontline healthcare providers in Emergency Departments regarding Workplace Violence during the COVID-19 pandemic: A protocol for an exploratory qualitative study from an LMIC.

Workplace violence (WPV) against Healthcare Workers (HCWs) has emerged as a global issue. Emergency Department (ED) HCWs as front liners are more vulnerable to it due to the nature of their work and exposure to unique medical and social situations. COVID-19 pandemic has led to a surge in the number of cases of WPV against HCWs, especially against ED HCWs. In most cases, the perpetrators of these acts of violence are the patients and their attendants as families. The causes of this rise are multifactorial; these include the inaccurate spread of information and rumours through social media, certain religious perspectives, propaganda and increasing anger and frustration among the general public,ED overcrowding, staff shortages etc. We aim to conduct a qualitative exploratory study among the ED frontline care providers at the two major EDs of Karachi city. The purpose of this study is to determine the perceptions, challenges and experiences regarding WPV faced by ED healthcare providers during the COVID-19 pandemic. For this research study, a qualitative exploratory research design will be employed using in-depth interviews and a purposive sampling approach. Data will be collected using in-depth interviews from study participants working at the EDs of Jinnah Postgraduate Medical Centre (JPMC) and the Aga Khan University Hospital(AKUH) Karachi, Pakistan. Thestudy data will be analysed thematically using NVivo V.12 Plus software. The ethical approval for this study was obtained from the Aga Khan University Ethical Review Committee and from Jinnah postgraduate Medical Center (JPMC). The results of the study will be disseminated to the scientific community and to the research subjects participating in the study.The findings of this study will help to explore the perceptions of ED healthcare providers regarding WPV during the COVID-19 pandemic and provide a better understanding of study participant's' challenges concerning WPV during the COVID-19 pandemic.

Naseem M ，Shahil Feroz A ，Arshad H ，Ashraf S ，Asim M ，Jamali S ，Mian A ... -  《BMJ Open》