Nurses' coping strategies caring for patients during severe viral pandemics: A mixed-methods systematic review.

BACKGROUND: Nurses play an essential role in responding to severe viral disease which bring considerable challenges to their personal and professional well-being. This subsequently can affect the delivery of care and healthcare systems' organisational capacity to respond. Understanding nurses' experiences of these challenges will help inform healthcare policies. AIM: To explore the experiences and coping strategies of nurses caring for patients during severe viral disease pandemics. DESIGN: A mixed-methods systematic review informed by the Joanna Briggs Institute (JBI) methodology. METHODS: A mixed-methods systematic review. Five electronic databases Medline, CINAHL, PsychInfo, ASSIA and Scopus were searched on 4th April 2021. Results were reported in accordance with PRISMA. The findings were analysed and reported in the context of the Self-Regulatory Common-Sense Model. RESULTS: In total, 71 peer-review primary research articles describing nurses' experiences of caring for patients during SARS, MERS, Swine flu H1N1, Avian influenza or SARS-CoV-2 / COVID-19 published in English from 2003 to 2021 were included. We found links between nurses' perception of the health threats, their emotional reactions, and coping strategies. Perceived health threats were influenced by organisational factors including frequent changes in clinical guidelines and workplace protocols, onerous workloads and working hours, unavailability of PPE, and lack of knowledge and training in pandemic management. These impacted nurses' physical, psychological and social well-being. Nurses also reported helpful and unhelpful coping strategies to manage the health threats. CONCLUSIONS: It is vital for stakeholders, policymakers, government and healthcare institutions to recognise and monitor the wider impact on healthcare workers from health emergencies. In addition, support to develop and implement effective systems and individual mechanisms to offset the anticipated impact pre and post pandemics/epidemics is needed. Our findings can inform those strategies for similar future health emergencies. RELEVANCE TO CLINICAL PRACTICE: Nurses are often the first point of contact in providing direct care to patients, hence they are at high risk of being infected. The findings from this review can help managers and policymakers in developing programmes to enhance resilience in the nursing workforce. NO PATIENT OR PUBLIC CONTRIBUTION: This was a literature review study.

Registered Nurses' and nursing students' perspectives on moral distress and its effects: A mixed-methods systematic review and thematic synthesis.

AIM: To examine Registered Nurses (RNs') and nursing students' perspectives on factors contributing to moral distress and the effects on their health, well-being and professional and career intentions. DESIGN: Joanna Briggs Institute mixed-methods systematic review and thematic synthesis. Registered in Prospero (Redacted). METHODS: Five databases were searched on 5 May 2021 for studies published in English since January 2010. Methodological quality assessment was conducted in parallel with data extraction. RESULTS: Searches yielded 2343 hits. Seventy-seven articles were included. Most were correlational design and used convenience sampling. Studies were mainly from North America and Asia and situated in intensive and critical care settings. There were common, consistent sources of moral distress across continents, specialities and settings. Factors related to perceived inability or failure to enact moral agency and responsibility in moral events at individual, team and structural levels generated distress. Moral distress had a negative effect on RNs health and psychological well-being. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution to this systematic review.

An interpretative phenomenological analysis of young men's experiences of addressing their sexual health and the importance of researcher reflexivity.

BACKGROUND: Incidence of sexually transmitted infections has increased in both young men and young women. Young men do not access sexual health services in the same numbers as young women, this study sought to discover young men's experiences. AIMS: This paper reports one overarching theme from an interpretative phenomenological study that sought to discover the experiences of young males (aged 20-24) addressing or failing to address their sexual health. Owing to the sensitive subject under investigation, these participants were hard to reach for research purposes. METHODS: This study used interpretative phenomenological analysis and the researcher was a young female (aged 20-30), in contrast with participants. This affected data collection and analysis so the importance of reflexivity in interpretative phenomenological analysis is discussed here. RESULTS: Six superordinate themes were identified: sexual health knowledge and attitudes; feelings about masculinities; communication; feelings about healthcare; feelings about working; and keeping fit. From these, three overarching themes were developed, these reflect the depth of data analysis undertaken. One of these themes, the 'hidden moral code', and the importance of researcher reflexivity in its identification are discussed here. CONCLUSIONS: It is suggested that interpretative phenomenological analysis is a particularly suitable method for nursing research, which allows and embraces the influence and attributes of the researcher. This paper considers one superordinate theme in depth, chosen because the researcher's attributes are a significant factor in its recognition.

Conducting research into hidden or hard-to-reach populations.

AIM: To explore the problems involved in conducting research with populations that are hidden or hard to reach, and to suggest strategies to recruit participants. BACKGROUND: Conducting research with populations that are hidden or hard to reach can pose problems. Recruitment is, by definition, difficult and it is impossible to determine if participants are representative of these populations. Nevertheless, it is important to extend research strategies to include such groups, particularly when developing targeted services. DATA SOURCES: This methodological paper draws on a research study undertaken as part of the author's doctoral studies, in which seven men aged 16-20 years old took part in semi-structured interviews. DISCUSSION: Several factors make research with populations that are hidden and hard to reach difficult, yet information from such populations is essential in identifying strategies that address the needs of the population as a whole. Researchers should adopt methods that allow them to engage with, rather than exclude, these populations, but this requires a critical acknowledgement and evaluation of the potential limitations of the chosen strategies. CONCLUSION: Problems with sampling must be examined and discussed. Well-evaluated but limited research data are preferable to no information from groups that are hidden and hard to reach. IMPLICATIONS FOR RESEARCH OR PRACTICE: Engaging these populations in research can further professionals' understanding of service provision.