From expert to novice and back: a qualitative study of interprofessional collaboration and the experiences of frontline healthcare professionals during the first wave of COVID-19.

BACKGROUND: The global coronavirus disease 2019 pandemic put extreme pressure on healthcare systems worldwide, forcing a heavy workload on healthcare professionals. Frontline treatment and care for patients with coronavirus disease 2019 compelled healthcare professionals to rapidly adapt to new working conditions. This study explores the experiences of frontline healthcare professionals to learn more about how frontline work affects their learning and skills development but also interprofessional collaboration during a pandemic. METHODS: In-depth, one-to-one semi-structured interviews were conducted with 22 healthcare professionals. A broad interdisciplinary group, the participants were employed in public hospitals in four of Denmark's five regions. Using a reflexive methodology for the data analysis allowed reflexive interpretation when interpreting subjects and interpreting the interpretation. RESULTS: The study identified two empirical themes: into the unknown and in the same boat, which we critically interpreted using learning theory and theory on interprofessionalism. The study found that the healthcare professionals moved from being experts in their own fields to being novices in the frontline of the pandemic, and then back to being experts based on interprofessional collaboration that included shared reflection. Working in the frontline was imbued with a unique atmosphere in which workers were equals and functioned interdependently, the barriers normally obstructing interprofessional collaboration set aside to focus on combating the pandemic. CONCLUSIONS: This study reveals new insights regarding knowledge on frontline healthcare professionals in terms of learning and developing new skills, as well as the importance of interprofessional collaboration. The insights contributed to the understanding of the importance of shared reflection and how the development of expertise was a socially embedded process where discussions were possible without fear of being ridiculed and healthcare professionals were willing to share their knowledge.

The marked body - a qualitative study on survivors embodied experiences of a COVID-19 illness trajectory.

BACKGROUND: Research on COVID-19 has reported data on epidemiology and pathophysiology but less about what it means to be a person living through this illness. Research involving the patients' perspectives may help to improve healthcare professionals' understanding of ways to support patients. AIMS: To gain in-depth understanding of the meaning of a COVID-19 illness trajectory from the patients' perspective. METHODS: Fifteen participants who had undergone an illness trajectory due to confirmed COVID-19 infection participated in individual qualitative interviews. Data collection, analysis and interpretation were inspired by Ricoeur's philosophy and Merleau-Ponty's phenomenology of perception and embodiment has been applied as a theoretical frame. FINDINGS: Being infected with coronavirus is expressed as an experience in which the participants oscillate between relief, security, imprisonment and raw fear. A predominant focus on the physical dimensions of the diseased body was found in the encounters between patient and healthcare system, and distance may furthermore be a consequence of use of protective equipment. Stigma and fear of infection were also expressed. After COVID-19, an overwhelming feeling of a door opening to freedom is perceived. However, the body is marked, and bears witness to decay from this insidious and frightening virus. The responsibility for assessing their bodily symptoms is placed with the individual patients themselves, who feel lonely and fearful and this keeps them indoors. CONCLUSIONS: During a COVID-19 illness, trajectory concerns about the unknown course of this disease are highlighted. Isolation is confrontational; however, a companionship between patients might emerge. The study shed light on an unavoidable gap between the patients and healthcare professionals due to the use protective equipment. After COVID-19, the body is labelled as something others fear and become a symbol of awe and alienation for others.

Like soldiers on the front - a qualitative study understanding the frontline healthcare professionals' experience of treating and caring for patients with COVID-19.

BACKGROUND: While people in the societies must stay home to reduce spread of the newly discovered coronavirus, healthcare professionals do the exact opposite. For them the coronavirus is an enemy that should be defeated as a part of one's job. They do, however, also have a daily life with family while doing their work obligations. The purpose of this study was to gain an in-depth understanding of the frontline healthcare professionals' experience of balancing work life and family life during the COVID-19 pandemic. METHODS: A sample of 22 frontline healthcare professionals caring for patients with COVID-19 was included and interviewed individually from May to August 2020. Ricoeur's phenomenological hermeneutical philosophy inspired the methodology in this study. RESULT: Frontline healthcare professionals treating and caring for patients with COVID-19 are, voluntarily or involuntarily, forced to be ready to change departments as well as being ready to face the unknown coronavirus. The frontline work leads to feelings of being abandoned among their families and friends due to the threat of bringing the infection home and spreading the virus. Although healthcare professionals are facing a working life filled with uncertainty and unpredictability impacting their family life, they express opposing feelings of being a part of something bigger. CONCLUSIONS: The work life balance for these healthcare professionals is threatened by changes in professional responsibilities, working hours and shifts. Fear of bringing the infection home challenges them ethically and creates a distance between healthcare professionals and their families, leading to a conflict within the individual if their work on the frontline is worth it - or if it is a too high price to pay. Despite facing a working life filled with uncertainty and unpredictability the healthcare professionals are being a part of something bigger that contributes to a fighting spirit and professional pride outweighing the negative consequences; like being soldiers on the front.

Testing for COVID-19 regulates behavior in the general population: A qualitative study of experiences of awaiting test result for COVID-19.

AIM: This study aimed to explore experiences of awaiting a test result for COVID-19 among individuals from the general population. METHODS: Fifteen participants were recruited from COVID-19 testing tents in the Capital Region of Denmark in March and April 2020. A phenomenological-hermeneutic approach inspired by Ricoeur's theory of interpretation was used. RESULTS: The analysis revealed five themes. (1) The participants' experiences of awaiting a COVID-19 test result illuminated concerns related to infecting others rather than their own health. Experiences of guilt for not taking all possible precautions to avoid the spread of COVID-19 were described and thoughts of potentially having exposed others bothered the participants. (2) The test result would guide their precautions and therefore regulate behaviour at home and in society. (3) Even though the participants did not take all possible precautions they made some changes in their everyday lives. (4) Leaving the individual with the responsibility for taking precautions based on their subjective experiences created feelings of insecurity and uncertainty. (5) Being met by health professionals was an experience that meant for the particpants that behaviour towards limiting the infection became very clear. The seriousness experienced around the test situation facilitated this attitude and behaviour in the participants. Conclusion: This study illuminated how testing for COVID-19 regulates behavior in the general population. The testing was both important for the individual's cautious behavior towards other people, work and in getting around in society but also a way to regulate behavior from a societal perspective to quicken suppression and avoid transmission of COVID-19.

It's Not Just a Virus! Lived Experiences of People Diagnosed With COVID-19 Infection in Denmark.

The purpose of this study was to explore the lived experiences of people infected with the coronavirus in Denmark during the first phase of the pandemic. An explorative qualitative design underpinned by a phenomenological hermeneutical approach was applied. Fifteen individuals with confirmed COVID-19 infection were included and interviewed individually by telephone. Analyses were inspired by Ricoeur's interpretation theory. The study illuminated how being diagnosed with COVID-19 was experienced not just a virus infecting the participants' biology; it was also a threat to their existence and bodily perception as well as an interference in ordinary social relationships. Beyond a supportive approach, the participants experienced being a special case where people around them acted with excitement and curiosity. Responsibility for existential and emotional care after COVID-19 has been placed with the individual ill person and within their ordinary social circle. We suggest follow-up and rehabilitation for people during and after COVID-19 to support recovery.

A stoic and altruistic orientation towards their work: a qualitative study of healthcare professionals' experiences of awaiting a COVID-19 test result.

BACKGROUND: Extensive measures to reduce person-to-person transmission of COVID-19 are required to control the current outbreak. Special attention is directed at healthcare professionals as reducing the risk of infection in healthcare is essential. The purpose of this study was to explore healthcare professionals' experiences of awaiting a test result for a potential COVID-19 infection. METHODS: Qualitative interviews with 15 healthcare professionals were performed, underpinned by a phenomenological hermeneutical analytical framework. RESULTS: The participating healthcare professionals' experiences of awaiting a COVID-19 test result were found to be associated with a stoic and altruistic orientation towards their work. These healthcare professionals presented a strong professional identity overriding most concerns about their own health. The result of the coronavirus test was a decisive parameter for whether healthcare professionals could return to work. The healthcare professionals were aware that their family and friends were having a hard time knowing that the COVID-19 infection risk was part of their jobs. This concern did not, however, cause the healthcare professionals to falter in their belief that they were doing the right thing by focusing on their core area. The threat to own health ran through the minds of the healthcare professionals occasionally, which makes access to testing particularly important. CONCLUSION: The participating healthcare professionals had a strong professional identity. However, a discrepancy between an altruistic role as a healthcare professional and the expectations that come from the community was illuminated. A mental health coronavirus hotline for healthcare professionals is suggested.