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      Nurses’ Caring Experiences in COVID-19 Pandemic: A Systematic Review of Qualitative Research

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          Abstract

          Nurses, as front-line care providers, strive to offer adequate care to their clients. They have acquired valuable experiences during the COVID-19 pandemic that enhance the nursing profession. This study aimed to explore nurses' caring experiences in the COVID-19 pandemic. This is a qualitative meta-aggregative systematic review. Electronic databases (Google Scholar, PubMed, Web of Science, CINHAL) in English were searched to find out the meaningful subjective data on the COVID-19 pandemic. The inclusion criteria were studies published in English related to nurses' caring experiences in the COVID-19 pandemic. Seventeen qualitative studies with several approaches were included. Three key themes were identified from the studies: Weaknesses and strengths of nursing at the beginning of the pandemic, Nursing beyond challenges related to the pandemic, and Family and career challenges.

          Nurses face different challenges in caring for patients with COVID-19 that benefit the health and nursing professions. Governments, policymakers, and managers have to support nurses during and after the pandemic. Without enough support, nurses are likely to experience significant psychological issues that can lead to burnout and frustration.

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          Methods for the thematic synthesis of qualitative research in systematic reviews

          Background There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. Methods We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. Results We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses. Conclusion We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.
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            Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review

            Background The coronavirus disease (COVID-19) has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. As of 31 January 2020, this epidemic had spread to 19 countries with 11 791 confirmed cases, including 213 deaths. The World Health Organization has declared it a Public Health Emergency of International Concern. Methods A scoping review was conducted following the methodological framework suggested by Arksey and O’Malley. In this scoping review, 65 research articles published before 31 January 2020 were analyzed and discussed to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus. The research domains, dates of publication, journal language, authors’ affiliations, and methodological characteristics were included in the analysis. All the findings and statements in this review regarding the outbreak are based on published information as listed in the references. Results Most of the publications were written using the English language (89.2%). The largest proportion of published articles were related to causes (38.5%) and a majority (67.7%) were published by Chinese scholars. Research articles initially focused on causes, but over time there was an increase of the articles related to prevention and control. Studies thus far have shown that the virus’ origination is in connection to a seafood market in Wuhan, but specific animal associations have not been confirmed. Reported symptoms include fever, cough, fatigue, pneumonia, headache, diarrhea, hemoptysis, and dyspnea. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. To date, no specific antiviral treatment has proven effective; hence, infected people primarily rely on symptomatic treatment and supportive care. Conclusions There has been a rapid surge in research in response to the outbreak of COVID-19. During this early period, published research primarily explored the epidemiology, causes, clinical manifestation and diagnosis, as well as prevention and control of the novel coronavirus. Although these studies are relevant to control the current public emergency, more high-quality research is needed to provide valid and reliable ways to manage this kind of public health emergency in both the short- and long-term.
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              The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study

              Summary Background In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak. Methods We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. Findings We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was “being fully responsible for patients' wellbeing—‘this is my duty’”. Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was “challenges of working on COVID-19 wards”. Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was “resilience amid challenges”. Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience. Interpretation The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. Funding National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.
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                Author and article information

                Journal
                Health Sci Rev (Oxf)
                Health Sci Rev (Oxf)
                Health Sciences Review (Oxford, England)
                The Author(s). Published by Elsevier Ltd.
                2772-6320
                2772-6320
                21 May 2022
                21 May 2022
                : 100030
                Affiliations
                [1 ]PhD in nursing, associate professor, Department of Medical Surgical, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
                [2 ]Associated Professor of Maternal Fetal Medicine Zabol, Medicinal Plants Research center Zabol University of medical Sciences, Zabol, Iran
                [3 ]Department of Geriatric Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Geronotological Care Center, Bojnurd, Iran
                [4 ]Ph.D. in Health Information Management, Assistant Professor, Department of Health Information Technology, School of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran.
                [5 ]Instructor, Department of Medical Surgical, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
                [6 ]Instructor, Department of Midwifery, School of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
                Author notes
                [* ]Correspondence author. Faculty of Nursing & Midwifery, Zabol University of Medical Sciences, Ferdosi shargi St., zabol, Iran, Pobox: 9861734184, Telephone: +985432224101, Fax: +985432223943
                Article
                S2772-6320(22)00019-8 100030
                10.1016/j.hsr.2022.100030
                9123825
                35615410
                8ecbb514-b046-43b7-9381-6f77d700dfe0
                © 2022 The Author(s). Published by Elsevier Ltd.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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                nursing care,qualitative synthesis,nurse,experiences,covid-19,pandemics

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