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      A divided community: A descriptive qualitative study of the impact of the COVID‐19 pandemic on nurses and their relationships

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          Abstract

          Aims

          To identify the personal and professional impact of the COVID‐19 pandemic on clinical nurses with regard to personal and workplace safety, personal and professional relationships and perceptions of their team, organization and community, and to understand lessons learned to inform future responses to pandemics or global emergencies.

          Design

          Qualitative, descriptive free‐text surveys, informed by appreciative inquiry.

          Methods

          Nurses working in adult COVID‐ and non‐COVID cohort medical‐surgical and intensive care units, outpatient cancer and general surgery centres were invited to participate. Data were collected between April and October 2021 and analysed using summative content analysis.

          Results

          In total, 77 participants completed free‐text surveys. Five themes were identified: (1) Constraints on nursing: barriers in communication and diminished patient safety and quality of care; (2) Navigating uncertainty: the emotional toll of the pandemic; (3) Team solidarity, renewed appreciation and reaffirming purpose in nursing work; (4) Enhanced trust versus feeling expendable; and (5) Increased isolation and polarization within communities. Nurses described a perceived negative impact on a number of their relationships, including with patients, employer and community. They described a huge emotional toll that included feelings of isolation and polarization. While some nurses described feeling supported by their team and employer, others described feeling expendable.

          Conclusion

          Nurses’ responses provided insights into negative emotional experiences during the pandemic due to heightened uncertainty and fear, and also the importance of support received from peers, colleagues and their employer. Nurses experienced feelings of isolation and polarization within their communities. The varied responses reflect the importance of societal solidarity when faced with global emergencies, and the need for nurses to feel valued by their patients and employer.

          Impact

          Effective responses to public health emergencies require individuals and communities to work together to achieve collective goals. Efforts to retain nurses are critical during global emergencies.

          Patient or Public Contribution

          No patient and public involvement.

          Related collections

          Most cited references40

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          Three approaches to qualitative content analysis.

          Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
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            Standards for reporting qualitative research: a synthesis of recommendations.

            Standards for reporting exist for many types of quantitative research, but currently none exist for the broad spectrum of qualitative research. The purpose of the present study was to formulate and define standards for reporting qualitative research while preserving the requisite flexibility to accommodate various paradigms, approaches, and methods.
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              Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study.

              Qualitative content analysis and thematic analysis are two commonly used approaches in data analysis of nursing research, but boundaries between the two have not been clearly specified. In other words, they are being used interchangeably and it seems difficult for the researcher to choose between them. In this respect, this paper describes and discusses the boundaries between qualitative content analysis and thematic analysis and presents implications to improve the consistency between the purpose of related studies and the method of data analyses. This is a discussion paper, comprising an analytical overview and discussion of the definitions, aims, philosophical background, data gathering, and analysis of content analysis and thematic analysis, and addressing their methodological subtleties. It is concluded that in spite of many similarities between the approaches, including cutting across data and searching for patterns and themes, their main difference lies in the opportunity for quantification of data. It means that measuring the frequency of different categories and themes is possible in content analysis with caution as a proxy for significance. © 2013 Wiley Publishing Asia Pty Ltd.
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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                Journal of Advanced Nursing
                Journal of Advanced Nursing
                Wiley
                0309-2402
                1365-2648
                December 2023
                June 26 2023
                December 2023
                : 79
                : 12
                : 4635-4647
                Affiliations
                [1 ] Center for Bioethics Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Cleveland Ohio USA
                [2 ] Stanley S. Zielony Institute for Nursing Excellence Cleveland Clinic Cleveland Ohio USA
                [3 ] Nursing Ethics Faculty Fellow, Center for Bioethics Cleveland Clinic Cleveland Ohio USA
                [4 ] Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Marymount Hospital Garfield Heights Ohio USA
                [5 ] Center for Neurological Restoration Neurological Institute, Cleveland Clinic Cleveland Ohio USA
                [6 ] Office of Nursing Research and Innovation Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic Health System Cleveland Ohio USA
                Article
                10.1111/jan.15747
                e6326a4b-0b10-40b6-a300-94409780dcb4
                © 2023

                http://creativecommons.org/licenses/by-nc-nd/4.0/

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