Summary of a Clinical Issue: COVID-19

Reviewing the Literature
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Reviewing the Literature
Summary of Clinical Issue (200-250 words):
COVID-19 is a new infectious disease that emerged from Wuhan, China, in late 2019. The World Health Organization declared the outbreak a pandemic after its rapid spread throughout the globe. It is critical to note that the pandemic has infected millions of people worldwide, and thousands of people have died. Additionally, about 20 percent of COVID-19 patients are likely to show severe symptoms requiring critical assistance such as oxygen therapy and other related inpatient interventions offered in an intensive care unit. The outbreak of COVID-19 increased the demand for healthcare practitioners such as nurses; the continued spreading of the outbreak has increased the death rate. The workload has also increased, and risks associated with a lack of personal protective equipment increased healthcare practitioners' vulnerability. Besides, the inadequate support for nurses and other practitioners facilitates the mental burden, affecting practitioners' productivity and impacts their well-being. Some of the symptoms common among nurses caring for COVID-19 patients include depression, anxiety, burnout, and traumatic stress, among other emotional and mental challenges. Furthermore, nurses have experienced stress and trauma from a patient dying, and they are also grieving the deaths of their family members who died after contracting the diseases. In some situations, nurses may also feel isolated since they must avoid contact with their children and spouses by having them live in hotel rooms provided by the hospital to reduce the risk of spreading the virus.
PICO Question:
For nurses caring for COVID-19 patients, what is the effect of psychological support on reducing their mental and emotional struggles, compared to no intervention within one year?
Part 1: Literature Evaluation Table
Criteria

Article 1

Article 2

Article 3

APA-Formatted Article Citation With Permalink

Galehdar, N., Kamran, A., Toulabi, T. & Heydari, H. (2020). Exploring nurses' experiences of psychological distress during care of patients with COVID-19: a qualitative study. BMC Psychiatry, 20(1), 1-9. Retrieved from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02898-1#citeas

Khanal, P., Devkota, N., Dahal, M., Paudel, K. & Joshi, D. (2020). Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal. Globalization and Health, 16(1), 1-12. Retrieved from https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-020-00621-z#citeas

Lai, J., Ma, S. & Wang, Y. (2020). Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open, 3(3), e203976. Retrieved from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229

How Does the Article Relate to the PICO Question?

The article examines and explores the psychological distress experienced by nurses when caring for patients with COVID-19. The article explains that when caring for these patients, nurses may become mentally disturbed.

The article examines and evaluating the mental health outcomes for healthcare workers involved in the COVID-19 response.

The article explains that healthcare workers handling COVID-19 may be stressed. Further, it evaluates factors linked to mental health outcomes among healthcare practitioners.

Quantitative, Qualitative (How do you know?)

The research is qualitative, and the authors explain that a qualitative research method was performed and that data collected was analyzed through content analysis.
The research findings are also descriptive in nature.

This is a quantitative study. Data analysis is done statistically, and results are also presented in tabular form.

This is quantitative research; the result of the study are presented numerically.

Purpose Statement

The study aimed to examine nurses' incidents of psychological distress when attending to patients with COVID-19.

The study aimed to assess mental health outcomes among practitioners participating in COVID-19 response.

The study was aimed at examining mental health outcomes for practitioners working with COVID-19 patients.

Research Question

The research question is precise, but the research examines the type of psychological problems that nurses face.

The study question is clearly outlined, but researchers focused on determining the factors associated with insomnia, anxiety, and depression.

The research question focused on determining the factors linked to mental health issues among healthcare practitioners taking care of COVID-19 patients in China

Outcome

Worsening anxiety levels are attributed to caring for the agonizing patients. Increase fear levels as practitioners are worried about infecting their family members.

The researchers focused on three major outcomes, including anxiety, depression, and insomnia.

The main outcomes include the extent of signs of depression, anxiety and insomnia, and severity of distress.

Setting
(Where did the study take place?)

The study is set in a public hospital, and the participating nurses were associated with the Lorestan University of Medical, and they were all involved in taking care of COVID-19 patients.

The study was set in health facilities in Nepal

The study is set in 34 hospitals in China with wards for COVID-19 patients.

Sample

The sample included twenty nurses, fifteen females, and five males.

The sample size had 475 healthcare participants

The study included 1070 participants who completed the questionnaires

Method

The study employed a qualitative approach where the data collected was analyzed through a content analysis approach. Further, the data was collected through phone call interviews and analyzed through the approach proposed by Lundman and Graneheim.

The researchers utilized a cross-sectional web-based survey. 14-item Hospital Anxiety and Depression Scale was used in measuring anxiety and depression.

The study used a cross-sectional hospital-based survey, and facilities were sampled between January 29 to February 3, 2020. It included hospitals in Wuhan and other provinces.

Key Findings of the Study

The findings suggest that some of the psychological distress faced by nurses include death anxiety, fear of spreading the virus, distress about time-wasting, the occurrence of obsessive thoughts, and bad feelings about protective equipment.

The study identified factors that facilitating anxiety, depression, insomnia and include inadequate precautionary measures, the risks of contracting the pandemic, and government incentives for healthcare providers.

The study results indicated that about 50.4% of participants had depression, 44.5% had anxiety, and 34.0% and 71.5% have insomnia and distress, respectively. Practitioners in other provinces had low risks of depression than those in Wuhan.

Recommendations of the Researcher

The researchers recommend the need for having moral support from decision and policymakers to facilitate nurses' mental well-being.
Delivering enough personal protection equipment may reduce nurses' mental burden.

The researchers recommend reducing stigma for people working with COVID-19 patients to improve their well-being and improving the living arrangements of healthcare providers with health facilities.

Researchers recommend that special attention should be given to nurses and health care workers working with COVID-19 patients.

Criteria

Article 4

Article 5

Article 6

APA-Formatted Article Citation With Permalink

Kackin, O., Ciydem, E., Aci, O.S. & Kutlu, F.Y. (2020). Experiences and psychosocial problems of nurses caring for patients diagnosed with COVID-19 in Turkey: A qualitative study. International Journal of Social Psychiatry, 1-10. Retrieved from https://journals.sagepub.com/doi/full/10.1177/0020764020942788

Yang, S., Kwak, S.G.& Chang, M.C. (2020). The psychological impact of COVID‐19 on hospital workers in nursing care hospitals. Nursing Open, 8(1), 284-289. Retrieved from https://onlinelibrary.wiley.com/doi/10.1002/nop2.628

Conti, C., Fontanesi, L., Lanzara, R., Rosa, I. & Porcelli, P. (2020). Fragile heroes. The psychological impact of the COVID-19 pandemic on healthcare workers in Italy. PLoS ONE, 15(11), e0242538. Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242538

How Does the Article Relate to the PICO Question?

The study evaluates the psychosocial problems that nurses face while caring for COVID-19 patients.

The article explores the psychological stress associated with coronavirus practitioners in nursing care hospitals.

The article examines the psychological implications of COVID-19 on healthcare workers.

Quantitative, Qualitative (How do you know?)

The study is qualitative because the results of the study are descriptive.

A quantitative study; data analysis is done statistically.

In a quantitative study, the results are analyzed numerically.

Purpose Statement

The study focuses on assessing encounters and psychosocial problems among nurse practitioners working with COVID-19 patients

The purpose is to examine COVID-19 disease-related psychological stress among practitioners in nursing care facilities.

The study aimed to evaluate mental health status and psychological needs for healthcare practitioners during COVID-19.

Research Question

Research questions focused on identifying nurses' experiences psychosocial issues while caring for COVID-19 patients. Questions nurses about their individual strategies.

The research question was precisely stated, but researchers focused on assessing COVID-19-related psychological stress

The research question is precise, but the study was aimed at assessing practitioners' psychological health.

Outcome

The researchers examine the extent of psychological outcomes such as depressive symptoms

Evaluates the extent of psychological stress such as anxiety among nurse practitioners

Outcomes included the level of depressive and anxiety symptoms

Setting
(Where did the study take place?)

The study was undertaken in May 2020 in Istanbul, Turkey.

The study was taken in April 2020 and included nursing care facilities in South Korea.

The study included healthcare workers in Italy

Sample

The study sample included ten nurses who were involved in taking care of COVID-19 patients.

The sample in 56 practitioners from nursing care hospitals.

The final sample included 933 participants, including physicians, nurses, and technicians.

Method

A descriptive phenomenological approach was utilized, and face-to-face interviews were conducted over the internet; the results were analyzed using Colaizzi's seven-step method.

A questionnaire survey was used to collect data from the workers in nursing care hospitals.

An online survey was undertaken using the Qualtrics platform, and the study was conducted in accordance with the World Medical Association Declaration of Helsinki

Key Findings of the Study

Nurses were affected by the worsening working conditions, the changing routines after the outbreaks, high workload, and fear of getting infected and dying.

Nurses who interact with very sick patients have a high presence of anxiety and depression

The study showed that female practitioners recorded high levels of anxiety. Young participants were at high risk of anxiety and PSTD

Recommendations of the Researcher

Researchers recommend the need for future research to determine secondary trauma may emerge in nurses

The researcher recommends that practitioners' symptoms should be monitored, and effective interventions should be provided

The researchers suggest that there is a need for psychological support for women and younger healthcare practitioners.

Criteria

Article 7

Article 8

Article 9