Conceptual Framework for the Psychosocial Support of Nurses Caring for Patients Diagnosed with COVID-19 Infection in North West Province, South Africa
Abstract
:1. Introduction
Purpose of the Study
2. Materials and Methods
2.1. Study Design
- Phase 1: Integrative literature review (ILR)
- Phase 2: The empirical phase
2.2. Population and Sampling
2.3. Data Collection
2.4. Setting
2.5. Recruitment of Nurses
2.6. Ethical Approval
2.7. Trustworthiness
3. Results
- Theme 1: Psychological support
- Employee Assistance Program (EAP)
- Pastoral counselling
- Psychotherapy
- Theme 2: Social support
- Family support
- Peer and colleagues’ support
- Management support
- Theme 1: Nurses’ knowledge of COVID-19 (Dikobe et al., 2022 [24]). The following categories detail the experiences of nurses caring for COVID-19 patients:
- Nurses’ conceptualisation of COVID-19
“COVID-19 is an infectious disease caused by virus known as SARS-CoV 2 and MERS. It affects the respiratory systems (P5)”.
“COVID-19 is an infectious communicable disease that can be transmitted from one person to another (P1)”.
- Theme 2: Nurses’ experiences of caring for patients diagnosed with COVID-19 infection (Dikobe et al., 2022 [24]).
- Nurses have distinct physical experiences in caring for patients diagnosed with COVID-19 infection.
- -
- Nurses verbalised that as a result of caring for patients diagnosed with COVID-19, they ended up developing physical problems, and some of the nurses indicated that they ended up having COVID-19 infection.
“It wasn’t easy seeing people dying day in and day out in your hands, we would be resuscitating patients with COVID-19 and most of us ended up having COVID-19. I was one of them (P3)”.
- Nurses have distinct psychological experiences in caring for patients diagnosed with COVID-19 infection.
- -
- Nurses reported that they are afraid of being infected with COVID-19, and they also felt that they would die of COVID-19.
“it was very traumatising and we were not sure whether we were going to get the infection or not. We were always on edge when we care for patients with COVID infection (P7)”.
“but it was not easy because at the same time we were scared that what if I get it or what if I don’t see that I have it and infect somebody that is closer to me and seeing the patients suffer in that way we were scared (P4)”.
- Nurses have distinct social experiences in caring for patients diagnosed with COVID-19 infection.
- -
- The findings of the study further revealed that nurses were stigmatised and socially isolated, because they were seen as carriers of COVID-19 infection.
“the hospital staff were afraid of us, they feared us, and they didn’t want us near them when we were meeting them in the corridors of the hospital (P2)”.
- Theme 1: Nurses’ challenges when caring for patients diagnosed with COVID-19 infection (Dikobe et al., 2022) [25]. The following categories detail the challenges of nurses caring for COVID-19 patients.
- Nurses experienced challenges in caring for patients diagnosed with COVID-19 infection.
- -
- The findings of this study revealed that because COVID-19 is a new disease, there is no specific treatment for COVID-19, and it is difficult to deal with its complications and complexities.
“People used concoctions, we had lots of renal failures. Patients were drinking traditional concoctions because there were no cure (P5)”.
- Nurses experienced challenges in obtaining support when caring for patients diagnosed with COVID-19 infection.
- -
- Participants indicated that it was difficult for them to obtain psychological support, and they further indicated that the management team was unproductive, as they never checked on the staff and/or referred them to occupational health and safety (OHS) for investigations such as X-rays.
“we do not go for the x-ray, we have to take ourselves to the private doctor to check x-ray. You cough and cough and they give you only 2 days off (P2)”.
- Theme 2: Psychosocial support needed by nurses caring for patients diagnosed with COVID-19 (Dikobe et al., 2022) [25]. The following categories detail the support needed by nurses caring for COVID-19 patients.
- Psychological and physical health support is needed by nurses who are caring for patients diagnosed with COVID-19.
“We needed to be attended to by our managers. We need them to hear our cry if we do not have the equipment they should supply…if we are sick they must hear us and take care of us (P2)”.
- Resources are needed by nurses who are caring for patients diagnosed with COVID-19.
“We also need to be supported with PPEs, there is a serious shortage (P3)”.
4. Discussion
4.1. Development of a Conceptual Framework
- Who is the agent of the framework (agent)?
- Who is the recipient of the framework (recipient)?
- In which context will the framework be implemented (context)?
- How will the framework be implemented (procedure)?
- What are the dynamics of the framework (dynamics)?
- What will be the endpoint of the framework (terminus)?
4.2. Description of the Structural Presentation of the Conceptual Framework
4.3. Relevance and Objective of the Conceptual Framework
4.4. Assumptions of the Conceptual Framework
4.4.1. Agent: Who Is the Agent of the Framework?
4.4.2. Recipient: Who Is the Recipient of the Framework?
4.4.3. Context: In Which Context Will the Framework Be Implemented?
4.4.4. Procedure: How Will the Framework Be Implemented?
4.4.5. Dynamics: What Are the Dynamics of the Framework?
4.4.6. Terminus: What Will Be the Endpoint of the Framework?
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Dikobe, J.; Moagi, M.; Sehularo, L. Psychosocial support for nurses caring for patients diagnosed with COVID-19 infection: An integrated literature review. Gend. Behav. 2023, unpublished. [Google Scholar]
- Bakar, A.Y.A.; Ramli, S. Psychosocial support for healthcare frontliners during COVID-19 pandemic in Malaysia. Asian J. Psychiatry 2020, 54, 102272. [Google Scholar] [CrossRef] [PubMed]
- Aughterson, H.; McKinlay, A.R.; Fancourt, D.; Burton, A. Psychosocial impact on frontline health and social care professionals in the UK during the COVID-19 pandemic: A qualitative interview study. BMJ Open 2021, 11, e047353. [Google Scholar] [CrossRef] [PubMed]
- Walton, M.; Murray, E.; Christian, M.D. Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. Eur. Heart J. Acute Cardiovasc. Care 2020, 9, 241–247. [Google Scholar] [CrossRef]
- Dickoff, J.; James, P.; Wiedenbach, E. Theory in a practice discipline: Part I. Practice Oriented Theory. Nurs. Res. 1968, 17, 415–434. [Google Scholar] [CrossRef] [PubMed]
- Glover, R.E.; van Schalkwyk, M.C.; Akl, E.A.; Kristjannson, E.; Lotfi, T.; Petkovic, J.; Petticrew, M.P.; Pottie, K.; Tugwell, P.; Welch, V. A framework for identifying and mitigating the equity harms of COVID-19 policy interventions. J. Clin. Epidemiol. 2020, 128, 35–48. [Google Scholar] [CrossRef]
- Bordage, G. Conceptual frameworks to illuminate and magnify. Med. Educ. 2009, 43, 312–319. [Google Scholar] [CrossRef]
- Springer, J. LibGuides: Chapter 1: Conceptual Framework; Internatinal Publisher: New York, NY, USA, 2020. [Google Scholar]
- Turan, F.D.; Dalgıç, A.İ.; Duman, Ö. Development of a conceptual framework for a Virtual Reality-based Seizure Management Education Program for Parents (VR-ESMEPP). Epilepsy Behav. 2022, 135, 108875. [Google Scholar] [CrossRef]
- Jabareen, Y. Building a conceptual framework: Philosophy, definitions, and procedure. Int. J. Qual. Methods 2009, 8, 49–62. [Google Scholar] [CrossRef]
- Rogers, R.H. Using lenses to make sense of research: A review of Sharon M. Ravitch and Matthew Riggan’s reason & rigor: How conceptual frameworks guide research. Qual. Rep. 2016, 21, 1708. [Google Scholar]
- Polit, D.F.; Beck, C.T. Nursing Research: Generating and Assessing Evidence for Nursing Practice; Lippincott Williams & Wilkins: Philadelphia, PA, USA, 2021. [Google Scholar]
- Ravitch, S.M.; Riggan, M. Reason & Rigor: How Conceptual Frameworks Guide Research; Sage Publications: Thousand Oaks, CA, USA, 2016. [Google Scholar]
- Billings, J.; Ching, B.C.F.; Gkofa, V.; Greene, T.; Bloomfield, M. Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: A systematic review and qualitative meta-synthesis. BMC Health Serv. Res. 2021, 21, 923. [Google Scholar] [CrossRef] [PubMed]
- Xu, J.; Liu, X.; Xiao, Y.; Fang, X.; Cheng, Y.; Zhang, J. Effect of EAP Psychological Intervention on Improving the Mental Health of Medical Workers under the Novel Coronavirus Epidemic in China. Front. Public Health 2021, 9, 649157. [Google Scholar] [CrossRef]
- Alnazly, E.; Khraisat, O.M.; Al-Bashaireh, A.M.; Bryant, C.L. Anxiety, depression, stress, fear and social support during COVID-19 pandemic among Jordanian healthcare workers. PLoS ONE 2021, 16, e0247679. [Google Scholar] [CrossRef]
- Al Thobaity, A.; Alshammari, F. Nurses on the frontline against the COVID-19 pandemic: An integrative review. Dubai Med. J. 2020, 3, 87–92. [Google Scholar] [CrossRef]
- Chew, Q.H.; Wei, K.C.; Vasoo, S.; Chua, H.C.; Sim, K. Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: Practical considerations for the COVID-19 pandemic. Singap. Med. J. 2020, 61, 350. [Google Scholar] [CrossRef] [PubMed]
- Fang, X.H.; Wu, L.; Lu, L.S.; Kan, X.H.; Wang, H.; Xiong, Y.J.; Ma, D.C.; Wu, G.C. Mental health problems and social supports in the COVID-19 healthcare workers: A Chinese explanatory study. BMC Psychiatry 2021, 21, 34. [Google Scholar] [CrossRef]
- Muller, A.E.; Hafstad, E.V.; Himmels, J.P.W.; Smedslund, G.; Flottorp, S.; Stensland, S.Ø.; Stroobants, S.; Van de Velde, S.; Vist, G.E. The mental health impact of the COVID-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Res. 2020, 293, 113441. [Google Scholar] [CrossRef]
- Rathnayake, S.; Dasanayake, D.; Maithreepala, S.D.; Ekanayake, R.; Basnayake, P.L. Nurses’ perspectives of taking care of patients with Coronavirus disease 2019: A phenomenological study. PLoS ONE 2021, 16, e0257064. [Google Scholar] [CrossRef]
- Sehularo, L.A.; Molato, B.J.; Mokgaola, I.O.; Gause, G. Coping strategies used by nurses during the COVID-19 pandemic: A narrative literature review. Health SA Gesondheid 2021, 26, 1652. [Google Scholar] [CrossRef]
- Shatri, H.; Putranto, R.; Faisal, E.; Fitrianti, F.; Adhiatma, K.; Zulmiyusrini, P.; Diba, S.F.; Lukman, P.R. Psychotherapy for healthcare provider during COVID-19 pandemic: An evidence based clinical review. Acta Med. Indones. 2021, 53, 225–232. [Google Scholar]
- Dikobe, J.; Moagi, M.; Sehularo, L. The lived experiences of nurses caring for patients diagnosed with COVID-19 infection in the North West Province. Open Public Health J. 2023, 7, 1–6. [Google Scholar]
- Dikobe, J.; Moagi, M.; Sehularo, L. The psychosocial support needed by nurses caring for patients diagnosed with Covid-19 infection in the North West Province, South Africa. Gend. Behav. 2022, 20, 20598–20607. [Google Scholar]
- Maben, J.; Bridges, J. COVID-19: Supporting nurses’ psychological and mental health. J. Clin. Nurs. 2020, 29, 2742–2750. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Semo, B.W.; Frissa, S.M. The mental health impact of the COVID-19 pandemic: Implications for sub-Saharan Africa. Psychol. Res. Behav. Manag. 2020, 13, 713. [Google Scholar] [CrossRef]
- Galanis, P.; Vraka, I.; Fragkou, D.; Bilali, A.; Kaitelidou, D. Nurses’ burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis. J. Adv. Nurs. 2021, 77, 3286–3302. [Google Scholar] [CrossRef]
- Turale, S.; Nantsupawat, A. Clinician mental health, nursing shortages and the COVID-19 pandemic: Crises within crises. Int. Nurs. Rev. 2021, 68, 12–14. [Google Scholar] [CrossRef]
Author(s) Year Country | Design and Method Population and Sample | Purpose | Quality Appraisal (Scale: High = h, Low = l nr = Not Reported |
---|---|---|---|
Alnazly et al., 2021 [16], USA | Cross-sectional, correlational design to collect data N = 365 | To assess the respective levels of fear, anxiety, depression, stress and social support and the associated factors experienced by Jordanian healthcare workers during the COVID-19 pandemic. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h)Limitations presented (h) Implications discussed |
Al Thobaity and Alshammari, 2020 [17], Saudi Arabia | Integrative review N = 95 | To explore the issues facing nurses during their response to the COVID-19 crisis. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h) Limitations presented (h) Implications discussed |
Chew et al., 2020 [18], Singapore | Narrative synthesis N = 144 | To synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h) Limitations presented (h) Implications discussed |
Fang et al., 2021 [19], China | Cross-sectional study design N = 540 | To understand the mental health status and needs of healthcare workers, so as to provide a scientific basis for alleviating their psychological pressure. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h) Limitations presented (h) Implications discussed |
Muller et al., 2020 [20], Norway | Systematic review N = 59 | To identify, assess and summarise research on the mental health impact of the COVID-19 pandemic on HCWs. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h) Limitations presented (h) Implications discussed |
Rathnayake et al., 2021 [21], Sri Lanka | Colaizzi’s phenomenological approach N = 14 | To explore the experiences and challenges of nurses who have worked with patients hospitalised with COVID-19. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h) Limitations presented (h) Implications discussed |
Sehularo et al., 2021 [22] SA | Narrative literature review | To explore and describe the coping strategies used by nurses during the COVID-19 pandemic. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h) Limitations presented (h) Implications discussed |
Shatri et al., 2021 [23] Indonesia | Evidence-based clinical review N = 6 | To identify psychotherapy as a psychological health intervention for healthcare workers during the COVID-19 pandemic. | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h) Limitations presented (h) Implications discussed. |
Xu et al., 2021 [15] China | Interventional clinical observation and psychological evaluation N = 1198 | To evaluate the mental health of hospital staff before and after a psychological intervention by the Employee Assistance Program (EAP). | (h) Aims and objectives clearly stated (h) Study design adequately described (h) Research methods appropriate (nr) Explicit theoretical framework (h)Limitations presented (h) Implications discussed |
VARIABLE | CATEGORIES | NUMBER |
---|---|---|
Gender | Male | 2 |
Female | 24 | |
Age in years | 33–60 | |
Nurses participating in the study per institution | Hospital A | 8 |
Hospital B | 5 | |
Hospital C | 7 | |
Hospital D | 6 | |
Current position of nurses Occupational categories | Professional nurses (PN) | 10 |
Enrolled nurses (EN) | 7 | |
Enrolled nursing auxiliary (ENA) | 9 | |
Educational level | Certificate | 16 |
Diploma | 6 | |
Degree | 4 | |
Years of experience in the above work position | All categories of nurses | 3–29 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Dikobe, J.M.; Moagi, M.M.; Sehularo, L.A. Conceptual Framework for the Psychosocial Support of Nurses Caring for Patients Diagnosed with COVID-19 Infection in North West Province, South Africa. Int. J. Environ. Res. Public Health 2023, 20, 5078. https://doi.org/10.3390/ijerph20065078
Dikobe JM, Moagi MM, Sehularo LA. Conceptual Framework for the Psychosocial Support of Nurses Caring for Patients Diagnosed with COVID-19 Infection in North West Province, South Africa. International Journal of Environmental Research and Public Health. 2023; 20(6):5078. https://doi.org/10.3390/ijerph20065078
Chicago/Turabian StyleDikobe, Joan Mologadi, Miriam Mmamphamo Moagi, and Leepile Alfred Sehularo. 2023. "Conceptual Framework for the Psychosocial Support of Nurses Caring for Patients Diagnosed with COVID-19 Infection in North West Province, South Africa" International Journal of Environmental Research and Public Health 20, no. 6: 5078. https://doi.org/10.3390/ijerph20065078
APA StyleDikobe, J. M., Moagi, M. M., & Sehularo, L. A. (2023). Conceptual Framework for the Psychosocial Support of Nurses Caring for Patients Diagnosed with COVID-19 Infection in North West Province, South Africa. International Journal of Environmental Research and Public Health, 20(6), 5078. https://doi.org/10.3390/ijerph20065078