Title : Nurses experiences of caring for severely ill patients during infection outbreaks (pandemic / epidemic): A mixed methods systematic review
Background: Nurses play an essential role in responding to severe infection outbreaks which bring considerable challenges to their personal and professional wellbeing. This subsequently can affect the delivery of care and healthcare organisational capacity to respond.
Aims: This review synthesised the literature on nurses' experiences and coping strategies when caring for patients during outbreaks of severe viral disease.
Methods: A mixed-methods systematic review (MMSR) (Lizarondo et al., 2020) informed by the Joanna Briggs Institute (JBI) methodology. Five electronic databases Medline, CINAHL, PsychInfo, ASSIA, and Scopus were searched on 4th April 2021. 71 peer-review primary research articles describing nurses’ experiences of caring for patients during SARS, MERS, Swine flu H1N1, Avian influenza, or SARS-CoV-2 / COVID-19 published in the English language from 2003 to 2021 were included.
Findings: The findings were synthesised and reported in the context of Leventhal et al.’s (1980; 1992) Self-regulatory Common-Sense Model. We found links between nurses’ perception of the health threats and their emotional reactions, and coping strategies. Health threats were particularly influenced by organisational factors including frequent changes in clinical guidelines and workplace protocols, heavy workloads and working hours, staff shortage, unavailability of PPE, and lack of knowledge and training. These challenges impacted nurses’ physical, psychological and social well-being. Nurses reported helpful and unhelpful coping strategies both problem-focused and emotion-focused to manage their perception of the health threats.
Conclusion: It is vital for stakeholders, policymakers, government, and healthcare institutions to recognise and monitor the wider impact on healthcare providers from health emergencies. In addition, support to develop and implement effective systems and individual mechanisms to off-set the impact pre and post pandemics / epidemics is needed. This work can inform those strategies for similar future emergencies.