The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study
Identifieur interne : 000099 ( 2020/Analysis ); précédent : 000098; suivant : 000100The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study
Auteurs : Qian Liu [République populaire de Chine] ; Dan Luo [République populaire de Chine] ; Joan E. Haase [États-Unis] ; Qiaohong Guo [République populaire de Chine] ; Xiao Qin Wang [République populaire de Chine] ; Shuo Liu [République populaire de Chine] ; Lin Xia [République populaire de Chine] ; Zhongchun Liu [République populaire de Chine] ; Jiong Yang [République populaire de Chine] ; Bing Xiang Yang [République populaire de Chine]Source :
- The Lancet. Global Health [ 2214-109X ] ; 2020.
Abstract
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.
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.
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.
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.
National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.
Url:
DOI: 10.1016/S2214-109X(20)30204-7
PubMed: NONE
PubMed Central: 7190296
Affiliations:
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Chine</country><wicri:regionArea>Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName></affiliation></author><author><name sortKey="Yang, Jiong" sort="Yang, Jiong" uniqKey="Yang J" first="Jiong" last="Yang">Jiong Yang</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName></affiliation></author><author><name sortKey="Yang, Bing Xiang" sort="Yang, Bing Xiang" uniqKey="Yang B" first="Bing Xiang" last="Yang">Bing Xiang Yang</name><affiliation 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Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nursing, School of Health Sciences, Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName><orgName type="university">Université de Wuhan</orgName></affiliation></author><author><name sortKey="Luo, Dan" sort="Luo, Dan" uniqKey="Luo D" first="Dan" last="Luo">Dan Luo</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff2">Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nursing, School of Health Sciences, Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName><orgName type="university">Université de Wuhan</orgName></affiliation></author><author><name sortKey="Haase, Joan E" sort="Haase, Joan E" uniqKey="Haase J" first="Joan E" last="Haase">Joan E. Haase</name><affiliation wicri:level="2"><nlm:aff id="aff4">School of Nursing, Indiana University, Indianapolis, IN, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>School of Nursing, Indiana University, Indianapolis, IN</wicri:regionArea><placeName><region type="state">Indiana</region></placeName></affiliation></author><author><name sortKey="Guo, Qiaohong" sort="Guo, Qiaohong" uniqKey="Guo Q" first="Qiaohong" last="Guo">Qiaohong Guo</name><affiliation wicri:level="3"><nlm:aff id="aff5">School of Nursing, Capital Medical University, Beijing, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>School of Nursing, Capital Medical University, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Wang, Xiao Qin" sort="Wang, Xiao Qin" uniqKey="Wang X" first="Xiao Qin" last="Wang">Xiao Qin Wang</name><affiliation wicri:level="4"><nlm:aff id="aff2">Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nursing, School of Health Sciences, Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName><orgName type="university">Université de Wuhan</orgName></affiliation></author><author><name sortKey="Liu, Shuo" sort="Liu, Shuo" uniqKey="Liu S" first="Shuo" last="Liu">Shuo Liu</name><affiliation wicri:level="4"><nlm:aff id="aff2">Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nursing, School of Health Sciences, Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName><orgName type="university">Université de Wuhan</orgName></affiliation></author><author><name sortKey="Xia, Lin" sort="Xia, Lin" uniqKey="Xia L" first="Lin" last="Xia">Lin Xia</name><affiliation wicri:level="4"><nlm:aff id="aff2">Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nursing, School of Health Sciences, Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName><orgName type="university">Université de Wuhan</orgName></affiliation></author><author><name sortKey="Liu, Zhongchun" sort="Liu, Zhongchun" uniqKey="Liu Z" first="Zhongchun" last="Liu">Zhongchun Liu</name><affiliation wicri:level="3"><nlm:aff id="aff6">Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName></affiliation></author><author><name sortKey="Yang, Jiong" sort="Yang, Jiong" uniqKey="Yang J" first="Jiong" last="Yang">Jiong Yang</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName></affiliation></author><author><name sortKey="Yang, Bing Xiang" sort="Yang, Bing Xiang" uniqKey="Yang B" first="Bing Xiang" last="Yang">Bing Xiang Yang</name><affiliation wicri:level="4"><nlm:aff id="aff2">Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nursing, School of Health Sciences, Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName><orgName type="university">Université de Wuhan</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff3">Population and Health Research Center, Wuhan University, Wuhan, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Population and Health Research Center, Wuhan University, Wuhan</wicri:regionArea><placeName><settlement type="city">Wuhan</settlement><region type="région">Hubei</region></placeName><orgName type="university">Université de Wuhan</orgName></affiliation></author></analytic><series><title level="j">The Lancet. Global Health</title><idno type="eISSN">2214-109X</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Findings</title><p>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.</p></sec><sec><title>Interpretation</title><p>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.</p></sec><sec><title>Funding</title><p>National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Chang, D" uniqKey="Chang D">D Chang</name></author><author><name sortKey="Xu, H" uniqKey="Xu H">H Xu</name></author><author><name sortKey="Rebaza, A" uniqKey="Rebaza A">A Rebaza</name></author><author><name sortKey="Sharma, L" uniqKey="Sharma L">L Sharma</name></author><author><name sortKey="Dela Cruz, Cs" uniqKey="Dela Cruz C">CS Dela Cruz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Sm" uniqKey="Lee S">SM Lee</name></author><author><name sortKey="Kang, Ws" uniqKey="Kang W">WS 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sortKey="Seibert, Dj" uniqKey="Seibert D">DJ Seibert</name></author><author><name sortKey="Mallinson, Rk" uniqKey="Mallinson R">RK Mallinson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Li, L" uniqKey="Li L">L Li</name></author><author><name sortKey="Xv, Q" uniqKey="Xv Q">Q Xv</name></author><author><name sortKey="Yan, J" uniqKey="Yan J">J Yan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Karam, M" uniqKey="Karam M">M Karam</name></author><author><name sortKey="Brault, I" uniqKey="Brault I">I Brault</name></author><author><name sortKey="Van Durme, T" uniqKey="Van Durme T">T Van Durme</name></author><author><name sortKey="Macq, J" uniqKey="Macq J">J Macq</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Marjanovic, Z" uniqKey="Marjanovic Z">Z Marjanovic</name></author><author><name sortKey="Greenglass, Er" uniqKey="Greenglass E">ER Greenglass</name></author><author><name sortKey="Coffey, S" uniqKey="Coffey S">S Coffey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Duan, L" uniqKey="Duan L">L Duan</name></author><author><name sortKey="Zhu, G" uniqKey="Zhu G">G Zhu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, Q" uniqKey="Chen Q">Q Chen</name></author><author><name sortKey="Liang, M" uniqKey="Liang M">M Liang</name></author><author><name sortKey="Li, Y" uniqKey="Li Y">Y Li</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Hubei</li><li>Indiana</li></region><settlement><li>Pékin</li><li>Wuhan</li></settlement><orgName><li>Université de Wuhan</li></orgName></list><tree><country name="République populaire de Chine"><region name="Hubei"><name sortKey="Liu, Qian" sort="Liu, Qian" uniqKey="Liu Q" first="Qian" last="Liu">Qian Liu</name></region><name sortKey="Guo, Qiaohong" sort="Guo, Qiaohong" uniqKey="Guo Q" first="Qiaohong" last="Guo">Qiaohong Guo</name><name sortKey="Liu, Qian" sort="Liu, Qian" uniqKey="Liu Q" first="Qian" last="Liu">Qian Liu</name><name sortKey="Liu, Shuo" sort="Liu, Shuo" uniqKey="Liu S" first="Shuo" last="Liu">Shuo Liu</name><name sortKey="Liu, Zhongchun" sort="Liu, Zhongchun" uniqKey="Liu Z" first="Zhongchun" last="Liu">Zhongchun Liu</name><name sortKey="Luo, Dan" sort="Luo, Dan" uniqKey="Luo D" first="Dan" last="Luo">Dan Luo</name><name sortKey="Luo, Dan" sort="Luo, Dan" uniqKey="Luo D" first="Dan" last="Luo">Dan Luo</name><name sortKey="Wang, Xiao Qin" sort="Wang, Xiao Qin" uniqKey="Wang X" first="Xiao Qin" last="Wang">Xiao Qin Wang</name><name sortKey="Xia, Lin" sort="Xia, Lin" uniqKey="Xia L" first="Lin" last="Xia">Lin Xia</name><name sortKey="Yang, Bing Xiang" sort="Yang, Bing Xiang" uniqKey="Yang B" first="Bing Xiang" last="Yang">Bing Xiang Yang</name><name sortKey="Yang, Bing Xiang" sort="Yang, Bing Xiang" uniqKey="Yang B" first="Bing Xiang" last="Yang">Bing Xiang Yang</name><name sortKey="Yang, Jiong" sort="Yang, Jiong" uniqKey="Yang J" first="Jiong" last="Yang">Jiong Yang</name></country><country name="États-Unis"><region name="Indiana"><name sortKey="Haase, Joan E" sort="Haase, Joan E" uniqKey="Haase J" first="Joan E" last="Haase">Joan E. 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