Department of Global Health and Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany.
Health Policy Plan. 2023 Aug 2;38(7):777-788. doi: 10.1093/heapol/czad023.
COVID-19 represented an unprecedented challenge for health workers around the world, resulting in strong concerns about impacts on their psychological well-being. To inform on-going support and future preparedness activities, this study documented health workers' experiences, well-being and coping throughout the first wave of the pandemic, in Burkina Faso, Senegal and The Gambia. We collected data from 68 primarily clinical staff from the COVID-19 treatment, maternity and emergency departments in 13 purposely hospitals and laboratories across the three countries. Following in-depth interviews via Zoom (mid-May to September 2020), we regularly followed up via WhatsApp until the end of 2020. We used a mixed deductive and inductive coding approach and a framework matrix to organize and analyse the material. All respondents initially assessed the situation as stressful and threatening. Major emotional reactions included fear of own infection, fear of being a risk to loved ones, guilt, compassion, and anxiety regarding the future. Many suffered from feeling left alone with the emerging crisis and feeling unvalued and unappreciated, particularly by their governments and ministries of health. Conversely, health workers drew much strength from support and valuation by direct supervisors and team members and, in part, also by patients, friends and family. We observed important heterogeneity between places of work and individual backgrounds. Respondents coped with the situation in various ways, particularly with strategies to manage adverse emotions, to minimize infection risk, to fortify health and to find meaning in the adverse circumstances. Coping strategies were primarily grounded in own resources rather than institutional support. Over time, the situation normalized and fears diminished for most respondents. With a view towards emergency preparedness, our findings underline the value of participation and transparent communication, institutional support and routine training to foster health workers' psychological preparedness, coping skill set and resilience more generally.
COVID-19 对全球卫生工作者构成了前所未有的挑战，这引发了人们对其心理健康影响的强烈关注。为了为正在进行的支持和未来的准备活动提供信息，本研究记录了布基纳法索、塞内加尔和冈比亚的卫生工作者在大流行第一波期间的经历、幸福感和应对情况。我们从来自 COVID-19 治疗、妇产科和急诊部门的 68 名主要临床工作人员那里收集了数据，这些工作人员来自三个国家的 13 家专门医院和实验室。在 2020 年 5 月中旬至 9 月期间通过 Zoom 进行深入访谈后，我们通过 WhatsApp 定期跟进，直到 2020 年底。我们使用了一种混合演绎和归纳的编码方法和框架矩阵来组织和分析材料。所有受访者最初都评估了这种情况是有压力和威胁的。主要的情绪反应包括对自身感染的恐惧、对成为亲人风险的恐惧、内疚、同情，以及对未来的焦虑。许多人感到在处理这场新出现的危机时感到孤立无援，并且感到不被重视和不被感激，特别是来自他们的政府和卫生部。相反，卫生工作者从直接主管和团队成员的支持和重视中获得了很大的力量，部分还来自患者、朋友和家人。我们观察到工作场所和个人背景之间存在很大的异质性。受访者以各种方式应对这种情况，特别是通过管理负面情绪、最小化感染风险、增强健康和在不利环境中找到意义的策略。应对策略主要基于自身资源，而不是机构支持。随着时间的推移，大多数受访者的情况变得正常，恐惧也减少了。为了为应急准备提供参考，我们的研究结果强调了参与和透明沟通、机构支持以及常规培训的价值，以更广泛地促进卫生工作者的心理准备、应对技能和韧性。
