COVID-19 PANDEMİSİ SIRASINDA HEMŞİRELERDE MESLEKİ YORGUNLUK VE ALGILANAN STRES DÜZEYİ ARASINDAKİ İLİŞKİ: TÜRKİYE'DEN KESİTSEL BİR ÇALIŞMA
Year 2022,
Volume: 3 Issue: 3, 331 - 337, 31.12.2022
Tülay Ortabağ
,
Sezer Avcı
,
Serpil Özdemir
,
Elif Dönmez
,
Suzan Havlioğlu
,
Eda Açıkgöz
Abstract
Amaç: Koronavirüs hastalığı (COVID 19), pandemide ön planda çalışan hemşirelerin mesleki yorgunluk ve stres düzeylerini etkileyen önemli bir sorundur. Bu çalışmanın amacı, COVID-19 pandemisi sürecinde hemşirelerde mesleki yorgunluk ile algılanan stres düzeyi arasındaki ilişkiyi belirlemekti.
Yöntem: Bu kesitsel çalışma, Türkiye'de 23 Mayıs-7 Haziran 2020 tarihleri arasında 1441 hemşire üzerinde çevrimiçi anket kullanılarak yapıldı.
Bulgular: Hemşirelerin mesleki yorgunluk ölçeği puanları kronik ve akut yorgunluk alt boyutlarında orta ile yüksek, iyileşme alt boyutunda orta ile düşük arasındaydı. Ayrıca bu çalışmada hemşirelerin algıladıkları ortalama stres düzeylerinin yüksek olduğu belirlendi.
Sonuç: Süregelen bu pandemi sürecinde hemşirelerin kendilerini toparlayabilmeleri ve stresle baş edebilmeleri için uzun çalışma saatlerinin ele alınması son derece önemlidir.
Supporting Institution
Yok
References
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Ruiz-Fernández MD, Ramos-Pichardo JD, Ibáñez-Masero O, Cabrera‐Troya J, Carmona‐Rega MI, Ortega‐Galán ÁM. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the Covid-19 health crisis in Spain. J Clin Nurs. 2020;29(21-22):4321-4330.
- Huang L, Lin G, Tang L, Yu L, Zhou Z. Special attention to nurses' protection during the Covid-19 epidemic. Crit Care. 2020;24(1):1-3.
- Mo Y, Deng L, Zhang L, et al. Work stress among Chinese nurses to support Wuhan in fighting against Covid-19 epidemic. J Nurs Manag. 2020;28(5):1002-1009.
- Neto MLR, Almeida H, Esmeraldo JD, et al. When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak. Psychiatry Research. 2020;288, 112972.
- Shen X, Zou X, Zhong X, Yan J, Li L. Psychological stress of ICU nurses in the time of Covid-19. Crit Care. 2020;24(1):1-3.
- Cai H, Tu B, Ma J, et al. Psychological impact and coping strategies of frontline medical staff in hunan between january and march 2020 during the outbreak of coronavirus disease 2019 (Covid‑19) in Hubei, China. Med Sci Monit. 2020;26:e924171-1-16.
- Techera U, Hallowell M, Stambaugh N, Littlejohn R. Causes and consequences of occupational fatigue: meta-analysis and systems model. J Occup Environ Med. 2016;58(10):961-973.
- Yamada K, Adams H, Ellis T, Clark R, Sully C, Sullivan M.L. Reductions in fatigue predict occupational re-engagement in individuals with work-related musculoskeletal disorders. J Occup Rehabil. 2020;30(1):135-145.
- Min A, Kim YM, Yoon YS, Hong HC, Kang M, Scott LD. Effects of work environments and occupational fatigue on care left undone in rotating shift nurses. J Nurs Scholarsh. 2021;53(1):126-136.
- Hazzard B, Johnson K, Dordunoo D, Klein T, Russell B, Walkowiak P. Work- and nonwork-related factors associated with PACU nurses' fatigue. J Perianesth Nurs. 2013;28(4):201-209.
- Steege LM, Pinekenstein BJ, Rainbow JG, Arsenault Knudsen É. Addressing occupational fatigue in nurses: current state of fatigue risk management in hospitals, part 1. JONA J Nurs Adm. 2017;47(9):426-433.
- Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976.
- Liu CY, Yang YZ, Zhang, XM, et al. The prevalence and influencing factors in anxiety in medical workers fighting Covid-19 in China: a cross-sectional survey. Epidemiol Infect. 2020;148:1-7.
- Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the Covid-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907.
- Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider burnout and fatigue during the Covid-19 pandemic: lessons learned from a high-volume intensive care unit. Anesth Analg. 2020;131:106-111.
- Zhang WR, Wang K, Yin L, et al. Mental Health and Psychosocial Problems of Medical Health Workers during the Covid-19 Epidemic in China. Psychother Psychosom. 2020;89(4):242-250.
- Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the Covid-19 pandemic–a review. Asian Journal of Psychiatry. 2020;51:102119.
- Shechter A, Diaz F, Moise N, et al. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the Covid-19 pandemic. Gen Hosp Psychiat. 2020;66:1-8.
- Sahin MK, Aker S, Sahin G, Karabekiroglu A. Prevalence of depression, anxiety, distress and insomnia and related factors in healthcare workers during Covid-19 pandemic in Turkey. J Community Health. 2020;45:1168-1177.
- Saruc S, Kızıltas A. An analysis of the healthcare personnel’s anxiety levels during the Covid-19 pandemic in terms of their psychological resilience and the problems they experienced. Journal of Psychiatric Nursing. 2021;12(4):314-323.
- Calıskan E, Kargın M. The relationship between coronavirus 19 fear and occupational fatigue, burnout and recovery levels in healthcare professionals in Turkey. Archives of Environmental & Occupational Health. 2021;1-10.
- Hicdurmaz D, Uzar Ozcetin YS. Protection of Covid-19 frontline nurses’ mental health and prevention of psychological trauma. Journal of Hacettepe University Faculty of Nursing. 2020;7(Special issue):1-7.
- Celik SŞ, Ozbas AA, Bulut H, et al. Turkish nurses association: a year last with the Covid-19 pandemic. Baskent University Faculty of Health Sciences Journal. 2021;6(Special issue):26-37.
- Sample Size Calculator, the guidelines are available at http://www.raosoft.com/samplesize.html.
Cohen S, Kamarck T, Mermelstein RA. global measure of perceived stress. J Health Soc Behav. 1983;24:385-396.
- Eskin M, Harlak H, Demirkıran F, Dereboy Ç. Adaptation of the perceived stress scale to Turkish: reliability and validity analysis. New Symposium J. 2013;51(3):132-140.
- Winwood PC, Winefield AH, Dawson D, Lushington K. Development and validation of a scale to measure work-related fatigue and recovery: the Occupational Fatigue Exhaustion/Recovery Scale (OFER). J Occup Environ Med. 2005;47:594-606.
- Havlioglu S, Ortabag T, Winwood PC. Turkish validity and reliability of the occupational fatigue exhaustion/recovery scale. Medicine. 2019;8(4):916-22.
- Du J, Dong L, Wang T, et al. Psychological symptoms among frontline healthcare workers during Covid-19 outbreak in Wuhan. Gen Hosp Psychiatry. 2020;67:144-145.
- Younan L, Clinton M, Fares S, Jardali FE, Samaha H. The relationship between work‐related musculoskeletal disorders, chronic occupational fatigue, and work organization: A multi‐hospital cross‐sectional study. J. Adv Nurs. 2019;75(8):1667-1677.
- Turkey Psychiatric Association Covid-19 Prevention of Burnout Epidemic of Health Workers Guide. 2020. The guidelines are available at https://www.psikiyatri.org.tr/uploadFiles/14202016552TukenmislikCOVID.pdf
Huang H, Liu L, Yang S, Cui X, Zhang J, Wu H. Effects of job conditions, occupational stress, and emotional intelligence on chronic fatigue among Chinese nurses: a cross-sectional study. Psychology Research and Behavior Management. 2019;12:351-360.
- Chen WL, Wang CC, Chiang ST, et al. The impact of occupational psychological hazards and metabolic syndrome on the 8-year risk of cardiovascular diseases a longitudinal study. PLOS ONE. 2018;13(8):e0202977.
- Steege LM, Pasupathy KS, Drake DA. A work systems analysis approach to understanding fatigue in hospital nurses. Ergonomics. 2018;61(1):148-161.
- Lee E, Jang I. Nurses' fatigue, job stress, organizational culture and turnover intention: a culture-work-health model. Western Journal of Nursing Research. 2020;42(2):108-116.
- Zhu Z, Xu S, Wang H, et al. Covid-19 in Wuhan: sociodemographic characteristics and hospital support measures associated with the immediate psychological impact on healthcare workers. EClinicalMedicine. 2020;24:100443.
- Nemati M, Ebrahimi B, Nemati F. Assessment of Iranian nurses’ knowledge and anxiety toward Covid-19 during the current outbreak in Iran. Arch Clin Infect Dis. 2020;15(Covid-19):e102848.
- Gifkins J, Johnston A, Loudoun R, Troth A. Fatigue and recovery in shift working nurses: A scoping literature review. Int J Nurs Stud. 2020;112:103710.
- Chekole YA, Yimer S, Mekuriaw B, Abate SM. Prevalence and risk factors of perceived stress on Covid-19 among health care providers in Dilla Town Health institutions, Southern Ethiopia: A cross-sectional study. Advances in Public Health. 2020;1-15.
- Vicario-Merino Á, Muñoz-Agustín N. Analysis of the stress, anxiety and healthy habits in the Spanish Covid-19 confinement. Health Science Journal. 2020;14(2):707-713.
- Dagget T, Molla A, Belachew T. Job related stress among nurses working in Jimma Zone public hospitals, South West Ethiopia: A cross sectional study. BMC Nursing. 2016;15(1):1-10.
- Li S, Li L, Zhu X, et al. Comparison of characteristics of anxiety sensitivity across career stages and its relationship with nursing stress among female nurses in Hunan, China. BMJ Open. 2016;6(5):e010829.
- Khamisa N, Peltzer K, Ilic D, Oldenburg B. Effect of personal and work stress on burnout, job satisfaction and general health of hospital nurses in South Africa. Health Sa Gesondheid. 2017;22:252-258.
- Alharbi J, Jackson D, Usher K. The potential for Covid‐19 to contribute to compassion fatigue in critical care nurses. J Clin Nurs. 2020;29:2762-2764.
- Chaiard J, Deeluea J, Suksatit B, Songkham W, Inta, N. Short sleep duration among Thai nurses: Influences on fatigue, daytime sleepiness, and occupational errors. J Occup Health. 2018;60:348-355.
- Cui S, Jiang Y, Shi O, et al. Impact of Covid-19 on psychology of nurses working in the emergency and fever outpatient: A cross-sectional survey. Research Square. 2020;1-19.
- TTB (2020), Number of the Covidien-19 Health Workers Who were Diagnosed Turkey Increasingly, The guidelines are available at https://www.ttb.org.tr/kollar/userfiles/files/ttbcovid-saglik-calisanlari_-EN-SON.pdf
- World Health Organization (WHO). 19 March 2020 Coronavirus disease (Covid-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health.
- Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. The Lancet Global Health. 2020;8(6):e790-e798.
- Costantini M, Sleeman KE, Peruselli C, Higginson IJ. Response and role of palliative care during the Covid-19 pandemic: a national telephone survey of hospices in Italy. Palliative Medicine. 2020;34(7):889-895.
- Fernandez R, Lord H, Halcomb E, et al. Implications for Covid-19: a systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies. 2020;111:103637.
- Sun N, Shi S, Jiao D, et al. A qualitative study on the psychological experience of caregivers of Covid-19 patients. American Journal of Infection Control. 2020;48(6):592-598.
THE RELATIONSHIP BETWEEN OCCUPATIONAL FATIGUE AND PERCEIVED STRESS LEVEL AMONG NURSES DURING THE COVID-19 PANDEMIC: A CROSS-SECTIONAL STUDY FROM TURKEY
Year 2022,
Volume: 3 Issue: 3, 331 - 337, 31.12.2022
Tülay Ortabağ
,
Sezer Avcı
,
Serpil Özdemir
,
Elif Dönmez
,
Suzan Havlioğlu
,
Eda Açıkgöz
Abstract
Objective: The coronavirus disease (COVID 19) is a significant problem that affects occupational fatigue and stress level of nurses working at the forefront of the pandemic. The purpose of this study is to determine the relationship between occupational fatigue and perceived stress level among nurses during the COVID-19 pandemic.
Method: This cross-sectional study was conducted on 1441 nurses between May 23 and June 7, 2020 using online questionnaire in Turkey.
Results: Nurses' occupational fatigue scale scores were moderate to high in chronic and acute fatigue sub-dimensions and moderate to low in the recovery sub-dimension. Furthermore, the average stress level perceived by nurses was reported to be high in this study.
Conclusion: It is extremely important for long working hours to be addressed so that nurses can recover and cope with stress during this ongoing pandemic.
References
- Sanyaolu A, Okorie C, Marinkovic A, et al. Comorbidity and its impact on Patients with Covid-19. SN Compr Clin Med. 2020;2(8):1069-1076.
- Pascarella G, Strumia A, Piliego C, et al. Covid-19 diagnosis and management: a comprehensive review. J Intern Med. 2020;288(2):192-206.
Ruiz-Fernández MD, Ramos-Pichardo JD, Ibáñez-Masero O, Cabrera‐Troya J, Carmona‐Rega MI, Ortega‐Galán ÁM. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the Covid-19 health crisis in Spain. J Clin Nurs. 2020;29(21-22):4321-4330.
- Huang L, Lin G, Tang L, Yu L, Zhou Z. Special attention to nurses' protection during the Covid-19 epidemic. Crit Care. 2020;24(1):1-3.
- Mo Y, Deng L, Zhang L, et al. Work stress among Chinese nurses to support Wuhan in fighting against Covid-19 epidemic. J Nurs Manag. 2020;28(5):1002-1009.
- Neto MLR, Almeida H, Esmeraldo JD, et al. When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak. Psychiatry Research. 2020;288, 112972.
- Shen X, Zou X, Zhong X, Yan J, Li L. Psychological stress of ICU nurses in the time of Covid-19. Crit Care. 2020;24(1):1-3.
- Cai H, Tu B, Ma J, et al. Psychological impact and coping strategies of frontline medical staff in hunan between january and march 2020 during the outbreak of coronavirus disease 2019 (Covid‑19) in Hubei, China. Med Sci Monit. 2020;26:e924171-1-16.
- Techera U, Hallowell M, Stambaugh N, Littlejohn R. Causes and consequences of occupational fatigue: meta-analysis and systems model. J Occup Environ Med. 2016;58(10):961-973.
- Yamada K, Adams H, Ellis T, Clark R, Sully C, Sullivan M.L. Reductions in fatigue predict occupational re-engagement in individuals with work-related musculoskeletal disorders. J Occup Rehabil. 2020;30(1):135-145.
- Min A, Kim YM, Yoon YS, Hong HC, Kang M, Scott LD. Effects of work environments and occupational fatigue on care left undone in rotating shift nurses. J Nurs Scholarsh. 2021;53(1):126-136.
- Hazzard B, Johnson K, Dordunoo D, Klein T, Russell B, Walkowiak P. Work- and nonwork-related factors associated with PACU nurses' fatigue. J Perianesth Nurs. 2013;28(4):201-209.
- Steege LM, Pinekenstein BJ, Rainbow JG, Arsenault Knudsen É. Addressing occupational fatigue in nurses: current state of fatigue risk management in hospitals, part 1. JONA J Nurs Adm. 2017;47(9):426-433.
- Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976.
- Liu CY, Yang YZ, Zhang, XM, et al. The prevalence and influencing factors in anxiety in medical workers fighting Covid-19 in China: a cross-sectional survey. Epidemiol Infect. 2020;148:1-7.
- Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the Covid-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907.
- Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider burnout and fatigue during the Covid-19 pandemic: lessons learned from a high-volume intensive care unit. Anesth Analg. 2020;131:106-111.
- Zhang WR, Wang K, Yin L, et al. Mental Health and Psychosocial Problems of Medical Health Workers during the Covid-19 Epidemic in China. Psychother Psychosom. 2020;89(4):242-250.
- Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the Covid-19 pandemic–a review. Asian Journal of Psychiatry. 2020;51:102119.
- Shechter A, Diaz F, Moise N, et al. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the Covid-19 pandemic. Gen Hosp Psychiat. 2020;66:1-8.
- Sahin MK, Aker S, Sahin G, Karabekiroglu A. Prevalence of depression, anxiety, distress and insomnia and related factors in healthcare workers during Covid-19 pandemic in Turkey. J Community Health. 2020;45:1168-1177.
- Saruc S, Kızıltas A. An analysis of the healthcare personnel’s anxiety levels during the Covid-19 pandemic in terms of their psychological resilience and the problems they experienced. Journal of Psychiatric Nursing. 2021;12(4):314-323.
- Calıskan E, Kargın M. The relationship between coronavirus 19 fear and occupational fatigue, burnout and recovery levels in healthcare professionals in Turkey. Archives of Environmental & Occupational Health. 2021;1-10.
- Hicdurmaz D, Uzar Ozcetin YS. Protection of Covid-19 frontline nurses’ mental health and prevention of psychological trauma. Journal of Hacettepe University Faculty of Nursing. 2020;7(Special issue):1-7.
- Celik SŞ, Ozbas AA, Bulut H, et al. Turkish nurses association: a year last with the Covid-19 pandemic. Baskent University Faculty of Health Sciences Journal. 2021;6(Special issue):26-37.
- Sample Size Calculator, the guidelines are available at http://www.raosoft.com/samplesize.html.
Cohen S, Kamarck T, Mermelstein RA. global measure of perceived stress. J Health Soc Behav. 1983;24:385-396.
- Eskin M, Harlak H, Demirkıran F, Dereboy Ç. Adaptation of the perceived stress scale to Turkish: reliability and validity analysis. New Symposium J. 2013;51(3):132-140.
- Winwood PC, Winefield AH, Dawson D, Lushington K. Development and validation of a scale to measure work-related fatigue and recovery: the Occupational Fatigue Exhaustion/Recovery Scale (OFER). J Occup Environ Med. 2005;47:594-606.
- Havlioglu S, Ortabag T, Winwood PC. Turkish validity and reliability of the occupational fatigue exhaustion/recovery scale. Medicine. 2019;8(4):916-22.
- Du J, Dong L, Wang T, et al. Psychological symptoms among frontline healthcare workers during Covid-19 outbreak in Wuhan. Gen Hosp Psychiatry. 2020;67:144-145.
- Younan L, Clinton M, Fares S, Jardali FE, Samaha H. The relationship between work‐related musculoskeletal disorders, chronic occupational fatigue, and work organization: A multi‐hospital cross‐sectional study. J. Adv Nurs. 2019;75(8):1667-1677.
- Turkey Psychiatric Association Covid-19 Prevention of Burnout Epidemic of Health Workers Guide. 2020. The guidelines are available at https://www.psikiyatri.org.tr/uploadFiles/14202016552TukenmislikCOVID.pdf
Huang H, Liu L, Yang S, Cui X, Zhang J, Wu H. Effects of job conditions, occupational stress, and emotional intelligence on chronic fatigue among Chinese nurses: a cross-sectional study. Psychology Research and Behavior Management. 2019;12:351-360.
- Chen WL, Wang CC, Chiang ST, et al. The impact of occupational psychological hazards and metabolic syndrome on the 8-year risk of cardiovascular diseases a longitudinal study. PLOS ONE. 2018;13(8):e0202977.
- Steege LM, Pasupathy KS, Drake DA. A work systems analysis approach to understanding fatigue in hospital nurses. Ergonomics. 2018;61(1):148-161.
- Lee E, Jang I. Nurses' fatigue, job stress, organizational culture and turnover intention: a culture-work-health model. Western Journal of Nursing Research. 2020;42(2):108-116.
- Zhu Z, Xu S, Wang H, et al. Covid-19 in Wuhan: sociodemographic characteristics and hospital support measures associated with the immediate psychological impact on healthcare workers. EClinicalMedicine. 2020;24:100443.
- Nemati M, Ebrahimi B, Nemati F. Assessment of Iranian nurses’ knowledge and anxiety toward Covid-19 during the current outbreak in Iran. Arch Clin Infect Dis. 2020;15(Covid-19):e102848.
- Gifkins J, Johnston A, Loudoun R, Troth A. Fatigue and recovery in shift working nurses: A scoping literature review. Int J Nurs Stud. 2020;112:103710.
- Chekole YA, Yimer S, Mekuriaw B, Abate SM. Prevalence and risk factors of perceived stress on Covid-19 among health care providers in Dilla Town Health institutions, Southern Ethiopia: A cross-sectional study. Advances in Public Health. 2020;1-15.
- Vicario-Merino Á, Muñoz-Agustín N. Analysis of the stress, anxiety and healthy habits in the Spanish Covid-19 confinement. Health Science Journal. 2020;14(2):707-713.
- Dagget T, Molla A, Belachew T. Job related stress among nurses working in Jimma Zone public hospitals, South West Ethiopia: A cross sectional study. BMC Nursing. 2016;15(1):1-10.
- Li S, Li L, Zhu X, et al. Comparison of characteristics of anxiety sensitivity across career stages and its relationship with nursing stress among female nurses in Hunan, China. BMJ Open. 2016;6(5):e010829.
- Khamisa N, Peltzer K, Ilic D, Oldenburg B. Effect of personal and work stress on burnout, job satisfaction and general health of hospital nurses in South Africa. Health Sa Gesondheid. 2017;22:252-258.
- Alharbi J, Jackson D, Usher K. The potential for Covid‐19 to contribute to compassion fatigue in critical care nurses. J Clin Nurs. 2020;29:2762-2764.
- Chaiard J, Deeluea J, Suksatit B, Songkham W, Inta, N. Short sleep duration among Thai nurses: Influences on fatigue, daytime sleepiness, and occupational errors. J Occup Health. 2018;60:348-355.
- Cui S, Jiang Y, Shi O, et al. Impact of Covid-19 on psychology of nurses working in the emergency and fever outpatient: A cross-sectional survey. Research Square. 2020;1-19.
- TTB (2020), Number of the Covidien-19 Health Workers Who were Diagnosed Turkey Increasingly, The guidelines are available at https://www.ttb.org.tr/kollar/userfiles/files/ttbcovid-saglik-calisanlari_-EN-SON.pdf
- World Health Organization (WHO). 19 March 2020 Coronavirus disease (Covid-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health.
- Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. The Lancet Global Health. 2020;8(6):e790-e798.
- Costantini M, Sleeman KE, Peruselli C, Higginson IJ. Response and role of palliative care during the Covid-19 pandemic: a national telephone survey of hospices in Italy. Palliative Medicine. 2020;34(7):889-895.
- Fernandez R, Lord H, Halcomb E, et al. Implications for Covid-19: a systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies. 2020;111:103637.
- Sun N, Shi S, Jiao D, et al. A qualitative study on the psychological experience of caregivers of Covid-19 patients. American Journal of Infection Control. 2020;48(6):592-598.