General Practice Nurses' experiences of changing care delivery during COVID-19. Implications for future practice: Qualitative study protocol.

AIM: To explore how General Practice Nurses experience implementing change at pace and scale in delivering care during consecutive waves of the COVID-19 pandemic. To evaluate the impact of changes to general practice nurses' working practices on professional wellbeing. BACKGROUND: In response to the COVID-19 pandemic, general practice rapidly and extensively changed care delivery. There has been little exploration of the experiences of General Practice Nurses and care delivery, job satisfaction, workload, stress and professional support. DESIGN: A qualitative case study design of three to five general practice case sites will explore General Practice Nurses' experiences during the Covid-19 pandemic. The study was funded and approved by the General Nursing Council Trust in June 2021. University ethics approval was gained in July 2021. Health Research Authority approval has been obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. METHODS: Data will consist of focus groups and/or semi-structured interviews with General Practice Nurses, primary healthcare team members and other key informants. Business/strategy and nurse team meetings relating to workforce planning/review will be observed. Documents will be analysed and routinely collected general practice data will provide descriptive contextualisation at each site. The study will be theoretically underpinned by the Non-adoption, Abandonment, Scale-up, Spread and Sustainability Framework and data analysed using framework analysis. DISCUSSION: General Practice Nurses have a unique sphere of knowledge and undertake specific work in primary care. This workforce is challenged by recruitment, retention and retirement issues, leading to the loss of highly experienced and knowledgeable professionals. It is important to explore how working practices brought about by Covid-19 affect General Practice Nurses. IMPACT: This study will explore working practices brought about by the Covid-19 pandemic to inform care delivery, patient care and support General Practice Nursing workforce wellbeing and will highlight and mitigate negative aspects of novel and changing care delivery. Key factors in implementing and supporting future practice and change implementation will be developed. TRIAL REGISTRATION: CPMS: 51834.

Men and loneliness in the Covid-19 pandemic: Insights from an interview study with UK-based men.

Since the onset of the Covid-19 pandemic, the UK, like many countries, has had restrictions on social contact, and injunctions of 'social distancing'. This study aimed to generate new insights into men's experiences of loneliness during the pandemic, and consider the ramifications of these for continued/future restrictions, the easing of restrictions, and the future beyond the pandemic. Twenty qualitative interviews were conducted with men between January and March 2021. A maximum variation purpose sample frame required at least three non-white men, three LGBTQ+men, three men with a university education, three without a university education, three 18-30 years old, and three aged 60+. Thematic analysis, focused on semantic themes, was employed as part of a 'grounded' epistemology whereby the stated perspectives of the interviewees drove the content of the study. Seven themes were constructed: (i) lost and new activities and routines; (ii) remote social interaction; (iii) narrowed social spheres; (iv) rethought and renewed recognition of what is important; (v) loneliness with a purpose; (vi) anxiety of social contact; and (vii) easier for themselves than others. Lost routines, fewer meaningful activities, and a reduction in face-to-face interaction, were framed as challenges to preventing loneliness. Solo-living gay men seemed particularly negatively affected. However, many men displayed new, more covid-safe routines and activities. Remote forms of interaction were often utilised, and though they were imperfect, were constructed as worth engaging with, and held capacity for improvement. A moral need to reduce transmission of SARS-COV-2, and a fear of catching it, became important features of participants lives that also affected loneliness. Men at higher risk of health complications from Covid-19 were particularly likely to highlight anxiety of social contact. Reducing restrictions alone may not return everyone to pre-pandemic levels of loneliness, particularly if the pandemic remains a significant public health issue.

Inflammatory bowel disease in the coronavirus (COVID-19) pandemic

This article aims to inform how specialist inflammatory bowel disease (IBD) nurses can protect IBD patients through the novel coronavirus (COVID-19) pandemic