Evaluation of the Brief Coping Orientation to Problems Experienced scale and exploration of coping among primary health care nurses during COVID-19.

AIM: This study aimed to explore primary health care nurses' coping strategies and evaluate the psychometric properties of the Brief Coping Orientation to Problems Experienced (COPE) scale. BACKGROUND: Primary health care nurses are experiencing significant COVID-19-related psychological impacts. Beyond understanding the impacts, there is a need to explore coping strategies. METHODS: This online cross-sectional survey was completed by 359 Australian primary health care nurses between October and December 2020. RESULTS: Factor analysis revealed seven factors (support, disengagement and venting, humour, positive reframing, acceptance, substance use and spiritual/religious beliefs) (Cronbach's alpha > .69). There was an association between age, years of nursing and years of primary health care nursing and the factors of 'support', 'disengagement and venting' and 'positive reframing'. Years of experience were also associated with the factor 'humour'. Urban respondents had higher scores for the 'support' factor. CONCLUSIONS: The Brief COPE scale is a valid and reliable tool for assessing primary health care nurses' coping. As demographic characteristics impact the coping strategies that nurses use, supports need to be tailored to optimize their impact. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers need to consider the workforce demographics when designing and implementing support strategies. The Brief COPE can identify current coping strategies and inform interventions to build coping capacity.

Experiences of Australian primary healthcare nurses in using telehealth during COVID-19: a qualitative study

ObjectiveThis study sought to explore the experiences of Australian primary healthcare (PHC) nurses in the use of telehealth during COVID-19. Telehealth was defined as the use of any telecommunications mode (eg, telephone and videoconferencing) to deliver healthcare.Design and settingThematic analysis of qualitative interviews undertaken in Australian PHC.ParticipantsTwenty-five PHC nurses who had participated in a national survey about their experiences during COVID-19 were recruited using purposive sampling.MethodsSemistructured telephone interviews were conducted from June to August 2020. Interviews lasted a mean of 38.5 min. They were audio-recorded and transcribed before thematic analysis was undertaken. The consolidated criteria for reporting qualitative research were followed.ResultsFour overarching themes were identified: preparedness, accessibility of telehealth, care experience and impacts on the PHC nurses’ role. Some nurses were experienced in the use of telehealth, while others indicated a lack of preparation and limited appropriate technology to support its use. Telehealth enabled patients to access care but did not support complex clinical assessment. Participants indicated that patient engagement in telehealth was dependent on access and confidence using technology, perceived safety when physically attending the practice and the value they placed on care via telehealth. Many participants expressed frustration about telehealth funding and its impact on facilitating nurses to practise to their full scope.ConclusionTelehealth has provided a means to continue PHC service delivery during COVID-19. While there are advantages to adopting this technology, considerations of the challenges and lessons from this experience are important to inform the future implementation of telehealth initiatives.

Mental health, safety and support during COVID-19: A cross-sectional study of primary health care nurses.

AIM: The aim of this study is to explore primary health care nurses' mental health, concerns and perceived safety and supports during COVID-19. BACKGROUND: Respiratory pandemics have negative impacts on nurses' wellbeing. While literature is replete with hospital nurses' experiences, there is less exploration of COVID-19 impacts on primary health care nurses. Given the importance of primary health care nurses in the health system, understanding their experiences is vital. METHODS: Three hundred and fifty nine primary health care nurses responded to an online cross-sectional survey. The Depression Anxiety Stress Scales (DASS-21) was used to measure emotional state. Data were analysed using descriptive and inferential statistics. RESULTS: DASS-21 scores indicated that 39.6% of participants were experiencing symptoms of depression, anxiety or stress. Of those, 41.8% were experiencing symptoms on one scale, 26.9% were experiencing symptoms on two scales and 31.2% were experiencing symptoms across all three scales. Most participants identified that their feelings were related to COVID-19. CONCLUSIONS: COVID-19 is having a significant impact on primary health care nurses' mental health. Nurse managers need to develop strategies to effectively address nurses' concerns and effectively support them to sustain the workforce during and after the pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: Findings from this study can inform the design of effective nurse support programmes to reduce mental health impacts and promote staff wellbeing during the pandemic.

The impact of COVID-19 on primary health care delivery in Australia.

AIMS: To validate the 'safe and effective staffing tool' and explore the impact of COVID-19 on the quality of Australian primary health care (PHC). DESIGN: A national survey was conducted from October to December 2020. METHODS: The online survey was distributed via social media and professional organisations to PHC nurses. RESULTS: Three-hundred fifty-nine PHC nurses participated. A two-factor solution was found with factors named; 'Perception of quality of care provided' and 'Personal satisfaction with care delivered'. Cronbach's alpha demonstrated good internal consistency for the total scale (α = .915) and each subscale (α = .879/α = .864). Nearly three-quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor 'perceptions of quality of care provided' and the total 'quality and satisfaction with care'. A lack of time, inadequate supervision and support, and performing non-nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID-19 had impacted negatively on the detection and management of non-COVID related health conditions. CONCLUSION: The 'safe and effective staffing tool' is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID-19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID-19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high-quality care to optimise health outcomes and maintain nurse satisfaction. IMPACT: This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses.

Primary Health Care Nurses' Perceptions of Risk During COVID-19: A Qualitative Study.

PURPOSE: COVID-19 has presented health care professionals with unprecedented challenges. Significant risks have emerged as nurses have continued to work in delivering frontline health care during the pandemic. Feeling "at risk" has significant deleterious effects on nurses. The study sought to explore the perceptions of risk by Australian primary health care nurses (PHC) during COVID-19. METHODS: Twenty-five Australian PHC nurses were purposively recruited from survey respondents who indicated a willingness to be interviewed. Phone interviews were undertaken between June and August 2020. Audio-recordings were transcribed and analyzed thematically. FINDINGS: Participants shared concerns about risks in the workplace that emerged during COVID-19 and described the strategies used to mitigate these identified risks. Three themes were identified: (a) Professional concerns, (b) Personal/family concerns, and (c) Patient needs. CONCLUSIONS: Understanding PHC nurses' perceptions of risk during COVID-19 provides an important insight into how they can be better supported to manage the risks that they face and feel safer in their workplace. Ensuring that PHC nurses are well-supported is important to optimize job satisfaction, reduce burnout and improve patient care. CLINICAL RELEVANCE: There is a need to ensure that nurses feel safe during crises such as pandemics to protect both individual nurses and the broader workforce. Protecting the health workforce is essential to optimizing service delivery and promoting health outcomes.

The psychological well-being of primary healthcare nurses during COVID-19: A qualitative study.

AIM: To explore primary healthcare nurses' psychological well-being related to the COVID-19 pandemic. DESIGN: Qualitative descriptive study. METHODS: Semi-structured interviews were conducted with 25 participants between June and August 2020 who indicated their willingness to participate in an interview following a national survey. Interviews were audio-recorded and transcribed verbatim by professional transcribers. Data were analysed using thematic analysis. RESULTS: The importance of professional and public support and acknowledgement of the nurses' role during the pandemic positively influenced feelings of being valued. The psychological impact of negative experiences increased anxiety and stress levels. Participants reported a range of self-care strategies, including increased vigilance with infection control at home and work and attention to physical exercise and diet. Most participants remained positive about their roles and career decisions, although some indicated that the negative psychological impacts prompted re-evaluation of their career. CONCLUSIONS: Primary healthcare nurses have been exposed to a range of personal and professional stressors during the pandemic that have impacted their psychological well-being. Awareness of stressors and an understanding of what has helped and what has impacted well-being are important in guiding future workplace support systems. Further work to explore the long-term impact of these stressors and the effectiveness of coping strategies employed by primary healthcare nurses is warranted. IMPACT: Managers and professional organisations need to consider the personal and professional stressors that have impacted on primary healthcare nurses' psychological well-being to promote health and well-being among nurses following COVID-19.