Psychological distress of frontline healthcare workers in the intensive care unit during the early stage of the COVID-19 pandemic: a qualitative study from China.

OBJECTIVE: The rapid spread of COVID-19 has overwhelmed healthcare systems across the world. During the early stage of the pandemic, frontline healthcare workers (FHWs) caring for patients at intensive care units (ICUs) faced extreme pressure and challenges. This qualitative study aimed to describe the different phases of psychological distress of FHWs during the early stage of the COVID-19 pandemic. DESIGN: Qualitative study. SETTING: The First Affiliated Hospital of Zhengzhou University, a designated hospital for patients with COVID-19 in central China. PARTICIPANTS: Eight physicians and six nurses working in the ICU who provided direct patient care for COVID-19 patients. METHODS: A descriptive phenomenological study using thematic analysis was applied. Semi-structured one-on-one interviews over telephone or Wechat (a social platform in China) rather than face-to-face interviews were conducted due to quarantine. Interviews were audio-recorded and transcribed verbatim and then were analysed thematically. FINDINGS: A total of 14 interviews were conducted, and each interview lasted 20-60 min. Five thematic categories were identified, and the participants' psychological experiences were classified into five stages (1) the mobilisation period: a sense of responsibility with worries; (2) the preparation period: worries, fears and doubts about the epidemic; (3) the transitional period: complex and diverse psychological feelings; (4) the adaptation period: self-adjustment and help from external support and (5) the reflection period: a reflection on life and nature. CONCLUSION: The study showed that the COVID-19 pandemic had significant psychological impacts on FHWs. Self-regulation and external support help FHWs to overcome challenges to a certain extent. More attention should be paid to the psychological wellbeing of ICU FHWs in COVID-19-designated hospitals.

Exploring the Pharmaceutical Care of Pharmacists in China During COVID-19-A National Multicenter Qualitative Study.

BACKGROUND: Pharmacists are one of the coronavirus disease-2019 (COVID-19) treatment team members in China, yet only a few single-center studies have described the work experience of pharmacists during the pandemic. PURPOSE: This study aimed to explore in-depth experiences of hospital pharmacists providing pharmacy services during the COVID-19 pandemic in China on a national scale. METHODS: This is a nationwide multicenter qualitative study that used the purposive sampling method. Semi-structured interviews were conducted with 11 pharmacists from large-scale tertiary hospitals in representative provinces of mainland China. The Colaizzi seven-step method was applied to analyze the interview data. RESULTS: Eleven semi-structured interviews were conducted. Each interview lasted 25-70 min. By analyzing the work experiences of pharmacists in COVID-19 designated treatment hospitals, five descriptive themes were categorized: (1) drug supply service; (2) routine clinical pharmacy services; (3) expanded pharmacy services during the epidemic; (4) drug management loopholes; (5) areas of improvements of pharmacy services during a pandemic. CONCLUSION: During the COVID-19 epidemic, Chinese hospital pharmacists played various vital roles. However, there were loopholes in managing narcotic drugs, psychotropic drugs, and donated drugs. The study uncovered areas of improvement in pharmacy services during the pandemic. The emergency response capacity of hospital pharmacists should be continuously improved in the future.

What Is the Role of Pharmacists in Treating COVID-19 Patients? The Experiences and Expectations of Front Line Medical Staff.

Aims: The study aimed to understand the role and the core values of pharmacists and the professional expectations of medical staff for pharmacists in treating COVID-19 patients from the perspectives of the frontline medical staff. The findings help to understand and provide a reference for the career growth path of future pharmacists. Methods: A phenomenological method was used to conduct in-depth interviews with frontline medical staff working in isolation wards during COVID-19. The interview data were analyzed, and the themes were extracted. Results: Pharmacists played a positive role in ensuring the supply of non-routinely stocked drugs, including traditional Chinese medicine preventative preparations, providing drug information and medication consultation for complex patients, and identifying adverse drug reactions. However, at present, the integration of pharmacists and nurses is poor with inadequate communication, and the pharmaceutical care activities provided to physicians were still not comprehensive. Conclusions: The level of pharmaceutical care provided by pharmacists needs to be further strengthened. Frontline medical teams generally have high professional expectations for pharmacists, including expecting pharmacists to become drug therapy experts. They expect pharmacists to fully participate in clinical decision-making, especially playing a central role in managing drug interactions, contraindications, and other clinical uses of drugs.

A qualitative study on the working experiences of clinical pharmacists in fighting against COVID-19.

BACKGROUND: The spread of coronavirus disease 2019 (COVID-19) has overwhelmed healthcare systems across the world. Along with the medical team, clinical pharmacists played a significant role during the public health emergency of COVID-19. This study aimed to explore the working experience of clinical pharmacists and provide reference for first-line clinical pharmacists to prepare for fighting against COVID-19. METHODS: A qualitative study based on descriptive phenomenology was employed with face-to-face and audio-recorded interviews to study the working experience of 13 clinical pharmacists (including two clinical nutritional pharmacists). All interviews were transcribed verbatim, and the interview data were analyzed thematically using NVivo software. RESULTS: Four themes emerged from interview data, including roles of clinical pharmacists, working experiences of clinical pharmacists, psychological feelings of clinical pharmacists, and career expectations of clinical pharmacists. CONCLUSIONS: The results contributed to a deeper understanding of the clinical pharmacists' work experiences in COVID-19 and offered guidance to better prepare clinical pharmacists in participating in a public health crisis.

Qualitative research on the work experience of pharmacists in fever clinics and isolation wards of designated hospitals for novel coronavirus pneumonia (COVID-19).

OBJECTIVE: To understand the work experiences of pharmacists in fever clinics and isolation wards of designated hospitals for the novel coronavirus pneumonia in China and provide the basis for work management strategies and psychological interventions in pharmacy for prevention and control of future epidemics. METHODS: Using qualitative research methods, 13 pharmacists who met the inclusion criteria and worked in fever clinics and isolation wards of designated hospitals for novel coronavirus pneumonia attended focus group interviews and semistructured interviews. The Colaizzi analysis method was used for data analysis, summary and induction. RESULTS: Three themes were identified: (1) the roles of pharmacists in fever clinics and isolation wards in epidemic prevention and control, including ensuring the supply of medicines, providing medication guidance for patients, providing medication information for physicians and nurses, and participating in infection control; (2) the difficulties at work, including the lack of office equipment, information equipment and other infrastructure, the difficulty of management of pharmacists in isolation wards, challenging environments, and insufficient attention of hospitals, medical staff, and society to pharmacists; (3) the loopholes in drug management, including the management of special-class drugs and national free AIDS antiviral drugs, and the retrieval of drugs. CONCLUSION: Pharmacists have played an essential role in the fight against the epidemic of novel coronavirus pneumonia in China. The themes and experiences identified in this study can offer guidance to the pharmacy society in implementing strategies to prepare for future public health events.

Analysis on clinical features of death patients with COVID-19: a retrospective, single-center study from Wuhan, China (preprint)

Background An ongoing global pandemic of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused thousands of deaths in China since December, 2019. We aimed to describe the clinical course of patients died of SARS-CoV-2 infection.Methods In this retrospective study, we reviewed 194 patients with SARS-CoV-2 infection, who died consecutively between Feb 3 to 24, 2020 in Tongji Hospital (Wuhan, China). Basic demographic and clinical information, laboratory findings, complications and treatments were extracted from electronic medical records of Hospital Information System. Unpaired t test was employed to evaluate the statistical differences of the serum level of high-sensitive cardiac troponin I (hs-cTnI) among different age or sex groups. The relationship between hs-cTnI and inflammatory cytokines were estimated using Spearman correlation analysis.Results The death patients aged 69.62 ± 10.98, in which 68.6% were male. 74.7% patients had underlying chronic illnesses. The most common symptoms were fever (83%), cough (69.3%), and dyspnea (65.6%). Decreased lymphocyte count (91.4%), elevated level of hs-cTnI (82.9%) and inflammatory parameters in serum were commonly seen. The hs-cTnI level was significantly higher in the group aged 60–79 and male patients. A week positive correlation was observed between hs-cTnI values and D-dimer values (r = 0.343, p༜0.05). Acute respiratory distress syndrome was the main complication. Assisted respiration, antimicrobial drugs, glucocorticoids and immune globulin were the major treatments.Conclusion Most non-survivors with SARS-CoV-2 infection were old with chronic illnesses, complicated by multiple organ dysfunction. Prevention is better than cure in high-risk population.