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BMJ Open ; 12(3): e055955, 2022 03 15.
Article in English | MEDLINE | ID: covidwho-1745690


OBJECTIVES: UK general practice has radically altered in response to COVID-19. The general practice nursing team has been central to these changes. To help learn from COVID-19 and maintain a sustainable nursing workforce, general practice should reflect on their support needs and perceptions of organisational strategies. This study aimed to explore primary care nurses' and healthcare assistants' experiences and perceptions of general practice, and the changes made to it, during the pandemic. DESIGN: Exploratory qualitative study using semistructured interviews. Interview data were analysed using Braun and Clarke's 'codebook' thematic analysis. SETTING: General practices in the Midlands, South East and South West England. Interviews were conducted in February and March 2021, as England began to unlock from its third national lockdown. PARTICIPANTS: Practice nurses (n=12), healthcare assistants (n=7), advanced nurse practitioners (n=4) and nursing associates (n=1) recruited using convenience and snowball sampling. RESULTS: Three themes were identified. Difficult changes describes dramatic changes made to general practice at the onset of the pandemic, creating confusion and anxiety. Dealing with change characterises how negative emotions were intensified by fear of infection, problematic government guidance, personal protective equipment (PPE) shortages and friction with doctors; but could be mitigated through effective practice communication, peer support and individual coping strategies. An opportunity for improvement highlights certain changes (eg, the increased use of telehealth) that participants believed could be adopted long term to improve efficiency. CONCLUSION: General practice should learn from the COVID-19 pandemic to nurture the clinical role and resilience of nurses and healthcare assistants in the postpandemic 'new normal'. Robust PPE provision could enable them to undertake their patient-facing duties safely and confidently. Judicious implementation of telehealth could help preserve the practical and caring nature of nursing. Improving channels of communication and interprofessional collaboration could help realise their potential within the primary care team.

COVID-19 , General Practice , Primary Care Nursing , Allied Health Personnel , COVID-19/epidemiology , Communicable Disease Control , Humans , Pandemics
BMJ Open ; 11(10): e051497, 2021 10 18.
Article in English | MEDLINE | ID: covidwho-1476604


OBJECTIVES: In spring 2020, the first COVID-19 national lockdown placed unprecedented restrictions on the behaviour and movements of the UK population. Citizens were ordered to 'stay at home', only allowed to leave their houses to buy essential supplies, attend medical appointments or exercise once a day. We explored how lockdown and its subsequent easing changed young children's everyday activities, eating and sleep habits to gain insight into the impact for health and well-being. DESIGN: In-depth qualitative interviews; data analysed using thematic analysis. SETTING: South West and West Midlands of England. PARTICIPANTS: Twenty parents (16 mothers; 4 fathers) of preschool-age children (3-5 years) due to start school in September 2020. Forty per cent of the sample were from Black, Asian or minority ethnic backgrounds and half lived in the most deprived areas. RESULTS: Children's activity, screen time, eating and sleep routines had been disrupted. Parents reported children ate more snacks, but families also spent more time preparing meals and eating together. Most parents reported a reduction in their children's physical activity and an increase in screen time, which some linked to difficulties in getting their child to sleep. Parents sometimes expressed guilt about changes in activity, screen time and snacking over lockdown. Most felt these changes would be temporary, though others worried about re-establishing healthy routines. CONCLUSIONS: Parents reported that lockdown negatively impacted on preschool children's eating, activity and sleep routines. While some positive changes were identified, many participants described lack of routines, habits and boundaries which may have been detrimental for child health and development. Guidance and support for families during COVID-19 restrictions could be valuable to help maintain healthy activity, eating, screen time and sleeping routines to protect child health and ensure unhealthy habits are not adopted.

COVID-19 , Child, Preschool , Communicable Disease Control , Humans , SARS-CoV-2 , Schools , Sleep