Balancing burdens of infection control: Norwegian district medical officers' ethical challenges during the COVID-19 pandemic.

BACKGROUND: In several countries, district medical officers (DMOs) are public health experts with duties including infection control measures. The Norwegian DMOs have been key actors in the local handling of the COVID-19 pandemic. METHODS: The aim of the study was to explore the ethical challenges experienced by Norwegian DMOs during the COVID-19 pandemic, and how the DMOs have handled these challenges. 15 in-depth individual research interviews were performed and analyzed with a manifest approach. RESULTS: Norwegian DMOs have had to handle a large range of significant ethical problems during the COVID-19 pandemic. Often, a common denominator has been the need to balance burdens of the contagion control measures for different individuals and groups. In another large set of issues, the challenge was to achieve a balance between safety understood as effective contagion prevention on the one hand, and freedom, autonomy and quality of life for the same individuals on the other. CONCLUSIONS: The DMOs have a central role in the municipality's handling of the pandemic, and they wield significant influence. Thus, there is a need for support in decision-making, both from national authorities and regulations, and from discussions with colleagues.

The Meaning of Online Social Work Education for Students and Faculty during COVID-19: Between Preservation and Change

Academic online social work (SW) education has developed over the decades, fully transitioning to it following the COVID-19 pandemic. Studies have examined the emotional responses, coping strategies and resilience of faculty and students to this transition. Our aim is to examine online education experiences and their meaning for faculty and SW students following the COVID-19 pandemic. Semi-structured qualitative interviews were audio-recorded, transcribed verbatim and analysed based on principles of thematic analysis. Interviewees included fifteen SW students and fifteen faculty members at schools of SW (n = 30) from universities and colleges throughout Israel, who also participated in a quantitative survey addressing online SW education. Findings include two themes: (i) Between the illusion of intimacy and the illusion of anonymity: Is it so? (ii) Experiences of difficulty, acceptance and choice relating to online education interactions. Both themes refer to interpersonal dimensions of communication and contact between faculty and students and among students. The desire to preserve a traditional education format versus openness to the online platform is discussed using critical reflexivity. Alternative education programmes combining the two should be developed. The unique and deceptive interplay between intimacy and anonymity in the online space should be considered in courses relying on interpersonal interaction and self-disclosure. The COVID-19 pandemic at the beginning of 2020 has dramatically changed lives in all domains, including the format of social work (SW) education, which shifted from face-to-face encounters to online. Although online education had been developed in SW education before the COVID-19 pandemic, it was restricted to SW courses on theory and policy and was never fully employed to include courses teaching SW practice skills. Accordingly, our aim is to examine online education experiences and their meaning for faculty and SW students following the COVID-19 pandemic. Semi-structured qualitative interviews were audio-recorded, transcribed verbatim and analysed. Participants included fifteen SW students and fifteen faculty members at schools of SW (n = 30) from universities and colleges throughout Israel. Students and faculty addressed the illusion of intimacy and anonymity in the online space, revealing its complexity, including difficulties, acceptance and choice relating to online education interactions. Findings refer to interpersonal dimensions of communication and contact between faculty and students and among students. We discuss preserving a traditional education format versus openness to online platforms and suggest developing alternative education programmes combining the two. Furthermore, the unique and deceptive interplay between intimacy and anonymity in the online space should be considered in courses requiring interpersonal interaction and self-disclosure.

Interprofessional weaning boards for invasively ventilated patients in intensive care units: Qualitative interview study with healthcare professionals in Germany.

Numbers of mechanically ventilated patients are increasing worldwide. Weaning Boards could support weaning from the ventilator by facilitating interprofessional consultations between Weaning Centers and nonpneumological intensive care units. This study, which is linked to the project Prevention of invasive Ventilation, aimed to explore the design and implementation of future Weaning Boards. Semistructured interviews were conducted with physicians, nurses, respiratory therapists, and physiotherapists of intensive care units and Weaning Centers in Baden-Wuerttemberg, Germany. Participants were asked to share their views on (a) required characteristics of Weaning Boards and (b) the current care of weaning patients in their wards. Qualitative data analysis included inductive and deductive steps referring to the Template for Intervention Description and Replication checklist and the Consolidated Framework for Implementation Research. The 14 interviewed healthcare professionals addressed characteristics of future Weaning Boards including (a) preconditions, (b) procedure, (c) interprofessional participants, (d) type of performance, and (d) time frame. Identified determinants for successful implementation were related to (a) individual characteristics of healthcare professionals, (b) ward characteristics, and (c) healthcare system characteristics. Weaning Boards could be a useful tool to advance knowledge sharing between professionals, improve education about weaning protocols, and support patient-oriented care. The implementation of Weaning Boards can be influenced by individual characteristics of participating professionals, difficulties in the interaction between professional groups, the present workplace culture, and the current coronavirus disease 2019 (COVID-19) pandemic.

Meaning in life among Chinese undergraduate students in the post-epidemic period: A qualitative interview study.

Background: COVID-19 epidemic has lasted for nearly 3 years, and revolutionized social life. In the study, in-depth interviews were conducted with Chinese undergraduate students to explore their understanding and experience of meaning in life. Meaning of life is interpreted from four aspects: life goals, life value, life enthusiasm, and life freedom. These four aspects are independent yet interrelated. Based on the free grasp of life, individuals explore and pursue the true meaning of life goals, acquire life value in evaluating the completion of life goals, and subsequently experience enthusiasm for life. Life enthusiasm and the perception of life value can help individuals to further understand and possess their meaning of life. Materials and methods: The present study adopts the qualitative method to understand the experience of meaning in life among Chinese undergraduate students. Semi-structured interviews were conducted, and six people participated the study. The Grounded Theory was adopted to analyze the qualitative data. Results: (1) Chinese undergraduates had clear life goals and obtained a certain sense of achievement and satisfaction when striving for these goals. (2) The life value of Chinese undergraduates was mainly to their families, but there was also a willingness to make due contributions to the country and society. (3) Chinese undergraduates' feelings about life were polarized, but they all expressed the view of "living in the moment and cherishing the present." (4) Chinese undergraduate students see life freedom as freedom of choice and generally believed that COVID-19 did not restrict their lives very much. (5) Chinese undergraduate students gained a deeper understanding of meaning in life after this major public health emergency.

What is the role of occupational physicians in the workplace during the COVID-19 pandemic in Japan? A qualitative interview study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had various impacts on businesses and workers worldwide. The spread of infection has been reported through cluster outbreaks in the workplace, and World Health Organization has emphasized workplace infection control measures. Occupational physicians (OPs) are expected to actively support employers' efforts to minimize the damage of the pandemic. However, there is little research on the role of these specialists during a pandemic. Clarification of the contributions of OPs to health and safety at the workplace in the COVID-19 pandemic would be beneficial to ensure that OPs can be effectively deployed in the next pandemic. METHODS: We employed semi-structured interviews and qualitative content analysis of the interview transcripts. Twenty OPs were selected as priority candidates from among 600 OPs certificated of the JSOH, and thirteen who met the eligibility criteria agreed to participate. The online interviews were conducted in November and December 2020 with thirteen OPs. We extracted meaning units (MUs) from interview transcripts according to the research question: "What was the role of OP in the COVID-19 pandemic?" and condensed and abstracted them into codes and categorized them. Validity was confirmed by additional 5 OPs interviews. RESULTS: A total of 503 MUs were extracted from the transcripts. These were abstracted into 10 sub-categories and two categories. Categories 1 and 2 dealt with "Role in confronting the direct effects of the pandemic" and "Role in confronting the indirect effects of the pandemic" and accounted for 434 (86.3%) and 69 (13.7%) MUs, respectively. These results were validated by another 5 interviews. CONCLUSION: This study identified the role of OPs in Japan in the COVID-19 pandemic. The results showed that they made a wide range of contributions to the direct and indirect effects of the pandemic. We hope our findings will help OPs during future pandemics or other long-term emergency situations.

Absent Bodies: Psychotherapeutic Challenges during COVID-19.

INTRODUCTION: The paper's main aim is to analyze the theme of psychotherapy which, during the months of lockdown, has undergone a considerable transformation as it moved, in many cases, to the virtual modality. The scarce literature on this subject is divided between those who maintain that the screen establishes a relational distance between the patient and the therapist (disengagement theory) and those who instead consider it an element that stimulates and facilitates communication (stimulation theory). METHOD: Utilizing a qualitative and phenomenological interview, which allowed me to collect the testimonies of therapists and patients, I will try to understand if and how the fundamental components of psychotherapy and clinical encounter have changed. RESULTS: I will describe how the lack of bodily resonance affects psychotherapy and emphasize the centrality of often-underestimated elements such as the atmosphere and setting. CONCLUSION: I will finally argue that what is missing is indeed an embodied trust which, in my view, is necessary for a successful therapeutic relationship.

Is There a Need for Cultural Adaptation of the Last Aid Course?-A Mixed-Methods Study across the Danish-German Border.

Last Aid courses (LAC) have been established in 20 countries in Europe, Australia, and America to improve the public discourse about death and dying and to empower people to contribute to end-of-life care in the community. A mixed-methods approach was used to investigate the views of LAC participants about the course and cultural differences in relation to care and nursing at the end of life in the border region of Germany and Denmark. One-day workshops were held, including Last Aid courses in German and Danish, focus group interviews, and open discussions by the participants. The results show that almost all participants appreciate the LAC as an option to talk and learn about death and end-of-life care. The informants find individual differences more important than cultural differences in end-of-life care but describe differences connected to regulations and organization of services across the border. Suggestions for adaptation and improvement of the LAC include the topics of organization and support across the border, religions, and cultures, and supporting people in grief. The findings of the study will inform a revision of the Last Aid curriculum and future projects across the border and will help to include the views of minorities.

Lessons for a COVID-19 era: Barriers and facilitators to court ordered online parenting programs for divorcing and separating parents.

Family courts are increasingly interested in online parenting programs for divorcing and separating parents, particularly during the COVID-19 pandemic. To our knowledge, no previous study has evaluated the barriers to and facilitators of parent participation in these programs for family law cases. We interviewed 61 parents in the midst of family law cases regarding their perspectives. While many parents viewed online parent programs positively (e.g., convenient), they also reported barriers to participation (e.g., technology problems). We offer recommendations (e.g., communication about program benefits) to support courts as they decide whether to continue ordering online parent programs following the pandemic.

["We knew it was going to be tough, but we didn't expect this!" Experiences with the inclusion of cancer patients with a migrant background and their relatives in the field of psycho-oncology]. / "Wir wussten, dass es schwierig wird, doch damit haben wir nicht gerechnet!" Erfahrungen beim Studieneinschluss von Krebspatient*innen mit Migrationshintergrund und Angehörigen im Bereich der Psychoonkologie.

BACKGROUND: The process of enrolling participants is an important component and often a time-consuming step in scientific research projects. Due to different financial, organisational and ethical framework conditions, the enrolment of participants is often a challenge. In this article, we report our experiences of enrolling patients in clinical trials made in the project "Psycho-oncological care of cancer patients with a migration background - a mixed methods study" (POM). METHODS: Participants were recruited through outpatient haemato-oncology practices. Patients and relatives were primarily made aware of the project by the treating physicians and recruited to participate in qualitative interviews. RESULTS: Nine patients and relatives were interviewed nationwide in individual qualitative interviews. In addition to the COVID-19 pandemic, there were other patient enrolment challenges. In many cases, participation was refused. The reasons included: "not interested", the use of the terms "psycho-oncology" or "person with a migration background", family denying permission to participate, no face-to-face interview due to the COVID-19 pandemic as well as too much emotional distress and deterioration of health after prior consent. DISCUSSION: Enrolling study participants from vulnerable groups for a sensitive topic such as psycho-oncology entails multiple challenges. In order to achieve successful study inclusion, regular telephone and written exchanges with the respective practice staff proved to be helpful, allowing an overview of challenges to be gained and study inclusion to be evaluated and adjusted in a timely manner. CONCLUSION: In research projects with vulnerable groups and on sensitive topics, both a target-group-specific, sensitive approach in plain language (layman's terms) and regular consultations with the persons responsible for study inclusion in care facilities should take place in order to adapt the existing procedure during the study inclusion process, if necessary.

Living with the risk of being infected: COPD patients' experiences during the coronavirus pandemic.

AIMS: To explore the existential significance of living with the risk of being infected with coronavirus in patients with COPD. BACKGROUND: Distancing measures aim to break the coronavirus transmission chains. Physical separation from social networks and social isolation are correlated with anxiety and depression. People with a chronic obstructive lung disease are particularly vulnerable due to the increased risk of a serious course of illness, so therefore many of them choose self-isolation to protect themselves from COVID-19. DESIGN: A qualitative exploratory study using individual semi-structured interviews. METHODS: From June-September 2020, 13 participants were recruited through advertisements on Facebook as a convenience sample for semi-structured individual interviews. The interviews took place through virtual platforms or in physical meetings. Data were analysed using Ricoeur's phenomenological approach, involving naïve reading, a structural analysis and a critical interpretation strategy. The study has been reported in line with COREQ guidelines. FINDINGS: Living with the threat of being infected with coronavirus has greatly affected everyday life for patients with COPD. The nagging fear of coronavirus as a death threat was a dominant feeling, together with anxiety, loneliness and hope. With self-isolation, followed concerns of being forgotten and thoughts of the future, balancing between fearing the worst, and hoping the best. CONCLUSIONS: Patients with moderate to severe COPD feel compelled to self-isolate, as they fear dying from COVID-19. The study revealed a need for proactive contact with health professionals to calm the patients' feelings of deprivation, loneliness, hopelessness and anxiety. RELEVANCE TO CLINICAL PRACTICE: Information about the patient's perspective may be used to develop targeted interventions aimed at giving adequate information, supporting hope, implementing digital or virtual solutions to keep in contact and avoid the feeling of being alone and forgotten during a pandemic crisis.

The experiences of nurses infected with COVID-19 in Wuhan, China: A qualitative study.

AIM: To understand about the experiences and feelings of the nurses infected with COVID-19 when caring for patients with COVID-19. BACKGROUND: With the sudden outbreak of coronavirus disease 2019 (COVID-19), nurses take care of patients with COVID-19 and have a very high risk of being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) themselves. METHODS: This study adopted a qualitative design of hermeneutic phenomenology. A purposeful sampling was used, and all data were collected through in-depth semi-structured telephone interviews then analysed using interpretative phenomenological analysis. RESULTS: The interview data generated 4 topics and 14 secondary topics. Four major themes were identified from this study, including 'experiences of infection', 'health belief', 'social support' and 'the pursuit of self-worth'. CONCLUSIONS: Nurses infected by COVID-19 experienced a physical and psychological shock. They had a strong sense of responsibility and willingness to take risks. Providing professional psychological counselling and physical rehabilitation services are crucial. IMPLICATIONS FOR NURSING MANAGEMENT: This manuscript provides nursing managers an understanding of the personal experiences and needs of clinical nurses in their work, especially during COVID-19. It is helpful for nursing managers to explore the greater driving force of nurses and prepare nursing human resources for greater challenges.