Your browser doesn't support javascript.
PSYCHOLOGICAL WELLBEING IN PROFESSIONALS WORKING IN THE CANCER SETTING: THE IMPACT OF THE COVID-19 PANDEMIC
Supportive Care in Cancer ; 30:S18-S19, 2022.
Article in English | EMBASE | ID: covidwho-1935774
ABSTRACT
Introduction The impact of the COVID-19 pandemic on the psychological wellbeing of oncology healthcare professionals (HCPs) is an emerging field of inquiry, with new research focusing on the experiences and needs of staff. Occupational health and workforce literature places emphasis on preventive initiatives in the workplace, and the promotion of positive psychological health amongst HCPs (Boorman 2009). There is an overwhelming literature on stress, anxiety and burnout amongst HCPs using self-report questionnaires, in contrast to how individuals develop and sustain positive wellbeing under difficult circumstances through the self-management of stress and mobilisation of coping strategies (Cai et al. 2020). The effects of high stress working environments, particularly in health crises may lead to poorer psychological wellbeing outcomes amongst HCPs because of reduced peer support, low autonomy and social belonging, increased staff turnover rates and high workloads (Morgantini et al. 2020). This study explores the evolving experiences of oncology HCPs in the workplace during the COVID pandemic, and its impact on their psychological health. We captured the experiences of a wide range of staff to provide a broad understanding of their needs and where support might be required. Qualitative methods were used to explore how HCPs coped and managed their wellbeing during the pandemic. Methods The study aims were to i) explore how oncology HCPs managed their psychological wellbeing during the pandemic, together with the support systems, coping strategies and knowledge and skills they used to maintain positive mental health, ii) identify the barriers and opportunities for psychological wellbeing, iii) inform the development of interventions and resources to promote and sustain the self-management of psychological wellbeing amongst oncology HCPs. Data was collected using diaries and semi-structured interviews over a period of 4 months from December 2020 to April 2021. A total of 102 HCPs were recruited comprising medical staff, nursing staff, radiographers, allied health professionals (non-Radiographers) and support staff (Cancer Support Workers, Healthcare Assistants). Fifty participants submitted diaries and 35 interviews were undertaken. The response rate was 64%. Thirty-five participants consented but did not submit data and two nurses requested to withdraw (37% non-response rate). Demographic data revealed the majority of participants were female (83%) and worked full-time (73%). The age range was evenly distributed between the 21-50 year groups (16% in the 51-60 age group). Most participants (62%) had been employed at the cancer centre for < 5 years, reflecting the recruitment of new staff associated with the expansion of the organisation. Transcribed diaries and interviews were analysed using Interpretative phenomenological analysis (Smith & Osborn 2015). IPA recognises individuals make sense of situations through an interpretation of events, and offers insights into how a person, within a specific context, understands and experiences a phenomenon. Results Participants experienced a myriad of emotions associated with coping during the COVID pandemic. Emotions fluctuated between positive and negative feelings, marked by the passage of time, life events and organisational changes. Regardless of professional group, individuals were dealing with similar challenges, as all were experiencing the pandemic in the context of the same organisational environment. Four main themes emerged 1) Self-management, 2) Delivery of patient care, 3) Managing professional roles, 4) Managing the employer/ employee relationships. Self-management Participants used different strategies to manage wellbeing such as concealing emotions and speaking out. The concealment of emotions was used to maintain the appearance of coping, which was important in managing professional relationships, such as not letting colleagues down. Various strategies were used to regulate emotions, including slowing down, appreciating life more and being positive. Thought rocessing enabled the long-term consequences of the pandemic to be managed, helping to minimise the impact of fatigue and loss of concentration, however, this was not without its consequences. Sustaining the ups and downs of positive outlooks over long periods was described as an emotional 'roller-coaster'. The 'emotional roller-coaster' metaphor was used in conjunction with 'Ground Hog' day, denoting the monotony and drawn out nature of the pandemic. Seeing the bigger picture and comparing self with others aided adjustment and self-regulation, supported by the belief that others were experiencing worse situations such a job losses. Participants expressed guilt and gratitude that they had not been redeployed to the COVID front line. Delivery of patient care The provision of high quality patient care was a dominant theme in the narratives of staff. Job satisfaction was contingent on being able to meet the needs of patients and feeling that a good job had been done. The transition to remote working, loss of face-to-face contact with patients and absence of patients' families required adjustment to new ways of working. Participants described how the loss of physical contact with patients impacted negatively on patient-professional communication, in particular, not being able to interpret the person's body language as a result of mask-wearing and social distancing. The pandemic dramatically altered the cancer care landscape from reductions and cancellations in elective care and cancer treatment to protect immunosuppressed patients, to delays in diagnoses and treatment, cessation of clinical trials, and more advanced stage disease in patients with poorer health outcomes. Service pressures linked to the reinstatement and escalation of cancer services required resilience and adjustment on the part of participants. Managing professional roles The management of professional roles during the pandemic disrupted usual ways of working linked to changes in patient care, multidisciplinary teamwork and workforce organisation. Although a proportion of staff continued to work in their clinical areas during the pandemic, other teams adopted a hybrid approach, working between clinical and home environments. Working from home, dealing with technology-related issues, finding a suitable location to work in, managing home schooling and care of elderly relatives alongside the job required additional psychological resources. Participants faced redeployment from their usual places of work to help other clinical areas in greater need. As staff transitioned to working from home, corridor conversations and informal networking opportunities were lost. That said, the normality of working life and support of colleagues was a constant in the lives of participants and provided a platform on which to build positive wellbeing. Participants described the 'Dunkirk spirit' and being 'in the same boat' as others, with team solidarity and camaraderie being a core component of the wellbeing experience. Managing the employer/employee relationships A number of staff expressed frustration that management did not appear to listen to concerns and were unaware of what staff were going through, however, others felt positively supported. Although several spoke of hiding their emotions and anxieties, openly displaying feelings resulted in support being offered. Staff believed more attention should be paid to the day-to-day pressures of providing patient care. It was acknowledged that managers may have their own mental health needs, but it was less clear how these were being met. Support was believed to differ between management grades, with those closer to the workforce and more visible being valued. Communication between staff and the organisation was seen as key to understanding wellbeing needs. Email appeared to be the preferred method for conveying information during the pandemic, however, access to email was variable across staff groups, potentially leading to inequalities in staff experiences. The majority of staff in this study had not accessed wellbeing resources, mainly due to lack of time and being unfamiliar with how to use them. Conclusions This study has identified the dynamic and evolving nature of mental health and wellbeing amongst HCPs. Participants displayed enormous resilience throughout the pandemic, rising to the challenges posed by COVID, however, the study has highlighted the importance of identifying mental health issues and how these may change over time.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Supportive Care in Cancer Year: 2022 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Supportive Care in Cancer Year: 2022 Document Type: Article