Survey of staff experiences of potential stigma during the COVID19 pandemic.

The impact of COVID-19 on everyone's lives has been significant. However, there is also another factor related to the well-being of healthcare workers (HCWs) and that is how they are perceived by the general public. The aim of this study is to provide insight into the scope of this potential problem and describe how HCWs perceive community views and if this influences provision of patient care. A paper-based survey was conducted within mental health wards and community services as well as medical and surgical wards of a large metropolitan hospital in Queensland. Exploratory Factor Analysis was used to explore the dimensionality of the HCW stigma scale from the staff survey. Confirmatory Factor Analysis was used to assess validity and reliability. A total of 545 staff (67.9% nursing, 6.6% medical, 14.7% Allied Health and 10.8% Administrative) completed the survey between June and July 2020. Exploratory Factor Analysis showed that five factors explained 55% of the variance and represent factors of (i) Alienation, (ii) Social isolation, (iii) Perceived workplace harmony, (iv) Perceived job demands, (v) Clinical self-efficacy. The survey displayed high internal reliability and discriminant validity was observed for all subscales. Australian HCW's reported feeling well supported at work and appreciated by society in general during the pandemic, possibly because Australian healthcare services were better prepared than those countries that first experienced COVID-19.

Implementation of the Safewards model in public mental health facilities: A qualitative evaluation of staff perceptions.

BACKGROUND: The Safewards model is gaining increasing acceptance in the mental health field in Australia and overseas. One of the most important goals of inpatient psychiatric services is to provide a safe and therapeutic environment for both patients and staff. However, this goal can be difficult to achieve if staff-patient interaction is not conducive to preventing violence and aggression. OBJECTIVE: The purpose of this study was to explore nursing staff perceptions of the factors impacting on their capacity to establish Safewards in acute adult inpatient wards. DESIGN: This study was guided by a phenomenological approach to develop a rich understanding of staff perceptions using semi-structured interviews. SETTING AND SAMPLE: The setting was three acute mental health wards attached to general hospitals; one in a large provincial hospital and two in metropolitan hospitals in south-east Queensland. Interview participants were a purposive sample of fifteen registered nurses across each of the three wards. METHOD: Semi-structured interviews were conducted at 12 months post-implementation of Safewards. The study was underpinned by Michie's integrative framework of behaviour change that helped identify target areas in order to enhance successful implementation of this model. RESULTS: Content analysis of interview transcripts highlighted a range of factors including failure to address the difficulties encountered by some staff in engaging with Safewards interventions, lack of support from management, poor use of nurse educator time, the 'language' of Safewards, high acuity on the study wards, and staff and patient turnover. CONCLUSION: This study highlights some difficulties with implementing Safewards and maintaining fidelity of the Safewards interventions in busy acute inpatient wards. Although these findings are from a qualitative study consisting of only 15 staff, our results indicate that efforts to implement Safewards need to address challenges faced by staff in engaging with the interventions, ensure buy-in from management, ensure adequate training and support during implementation and review training materials to ensure they fit with the local (i.e. Australian) context. Safewards provides an opportunity for a change in attitudes and development of a more therapeutic ward environment.