Puerto Rican healthcare workers' perspectives on the impact of COVID-19 pandemic on their role, patient care, and mental health.

PURPOSE: To explore the personal and work-related stressors of healthcare workers in Puerto Rico and the organizational support they received during the pandemic. DESIGN AND METHODS: We used a qualitative descriptive design and from April - November, 2021, conducted semi-structured individual interviews with Puerto Rican frontline healthcare workers (n = 12) and supervisors (n = 5). FINDINGS: Thematic analysis revealed five major themes: (a) Organizations' response to COVID-19; (b) increased complexity of patients; (c) intensified work and psychological demand for nurses; (d) overwhelmed and overworked; and (e) recommendations for healthcare leadership. Participants explained that their organizations' responses to COVID-19 were insufficient for  meeting the demands and acuity of the patients. Closure of outpatient services contributed to people presenting to hospitals with exacerbated chronic conditions - especially the elderly. With COVID-19 precautions prohibiting family visitation, nurses became responsible for total care, including emotional support of patients. In addition, the shortage of staff contributed to nurses assuming greater workloads, feeling overwhelmed and overworked, and healthcare worker resignations. Given their experiences, healthcare workers recommended that healthcare leadership show more appreciation for staff, demonstrate empathy, include frontline workers in decision-making, and provide mental health resources for staff. CONCLUSIONS: This study with Puerto Rican frontline workers and supervisors uncovers the multiple stressors experienced during the COVID-19 pandemic. Our findings underscore the need for prioritizing the well-being of healthcare workers, preparing healthcare leadership on how to support staff, and mandating nurse-to-patient ratios. CLINICAL RELEVANCE: Healthcare workers explained the barriers they experienced for providing quality care to their patients. They also presented recommendations for healthcare leadership to facilitate supporting frontline workers, which ultimately contributes to optimal patient care.

Teen Dating Violence and the Acceptability of a Safety Decision Aid: Perspectives of Puerto Rican Youth.

INTRODUCTION: The purpose of this study was to describe Puerto Rican adolescents' perspectives about an application "app" to prevent further injury from teen dating violence (TDV). METHODS: We conducted three semistructured focus group interviews. RESULTS: Participants (N = 16) were 14-20 years old. Most (63%) were not currently in a relationship; three participants reported a history of TDV, and seven reported that they "did not know" whether they had ever experienced TDV. We identified four themes: (a) clarifying dating violence, (b) psychological abuse-the reality of TDV, (c) silence around dating violence, and (d) youth need a different tool. Adolescents thought that the app was beneficial for educating the user about dating violence behaviors. They also identified that the app should be modified to better suit adolescents, in part by, focusing more on psychological abuse and using other visuals to relay information rather than text. Adolescents also questioned the utility of the app as a bystander because TDV is often concealed and not discussed. CONCLUSION: Puerto Rican adolescents in our study expressed the need for information that could be presented in a more concise and dynamic format and highlighted the cultural barriers of silence around issues of dating violence.