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      Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice

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          Abstract

          Background

          Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear.

          Aims

          The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers’ needs and provide recommendations for supporting front-line staff during the current and future pandemics.

          Method

          This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK ( n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic ( n = 14).

          Results

          The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules.

          Conclusions

          Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.

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          Most cited references50

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

            Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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              Using the framework method for the analysis of qualitative data in multi-disciplinary health research

              Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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                Author and article information

                Journal
                BJPsych Open
                BJPsych Open
                BJO
                BJPsych Open
                Cambridge University Press (Cambridge, UK )
                2056-4724
                January 2021
                10 December 2020
                : 7
                : 1
                : e15
                Affiliations
                [1]Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London , UK; and Rapid Research Evaluation and Appraisal Lab, University College London , UK
                [2]Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London , UK; and Department of Psychiatry, School of Medicine, Pontifical Catholic University of Chile , Chile
                [3]Institute for Global Health, University College London , UK; and Rapid Research Evaluation and Appraisal Lab, University College London , UK
                [4]Institute of Epidemiology and Health Care, University College London , UK
                [5]Department of Anthropology, University College London , UK
                [6]Institute of Epidemiology and Health Care, University College London , UK
                [7]Institute of Epidemiology and Health Care, University College London , UK
                [8]Institute of Population Health Science, Queen Mary University of London , UK
                [9]Marie Curie Palliative Care Research Department, University College London , UK
                [10]Health Services Research Centre, National Institute of Academic Anaesthesia , London, UK; and Rapid Research Evaluation and Appraisal Lab, University College London , UK
                [11]Department of Targeted Intervention, University College London , UK; and Rapid Research Evaluation and Appraisal Lab, University College London , UK
                Author notes
                Correspondence: Dr Norha Vera San Juan. Email: n.verasanjuan@ 123456ucl.ac.uk
                Author information
                https://orcid.org/0000-0002-8677-7341
                https://orcid.org/0000-0002-2967-5816
                Article
                S2056472420001489
                10.1192/bjo.2020.148
                7844154
                33298229
                4c118113-4e17-4f03-b957-f53dbd633795
                © The Author(s) 2020

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 July 2020
                : 26 October 2020
                : 12 November 2020
                Page count
                Figures: 1, Tables: 3, References: 48, Pages: 9
                Categories
                Review

                covid-19,healthcare workers,well-being,qualitative research,rapid review

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