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      The Safe Coping Strategy of Nurses Working in the Care Units of Patients with COVID-19: A Qualitative Study

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          Abstract

          Background:

          Nurses are in direct contact with patients with COVID-19 and have faced much tension with the rapid spread of coronavirus. This study aimed to explore the safe coping strategies of nurses when facing the COVID-19 pandemic.

          Materials and Methods:

          In this qualitative study, data were collected from September 20 to December 20, 2020, in Isfahan (Iran) through individual semi-structured interviews with 12 nurses working in the five referral centers for patients with COVID-19. Informants were selected via purposeful sampling and interviewed in one or several sessions at the appropriate time and place. The interviews continued until data saturation. All interviews continued until no new data were added to the continuous content analysis. Data analysis was performed using conventional content analysis based on Graneheim and Lundman’s approach. We used Guba and Lincoln’s criteria (including credibility, transferability, conformability, and dependability) to guarantee trustworthiness and rigor.

          Results:

          Safe coping strategies for nurses were discovered in two categories of “wise liberation” and “care,” and six subcategories. “Wise liberation” consisted of four subcategories: “living in the moment,” “accepting the inner and outer world,” “life enrichment,” and “building opportunities.” “Care” contained two subcategories: “caring for others” and “caring for oneself.”

          Conclusions:

          Discovering safe coping strategies for nurses could set the stage for special educational–therapeutic interventions so they can better understand their experiences and take advantage of the best coping strategies.

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          Most cited references28

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          Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

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            A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

            Summary Background An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. Methods In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. Findings From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36–66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3–6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6–10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. Interpretation Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. Funding The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).
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              Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

              Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.

                Author and article information

                Journal
                Iran J Nurs Midwifery Res
                Iran J Nurs Midwifery Res
                IJNMR
                Iran J Nurs Midwifery Res
                Iranian Journal of Nursing and Midwifery Research
                Wolters Kluwer - Medknow (India )
                1735-9066
                2228-5504
                Mar-Apr 2023
                14 April 2023
                : 28
                : 2
                : 214-219
                Affiliations
                [1 ] Associate Professor, Department of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan
                [2 ] PhD in Nursing, Nursing and Midwifery Care Research Center, Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan
                [3 ] PhD Candidate in Industrial and Organizational Psychology, Department of Psychology, Faculty of Educational Sciences and Psychology, Isfahan University, Isfahan
                [4 ] PhD in Psychology Islamic Azad University Science and Research Branch, Tehran(Esfahan), Isfahan
                [5 ] MSc in Health Psychology, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                Address for correspondence: Mr. Seyed Mohamad Hossein Mousavi, MSc in Health Psychology, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: Seyedmhm74@ 123456gmail.com
                Article
                IJNMR-28-214
                10.4103/ijnmr.ijnmr_138_21
                10275468
                37332374
                5291cfc3-14bf-4b79-acb4-b43bdf4d1ecb
                Copyright: © 2023 Iranian Journal of Nursing and Midwifery Research

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 17 April 2021
                : 07 December 2022
                : 26 December 2022
                Categories
                Original Article

                Nursing
                strategies,coping,covid-19,nurses,occupational health,adaptation,psychological
                Nursing
                strategies, coping, covid-19, nurses, occupational health, adaptation, psychological

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