Instructive Messages and Lessons From Chinese Countermarching Nurses of Caring for COVID-19 Patients: A Qualitative Study

Abstract

Introduction:

The World Health Organization declared the COVID-19 outbreak as a Public Health Emergency of International Concern on January 31, 2020. China was the first country to experience the challenges of controlling COVID-19. Therefore, the purpose of this study was to examine the experiences of Chinese nurses who countermarched to the outbreak city for medical support in the very first period of this global infection.

Methodology:

A qualitative study of phenomenological research design was used to describe the experiences of 10 Chinese nurses. Data were collected in February 2020 through in-depth interviews and analyzed by conventional content analysis methods.

Results:

Chinese nurses experienced different psychological stages, work pressure, and challenges. New concepts of nursing also emerged during their clinical care for COVID-19 patients.

Discussion:

The guidance synthesized from the Chinese nurse stories could give specific direction for a well-prepared global nursing workforce and high-quality patient care in the present and future epidemics. The worries about discrimination of COVID-19 patients’ needs to be addressed culturally and emotionally as a priority by health care workers when they care for COVID-19 patients.

Keywords

COVID-19 nurses qualitative study China nursing

Get full access to this article

View all access options for this article.

References

Anderson

R. M.

Heesterbeek

Klinkenberg

Hollingsworth

T. D.

(2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet, 395(10228), 931-934. https://doi.org/10.1016/s0140-6736(20)30567-5

Babrow

A. S.

Kasch

C. R.

Ford

L. A.

(1998). The many meanings of uncertainty in illness: Toward a systematic accounting. Health Communication, 10(1), 1-23. https://doi.org/10.1207/s15327027hc1001_1

Bastani

Bahrami

M. A.

(2020). COVID-19 related misinformation on social media: A qualitative study from Iran. Journal of Medical Internet Research. Advance online publication. https://doi.org/10.2196/18932

Bohlken

Schömig

Lemke

M. R.

Pumberger

Riedel-Heller

S. G.

(2020). COVID-19 pandemie: Belastungen des medizinischen personals: Ein kurzer aktueller peview [COVID-19 pandemic: Stress experience of health care workers: A short current review]. Psychiatrische Praxis, 47(4), 190-197. https://doi.org/10.1055/a-1159-5551

Bruns

D. P.

Kraguljac

N. V.

Bruns

T. R.

(2020). COVID-19: Facts, cultural considerations, and risk of stigmatization. Journal of Transcultural Nursing, 31(4), 326-332. https://doi.org/10.1177/1043659620917724

Chen

Liang

Guo

Fei

Wang

Sheng

Cai

Wang

Zhang

(2020). Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry, 7(4), e15-e16. https://doi.org/10.1016/s2215-0366(20)30078-x

Dicicco-Bloom

Crabtree

B. F.

(2006). The qualitative research interview. Medical Education, 40(4), 314-321. https://doi.org/10.1111/j.1365-2929.2006.02418.x

Elo

Kyngäs

(2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x

Graneheim

U. H.

Lindgren

B. M.

Lundman

(2017). Methodological challenges in qualitative content analysis: A discussion paper. Nurse Education Today, 56, 29-34. https://doi.org/10.1016/j.nedt.2017.06.002

10.

Graneheim

U. H.

Lundman

(2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105-112. https://doi.org/10.1016/j.nedt.2003.10.001

11.

Huang

Lin

Tang

Zhou

(2020). Special attention to nurses’ protection during the COVID-19 epidemic. Critical Care, 24(1), Article 120. https://doi.org/10.1186/s13054-020-2841-7

12.

Hung

L. S.

(2003). The SARS epidemic in Hong Kong: What lessons have we learned? Journal of the Royal Society of Medicine, 96(8), 374-378. https://doi.org/10.1258/jrsm.96.8.374

13.

Hunter

Price

D. A.

Murphy

van der Loeff

I. S.

Baker

K. F.

Lendrem

Matthias

Schmid

M. L.

Pareja-Cebrian

Welch

Payne

B. A. I.

Duncan

C. J. A.

(2020). First experience of COVID-19 screening of health-care workers in England. Lancet, 395(10234), e77-e78. https://doi.org/10.1016/s0140-6736(20)30970-3

14.

International Council of Nursing. (2020). ICN COVID-2019 Update: Data on infected healthcare workers and access to protective equipment in the prevention of the virus. https://www.icn.ch/news/icn-covid-2019-update-data-infected-healthcare-workers-and-access-protective-equipment-vital

15.

Kallio

Pietilä

A. M.

Johnson

Kangasniemi

(2016). Systematic methodological review: Developing a framework for a qualitative semi-structured interview guide. Journal of Advanced Nursing, 72(12), 2954-2965. https://doi.org/10.1111/jan.13031

16.

Lai

Wang

Cai

Wei

Chen

Tan

Kang

Yao

Huang

Wang

Liu

(2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), Article e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976

17.

Yang

Liu

Z. H.

Zhao

Y. J.

Zhang

Cheung

Xiang

Y. T.

(2020). Progression of mental health services during the COVID-19 outbreak in China. International Journal of Biological Science, 16(10), 1732-1738. https://doi.org/10.7150/ijbs.45120

18.

Mishel

M. H.

(1990). Reconceptualization of the uncertainty in illness theory. Image: Journal of Nursing Scholarship, 22(4), 256-262. https://doi.org/10.1111/j.1547-5069.1990.tb00225.x

19.

Deng

Zhang

Lang

Liao

Wang

Qin

Huang

(2020). Work stress among Chinese nurses to support Wuhan for fighting against the COVID-19 epidemic. Journal of Nursing Management, 28(5), 1002-1009. https://doi.org/10.1111/jonm.13014

20.

Nielsen

D. S.

Dieperink

K. B.

(2020). Cultural perspectives and nurses reactions on the corona pandemic: A critical view from Denmark. Journal of Transcultural Nursing, 31(4), 333-336. https://doi.org/10.1177/1043659620924118

21.

Petzold

M. B.

Plag

Ströhle

(2020). Umgang mit psychischer Belastung bei Gesundheitsfachkräften im Rahmen der Covid-19-Pandemie [Dealing with psychological distress by health care professionals during the COVID-19 pandemia]. Nervenarzt, 91(5), 417-421. https://doi.org/10.1007/s00115-020-00905-0

22.

Schultz

G. S.

Cobb-Stevens

(2004). Husserl’s theory of wholes and parts and the methodology of nursing research. Nursing Philosophy, 5(3), 216-223. https://doi.org/10.1111/j.1466-769X.2004.00190.x

23.

Tan

L. F.

Seetharaman

S. K.

(2020). COVID-19 outbreak in nursing homes in Singapore. Journal of Microbiology, Immunology, and Infection. Advance online publication. https://doi.org/10.1016/j.jmii.2020.04.018

24.

Thompson

D. R.

Lopez

Lee

Twinn

(2004). SARS: A perspective from a school of nursing in Hong Kong. Journal of Clinical Nursing, 13(2), 131-135. https://doi.org/10.1046/j.1365-2702.2003.00884.x

25.

World Health Organization. (2020, June 16). Coronavirus disease (COVID-19) emergency dashboard. https://covid19.who.int/

26.

Xiang

Y. T.

Zhao

Y. J.

Liu

Z. H.

X. H.

Zhao

Cheung

C. H.

(2020). The COVID-19 outbreak and psychiatric hospitals in China: Managing challenges through mental health service reform. International Journal of Biological Science, 16(10), 1741-1744. https://doi.org/10.7150/ijbs.45072

27.

Zhan

Qin

Xue

Zhu

(2020). Death from Covid-19 of 23 health care workers in China. New England Journal of Medicine, 382, 2267-2268. https://doi.org/10.1056/NEJMc2005696

28.

Zhao

Zhu

Pérez

A. E.

Zhang

Shi

Zhang

Gao

Wang

Yang

Zaller

Sun

Operario

Zhang

(2018). MHealth approach to promote oral HIV self-testing among men who have sex with men in China: A qualitative description. BMC Public Health, 18(1), Article 1146. https://doi.org/10.1186/s12889-018-6046-9

29.

Zhu

Sun

Zhang

Wang

Fan

Yang

Xiao

(2020). Prevalence and influencing factors of anxiety and depression symptoms in the first-line medical staff fighting against COVID-19 in Gansu. Frontiers in Psychiatry, 11, Article 386. https://doi.org/10.3389/fpsyt.2020.00386