Chapter 2

REVIEW OF RELATED LITERATURE

This chapter contains the literature and studies related to the reasons why students don’t

use the library when researching.

COVID-19

COVID-19 is an infectious disease caused by severe acute respiratory syndrome

coronavirus 2 (SARS-CoV-2). Not only is the COVID-19 pandemic a threat to physical health; it

also affects mental health. During a crisis it is natural for individuals to feel fear, sadness and

anxiety. While governments around the world are acting to contain and end this pandemic, the

strain on health, social and economic systems in all countries is unprecedented as stated by

Ghebreyesus (2020).

Experiences of Frontline Healthcare Workers and Their Views about Covid-19

The predominant concern across most staff groups, across all pandemics, was becoming

infected with the virus themselves. Apart from this, fears of contamination were exacerbated by

experiences of inadequate PPE which was a recurrent theme across many papers, transcending

different countries and pandemics as said by Shih et. al (2020).

Thirteen years later, Yin & Zeng (2020) document nurses’ experiences of treating

COVID-19 in China and quote one of their participants, “I hope that personal protective

equipment is available every day so that I don’t have to worry as much about myself or my

colleagues getting infected.”

A few studies provided exceptions where frontline workers reported less concern over

their own immediate health, but nevertheless still expressed significant concerns for others as
said by Chen Q. et.al (2020). Workers were preoccupied about their families becoming ill and

were particularly concerned that they themselves might transmit the illness to their loved ones.

Many made sacrifices and sought to protect their loved ones by staying away from them.

For example, Yin and Zeng (2020) quote a nurse in China in the early stages of COVID-19, “I

stay at a hotel every day and am afraid of getting my family sick. I’m afraid to go home and

haven’t seen my mom and dad for a long time.”

Healthcare workers were also impacted by practical and environmental issues in the

settings in which they worked. Whilst, for the most part, healthcare workers’ fears were allayed

by adequate PPE, it was also noted in several papers how the PPE caused discomfort and

impacted on communication. For example, Broom et al. (2017), described the experience of

doctors and nurses in an Australian hospital: The equipment was described as cumbersome and

hot, and staff reported finding it difficult to communicate with others who were wearing the PPE.

Basic clinical procedures were deemed impossible by participants while wearing the

recommended PPE.

However, because of staff shortages, some participants were noted to describe feeling

guilty for taking time off to rest as said by Gherson R. et. al (2016). Even when able to take a

break, this was not always possible. Several studies described staff being unable to leave the

hospital or hotel environment, feeling isolated outside of work or having little access to other

activities.

It also appeared in the studies of COVID-19. Fawaz and Samaha (2020) quoted one of

the nurses in their sample from Lebanon: “My aunt was standing way far from me when I saw

her in the street…she felt like I was infected…treated me as if I am the virus.”

 This also extended to the families of healthcare workers with some reporting their

children being discriminated against as reported by Kim Y. (2018). Other studies pointed to the

hypocrisy that some healthcare workers experienced when they were publicly commended for

their work but privately discriminated against stated by Im SB et. al (2018).

For the most part, healthcare workers appreciated the opportunity to stay in touch with

friends and family, usually over the phone. This was reported to bring them comfort as well as

allay the worries of their loved ones. However, this could still place an emotional burden on the

workers: “Sometimes, I was too tired to talk over the phone but I still wanted to switch on the

mobile because I was concerned about my family’s condition…I found I could not control my

temper during that period. After two sentences of talk with my family, I felt short of breath and

became very frustrated. I understood that my family would like to listen to my voice, but I just

could not talk.” said one of the nurses as reported by Mok E et. al (2019)

As the number of COVID-19 cases increase in the Philippines, the humanitarian

community is concerned about how the most vulnerable and disadvantaged families and children

in this region will be affected by the pandemic.

At a time when communities and families are in quarantine, health workers,

humanitarians and other essential workers in the region are at the forefront of the emergency

response, working hard to stop the spread of the virus and provide life-saving services, supplies

and information.

“We are in a different war with COVID-19. This is not like ISIS where we can see the

enemy,” said Dr. Macmac as written by Rosa Mae Atem (2020) in an article online, rural

health unit officer in Lumba Bayabao, Lanao del Sur. Dr. Macmac and other health care workers

face enormous pressure to stop COVID-19 infections.

 Living with the COVID-19 pandemic and working with its victims is a new phenomenon.

Thus, the challenges frontline health workers faced were unprecedented. So, the researchers used

a phenomenological design to study the experiences of physicians and nurses during the COVID-

19 pandemic. This way, the researchers could capture the essence of what the COVID-19

pandemic was like for them through the eyes of people who had experienced it, according to

Terehari (2015)

Health professionals, also known as frontliners, have been working dedicatedly

throughout this global health crisis. Eftekhar M. (2021), also found that stress and anxiety were

prevalent among healthcare professionals as a result of this pandemic. They had a feeling of

helplessness, hopelessness, and powerlessness in the pandemic, as well as a lack of control over

this new situation. They were also worried about their own health as well as the health of their

family and friends, particularly the elderly and sick.

The new global health hazard also puts an extra workload on health workers. Our study

discovered that, due to the alteration in shifts in the work schedule, the front-liners felt stressed,

which is consistent with the study of Coto J. (2020) Besides, they were frightened that they

might spread the virus to their family and friends. They required the necessary personal

protective equipment (PPE), training; however, they lacked safety precautions, which made them

susceptible when the crisis erupted.

The present findings were also consistent with those of Vindrola-Padros (2020), which

showed that their tireless duties during the pandemic and frequent changes in the guidelines

caused excessive pressure on the frontline workers in the hospitals. The pandemic has revealed

that the incorrect size of the PPEs and heating issues with them have caused discomfort at work

among the workers. This and similar “surprises” spurred burnout, anxiety, and stress.
 The pr esent study intended to explore the lived experiences of frontline healthcare

professionals during the COVID-19 pandemic. The infection and death rate due to the virus had

a multifaceted impact on people’s lives. The SARS-CoV-2 virus disrupted people’s physical and

mental health all around the world, regardless of gender, ethnicity, profession, or other factors,

and it is still rapidly spreading. The pandemic had a direct impact on medical professionals as

they delivered superior healthcare to the public while they endured the worst conditions they had

ever experienced, as said by Shen B. (2020).

The researchers found that health professionals felt severely shocked by the high death

rate, which they had never encountered in normal hospital work. The physicians and nurses had

to support their COVID-19 patients emotionally. Sterling (2020), investigated how in addition to

their typical caring activities, healthcare staff watched patients for COVID-19 symptoms such as

fever, shortness of breath, and so on, and generally tended to their patients’ mental wellbeing.

According to Chang D. (2020), people who work in the medical health service have to

deal with a lot of problems both at work and at home. As a result of the worldwide health

catastrophe, they are experiencing feelings of loneliness, exhaustion, concern, and anxiety.

Frontline healthcare workers, on the other hand, are valuable assets for any government aiming

to reduce the disease burden. Their health and safety are essential not just for providing sufficient

and safe care delivery, but also for disease prevention.

Moreover, there is a chance to learn from the experiences of pandemics and provide

greater support for healthcare workers. Throughout the COVID-19 crisis, they demonstrated a

remarkable sense of responsibility and coordinated attempts to ease patients’ miseries.

Furthermore, they played critical roles in the treatment of COVID-19 patients, and they

attempted to offer the finest service to patients in a tough circumstance, said by Luo D. (2020).
 Morgantini (2020), also identified the relationship between job-related stress and

workload, along with inadequate organizational support, and burnout among healthcare workers.

The researchers found that health professionals felt severely shocked by the high death rate,

which they had never encountered in normal hospital work. The physicians and nurses had to

support their COVID-19 patients emotionally.

 REFERENCES

 Kristina L Newman, Yadava Jeve, Pallab Majumder: Experiences and emotional strain of

NHS frontline workers during the peak of the COVID-19 pandemic. International Journal

of Social Psychiatry 68 (4), 783-790

 Maryam Riaz, Mueen Abid & Zaqia Bano (2021) Psychological problems in general

population during covid-19 pandemic in Pakistan: role of cognitive emotion regulation,

Annals of Medicine, 53:1, 189-196, DOI: 10.1080/07853890.2020.1853216

 Dalmacito A Cordero, Jr., Personal Protective Equipment During the COVID-19

Pandemic in the Philippines: Challenges and Interventions, Annals of Work Exposures

and Health, 2023;, wxad019, https://doi.org/10.1093/annweh/wxad019

 Rahman, M., Hoque, N., Alif, S.M. et al. Factors associated with psychological distress,

fear and coping strategies during the COVID-19 pandemic in Australia. Global Health

16, 95 (2020). https://doi.org/10.1186/s12992-020-00624-w

 Su Z, McDonnell D, Cheshmehzangi A, Li X, Maestro D, Šegalo S, Ahmad J, With Great

Hopes Come Great Expectations: Access and Adoption Issues Associated With COVID-

19 Vaccines, JMIR Public Health Surveill 2021;7(8):e26111

DOI: 10.2196/2611

 Ghebreyesus TA. Addressing mental health needs: an integral part of COVID-19

response. World Psychiatry. 2020;19(2):129–30. https://doi.org/10.1002/wps.20768.

 Shih FJ, Gau ML, Kao CC, Yang CY, Lin YS, Liao YC, et al. Dying and caring on the

edge: Taiwan's surviving nurses' reflections on taking care of patients with severe acute

respiratory syndrome. Appl Nurs Res. 2007;20(4):171–80.

https://doi.org/10.1016/j.apnr.2006.08.007

 Yin X, Zeng L. A study on the psychological needs of nurses caring for patients with

coronavirus disease 2019 from the perspective of the existence, relatedness, and growth

theory. Int J Nurs Sci. 2020;7(2):157–60. https://doi.org/10.1016/j.ijnss.2020.04.002.

 Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff

in China during the COVID-19 outbreak. Lancet Psychiatry. 2020;7(4):e15–6.

https://doi.org/10.1016/S2215-0366(20)30078-X.

 Broom J, Broom A, Bowden V. Ebola outbreak preparedness planning: a qualitative

study of clinicians' experiences. Public Health. 2017;143:103–8.

https://doi.org/10.1016/j.puhe.2016.11.008.

 Gershon R, Dernehl LA, Nwankwo E, Zhi Q, Qureshi K. Experiences and psychosocial

impact of West Africa Ebola deployment on US health care volunteers. PLoS Currents.

2016;8. https://doi.org/10.1371/currents.outbreaks.c7afaae124e35d2da39ee7e07291b6b5

 Fawaz M, Samaha A. The psychosocial effects of being quarantined following exposure

to COVID-19: A qualitative study of Lebanese health care workers. Int J Soc Psychiatry.

2020;66(6);560–5. https://doi.org/10.1177/0020764020932202.
 Kim Y. Nurses' experiences of care for patients with Middle East respiratory syndrome-

coronavirus in South Korea. Am J Infect Control. 2018;46(7):781–7.

https://doi.org/10.1016/j.ajic.2018.01.012.

 Im SB, Baumann SL, Ahn M, Kim H, Youn BH, Park MK, et al. The experience of

Korean nurses during the Middle East respiratory syndrome outbreak. Nurs Sci Q.

2018;31(1):72–6. https://doi.org/10.1177/0894318417741119.

 Mok E, Chung BP, Chung JW, Wong TK. An exploratory study of nurses suffering from

the effects of Covid-19. Int J Nurs Pract. 2019. ;11(4):150–60.

https://doi.org/10.1111/j.1440-172X.2005.00520.x.

 Rosa Mae Atem. Stories from the frontline, “Humanitarian workers going beyond the

call of duty to stop the spread of COVID-19 in the Bangsamoro region”. (2020).

https://www.unicef.org/philippines/stories/stories-frontline

 Coto J, Restrepo A, Cejas I, Prentiss S. The impact of COVID-19 on allied health

professions. PLoS One. 2020;15(10):e0241328.

 Vindrola-Padros C, Andrews L, Dowrick A, et al. Perceptions and experiences of

healthcare workers during the COVID-19 pandemic in the UK. BMJ Open.

2020;10(11):e040503.

 Eftekhar Ardebili M, Naserbakht M, Bernstein C, Alazmani-Noodeh F, Hakimi H,

Ranjbar H. Healthcare providers experience of working during the COVID-19 pandemic:

a qualitative study. Am J Infect Control. 2021;49(5):547-554

 Teherani A, Martimianakis T, Stenfors-Hayes T, Wadhwa A, Varpio L. Choosing a

qualitative research approach. J Grad Med Educ. 2015;7(4):669-670

 . Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological

distress among Chinese people in the COVID-19 epidemic: implications and policy

recommendations. Gen Psychiatr. 2020;33(2):e100213.

 Razu SR, Yasmin T, Arif TB, et al. Challenges faced by healthcare professionals during

the COVID-19 pandemic: a qualitative inquiry from Bangladesh. Public Health Front.

2021;9:647315.

 Sterling MR, Tseng E, Poon A, et al. Experiences of home health care workers in New

York City during the coronavirus disease 2019 pandemic: a qualitative analysis. JAMA

Intern Med. 2020;180(11):1453-1459

 Chang D, Xu H, Rebaza A, Sharma L, Dela Cruz CS. Protecting health-care workers

from subclinical coronavirus infection. Lancet Respir Med. 2020;8(3):e1

 Liu Q, Luo D, Haase JE, et al. The experiences of health-care providers during the

COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020;8(6):e790-

e798.

 Morgantini LA, Naha U, Wang H, et al. Factors contributing to healthcare professional

burnout during the COVID-19 pandemic: a rapid turnaround global survey. PLoS One.

2020;15(9):e0238217.