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      Trying to Control the Situation: A Theory of Iranian Midwives’ Experiences of the Coping Process with their Professional Roles Following COVID-19

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          Abstract

          Background:

          Midwives are at the frontlines of the fight against the Coronavirus Disease (COVID-19) pandemic. Working under these circumstances threatens their lives and that of their family members; midwives’ adjustment to work increases their efficiency in providing care services to pregnant mothers, but midwives’ coping process is ambiguous and complex. Thus, the aim of this study was to explore the coping process of midwives with their professional roles following COVID-19.

          Materials and Methods:

          This study was conducted using grounded theory during 2020 to 2021. For this purpose, 30 midwives were purposively and theoretically selected from two educational hospitals and health centers in Mashhad and Torbat Heydarieh cities, Iran. The data were collected using in-depth semi-structured interviews. The collected data were analyzed using the Strauss and Corbin method (2008) in MAXQDA software.

          Results:

          The main concern of the participants was “perception of the threats to their health” and the core category revealed from the data was “trying to control the situation.” Midwives coped with the COVID-19 pandemic in four steps, namely early initial confrontation, reaction to the COVID-19 pandemic, management of challenges, and reconstructing. Support from family and the health system and religious belief were the interventional conditions in this theory.

          Conclusions:

          Results of this study can be used to provide health managers with a better understanding of the conditions affecting the coping strategies of midwives with their professional roles during COVID-19. Therefore, this study provides the required data for developing an effective intervention to help nurse midwives to cope with this issue.

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          Most cited references25

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          The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study

          Summary Background In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak. Methods We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. Findings We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was “being fully responsible for patients' wellbeing—‘this is my duty’”. Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was “challenges of working on COVID-19 wards”. Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was “resilience amid challenges”. Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience. Interpretation The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. Funding National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.
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            Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID-19) in Hubei, China

            Background Throughout China, during the recent epidemic in Hubei province, frontline medical staff have been responsible for tracing contacts of patients infected with coronavirus disease 2019 (COVID-19). This study aimed to investigate the psychological impact and coping strategies of frontline medical staff in Hunan province, adjacent to Hubei province, during the COVID-19 outbreak between January and March 2020. Material/Methods A cross-sectional observational study included doctors, nurses, and other hospital staff throughout Hunan province between January and March 2020. The study questionnaire included five sections and 67 questions (scores, 0–3). The chi-squared χ2 test was used to compare the responses between professional groups, age-groups, and gender. Results Study questionnaires were completed by 534 frontline medical staff. The responses showed that they believed they had a social and professional obligation to continue working long hours. Medical staff were anxious regarding their safety and the safety of their families and reported psychological effects from reports of mortality from COVID-19 infection. The availability of strict infection control guidelines, specialized equipment, recognition of their efforts by hospital management and the government, and reduction in reported cases of COVID-19 provided psychological benefit. Conclusions The COVID-19 outbreak in Hubei resulted in increased stress for medical staff in adjacent Hunan province. Continued acknowledgment of the medical staff by hospital management and the government, provision of infection control guidelines, specialized equipment and facilities for the management of COVID-19 infection should be recognized as factors that may encourage medical staff to work during future epidemics.
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              Women’s and men’s work, housework and childcare, before and during COVID-19

              Evidence from past economic crises indicates that recessions often affect men’s and women’s employment differently, with a greater impact on male-dominated sectors. The current COVID-19 crisis presents novel characteristics that have affected economic, health and social phenomena over wide swaths of the economy. Social distancing measures to combat the spread of the virus, such as working from home and school closures, have placed an additional tremendous burden on families. Using new survey data collected in April 2020 from a representative sample of Italian women, we analyse the effects of working arrangements due to COVID-19 on housework, childcare and home schooling among couples where both partners work. Our results show that most of the additional housework and childcare associated to COVID-19 falls on women while childcare activities are more equally shared within the couple than housework activities. According to our empirical estimates, changes to the amount of housework done by women during the emergency do not seem to depend on their partners’ working arrangements. With the exception of those continuing to work at their usual place of work, all of the women surveyed spend more time on housework than before. In contrast, the amount of time men devote to housework does depend on their partners’ working arrangements: men whose partners continue to work at their usual workplace spend more time on housework than before. The link between time devoted to childcare and working arrangements is more symmetric, with higher percentages of both women and men spending less time with their children if they continue to work away from home. For home schooling, too, parents who continue to go to their usual workplace after the lockdown are less likely to spend greater amounts of time with their children than before. Similar results emerge for the partners of women not working before the emergency. Finally, analysis of work–life balance satisfaction shows that working women with children aged 0–5 are those who find balancing work and family more difficult during COVID-19. The work–life balance is especially difficult to achieve for those with partners who continue to work outside the home during the emergency.
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                Author and article information

                Journal
                Iran J Nurs Midwifery Res
                Iran J Nurs Midwifery Res
                IJNMR
                Iranian Journal of Nursing and Midwifery Research
                Wolters Kluwer - Medknow (India )
                1735-9066
                2228-5504
                Jul-Aug 2022
                09 August 2022
                : 27
                : 4
                : 294-300
                Affiliations
                [1 ] Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
                [2 ] Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
                [3 ] Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
                [4 ] Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
                Author notes
                Address for correspondence: Morvarid Irani, Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh Universityof Medical Sciences, Torbat Heydariyeh, Iran. E-mail: Irani.morvarid@ 123456google.com
                Article
                IJNMR-27-294
                10.4103/ijnmr.ijnmr_245_21
                9580573
                36275346
                59db3392-81c0-4d6d-8822-fc265055ca46
                Copyright: © 2022 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
                : 07 August 2021
                : 01 November 2021
                : 16 February 2022
                Categories
                Original Article

                Nursing
                covid-19,grounded theory,nurse midwives,professional role
                Nursing
                covid-19, grounded theory, nurse midwives, professional role

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