The Barriers and Facilitators of Covid-19 Patient Care: A Conventional Content Analysis

Background & Aims: Epidemics and their consequences have widespread effects on health care workers. Since hospital work environments are under high workload, complexity, and chaos, and are constantly changing due to different medical and care developments. During epidemic and pandemic crises, this situation is exacerbated by an increase in the number of patients and lack of resources, resulting in an increased likelihood of physical and mental vulnerability of staff. In this regard, the Covid-19 pandemic has caused physical and psychological challenges for hospital staff more than the previous epidemic, especially since the high prevalence and mortality rate of the virus is the most important challenge in this field. The other common unprecedented consequence of these conditions can be depression, anxiety, insomnia, and burnout of staff especially among the elderly and experienced staff. These secondary consequences have negative impacts on the quality of the services provided by the staff and act as major barriers to effective health care delivery. However, despite the many barriers, some facilitators can facilitate and improve the delivery of different services. For example, protective actions, social distancing, and widespread detective strategies, and detection of patients can play an important role in controlling the disease and thus reducing the workload of health staff. Therefore, identifying barriers and facilitators in health care delivery for patients can be helpful in the management of this pandemic and we can rely on them to provide the basis for further studies and thus better planning. Therefore, this study aimed to explore the barriers and facilitators of caring for Covid-19 patients . Materials & Methods: This qualitative study was conducted in 2020 employing Conventional content analysis Approach. In this study, semi-structured interviews were conducted with 11 physicians and 14 nurses who were working in the Covid-19 units of hospitals affiliated to Tehran University of Medical Sciences and were willing to participate in the study. In order to follow the social distancing, all interviews were conducted virtually in which the individual raised issues such as lack of privacy, and not being at the bedside of a dying patient as his main concerns. Lack of privacy, reliance on writing the last name on the clothes and not introducing themselves to the patient at the beginning of the patient admission due to high workload and lack of time, elimination of the principle of respect for autonomy, lack of regular patient visits in the final stages of life except moral distress are discussed and classified. Conclusion: According to the results, culture, individual, and organizational factors can be considered as both barriers and facilitators. But ethical challenges, as an important obstacle, can cause burnout in the medical staff. It is suggested that the authorities provide more psychological support to the treatment team, or give them a recovery period by employing new staff and reducing the workload of the treatment team. Also, getting help from a psychologist and psychiatrist, encouraging people to exercise, meditation and music can help strengthen the workforce in hospitals. Therefore, authorities should plan to increase the resilience of the medical staff in emerging and man- made phenomena such as the Covid-19 pandemic.