Health care workers’ experiences during the COVID-19 pandemic: a scoping review

(2022) 20:27 Chemali et al. Human Resources for Health https://doi.org/10.1186/s12960-022-00724-1 Open Access RESEARCH Health care workers’ experiences during the COVID‑19 pandemic: a scoping review Souaad Chemali1, Almudena Mari‑Sáez1, Charbel El Bcheraoui2 and Heide Weishaar2* Abstract Background: COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers’ (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published dur‑ ing the first year of the COVID-19 pandemic to identify factors affecting HCWs’ experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included. Results: 161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs’ well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs’ personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as impor‑ tant factors affecting HCWs’ experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs’ experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital set‑ tings, and HCWs in low- and lower middle income countries. Discussion: This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual fac‑ tors impacting their experiences and needs. To better understand HCWs’ experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pan‑ demics need to consider HCWs’ circumstances. Conclusions: Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strength‑ ening health systems for future pandemics. Keywords: Health care workers, Experiences, Resilience, Coping, COVID-19, Health systems, Pandemic *Correspondence: 2 Evidence‑Based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany Full list of author information is available at the end of the article Introduction The COVID-19 pandemic has put health systems worldwide under pressure and tested their resilience. The World Health Organization (WHO) acknowledges health © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Chemali et al. Human Resources for Health (2022) 20:27 workforce as one of the six building blocks of health systems [1]. Health care workers (HCWs) are key to a health system’s ability to respond to external shocks such as outbreaks and as first responders are often the hardest hit by these shocks [2]. Therefore, interventions supporting HCWs are key to strengthening health systems resilience (ibid). To develop effective interventions to support this group, a detailed understanding of how pandemics affect HCWs is needed. Several recent reviews [3–27] focus on HCWs’ experiences during COVID-19 and the impact of the pandemic on HCWs’ well-being, including their mental health [3, 7, 8, 11–14, 16–27]. Most of these reviews refer to psychological scales measurements to provide quantifiable information on HCWs’ well-being and mental health [8, 13, 14, 19, 21–25, 28]. While useful in assessing the scale of the problem, such quantitative measures are insufficient in capturing the breadth of HCWs’ experiences and the factors that impact such experiences. The added value of qualitative studies is in understanding the complex experiences of HCWs during COVID-19 and the contextual factors that influence them [29]. This paper reviews qualitative studies published during the first year of the pandemic to investigate what is known about HCWs’ experiences during COVID-19 and the factors and support needs associated with those experiences. By presenting HCWs’ perspectives on the pandemic, the scoping review provides the much-needed evidence base for interventions that can help strengthen HCWs and alleviate the pressures they experience during pandemics. Methods The review follows the Joanna Briggs Institute (JBI) process and guideline on conducting scoping reviews [30]. JBI updated guidelines identify scoping reviews as the most suitable choice to explore the breadth of literature on a topic, by mapping and summarizing available evidence [30]. Scoping reviews are also suitable to address knowledge gaps and provide insightful input for decision-making [30]. The review also applies the PRISMA checklist guidance on reporting literature reviews [31]. Information sources A systematic search was conducted on PubMed database between the 9th and 28th of March 2021. Search strategy Drawing on Shaw et al. [32] and WHO [33], the search strategy used a controlled vocabulary of index terms including Medical Subject Headings (Mesh) of the keywords and synonyms “COVID-19”, “HCWs”, and Page 2 of 17 “qualitative”. Keywords were combined using the Boolean operator “AND” (see Additional file 1). Eligibility criteria The populat (...truncated)