The experiences of Red Crescent relief workers during the COVID-19 pandemic in Iran: a qualitative phenomenological study

Mohammadkhani et al. BMC Health Services Research https://doi.org/10.1186/s12913-023-09920-8 (2023) 23:956 BMC Health Services Research Open Access RESEARCH The experiences of Red Crescent relief workers during the COVID-19 pandemic in Iran: a qualitative phenomenological study Minoo Mohammadkhani1 , Mohammad Sadegh Tavakoli Sani2, Arezoo Sarani2 and Narges Khanjani3* Abstract Background The daily increase of infected individuals and mortalities related to COVID-19 in Iran increased public fear and anxiety and affected the job performance of many health workers, including the Iranian Red Crescent Society, as one of the organizations responding to COVID-19. Methods This study aimed to explore the experiences of Red Crescent rescuers, using a qualitative method with an interpretative phenomenological analysis (IPA), and by conducting semi-structured and in-depth interviews with Red Crescent relief workers from Mashhad in September 2020. Participants were selected by purposive sampling. Results Rescuers in the Red Crescent Society, had gained different experiences during the COVID-19 pandemic. The experiences were categorized into four main themes. These main themes were: (1) Psychological disorders, (2) Organizational support (3) Mis-management (both structural and human factors), and (4) Opportunities. Conclusion The COVID-19 epidemic did create unique opportunities to understand the pitfalls of the Red Crescent aid services. Red Crescent rescue workers suffered from psychological symptoms, and mismanagement was also present. Psychological support and organizational improvements should be implemented. Keywords Red Crescent Society, COVID-19, Qualitative research, Phenomenology *Correspondence: Narges Khanjani 1 Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran 2 Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 3 Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA Background Coronavirus disease 19 (COVID-19), originated in Wuhan Province in China in December 2019 [1–3], and became a major health crisis. On January 30, 2020 [4], the World Health Organization declared it a public health emergency of international concern [5]. Although most of the symptoms of COVID-19, such as fever, cough, and fatigue, are similar to those of other coronavirus diseases such as SARS and MERS, many people can be infected with the virus yet asymptomatic, and this causes high unintentional and hidden disease transmission [6]. As a result, governments around the world enacted unprecedented public policies such as social distancing, segregation, and quarantine to prevent the spread of disease [7]. © The Author(s) 2023. 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://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Mohammadkhani et al. BMC Health Services Research (2023) 23:956 Given the nature of this pandemic, the contradictory news, and the policies adopted to prevent morbidity and mortality, the disease has had far-reaching and unprecedented economic and psychosocial consequences worldwide [1, 7]. Following the outbreak of diseases such as SARS, influenza and COVID-19, adverse mental health consequences such as fear, anxiety and post-traumatic stress disorder have been observed, especially among the patients [8]. Fear is defined as an unpleasant emotional state caused by perceiving threatening stimuli [9]. Understanding the sensitivity of the issue can lead to an understanding of danger, preventative measures and feelings such as fear and anxiety, which can lead to unusual behaviors. The association between fear and healthrelated behaviors is complex, as fear has been used to change people’s attitudes and behaviors on various subjects (e.g., smoking, breast exams, sunscreen use, and regular medication use) [7]. Fear of infection causes individuals to avoid behaviors that may put them at risk for the disease, and above all, fear of COVID-19 is a breeding ground for social stigma that has led individuals to hide their illness [1, 7]. These conditions can have psychological effects on people worldwide. For instance, a recent study in Canada reported that from 1354 participants, one-third of them were concerned about COVID-19 [7]. In addition, in an online survey of 808 adults in the USA, 56% of participants reported they were concerned or very concerned about the prevalence of COVID-19 [7]. Another study in the US reported that individuals were more concerned about COVID-19 than seasonal flu (37% vs. 27%) [10]. McGlinchey et al. reported that the mental state of health care professionals was affected during the COVID-19 pandemic, and many of them had experienced feelings of fear and sadness in addition to physical fatigue [11]. The Red Crescent Society, as a non-governmental humanitarian organization, consists of volunteers and employees who provided various services and also participated in the fight against COVID-19, by screening the population to identify infected patients [12]. However, by the time this study was conducted no research was done on Red Crescent relief workers, with a qualitative approach, to examine their experiences, the challenges ahead and the support strategies of the organization. Documenting their experiences can help find appropriate solutions to improve the performance of Red Crescent rescuers in the future. Methods Study design A qualitative interpretative phenomenological analysis (IPA) was used to explore the experiences of Red Crescent rescuers during COVID-19 [13, 14]. Although Page 2 of 9 descriptive and interpretive phenomenology are both systematic thematic-descriptive methods, they follow different approaches. In descriptive phenomenology, researchers focus on the interdependent components of the phenomenon’s structure, and it is done in situations where there is little or ambiguo (...truncated)