An analysis of COVID-19 disease perceptions and metaphors  of nurses working in COVID-19 intensive care units

KAPUCU, SEVGİSUN; ÇALIK, AFRA; Çakmak, Betül

doi:10.14744/phd.2022.17048

An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units

Afra ÇALIK, (Hacettepe Üniversitesi, Hemşirelik Fakültesi, Dahiliye Hemşireliği Anabilim Dalı, Ankara, Türkiye)

Betül ÇAKMAK, (Yıldırım Beyazıt Üniversitesi, Sağlık Bilimleri Fakültesi, Dahiliye Hemşireliği Anabilim Dalı, Ankara, Türkiye)

Sevgisun KAPUCU (Hacettepe Üniversitesi, Hemşirelik Fakültesi, Dahiliye Hemşireliği Anabilim Dalı, Ankara, Türkiye)

Psikiyatri Hemşireliği Dergisi

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Yıl: 2023 Cilt: 14 Sayı: 1 Sayfa Aralığı: 24 - 32 Metin Dili: İngilizce DOI: 10.14744/phd.2022.17048 İndeks Tarihi: 04-06-2023

An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units

Öz:

Objectives: Coronavirus disease 2019 (COVID-19) is seen not only as a disease, but it is also defined by a series of met aphors: mysterious, evil, an invisible enemy, an insidious danger, and a democratic virus. This study was conducted to analyze the nurses’ perceptions of COVID-19 through metaphors. Methods: This qualitative research was planned as a descriptive phenomenological approach. Twenty-eight nurses working in the COVID-19 intensive care unit (ICU) participated in the study. The metaphor-based data collection pro cess was carried out with five open-ended questions. The data were analyzed through a thematic analysis. The Consol idated Criteria for Reporting Qualitative Research Checklist was used to analyze this study. Results: Most military and fatigue related to the time nurses work in intensive care; Hero and nightmare of patient care with COVID-19; distance and restlessness in family relationships; their mental health darkroom and fatigue; COVID-19 as an insidious enemy and infinity . A total of 128 metaphors were produced. Conclusion: Working during the COVID-19 epidemic, COVID-19 ICU nurses exhibit unfavorable approaches toward their jobs, family relationships, and mental health. Improving the working conditions of ICU nurses and considering their desires will help contribute to a favorable direction.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Liu Q, Luo D, Haase JE, Guo Q, Wang XQ, Liu S, et al. The expe riences of health-care providers during the COVID-19 crisis in China: A qualitative study. Lancet Glob Health 2020;8:e790−8.
2. WHO. Year of health and care workers 2021. Available at: https://www.who.int/campaigns/annual-theme/year-of health-and-care-workers-2021#:~:text=2021%20has%20 been%20designated%20as,%2C%20under%20the%20 theme%20%E2%80%93%20Protect. Accessed Mar 8, 2023.
3. Cadge W, Lewis M, Bandini J, Shostak S, Donahue V, Tracht enberg S, et al. Intensive care unit nurses living through COVID-19: A qualitative study. J Nurs Manag 2021;29:1965−73.
4. Gao X, Jiang L, Hu Y, Li L, Hou L. Nurses' experiences regarding shift patterns in isolation wards during the COVID-19 pandem ic in China: A qualitative study. J Clin Nurs 2020;29:4270−80.
5. Cho H, Brzozowski S, Arsenault Knudsen ÉN, Steege LM. Chang es in fatigue levels and sleep measures of hospital nurses during two 12-hour work Shifts. J Nurs Adm 2021;51:128−34.
6. Norful AA, Rosenfeld A, Schroeder K, Travers JL, Aliyu S. Prima ry drivers and psychological manifestations of stress in front line healthcare workforce during the initial COVID-19 out break in the United States. Gen Hosp Psychiatry 2021;69:20−6.
7. Millar RC. Nursing a patient with Covid-19 infection. J Ev id-Based Nurs Pract 2020;1:4–8.
8. Greenberg N, Weston D, Hall C, Caulfield T, Williamson V, Fong K. Mental health of staff working in intensive care during Covid-19. Occup Med (Lond) 2021;71:62−7.
9. Hendin A, La Rivière CG, Williscroft DM, O'Connor E, Hughes J, Fischer LM. End-of-life care in the emergency department for the patient imminently dying of a highly transmissible acute respiratory infection (such as COVID-19). CJEM 2020;22:414−7.
10. Spina M, Arndt J, Landau MJ, Cameron LD. Enhancing health message framing with metaphor and cultural values: Im pact on latinas' cervical cancer screening. Ann Behav Med 2018;52:106−15.
11. Lazard AJ, Bamgbade BA, Sontag JM, Brown C. Using visual metaphors in health messages: A strategy to ıncrease effec tiveness for mental illness communication. J Health Commun 2016;21:1260−8.
12. Aykutalp A, Karakurt M. Illness as a metaphor: An evaluation on Covid-19. Ankara: 3rd International Congress of Human Studies; 2020. p.185.
13. Mohamed HAS. A critical analysis of the use of war metaphors in the news discourse of the COVID-19 pandemia. Habitus J Soci 2021;2:33−53.
14. Maben J, Bridges J. Covid-19: Supporting nurses' psychologi cal and mental health. J Clin Nurs 2020;29:2742−50.
15. Bates BR. The (in) appropriateness of the WAR metaphor in re sponse to SARS-CoV-2: A rapid analysis of Donald J. Trump's rhetoric." Frontiers Commun 2020;5:1−12.
16. Fuks A. The military metaphors of modern medicine. In: Li Z, Long TL, editors. The meaning management challenge: Mak ing Sense of Health, Illness, and Disease. United Kingdom: In ter-Disciplinary Press; 2009. p.55−68.
17. Malm H. Military metaphors and their contribution to the problems of overdiagnosis and overtreatment in the "War" against cancer. Am J Bioeth 2016;16:19−21.
18. Nie JB, Gilbertson A, de Roubaix M, Staunton C, van Niekerk A, Tucker JD, et al. Healing without waging war: Beyond military metaphors in medicine and HIV cure research. Am J Bioeth 2016;16:3−11.
19. Bleakley A. Force and presence in the world of medicine. Healthcare (Basel) 2017;5:58.
20. Lane HP, McLachlan S, Philip J. The war against dementia: Are we battle weary yet? Age Ageing 2013;42:281−3.
21. Khan Z, Iwai Y, DasGupta S. Military metaphors and pandemic propaganda: Unmasking the betrayal of 'Healthcare Heroes'. J Med Ethics 2021;47:643−4.
22. Hagan TL, Fishbein JN, Nipp RD, Jacobs JM, Traeger L, Irwin KE, et al. Coping in patients with incurable lung and gastrointesti nal cancers: A validation study of the brief COPE. J Pain Symp tom Manage 2017;53:131−8.
23. Rettie H, Daniels J. Coping and tolerance of uncertainty: Pre dictors and mediators of mental health during the COVID-19 pandemic. Am Psychol 2021;76:427−37.
24. Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, et al. A lon gitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behav Immun 2020;87:40−8.
25. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 pa tients. Am J Infect Control 2020;48:592−8.
26. Shen X, Zou X, Zhong X, Yan J, Li L. Psychological stress of ICU nurses in the time of COVID-19. Crit Care 2020;24:200.
27. Moradi Y, Baghaei R, Hosseingholipour K, Mollazadeh F. Chal lenges experienced by ICU nurses throughout the provision of care for COVID-19 patients: A qualitative study. J Nurs Manag 2021;29:1159−68.
28. Kaniadakis E. Staff is down to the bone”: Italian doctors and nurs es share experiences of the COVID-19 frontline. Euronews. Avail able at: https://www.euronews.com/my-europe/2020/04/08/ staff-is-down-to-the-bone-italian-doctors-and-nurses-share experiences-of-the-covid-19-fr. Accessed Mar 23, 2023.
29. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007;19:349−57.
30. Chung G, Lanier P, Wong PYJ. Mediating effects of paren tal stress on harsh parenting and parent-child relationship during Coronavirus (COVID-19) pandemic in Singapore. J Fam Violence 2022;37:801−12.
31. Rajkumar RP. COVID-19 and mental health: A review of the ex isting literature. Asian J Psychiatr 2020;52:102066.
32. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77−101.
33. Clarke V, Braun V. Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. Psychologist 2013;26:120−3.
34. Sundler AJ, Lindberg E, Nilsson C, Palmér L. Qualitative the matic analysis based on descriptive phenomenology. Nurs Open 2019;6:733−9.
35. Diogo PMJ, Sousa MOCLE, Rodrigues JRGDV, Silva TAAMAE, Santos MLF. Emotional labor of nurses in the front line against the COVID-19 pandemic. Rev Bras Enferm 2021;74(Suppl 1):e20200660.
36. Varma S. A pandemic is not a war: COVID-19 urgent anthropo logical reflections. Soc Anthropol 2020;28:376−8.
37. Franza F, Basta R, Pellegrino F, Solomita B, Fasano V. The role of fatigue of compassion, burnout and hopelessness in health care: Experience in the time of COVID-19 outbreak. Psychiatr Danub 2020;32(Suppl 1):10−4.
38. Neto MLR, Almeida HG, Esmeraldo JD, Nobre CB, Pinheiro WR, de Oliveira CRT, et al. When health professionals look death in the eye: The mental health of professionals who deal daily with the 2019 coronavirus outbreak. Psychiatry Res 2020;288:112972.
39. Arnetz JE, Goetz CM, Arnetz BB, Arble E. Nurse reports of stressful situations during the COVID-19 pandemic: Qual itative analysis of survey responses. Int J Environ Res Public Health 2020;17:8126.
40. Navuluri N, Solomon HS, Hargett CW, Kussin PS. Where have all the heroes gone? Med Anthropol 2021;40:209−13.
41. Corley A, Hammond NE, Fraser JF. The experiences of health care workers employed in an Australian intensive care unit during the H1N1 Influenza pandemic of 2009: A phenomeno logical study. Int J Nurs Stud 2010;47:577−85.
42. Lam SKK, Kwong EWY, Hung MSY, Pang SMC, Chien WT. A quali tative descriptive study of the contextual factors influencing the practice of emergency nurses in managing emerging infectious diseases. Int J Qual Stud Health Well-being 2019;14:1626179.
43. Eftekhar Ardebili M, Naserbakht M, Bernstein C, Alazmani-Noo deh F, Hakimi H, Ranjbar H. Healthcare providers experience of working during the COVID-19 pandemic: A qualitative study. Am J Infect Control 2021;49:547−54.
44. Park SC, Park YC. Mental health care measures in response to the 2019 novel coronavirus outbreak in Korea. Psychiatry In vestig 2020;17:85−6.
45. Cheung T, Yip PS. Depression, anxiety and symptoms of stress among Hong Kong nurses: A cross-sectional study. Int J Envi ron Res Public Health 2015;12:11072−100.
46. Khodadadi E, Hosseinzadeh M, Azimzadeh R, Fooladi M. The relation of depression, anxiety and stress with personal char acteristics of nurses in hospitals of Tabriz, Iran. Int J Med Res Health Sci 2016;5:140−8.
47. Legido-Quigley H, Mateos-García JT, Campos VR, Gea-Sánchez M, Muntaner C, McKee M. The resilience of the Spanish health system against the COVID-19 pandemic. Lancet Public Health 2020;5:e251−2.
48. Bruyneel A, Smith P, Tack J, Pirson M. Prevalence of burnout risk and factors associated with burnout risk among ICU nurs es during the COVID-19 outbreak in French speaking Belgium. Intensive Crit Care Nurs 2021;65:103059.
49. Hu Z, Wang H, Xie J, Zhang J, Li H, Liu S, et al. Burnout in ICU doctors and nurses in mainland China-A national cross-sec tional study. J Crit Care 2021;62:265−70.
50. Cooper S, Cant R, Bogossian F, Kinsman L,Bucknall T. Patient deterioration education: Evaluation of face-to-face simulation and e-Simulation approaches. Clin Sim Nurs 2015;11:97−105.

APA	ÇALIK A, Çakmak B, KAPUCU S (2023). An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. , 24 - 32. 10.14744/phd.2022.17048
Chicago	ÇALIK AFRA,Çakmak Betül,KAPUCU SEVGİSUN An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. (2023): 24 - 32. 10.14744/phd.2022.17048
MLA	ÇALIK AFRA,Çakmak Betül,KAPUCU SEVGİSUN An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. , 2023, ss.24 - 32. 10.14744/phd.2022.17048
AMA	ÇALIK A,Çakmak B,KAPUCU S An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. . 2023; 24 - 32. 10.14744/phd.2022.17048
Vancouver	ÇALIK A,Çakmak B,KAPUCU S An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. . 2023; 24 - 32. 10.14744/phd.2022.17048
IEEE	ÇALIK A,Çakmak B,KAPUCU S "An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units." , ss.24 - 32, 2023. 10.14744/phd.2022.17048
ISNAD	ÇALIK, AFRA vd. "An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units". (2023), 24-32. https://doi.org/10.14744/phd.2022.17048

APA	ÇALIK A, Çakmak B, KAPUCU S (2023). An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. Psikiyatri Hemşireliği Dergisi, 14(1), 24 - 32. 10.14744/phd.2022.17048
Chicago	ÇALIK AFRA,Çakmak Betül,KAPUCU SEVGİSUN An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. Psikiyatri Hemşireliği Dergisi 14, no.1 (2023): 24 - 32. 10.14744/phd.2022.17048
MLA	ÇALIK AFRA,Çakmak Betül,KAPUCU SEVGİSUN An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. Psikiyatri Hemşireliği Dergisi, vol.14, no.1, 2023, ss.24 - 32. 10.14744/phd.2022.17048
AMA	ÇALIK A,Çakmak B,KAPUCU S An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. Psikiyatri Hemşireliği Dergisi. 2023; 14(1): 24 - 32. 10.14744/phd.2022.17048
Vancouver	ÇALIK A,Çakmak B,KAPUCU S An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units. Psikiyatri Hemşireliği Dergisi. 2023; 14(1): 24 - 32. 10.14744/phd.2022.17048
IEEE	ÇALIK A,Çakmak B,KAPUCU S "An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units." Psikiyatri Hemşireliği Dergisi, 14, ss.24 - 32, 2023. 10.14744/phd.2022.17048
ISNAD	ÇALIK, AFRA vd. "An analysis of COVID-19 disease perceptions and metaphors of nurses working in COVID-19 intensive care units". Psikiyatri Hemşireliği Dergisi 14/1 (2023), 24-32. https://doi.org/10.14744/phd.2022.17048