Mental-Health-Needs-Of-The-Covid-19
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Global Mental Health Mental health needs of the COVID-19 patients and staff in the Fangcang shelter hospital: cambridge.org/gmh a qualitative research in Wuhan, China 1 1,2 1 1 3 Policy and Systems Jing Lu ,MinZhao , Qianying Wu , Chenyi Ma ,XiangdongDu, Xinchuan Lu3,QiufangJia3 and Chuanwei Li3 Original Research Paper 1Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 2Suzhou Cite this article: Lu J, Zhao M, Wu Q, Ma C, Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China and 3Shanghai Key Du X, Lu X, Jia Q, Li C (2021). Mental health Laboratory of Psychotic Disorders, Shanghai, China needs of the COVID-19 patients and staff in the Fangcang shelter hospital: a qualitative research in Wuhan, China. Global Mental Abstract Health 8, e33, 1–8. https://doi.org/10.1017/ gmh.2021.23 Background. During the coronavirus disease 2019 (COVID-19) pandemic, Fangcang shelter hospitals were opened in Wuhan, China, to isolate and care for patients with mild or mod- Received: 16 December 2020 erate symptoms. The patients and staff in the hospitals faced mental health challenges. This Revised: 8 May 2021 paper reports the experiences and mental health needs from them. Accepted: 7 June 2021 Method. Following the qualitative design, semi-structured interviews were conducted in the Key words: EastWest Lake Fangcang Shelter Hospital, Wuhan on March 2020. Data collection and ana- COVID-19; Fangcang shelter hospital; medical lysis was based on grounded theory. Open coding was adapted and a structured codebook was workers; mental health; patients; qualitative developed through coding seminars. The themes and subthemes were then confirmed through research; Wuhan thematic analysis. The findings were further explained and integrated in a theoretical Author for correspondence: framework. Chuan Wei Li, E-mail: [email protected] Results. A total of 10 COVID-19 patients and 13 staff, including doctors, nurses, psychiatrists, and policemen participated in the interviews. They have common needs, as well as their own needs. The perspectives from the staff also did complement for needs of the patients. The mental health needs were generalized into four themes, that is, basic needs, information and communication, emotional needs, and social support, each with several subthemes. In addition, there were some external factors that regulated the internal needs, which were sum- marized in a theoretical framework. Conclusions. The study indicates the directions on hospital management, mental health ser- vices, policy making, and social work to meet the mental health needs of the inpatients and staff from temporary shelter hospitals like Fangcang in Wuhan during the COVID-19 pandemic. Background At the end of 2019, the new coronavirus disease 2019 (COVID-19) was discovered in Wuhan, China, and quickly evolved into a serious epidemic outbreak (Lu et al., 2020). After that, COVID-19 spread rapidly around the world, becoming a public health emergency. According to the World Health Organization (Organization), more than 61 million people worldwide have been infected with COVID-19 by 30 November 2020, and more than 1.4 mil- lion people have died. As the epicenter of the COVID-19 pandemic in China, Wuhan was heavily burdened on the city’s medical system. In order to solve the problem of insufficient beds in the designated hospitals and accelerate the admission of patients, many Fangcang shelter hospitals (FSHs) had been opened (Chen et al., 2020) since 5 February 2020 in Wuhan. FSHs were temporary medical facilities that converted from public venues, such as stadiums and exhibition halls, to isolate and care for patients with mild or moderate symptoms of COVID-19. A total of more than 12 000 confirmed COVID-19 patients had been treated in FSHs (Shu et al., 2020), which © The Author(s), 2021. Published by played a crucial role in the prevention and treatment of COVID-19 (Zhou et al., 2020; Wang Cambridge University Press. This is an Open et al., 2020a, 2020b). Access article, distributed under the terms of COVID-19 had caused mental health impacts on both the patients and the medical health the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), workers. The patients with confirmed or suspected COVID-19 experienced fear of the conse- which permits unrestricted re-use, distribution quences of infection, and also boredom, loneliness, and anger (Xiang et al., 2020) in their and reproduction, provided the original article quarantine. The frontline medical workers were also heavily pressured by risk of infection, is properly cited. inadequate protection, overwork, lack of contact with their families, and exhaustion (Kang et al., 2020a). A cross-sectional study (Kang et al., 2020b) of 994 medical workers in Wuhan found that about 63% of them had mental health problems. Since the FSHs are greatly different from the designated hospitals on patient populations and environments, it is necessary to explore the mental health status of the patients and Downloaded from https://www.cambridge.org/core. IP address: 170.106.202.8, on 29 Sep 2021 at 16:42:13, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/gmh.2021.23 2 Jing Lu et al. staff in FSHs. The previous quantitative studies (Dai et al., 2020; Table 1. Semi-structured interview outlines Gu et al., 2020;Liet al., 2020) focused on psychological symp- Participants Questions toms of the participants, but did not include their experiences, feelings, needs, or the effects of some external factors. Patients 1. How is your life in the Fangcang shelter hospital? Therefore, in the study, mental health needs are defined as all self- 2. What is your inner feeling and thought recently? reported thoughts and needs that may be related to mental health. Qualitative design is adopted to explore various mental health 3. What problems are you facing and how to solve it? Do needs of the COVID-19 patients and the staff with different occu- you need any help for that? pations in the FSH, so as to develop recommendations for the 4. How do the virus and the hospitalization affect you? mental health service, FSH management, and policy making. 5. What do you think about the future life after leaving the hospital? Method Staff 1. What do you think about the patients and your relationship with them? Study design, setting, and participants 2. How is your work in the Fangcang shelter hospital? Qualitative research can improve the description and explanation 3. What is your inner feeling and thought recently? of complex, real-world phenomena such as mental health needs (Bradley et al., 2007). In this study, semi-structured interviews 4. What problems are you facing and how to solve it? Do you need any help for that? were conducted and reported following the consolidated criteria for reporting qualitative research (COREQ) standards (Tong 5. How does the emergency support work in Wuhan et al., 2007). affects you? The face-to-face interviews were carried out in the EastWest Lake Fangcang Shelter Hospital. The interviewer (CWL), who worked in the hospital as a member of the Psychological In every interview, we tried to validate previous findings and Assistance Team from JiangSu, obtained permission for inter- looked for new relevant factors. The conversations continued views from the management. The EastWest Lake Fangcang until the interviewer found no new meaningful viewpoints Shelter Hospital was one of the first three FSHs built in Wuhan emerging. and began to accept COVID-19 patients, mainly of mild symp- A total of 19 interviews were completed, with 23 participants toms, from 7 February 2020. There were 1440 beds, three (10 patients and 13 staff). All the 10 patients and six staff were wards, and several departments including medical, nursing, phar- interviewed individually, and the rest seven staff were interviewed macy, and radiology. The highest number of patients in the hos- in 2–3 persons. They worked together in the hospital. In the inter- pital was 1434 and the total number including all the staff was views, they complemented and contrasted the answers of one more than 3000 (Radio). The medical workers in the hospital another. were mainly from the assistance teams of Xinjiang, Ningxia, Guangdong, and Fujian. Data analysis The confirmed COVID-19 patients and the staff that aged more than 18 years and stayed more than 1 week in the hospital The audio recordings were transcribed verbatim and checked for received our verbal invitation. And the individuals who responded accuracy. All the thoughts, emotions, and demands of the partici- to our invitation formed a convenience sample. They were asked pants in the 19 completed interviews were included in the data to talk about their experience in the FSH after giving the informed analysis. consents. All the interviews took place in independent spaces. The analysis was also based on grounded theory (Corbin and Strauss, 1990). Using the method of open coding, three research- ers (JL, CWL, and QYW), including the interviewer, openly iden- Data collection tified the data into concepts with practical meanings, and then The semi-structured interview outlines (Table 1) were completed compared, combined, and classified the concepts to generate and modified under the guidance of specialists in infectious dis- codes. A structured codebook was developed as dataset of the eases, psychiatry and psychology. We then conducted pre- inductive codes. In the coding seminars of the research team, interviews and make several adjustments to the problem the codebook was supplemented and modified until no new descriptions. codes were proposed. The thematic analysis was then performed According to arrangement of the hospital, the interviews were using the similar comparative analytic process used to produce carried out on 7 March 2020, the day before the hospital was offi- codes, which was a key component of grounded theory.