UK Health Workers Fatigue and Emotion Factors Amid COVID-19

Factors Affecting Fatigue And Emotions Of UK Health Workers In Clinical Areas During The COVID-19 Pandemic

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1. Assessment 1

1.1. Research approaches and methodologies

Methodology	Advantages of using this approach for this project	Uses – why are you accepting this method for your project?
Descriptive Method	Effective analysis of non-quantified issues and information associated with the external factors that affected the emotions and fatigue of caregivers in the medical sector during the COVID-19 pandemic. The descriptive method helps in the determination of the phenomenon or cases that have adopted a stable and constant environment (Doyle et al. 2020). It consumes less time than qualitative studies. It provided the study developers with the opportunity to integrate effective “quantitative and qualitative” methods during the data collection process. The descriptive approach generally helps the study developers in the practical utilization of research findings that are associated with their decision-making and problem-solving processes.	The descriptive method is accepted by the researchers to develop a study with all authentic and detailed information based on the topic associated with all essential factors affecting the emotions and fatigue of caregivers in the medical sector during the COVID-19 pandemic. It has helped the study developers with all motivation tools that can be adapted to the hospitality sector during any critical situation like a global pandemic. The method helps the researchers to analyze all information that has been gathered through primary and secondary research. The data analysis helps in the identification of the impacts of the factors and their causes during the COVID-19 pandemic.
Primary Qualitative Method	The major advantages of this “Primary Qualitative Method” helps the study developers with detailed and in-depth analysis of the data that have been gathered via interviews and surveys. The data that is collected from several members of target groups are authentic and can be kept organized in record books for future reference (Kaur et al. 2019). The data are generally collected from a large group of candidates through “ethnographic research, face-to-face interviews, questionnaires, sampling techniques, and surveys”.  The method helps with a large quality of data that can be generated that will help the study developers in further research in future.	The method like “primary qualitative research” has been used and accepted by the study developers as the data on how the COVID-19 pandemic has affected the emotional and mental health of the people can be gathered from authentic sources. The results of all research can be generalized through this effective method. The study developers selected this method as this method will provide them will all data and information that are “up-to-date and relevant”. The research method generally aims to reveal accurate trends. The “Primary Qualitative Method” has also helped the researchers to control the “ownership” of collected data.
Analytical Method	Modern “analytical methods” generally allow the study developers to save quality time during their research on the impacts of external factors on individuals’ mental and emotional health (Li et al. 2020). The method provides an accurate analysis of the results that are generated during the research.  The information and data that are collected via both primary and secondary research are accurate as all errors are eliminated by this method.	The analytical method is accepted by the study developers as they can able to make all decisions quickly and accurately. Analytical methods also helped the research to identify the literature gap or the portions that need further research in future. The researchers are allowed to analyze all information or data that they have collected through interviews, case study reviews, and surveys during the execution period of the study.

Table 1: Research approaches and methodologies

1.2. Key stages in a research project

Figure 1: Stages of the research project

A research project consists of various stages that are necessary for the completion of the project. This research is mainly based on the workload of the healthcare staff and the result of it. The research presents that workload causes staff burnout in the health sector. Therefore, research is necessary regarding this matter and this project has gone through various stages (Eccles and Wigfield, 2020). Here, the stages include a) choosing the area for research, b) conducting the preliminary research, c) deciding the topic for research, d) deciding the methodology, e) submission of the research proposal for approval, f) finalization of the topic as well as methodology, g) fieldwork for the research, h) analysis of data, i) writing up, as well as j) submission of the research project.

This research has also gone through these several processes and multiple activities have been done for it. The important technique for managing the project is necessary for this project. The most important step is choosing the area for research and then deciding the topic for research is another essential point (nejm.org, 2022). The reason behind the importance of those stages is that the entire research is based on the chosen areas.    

1.3. Discuss three tools used to analyse data

Figure 2: Thematic analysis

In this study, three important tools have been used for the analysis of data and they are the "Thematic analysis, Narrative analysis, and Grounded theory analysis". “Thematic analysis” is an important type of analysis that helps to identify, analyse, as well as interpret the patterns in the maintenance of "qualitative data" (Knight, 2019). This analysis can help in this research to analyse the theme of staff burnout problems in the healthcare sectors. On the other hand, it helps to understand the behaviour as well as the needs of the user. The most important part of the “Narrative analysis” is that it helps to interpret the stories of the research participants. It focuses on the interview, case studies, as well as testimonials of the researchers.

This analysis can help the teams understand the value as well as the complexity of the lives, feelings, as well as behaviours of the customers. This is an important analysis in the field of research and prioritises the reviews of the customers. “The Grounded theory analysis” is another important tool used in this research (Kumari et al. 2018). It focuses on qualitative research by examining real data. This theory focuses on the collection as well as evaluation of the "qualitative data". 

2. Assessment 2

2.1. Justify a topic for research within the healthcare

The Healthcare sector is the most important in today's world and it is a part of society. Therefore, the maintenance of a good environment within the sectors is another part of importance. In this study, the chosen topic is the causes of staff burnout in the private sector. The focus has been given to the fatigue as well as emotional disturbances of the healthcare staff due to the heavy workload (Neuendorf, 2018). The study chooses to research this topic as the nursing staff’ plays an important role in the well-being of society. They play a vital role in the healthy living of society and therefore taking care of their mental as well as emotional condition is important. That is the reason for giving importance to the staff burnt issue in the healthcare sector.

In this study, this particular topic of the fatigue and emotions of the health workers in the clinical areas as well as the factors that is responsible for these reasons have been given importance (Kumari et al. 2018). The heavy workload is one of the huge reasons for this problem and these factors lead to mental as well as physical fatigue of them. Therefore, keeping an eye on the well-being of those nurses is important and that is why the chosen topic for this research is staff burnout in the healthcare sector.   

2.2. Research plan

• Topic

Factors affecting fatigue and emotions of UK health workers in clinical areas during the Covid-19 pandemic

• Aims and objectives

To analyse the impact of COVID-19 on the healthcare workers

To analyse the factors that affect the fatigue and emotions of Healthcare workers

To assess the impact of burnout on healthcare workers

To analyse healthcare worker burnout in the healthcare sector of the UK

• Research Question/ Hypothesis Research Questions

1. What is the impact of COVID-19 on healthcare workers?
2. What is the effect of fatigue and emotions on healthcare workers?
3. What is the effect of fatigue and emotions on healthcare workers?
4. What is the effect of healthcare staff burnout in the associated sector in the UK?

Hypothesis

H1: COVID-19 had imparted a negative impact on healthcare workers.

H0: COVID-19 has not affected the emotional and physical aspects of healthcare workers

• Methodology/methodologies.

The methodological approach that has been used in this research is primary qualitative research. It is a descriptive approach that outlines the necessary aspects regarding a particular scenario. This approach has been undertaken in this course to assess the impact of COVID-19 on healthcare workers (Gilleen et al. 2021). The extensive work hours have vehemently influenced the work process of the nurses and other front-line service workers in the healthcare sectors. The associated influence has been observed in a high attrition rate and quality of the healthcare service in the later days of 2021.

2.3. Rationale

COVID-19 has taken a severe toll on every individual around it and has been highly influential in the overall lifestyle and functioning of people around the world. At its peak, the pandemic scenario has vehemently impacted the mental health and emotion of people.

Figure 3: Impact of COVID-19 on adults in the UK

It has been observed throughout the period that a lot of people have suffered from mental health issues during the period of the pandemic. Most people in the UK have suffered from anxiety and stress-oriented issues that have a long-term impact on their mental health (statista.com, 202). The events, news and other scenarios of the pandemic that prevailed all around the world were noticed to have negatively impacted the lifestyle and course of events of people. This situation was most prevalent for people involved in the healthcare sector who were the frontline workers that catered to the medical needs and emergencies that prevailed in the UK (Khosraviet al. 2022). Resultantly, it took a massive mental as well as physical toll on healthcare workers which was noted in the quality of service being provided to the patients. A concern arose during the events of the pandemic when patients were provided with inadequate healthcare facilities in the later days of the pandemic.

The influence of that scenario is still observed to date along with the work culture and the conditions of the workers involved in the healthcare sector.

Figure 4: Number of patients in hospitals in the UK

In 2022, 11,641 confirmed cases of COVID-19 patients were admitted to hospitals in the UK. This number was staggeringly high in 2021. 39.2 thousand Patients were admitted to the hospital on January 18, 2021 (statista.com, 2022). Needless to mention, the healthcare workers had to work extensive shifts. At times patients were not even allowed to go home to their close ones. Resultantly there was a negative impact on the availability and accessibility of the resources (Blake et al. 2020). It imparted a significant amount of emotional and mental fatigue to them.

In current times the side effects of the pandemic and the associated continue to prevail in the ambience of healthcare workers. It has barely been a year and they are yet to recover from the stress that they incurred during the event of pandemic (Raudenskáet al. 2020). It can be observed from the condition of the National Healthcare Services in the UK. In 2022 around 39, 652 nurses and 8,158 posts for nurses and doctors have been left vacant, respectively (theguardian.com, 2022). This is a direct consequence of the work-oriented stress that was incurred by the workers during the pandemic. It has prompted a warning that this situation would lead to a delay in the availability of healthcare facilities for people in the UK (Leiteet al. 2020). The NHS employees have reaffirmed this situation and have commented it is due to the impact of the pandemic (Carminati et al. 2021). It also associates aspects like low wages and extensive workload burnout that had led to a demotivated work culture that led to the massive healthcare employee resignation.

It sheds light on a serious issue that prevails in society regarding healthcare facilities. It is necessary to implement necessary measures to address the basic needs and requirements of the employees involved in the workplace (Alshahrani, 2020). It is critically important that the employees remain motivated so they can work efficiently toward the organisational goals and vision.

A qualitative research method was undertaken that was implemented through interviews and the utilisation of relevant authentic journals and online articles. It was considered because a descriptive account was necessary for the research regarding the first-hand account of NHS healthcare workers (Carminati, 2018). It also shows their conditions during the pandemic and other methodological processes were rejected because they would add up to an extra amount of data and relevancy will be compromised during the event of data collection processes.

2.4. Ethical implications

In the course of this research ethical values have been prioritised effectively. The entire interview adhered to the Data Protection Act of 2018, where only relevant data were collected from the individuals (gov. uk, 2022). In the course of the interview, it was strictly ensured that no personal information was used during the interview. Consent is an important factor during the interview (Madera and Hebl, 2019). Consent was taken from the participants before the process of the interview and clarity was maintained with them regarding the course and entirety of the interview. Participants were informed regarding the questionnaire and given proper time to think through and answer at their own pace. Discretion was maintained during the process of the interview. Participants’ anonymity was held in high regard during and after the events of interviews. Their names or any other additional information was not disclosed to any other participants or people outside this process. Ethical principles are important in the course of an interview (Arifin, 2018). Ethics were maintained thoroughly throughout this interview. They were not probed or influenced to answer any questions. A comfortable ambience was ensured for the participants.

2.5. Literature Review

Social Cognitive Theory

Social cognition is an important aspect and another name for this theory is “Social Learning Theory” or SLT. It mainly develops the influences of the individual perspective and experiences. NHS is the matter of discussion here and it describes the condition of healthcare services nationally (sphweb.bumc.bu.edu, 2022). The nursing sector has faced many difficulties during the situation of Covid-19. The present “Social Cognitive Theory” or SCT guidelines the individual experiences, and factors affecting the environment, as well as others’ actions. The matter also included the health behaviours of individuals. Albert Bandura, a famous person gives to light the theory and as per the view of this person, behaviour, interaction, and environment are most important. ACT mainly focuses on social influence as well as internal and external reinforcement.

The health workers of the UK experience physical as well as mental fatigue related to the work. COVID-19 had a great influence on fatigue as well as emotional disturbances in health workers. Nurses play important roles in the treatment of patients and as per the study "50.2%" of the nurses faced work-related fatigue (Schunk and DiBenedetto, 2020). Physical fatigue can be caused by physical labour such as standing for hours and changing the positions of the patients. The professional of the healthcare centres faces those difficulties and these factors lead to "musculoskeletal disorders". As per the view of Lin et al. (2020), the lack of motivation among workers lead towards mental fatigue and this factor affects their psychological, biological, as well as cognitive process. These factors are affecting the performance of the nurses and therefore the application of some theory is needed.

The nurses have faced serious burnout in handling the patients during the time of COVID-19. These matters created mental disturbances for the health workers and their level of performance decreased. This theory is an important theory that can help in resolving the issues that have come up in the Covid situation. According to Schunk and DiBenedetto, (2020), burnout in the workplace can be prevented by framing the mindset of the nursing workers. The workers face the issue due to the workload as well as mental stress and therefore getting time for caring for themselves is most important and can help in resolving the issue. Healthcare workers can set their boundaries and therefore go in this direction for maintaining burnout (sphweb.bumc.bu.edu, 2022). This theory of social cognition gives the importance of the environment, behaviour, as well as individual experiences and cognition.

The theory depicts that one can learn from the social context by the reciprocal as well as a dynamic interaction of the person, behaviour, and environment. Health workers can apply this theory to get out of the situation of burnout at the workplace (Lin et al. 2020). It discussed the four most important components and they are sociostructural variables, self-efficacy, outcome expectancies, as well as goals. Therefore it can be said that workers can take time for self-care or self-improvement so that they can avoid burnout at work, workplace fatigue, and emotions.               

Conservation of Resources Theory

This theory is widely associated with stress and burnout experienced by different individuals. It orients with the motivation that enables individuals to assess the prevalent resources and utilise new resources at the same time. This Theory was outlined by Dr Stevan E. Hobfoll to outline the expanse of stress as a constructive measure found in individuals. The basic theme of this theory aligns with the aspect of motivation to be imparted upon an individual. The COR theory mostly deals with human nature and its desire to acquire, conserve and utilise different resources they deem necessary for their survival (Wu et al. 2020). In the case of social needs, it deals with personal preferences, needs and bonds.

The nursing staff in the UK experienced terrible burnout during the events and prevalence of the COVID-19 pandemic. The prolonged working hours and the associated stress took a serious mental toll on the nursing staff who worked day in and day out. The conservation of Resources theory states that the burnout of individuals generally occurs when they experience losses in terms of a) objects b) conditions c) personal traits and d)energy. These four scenarios impart a severe amount of stress to any individual and these aspects associated with the availability and utilisation of resources impart terrible stress upon the nursing staff (Trujillo, 2022). This stress and associated anxiety of the nursing staff had impacted the workplace performances over time; this was observed in the later stages of substandard quality of healthcare provision which was a direct consequence of nursing staff shortages during 2020-21.

A serious decline was experienced in the latter half of the pandemic. It was a direct consequence of the burnout experienced by the nursing staff (Statista, 2022).  The COR theory states that the stress level of a person directly influences the performative output of an individual. A threat to the aforementioned resources, their availability and burnout impact the working culture and performances of nurses. In the case of nursing staff in the UK, this condition impacted the healthcare associatively negatively impacted the safety of patients.

Henceforth the healthcare organisation needs to come up with strategies to enhance the quality of performance of the nursing staff along with the nursing administration strategies. They are the frontline workers involved in the face of critical situations and hence it is important to cater to their essential requirements to motivate them towards better performances. It is essential to mitigate the threats involving loss of resources and reduce the events of burnout taking place among the nursing staff (online library. Wiley, 2022). This will in turn enhance the overall healthcare system and contribute to the progress of patient safety in the UK. This aspect is important to consider in the case of people involved in the healthcare system. Due to the rapid increase in population and pollution, the rises cases of illness are on the rise and hence frontline workers need to be provided with efficient support that would enhance their motivation and dedication.

Perspective and Developmental Process Model

The model of perspective and the developmental process is an important aspect that mainly focuses on the feelings, thoughts, as well as behaviour transition of the life of a human being. As per the view of Perannagari and Chakrabarti, (2019), the most important concept of this theory is the three questions. It focuses on the three most important questions for the development of a person. Among the three questions, the first one describes the importance of nature for the development of a child. The second question was whether the development of humans happened in stages or continuously. The third one described the constant remaining factors after the change of humans (frontiersin.org, 2022). The present theory is a helpful theory for the healthcare sectors as they are facing staff burnt problems in the sectors.

The healthcare staff have faced too many problems in the pandemic situations and the "Developmental Perspective model" mainly describes their main questions and they are:

• Is nature important for the process of development of a person?
• Is the process of development continuous or happen in stages?
• How does one change throughout the process of development?

Normally, it is seen that the theory has the main aspect of three questions about development. However, it also describes the stages of development and they are the a) infant stage, b) early and middle childhood, c) stage of adolescence, d) early as well as middle adulthood, and e) old age. Although these are the stages from birth to death of a person it is related to the development of staff burnt in the healthcare sectors. According to Saugelet al. (2021), the developmental process model guides a person towards the improvement of the behaviour of a person. This aspect is most helpful for the healthcare staff as it can help them in improving their mental as well as physical fatigue in the sectors.

The model describes the development of positive thoughts throughout the process. The healthcare staff due to the heavy workload feel staff burnt in the NHS healthcare settings. This model can help them improve their positive attitudes towards the work and in this way, mental and physical fatigue within the health sectors can be reduced (Kent.ac.uk, 2022). Sometimes, it is seen that the work performance of the staff goes down and the responsible factor for this is the heavy workload and therefore it will have to be removed. The application of this perspective and developmental model can help in removing the fatigue or the staff burnt problem from the health sectors.

Healthcare staff have high demand nowadays as the hospitality sector is involved in the service for the highly rich sector people. Therefore workload rises and it also impacts the extension of working hours. This theory of the Developmental Process can bring positive impacts towards employee performance within the workplace (Saugelet al. 2021). Therefore, it can be said that the theory can be helpful for the development of conditions for healthcare employees. It focuses on the behaviour of an individual and it is based on the different stages of psychological development. 

Demands-Resources Model

The demand resource model which is also termed the JD-R model is associated with the stress in the course of their job. This theoretical model states that with the increase of job demands situations arise that the positive sides of the job lower down. This situation arises due to the rise in manpower.

This model puts the working conditions into two distinct categories:

• Job demands: This situation directly impacts the physical and emotional aspects of people involved in this line of work. It includes stringent deadlines and their associated pressure (Mazzettiet al. 2021). Similarly, a stressful working ambience, conditions of relationship in engagement with the job role and emotional labour is also involved in this line of work.
• Job resources: These resources impact the positive points involved in a line of work. These factors include the physical and social factors involved in the line of work. Availability and efficiency in resources enhance the motivation level of people involved in the workplace (researchgate.net, 2022). Therefore this factor is considered a positive factor involved in the line of work. The resources include job role advancement opportunities and associated learning and developmental programmes (Albrecht et al. 2021). A well-coordinated working environment and senior mentoring are also included in this factor.

Often the resource allocation goes down because that does not meet the requirements essential in the course of the job. This situation hinders the work-life balance of people involved in a specific line of work (White et al. 2020). Eventually, this leads to severe burnout and fatigue. Similarly, if the workforce's efforts are acknowledged and they are treated with necessary resources, it results in a positive impact prevailing within the work-life ambience of people. This aspect directly encourages motivation for people and also enhances their engagement.

These conditions are highly prevalent in the working ambience of the work-life culture in the nursing and hospitality sectors. People involved in the hospitality sector are the front-line workers working towards the benefit of society. However, the rising demand extends their working hours and also hinders their access to resources (Kim and Beehr, 2021). It impacts the course of the work process. The model outlined by Baker and Demerouti acknowledges the positive impact that would arise that otherwise negatively affects the performance of the employees involved within a workplace. Some of the notable factors that are noted in this line of the line include short deadlines, and emotional drainage while handling critical patients (Moreno Cunha et al. 2022). In a hierarchal structure adhered to by an organisation often the employees are subjected to following a bureaucratic approach that constricts their course of work under the pressure of rules and pressure. All these conditions associated with a high volume of work have several impacted the performance of nurses in the UK during the pandemic. This resulted in severe fatigue and emotional burnout for the healthcare workers while working rigorous shifts at the peak of the pandemic and in the long run, it affected patient safety as well (Batubara et al. 2020). Resultantly, a mass shortage among the nursing staff was observed by the end of 2021 which affected the overall condition of the health sector in the UK.

3.1. Research plan analysis

The course of the research was conducted following a specific pattern. In this process, the people's certain objectives were outlined and a hypothesis was postulated to adhere to throughout the research. A qualitative research method has been taken into consideration where the interview has been conducted on three people in adherence to the Data Protection Act of 2018 and their privacy has been respected throughout the process (gov. uk, 2022). A literature review was conducted based on relevant theoretical models that gave out a literature gap in the course which is necessary to be catered to. Lastly, a conclusion and analysis have been drawn regarding the flow of this research.

3.2. Collection and recording data. (200)

Q1. Have you experienced any stress or anxiety-oriented issues in your healthcare duties during the pandemic period?

Healthcare professional 1	Healthcare professional 2	Healthcare professional 3
“Initially, I was highly motivated to perform my duties towards the people. Over time, the workload had become extensively stressful and the continuous incoming of patients had immensely impacted my response to different situations.”	“I experienced minute anxiety attacks from my teenage days; it multiplied by folds when I saw the people suffering. They could not breathe and were going numb now and then. It triggered my anxiety attacks to a serious extent. However, I had to carry on with my duties so I performed to my best regardless of my condition.”	“Initially the situation was shocking to me as well. However, I had to stay strong to be responsive to the people in front of me. So I managed to brace for the impact and regulated my response accordingly. Yes, the working conditions were stressful but did not hinder my pace of work”.

Q2. What was the impact of COVID-19 on your physical health as a healthcare worker during 2020 and 2021?

Healthcare professional 1	Healthcare professional 2	Healthcare professional 3
"The continuous rigorous shift was draining, to say the least. Often I was experiencing a hard time barely even standing straight and performing my duties. I often felt nauseatic but I had to serve those poor people"	“The physical exhaustion was almost unbearable. We could not go for days. In the initial half of 2021. I even remember staying in the hospital for almost a week. My muscles felt like tearing apart from my body”	“The physical labour was critical. It was highly stressful I had to stand long hours throughout the day but the patients were suffering more than I. My pain felt quite less compared to theirs”.

Q3. How would you describe your emotional condition when you were dealing with coronavirus-infected patients?

Healthcare professional 1	Healthcare professional 2	Healthcare professional 3
“It was an emotional roller coaster in there. Even now when I remember the times, It takes the life out of me. I do not want to recollect those memories.”	“I could not meet my family for days. My children and husband were there at home. I saw those people and my heart cried out for my family. However, I had to maintain my strength in front of them”.	“I could not afford to be emotionally vulnerable. I had to maintain a strong stature for my team and the people around me. It sure was a tough time.”

4.1. Research data analysis

It has been derived through the aforementioned data that the people involved in the NHS as healthcare worker has been suffering extensively throughout their extensive workload. On top of it, their personal needs were not addressed as well. Low wages, extensive workload and the associated physical toll hampered the quality of the job.

4.2. Conclusions and recommendations.

The research helps in drawing a necessary conclusion for the events of the research it has been inferred that the span of 2020-21 was highly impactful upon the healthcare workers involved in the line of work NHS. The scarcity of necessary resources that would have catered to the basic needs reflected on their motivational level and their associated performative output. Even in recent times, people are suffering from the emotional and mental stress that they incurred during the period of the pandemic.

It is recommended that people who are involved in the field of work and are relentlessly serving people in terms of dire need should be provided with basic amenities and facilities. It is necessary to do so to maintain and enhance their dedication and motivation level to serve their duties in the future days.

4.3. Possible application of research findings.

The research findings can further help give a clear and concise idea regarding the issue that has been faced by the workers during the pandemic. The research also outlines the present condition of the workers which is a direct consequence of the extensive stretch of work they had to work in under scarce availability of resources. This research finding can be beneficial to be considered by NHS and other relevant institutions to provide better facilities and resources (White et al. 2020). People irrespective of their field of work must be facilitated with efficient resources that would otherwise help them to grow and prosper with the relevant working conditions. It is extremely crucial for healthcare workers of NHS in the UK

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