{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:50:20Z","timestamp":1772160620144,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore healthcare workers' experiences of the changed caring reality during the COVID\u201019 pandemic in Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An online fully mixed\u2010methods design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A web\u2010based self\u2010reported questionnaire with fixed and open\u2010ended answers collected data from March to April 2021,\u00a0analysed in three steps. First, free\u2010text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta\u2010inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Meta\u2010inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme;\n                      <jats:italic>When work became a frightening experience in a dehumanized reality<\/jats:italic>\n                      , comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post\u2010traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID\u201019 pandemic and to prevent mental health illness in future crisis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta\u2010analyses and systematic reviews. In\u2010depth understanding on experiences and how symptoms of post\u2010traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post\u2010traumatic stress disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Practice\/Policy<\/jats:title>\n                    <jats:p>This study might guide how to prepare for resilience in future emergencies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16083","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T05:17:55Z","timestamp":1706851075000},"page":"4295-4309","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Struggling in the dehumanized world of\n                    <scp>COVID<\/scp>\n                    \u2014An exploratory mixed\u2010methods study of frontline healthcare workers' experiences"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-849X","authenticated-orcid":false,"given":"Hillewi","family":"Carnesten","sequence":"first","affiliation":[{"name":"School of Health, Care and Social Welfare M\u00e4lardalen University  Eskilstuna\/V\u00e4ster\u00e5s Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"von Heideken\u00a0W\u00e5gert","sequence":"additional","affiliation":[{"name":"School of Health, Care and Social Welfare M\u00e4lardalen University  Eskilstuna\/V\u00e4ster\u00e5s Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena Wiklund","family":"Gustin","sequence":"additional","affiliation":[{"name":"School of Health, Care and Social Welfare M\u00e4lardalen University  Eskilstuna\/V\u00e4ster\u00e5s Sweden"},{"name":"Department of Health and Care Sciences UiT\/The Arctic University of Norway  Narvik 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