How do care environments shape healthcare? A synthesis of qualitative studies among healthcare workers during the COVID-19 pandemic

Abstract

ObjectiveTo investigate how care is shaped through the material practices and spaces of healthcare environments during the COVID-19 pandemic.DesignCritical interpretive synthesis (CIS) of qualitative research.ParticipantsStudies included qualitative research investigating the experiences of healthcare workers involved in the care of individuals during the COVID-19 pandemic.Results134 articles were identified in the initial sampling frame with 38 studies involving 2507 participants included in the final synthesis. Three themes were identified in the analysis: (1) the hospital transformed, (2) virtual care spaces and (3) objects of care. Through the generation of these themes, a synthesising argument was developed to demonstrate how material spaces and practices of healthcare shape care delivery and to provide insights to support healthcare providers in creating enabling and resilient care environments.ConclusionsThe findings of this study demonstrate how healthcare environments enable and constrain modes of care. Practices of care are shaped through the materiality of spaces and objects, including how these change in the face of pandemic disruption. The implication is that the healthcare environment needs to be viewed as a critical adaptive element in the optimisation of care. The study also develops a versatile and coherent approach to CIS methods that can be taken up in future research.

Uncertainty and decision-making in Critical Care: lessons from managing COVID-19 ARDS for the next pandemic

“…A small body of research exists that has explored how healthcare environments, including resources such as equipment and disposable items, enabled and constrained modes of care during the pandemic, although none have focussed speci cally on decisionmaking. [20] The link between distraction and decreased decisional ability is well established; [21,22] however, it may be that the stressors related to resource limitations in general created a sub-optimal context for decision-making. Again, the WHO / ESCIM C19SPACE training may be an ideal platform to add a module for hospital logisticians and administrators to enhance their performance in the vital role of pandemic preparedness.…”

Constitution of Long COVID illness, patienthood and recovery: a critical synthesis of qualitative studies

“…This requires critical, iterative and reflexive approaches to developing a research question and undertaking sampling and analysis, rather than the systematic strategies used in many other review methodologies 25 27. We outline the steps of our methods below, which build upon an existing, adapted approach to CIS methods 28…”

“…First, we conducted searches of PubMed and Web of Science databases on 14 September 2023, using analogous search queries (online supplemental table 1). As CIS methods do not require a systematically generated sample of literature, additional manual searches and citation chaining methods were periodically conducted (until 15 December 2023) to identify other relevant studies for consideration 28 29. These manual search strategies did not yield additional articles for inclusion.…”

The Enduring Effects of COVID for Cancer Care: Learning from Real-Life Clinical Practice

“…In terms of relations of estrangement, the spatial dynamics of distance and proximity in the provision of care, including the micro-landscapes of the hospital room or clinic, the possibilities of remote/virtual care, and the significance of touch and separation have been key themes in health geography and related scholarship (33). Recent studies have interrogated how these dynamics were reconfigured in response to COVID-19 (34,35), illuminating how the material environment shapes the quality and emotional resonance of care.…”