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Healthcare providers on the frontlines: A qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic

McMahon, S.; Ho, L.; Brown, H.; Miller, L.; Ansumana, R.; Kennedy, C.

Healthcare providers on the frontlines: A qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic Thumbnail


Authors

S. McMahon

L. Ho

L. Miller

R. Ansumana

C. Kennedy



Abstract

Although research on the epidemiology and ecology of Ebola has expanded since the 2014–15 outbreak in West Africa, less attention has been paid to the mental health implications and the psychosocial context of the disease for providers working in primary health facilities (rather than Ebola-specific treatment units). This study draws on 54 qualitative interviews with 35 providers working in eight peripheral health units of Sierra Leone's Bo and Kenema Districts. Data collection started near the height of the outbreak in December 2014 and lasted 1 month. Providers recounted changes in their professional, personal and social lives as they became de facto first responders in the outbreak. A theme articulated across interviews was Ebola’s destruction of social connectedness and sense of trust within and across health facilities, communities and families. Providers described feeling lonely, ostracized, unloved, afraid, saddened and no longer respected. They also discussed restrictions on behaviors that enhance coping including attending burials and engaging in physical touch (hugging, handshaking, sitting near, or eating with colleagues, patients and family members). Providers described infection prevention measures as necessary but divisive because screening booths and protective equipment inhibited bonding or ‘suffering with’ patients. To mitigate psychiatric morbidities and maladaptive coping mechanisms—and to prevent the spread of Ebola—researchers and program planners must consider the psychosocial context of this disease and mechanisms to enhance psychological first aid to all health providers, including those in peripheral health settings.

Citation

McMahon, S., Ho, L., Brown, H., Miller, L., Ansumana, R., & Kennedy, C. (2016). Healthcare providers on the frontlines: A qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic. Health Policy and Planning, 31(9), 1232-1239. https://doi.org/10.1093/heapol/czw055

Journal Article Type Article
Acceptance Date Apr 10, 2016
Online Publication Date Jun 8, 2016
Publication Date Nov 1, 2016
Deposit Date Jun 22, 2016
Publicly Available Date Mar 28, 2024
Journal Health Policy and Planning
Print ISSN 0268-1080
Electronic ISSN 1460-2237
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 31
Issue 9
Pages 1232-1239
DOI https://doi.org/10.1093/heapol/czw055

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Copyright Statement
Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2016. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.







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