Navigating the barriers: an in-depth exploration of how personal protective equipment influences the relational dynamics between healthcare workers and patients

Navigating the barriers: an in-depth exploration of how personal protective equipment influences the relational dynamics between healthcare workers and patients

Authors

  • Maria Bertuol Department of Medicine and Surgery, University of Parma, Italy
  • Serena Barello Department of Brain and Behavioural Sciences, University of Pavia
  • Giovanna Casella Department of Medicine and Surgery, University of Parma, Italy
  • Federico Dibennardo Department of Medicine and Surgery, University of Parma, Italy
  • Marta Acampora Department of Medicine and Surgery, University of Parma, Italy
  • Angelica Buscella Department of Medicine and Surgery, University of Parma, Italy
  • Jessica Mancini Department of Medicine and Surgery, University of Parma, Italy
  • Elena Bertuzzi Department of Medicine and Surgery, University of Parma, Italy
  • Leopoldo Sarli Department of Medicine and Surgery, University of Parma, Italy
  • Antonio Bonacaro Department of Medicine and Surgery, University of Parma, Italy
  • Giovanna Artioli Department of Medicine and Surgery, University of Parma, Italy

Keywords:

patient centred medicine, medical humanities, qualitative research, covid-19, patient-doctor communication

Abstract

Background and aim: This study explores the communication dynamics between healthcare professionals and patients amidst the mandatory use of personal protective equipment (PPE) during the Covid-19 pandemic. It specifically examines the strategies employed by healthcare professionals to address communication barriers posed by these protective instruments. Methods: A qualitative approach was taken using semi-structured interviews. With participants' consent, interviews were recorded, transcribed verbatim, and analyzed thematically. Results: Thirteen qualitative semi-structured interviews were conducted with a diverse group of professionals in medical and critical care settings in northern Italy. Thematic analysis unveiled three key themes: (1) The influence of Personal Protective Equipment (PPE) on the healthcare worker-patient relationship, (2) Strategies and tools for improving patient communication, and (3) Key takeaways and lessons learned. Conclusions: The COVID-19 pandemic catalyzed a transformation in global healthcare communication dynamics. Despite the challenges posed by PPE usage, healthcare professionals displayed remarkable resilience, creativity, and unwavering dedication to patient care. The unique circumstances of the COVID-19 pandemic make it a valuable observatory for drawing lessons applicable to contexts where PPE remains a necessity. The challenges faced during this period provide insights into how healthcare professionals adapted their communication methods to ensure effective and empathetic patient interaction despite the physical barriers introduced by PPE. By scrutinizing the experiences and strategies employed in this extraordinary context, this study seeks to contribute to a broader understanding of effective communication in healthcare settings that require ongoing PPE usage

Author Biographies

Maria Bertuol, Department of Medicine and Surgery, University of Parma, Italy

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Giovanna Casella, Department of Medicine and Surgery, University of Parma, Italy

.

Federico Dibennardo, Department of Medicine and Surgery, University of Parma, Italy

.

Marta Acampora, Department of Medicine and Surgery, University of Parma, Italy

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Angelica Buscella, Department of Medicine and Surgery, University of Parma, Italy

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Jessica Mancini, Department of Medicine and Surgery, University of Parma, Italy

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Elena Bertuzzi, Department of Medicine and Surgery, University of Parma, Italy

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Leopoldo Sarli, Department of Medicine and Surgery, University of Parma, Italy

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Antonio Bonacaro, Department of Medicine and Surgery, University of Parma, Italy

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Giovanna Artioli, Department of Medicine and Surgery, University of Parma, Italy

.

References

Sheppard M. Client satisfaction, extended intervention and interpersonal skills in community mental health. J Adv Nurs. 1993;18(2):246-259. doi: 10.1046/j.1365-2648.1993.18020246.x.

Meuter RF, Gallois C, Segalowitz NS, et al. Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC Health Serv Res. 2015;15(1):1-5. doi: 10.1186/s12913-015-1024-8.

Laschinger HK, Boss MW. Learning styles of nursing students and career choices. J Adv Nurs. 1984;9(4):375-380. doi: 10.1111/j.1365-2648.1984.tb00386.x.

Bullington J, Söderlund M, Sparén EB, et al. Communication skills in nursing: A phenomenologically-based communication training approach. Nurse Educ Pract. 2019;39:136-141. doi: 10.1016/j.nepr.2019.08.011.

Granados-Gámez G, Sáez-Ruiz IM, Márquez-Hernández VV, et al. Development and validation of the questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication. Patient Educ Couns. 2022;105(1):145-150. doi: 10.1016/j.pec.2021.05.008.

Grassi L, Caruso R, Costantini A, et al. Communication with patients suffering from serious physical illness. Clin Challenges Biopsychosoc Interface. 2015;34:10-23. doi: 10.1159/000369050.

Watzlawick P, Beavin JH, Jackson DD, et al. Pragmatica della comunicazione umana. Astrolabio. 1971;Roma(35):1-47.

Rubinelli S, Myers K, Rosenbaum M, et al. Implications of the current COVID-19 pandemic for communication in healthcare. Patient Educ Couns. 2020;103(6):1067. doi: 10.1016/j.pec.2020.04.021.

Kobayashi R, Hayashi H, Kawakatsu S, et al. Recognition of the coronavirus disease 2019 pandemic and face mask wearing in patients with Alzheimer’s disease: an investigation at a medical centre for dementia in Japan. Psychogeriatrics. 2020. doi: 10.1111/psyg.12617.

Ten Hulzen RD, Fabry DA, et al. Impact of Hearing Loss and Universal Face Masking in the COVID-19 Era. Mayo Clin Proc. 2020. doi: 10.1016/j.mayocp.2020.07.027.

Aengst J, Walker-Stevenson G, Harrod T, et al. Uncomfortable yet necessary: The impact of PPE on communication in emergency medicine. Int J Qual Health Care. 2022;34(4):mzac095. doi: 10.1093/intqhc/mzac095.

Kratzke IM, Rosenbaum ME, Cox C, et al. Effect of clear vs standard covered masks on communication with patients during surgical clinic encounters: a randomized clinical trial. JAMA Surg. 2021;156(4):372-378. doi: 10.1001/jamasurg.2021.0836.

Porschmann C, Lubeck T, Arend JM, et al. Impact of face masks on voice radiation. Acoust Soc Am J. 2020. doi: 10.1121/10.0002853.

Marini M, Anzani A, Paglieri F, et al. The impact of facemasks on emotion recognition, trust attribution and reidentification. Nature - Sci Rep. 2021. doi: 10.1038/s41598-021-84806-5.

Giovanelli E, Valzolgher C, Gessa E, et al. Unmasking the Difficulty of Listening to Talkers With Masks: lessons from the COVID-19 pandemic. SAGE J. 2021. doi: 10.1177/2041669521998393.

Kelly S, Kaehny M, Powell MC. Learning from Nursing Home Infection Prevention and Control Citations During the COVID-19 Pandemic. J Gerontol Nurs. 2023;49(2):36-42. doi: 10.3928/00989134-20230106-06.

Pope C, Mays N. Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health service research. BMJ. 1995;311:42-5. doi: 10.1136/bmj.311.6996.42.

Eatough V, Smith JA. Interpretative phenomenological analysis. The Sage handbook of qualitative research in psychology. 2017:193-209.

Patra M, Hamiduzzaman M, McLaren H, Siddiquee NA. A scoping review of changes to patient-doctor communication during COVID-19. Health Communication. 2024;39(1):25-48.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101.

Braun V, Clarke V. Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches. Counsel Psychother Res. 2021;21(1):37-47. doi: 10.1002/capr.12360.

Barello S, Caruso R, Palamenghi L, et al. Factors associated with emotional exhaustion in healthcare professionals involved in the COVID-19 pandemic: an application of the job demands-resources model. Int Arch Occup Environ Health. 2021:1-11. doi: 10.1007/s00420-021-01669-z.

Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Res. 2020;290:113129. doi: 10.1016/j.psychres.2020.113129.

Chen R, Sun C, Chen JJ, et al. A large‐scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID‐19 pandemic. Int J Ment Health Nurs. 2021;30(1):102-116. doi: 10.1111/inm.12796.

Zhang N, Bai B, Zhu J. Stress mindset, proactive coping behavior, and posttraumatic growth among health care professionals during the COVID-19 pandemic. Psychol Trauma, Theory, Res Pract Policy. 2022;15(3):515.

Marler H, Ditton A. “I'm smiling back at you”: exploring the impact of mask wearing on communication in healthcare. Int J Lang Commun Disord. 2021;56(1):205-214. doi: 10.1111/1460-6984.12578.

Bani M, Russo S, Ardenghi S, et al. Behind the mask: Emotion recognition in healthcare students. Med Sci Educ. 2021;31(4):1273-1277. doi: 10.1007/s40670-021-01317-8.

Barello S, Graffigna G. Caring for health professionals in the COVID-19 pandemic emergency: toward an “epidemic of empathy” in healthcare. Front Psychol. 2020;11:1431.

Okazaki S, Yamanami H, Nakagawa F, Takuwa N, Kawabata Duncan KJ. Mask wearing increases eye involvement during smiling: A facial EMG study. Sci Rep. 2021;11(1):20370. doi: 10.1038/s41598-021-99872-y.

Ganeshan S, Hsiang E, Peng T, et al. Enabling patient communication for hospitalized patients during and beyond the COVID-19 pandemic. BMJ Innov. 2021;7(2). doi: 10.1136/bmjinnov-2020-000636.

Provenzi L, Grumi S, Borgatti R. The experience of child neuropsychiatry residents who volunteered in Italian COVID-19-designated hospitals. Acad Psychiatry. 2020;45:587-592. doi: 10.1007/s40596-021-01442-x.

Provenzi L, Grumi S, Borgatti R. Alone with the kids: Tele-medicine for children with special healthcare needs during COVID-19 emergency. Front Psychol. 2020;11:2193. doi: 10.3389/fpsyg.2020.02193.

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Published

24-04-2024

Issue

Section

HEALTH PROFESSIONS

How to Cite

1.
Bertuol M, Barello S, Casella G, Dibennardo F, Acampora M, Buscella A, et al. Navigating the barriers: an in-depth exploration of how personal protective equipment influences the relational dynamics between healthcare workers and patients. Acta Biomed [Internet]. 2024 Apr. 24 [cited 2024 Jul. 18];95(2):e2024088. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/15671