Mapping emotional coping interventions for health care providers: a scoping review.

Abstract

Background: Primary Health Care (PHC) nurses in low and middle-income countries (LMICs) such as South Africa, are confronted by socio-economic inequalities that impact their health and well-being, and capacity to provide person-centred care (PCC). Concurrently, the organisational/system changes amplified pre-existing emotional strain (i.e., burnout, stress, and compassion fatigue). Through the driving of PCC, Human Resources for Health (HRH) strategies, the implementation of National Health Insurance (NHI) plan and re-engineering of PHC which aim to meet the global health care sector standards. The delivery of emotional coping skill interventions capacitates PHC nurses to cope and provide optimum PCC in PHC. This scoping review focused on broadly reviewing emotional coping skill interventions for health care providers in LMICs. Subsequently, the findings were refined to infer knowledge on building emotional coping skills interventions, particularly for PHC nurses in the South African context. Purpose: To map emotional coping skills interventions for health care providers within LMICs to improve the well-being of the PHC nurses to provide optimum care in PHC. Methods and Analysis: The Arksey and O'Malley’s framework scoping review was used to map evidence on emotional coping skills interventions for health care providers (i.e., nurses) within LMICs. Furthermore, the PRISMA-SCR flowchart and checklist were utilised to depict the search strategy. A narrative review approach was utilised to chart the data, and the database search was recorded as follows; author(s) & year of publication, study location (country), aims and objectives of the study, methodology, study population, intervention type, duration of the intervention, outcome measures, key findings, and limitations. Data were thematically analysed and guided by the Thomas and Harden (2008) thematic framework to identify trends and gaps. Findings: The review distilled 5 eligible articles, published between the years 2015 to 2018. The findings revealed two major themes set by the study's research objectives. Theme 1revealed a gap for context-specific interventions as there was a myriad of factors specific to the South African health care sector to be accounted for in the curation of interventions and a paucity of primary research on emotional coping skill interventions to cope with the adverse “people work” (i.e., burnout, stress, and compassion fatigue). Theme 2 revealed factors that contributed to improved well-being namely, education and training, communication, debriefing/venting, religion and spirituality, social support, humour, and duration of interventions and working hours.

Conclusion and Recommendations: The findings of the scoping review substantiate that emotional coping skill interventions exist in LMICs and are beneficial to the well-being of PHC nurses. From an organisational perspective, the findings demonstrate that the existing interventions propose a basis for future emotional coping skill interventions for PHC nurses to be capacitated with the necessary tools to cope. In addition, further primary research is required to propose a South African context of standard of best practice to shape subsequent interventions.