No abstract

The highly contagious and deadlycoronavirus disease 2019 (COVID-19) has caused significant disruption in the small care sector of Pakistan. This study accordingly explores the perceptions and experiences of staff providing direct caregiving services to the elderly residents at three care homes during the time of the coronavirus pandemic in Karachi, Pakistan. Design: Using a qualitative approach, 27 digitally recorded, semi-structured, face-toface interviews were performed with current and former caregiving staff members. The data were analyzed through qualitative content analysis. Results: Analysis highlights various kinds of challenges that were faced by the caregivers and their families during the pandemic. The main theme class identified from the data was "living in anxiety and fear." The work-related decisions made by caregivers at that time were mainly influenced by their familial demands and responsibilities. Conclusion: Caregivers were at risk of catching the lethal virus through inhalation of or physical contact with infectious particles, but despite that most of them continued to render elderly care services. This study's findings could be used by government leaders and care home administrations when making coronavirus containment policies, designing economic relief packages, and formulating caregiving training programs in Pakistan or other countries in the world.

The present study examines whether patient-perpetrated violence triggers anger, hatred and other negative emotions that, under certain circumstances, might motivate nurses to behave violently with patients. In doing so, this study considers burnout as a mediator in the patient violence-nurse violence relationship. To test the causal paths, data were collected from 182 nurses working in two government-sector teaching hospitals of Pakistan's Punjab province. Results confirm that patient violence toward nurses leads to nurse violence toward patients through the mediating effect of burnout. The study advises hospitals to provide wellness and stress management programs to nurses who regularly experience events involving patient violence. Hospitals may consider allowing nurses to take short breaks after an encounter with violently behaving patients. In addition, hospitals should conduct empathy-promoting training, emotional intelligence training and 'lens of the patient' training programs to sensitize their nursing staff.

This exploratory study determined the impact of organizational structure, particularly participation in decision making, instrumental communication, formalization, integration, and promotional opportunity, on burnout among Pakistani pediatric nurses. Data were collected from pediatric nurses working for Punjab's largest state-run hospital. The findings revealed that participation in decision making, instrumental communication, and promotional opportunity prevented burnout. Formalization contributed to burnout but integration was not related to burnout. Quite interestingly, except for supervisory status, most control variables for this study were not significantly related to emotional burnout. Hence, the hypothesis that organizational structure is a determinant of job burnout was accepted.