Consortium PSYCHIATRICUMConsortium PSYCHIATRICUMConsortium PSYCHIATRICUM2712-76722713-2919Eco-Vector15410.17816/CP154RESEARCHИССЛЕДОВАНИЕResearch ArticleExperiences of Kyrgyzstani Frontline Healthcare Workers during the “Black July” of 2020: a Qualitative StudyОпыт медиков Кыргызстана, оказывающих медицинскую помощь во время «Черного июля» 2020 года: качественное исследованиеhttps://orcid.org/0000-0002-4268-900856993086700MolchanovaElena S.МолчановаЕлена Сергеевна
Kyrgyzstan

MD (Psychiatry), Full Professor of Psychology Program of the Social Science Division

кандидат медицинских наук, научный консультант Кыргызской психиатрической ассоциации, старший консультант Республиканского Центра психического здоровья, профессор кафедры психологии департамента социальных наук

molchanova_e@auca.kgKharsunVeronika S.ХарсунВероника Сергеевна
Kyrgyzstan

MA, alumna of Master Program in Applied Psychology

veronika.kharsun@yandex.comKenzhebaevaZhibek S.КенжебаеваЖибек Советбековна
Kyrgyzstan

MA, alumna of Master Program in Applied Psychology

kenzhebaeva_z@auca.kgAlikanovaAigul S.АликановаАйгуль Сагынбаевна
Kyrgyzstan

MA, alumna of Master Program in Applied Psychology

aigulia0105@gmail.comAmerican University of Central AsiaАмериканский университет в Центральной Азии080620220507202232971101102202216052022Copyright ©; 2022, Molchanova E.S., Kharsun V.S., Kenzhebaeva Z.S., Alikanova A.S.Copyright ©; 2022, Молчанова Е.С., Харсун В.С., Кенжебаева Ж.С., Аликанова А.С.2022Molchanova E.S., Kharsun V.S., Kenzhebaeva Z.S., Alikanova A.S.Молчанова Е.С., Харсун В.С., Кенжебаева Ж.С., Аликанова А.С.https://creativecommons.org/licenses/by/4.0https://consortium-psy.com/jour/article/view/154

BACKGROUND: The peak of the pandemic in Kyrgyzstan occurred in July 2020 with highest infection rates, almost 1000 cases daily, compared to 100 cases prior to this date. The state health system was fatally unprepared to accommodate patients, mobilize medical staff, or provide clear instructions to the population. This study explores personal narratives of healthcare practitioners who were affected by and survived COVID-19 during the “Black July” of 2020 in Bishkek, Kyrgyzstan.

METHOD: Healthcare workers (n=10) were interviewed using a semi-structured interview protocol. Interviews were transcribed then analyzed in accordance with interpretative phenomenological study guidelines.

RESULTS: The narratives demonstrated both post-traumatic depreciation and post-traumatic growth, resulting in changes of attitudes, lifestyle, and identity. An important aspect of identity shift included an emerging desire for increased self-care, which was characterized by resistance against a heroic Hippocratic ideal to “to save everybody”.

CONCLUSION: COVID-19 is perceived as a psycho-socio-cultural phenomenon, which has transformed the identities of healthcare workers in the Kyrgyz Republic. Further research is recommended into developing rehabilitation programs for healthcare workers.

ВВЕДЕНИЕ: Пик пандемии в Кыргызстане пришелся на июль 2020 года, когда были зарегистрированы самые высокие показатели заболеваемости. Государственная система здравоохранения оказалась фатально не готова к приему пациентов, мобилизации медицинского персонала и предоставлению четких инструкций населению. В данном исследовании рассматриваются индивидуальные нарративы медицинских работников, которые пострадали от COVID-19 и пережили его во время "черного июля" 2020 года в Бишкеке.

МЕТОД: Медицинские работники (n=10) были опрошены с использованием протокола полуструктурированного интервью. Интервью были проанализированы в соответствии с принципами интерпретативного феноменологического анализа.

РЕЗУЛЬТАТЫ: Истории участников исследования продемонстрировали как посттравматическое обесценивание, так и посттравматический рост, изменивший как образ жизни, так и отношение медиков к себе. Желание позаботиться о себе сопротивлялось героическому идеалу Гиппократа "спасти всех".

ЗАКЛЮЧЕНИЕ: COVID-19 воспринимается как психо-социо-культурный феномен, который трансформировал идентичность медицинских работников в Кыргызской Республике. Рекомендуется проведение дальнейших исследований по разработке реабилитационных программ медиков.

COVID-19pandemichealthcare workerspost-traumatic growthpost-traumatic depreciationEric FrommCOVID-19пандемиямедицинские работникипосттравматический ростпосттравматическое обесцениваниеЭрик ФроммAmerican University of Central Asia (AUCA)Американский Университет в Центральной Азии (АУЦА)Giusti EM, Pedroli E, D’Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C, Stramba Badiale M, Riva G, Castelnuovo G, Molinari E. The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Front Psychol. 2020;11:1684. doi: 10.3389/fpsyg.2020.01684.Galbraith N, Boyda D, McFeeters D, Hassan T. The mental health of doctors during the COVID-19 pandemic. BJPsych Bull. 2021 Apr;45(2):93–97. doi: 10.1192/bjb.2020.44.Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ. 2020 Mar 26;368:m1211. doi: 10.1136/bmj.m1211.Kaktus.media [Internet]. Maslova D. [How the salaries of doctors have decreased (!) in Kyrgyzstan. Address to the President, 2020, July 16][cited 19 May 2022]. Available from: https://kaktus.media/doc/417240_kak_v_kyrgyzstane_ymenshalas_zarplata_medikov._obrashenie_k_prezidenty.html Russian.Kaktus.media [Internet]. Shabalin A. [Bishkek, New York, London. Comparing the cost of living, 2019, March 1][cited 19 May 2022]. Available from: https://kaktus.media/doc/387511_bishkek_nu_york_london._sravnivaem_stoimost_jizni.html Russian.Eurasianet [Internet]. Kumenov A, Imanalieva A. Pneumonia fudge hiding scale of Central Asia’s coronavirus emergency. 2020, July 16 [cited 19 May 2022]. Available from: https://eurasianet.org/pneumonia-fudge-hiding-scale-of-central-asias-coronavirus-emergencyDzushupov K, Lucero-Prisno DE, 3rd, Vishnyakov D, Lin X, Ahmadi A. COVID-19 in Kyrgyzstan: Navigating a way out. J Glob Health. 2021 Jan 30;11:03020. doi: 10.7189/jogh.11.03020.Molchanova E. Preliminary results of the nationwide survey on COVID-19 consequences [Paper presentation]. Bishkek: Kyrgyz State Medical Academy Annual Meeting; 2021.Xiong LJ, Zhong BL, Cao XJ, Xiong HG, Huang M, Ding J, Li WT, Tong J, Shen HY, Xia JH, et al. Possible posttraumatic stress disorder in Chinese frontline healthcare workers who survived COVID-19 6 months after the COVID-19 outbreak: prevalence, correlates, and symptoms. Transl Psychiatry. 2021 Jul 5;11(1):374. doi: 10.1038/s41398-021-01503-7.Jayawickreme E, Blackie LER. Post–traumatic Growth as Positive Personality Change: Evidence, Controversies and Future Directions. European Journal of Personality. 2014;28(4):312–331. doi: 10.1002/per.1963.Moreno-Jiménez JE, Blanco-Donoso LM, Demerouti E, Belda Hofheinz S, Chico-Fernández M, Moreno-Jiménez B, Garrosa E. The Role of Healthcare Professionals’ Passion in Predicting Secondary Traumatic Stress and Posttraumatic Growth in the Face of COVID-19: A Longitudinal Approach. International Journal of Environmental Research and Public Health. 2021;18(9):4453. doi: 10.3390/ijerph18094453.Park CL. Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events. Psychol Bull. 2010 Mar;136(2):257–301. doi: 10.1037/a0018301.Roepke AM, Jayawickreme E, Riffle OM. Meaning and Health: A Systematic Review. Applied Research in Quality of Life. 2013;9(4):1055–1079. doi: 10.1007/s11482-013-9288-9.Ikizer G, Karanci AN, Gul E, Dilekler I. Post-traumatic stress, growth, and depreciation during the COVID-19 pandemic: evidence from Turkey. Eur J Psychotraumatol. 2021 Feb 18;12(1):1872966. doi: 10.1080/20008198.2021.1872966.Kalaitzaki A. Posttraumatic symptoms, posttraumatic growth, and internal resources among the general population in Greece: A nation-wide survey amid the first COVID-19 lockdown. Int J Psychol. 2021 Oct;56(5):766–771. doi: 10.1002/ijop.12750.Gergen KJ. Social Construction in Context. London: Sage; 2001. p. 150–151.Alase A. The Interpretative Phenomenological Analysis (IPA): A Guide to a Good Qualitative Research Approach. International Journal of Education and Literacy Studies. 2017;5(2):9. doi: 10.7575/aiac.ijels.v.5n.2p.9.Rossi G, editor. Psychology: selected papers. Rijeka, Croatia: InTech; 2012. Qualitative research methods in psychology; p. 175–206.Giorgi A. The Theory, Practice, and Evaluation of the Phenomenological Method as a Qualitative Research Procedure. Journal of Phenomenological Psychology. 1997;28(2):235–260. doi: 10.1163/156916297x00103.Smith J. Qualitative psychology. London: Sage; 2007.Bazarkulova D, Compton J. Gender Differences in Self-Reported Stress and Health Behaviors of Doctors in Kazakhstan During COVID-19. Feminist Economics. 2021;27(1–2):81–102. doi: 10.1080/13545701.2020.1853789.Konstantinov V, Berdenova S, Satkangulova G, Reznik A, Isralowitz R. COVID-19 Impact on Kazakhstan University Student Fear, Mental Health, and Substance Use. Int J Ment Health Addict. 2022;20(2):888–894. doi: 10.1007/s11469-020-00412-y.Uzakov O, Komissarova S, Alymkulov A, Kermaly kyzy M. Comparative Characteristics of the Frequency and Level of Anxiety Disorders Among Respondents Living in Kyrgyzstan and Kazakhstan during COVID-19 Pandemic. Eurasian Medical Journal. 2021;(3):24–31.Fromm E. The Sane Society. New York: Rinehart and Company; 1955.Business Ombudsman Institute (BOI) of the Kyrgyz Republic. (2021, April 21). Annual Report 2020. https://boi.kg/media/images/af0f4fd4-1540-4e52-a5b3-c17ddedfe474.pdfTransparency International [Internet]. Corruption Perceptions Index (CPI) 2020: Eastern Europe and Central Asia. 28 January 2021 [cited 19 May 2022]. Available from: https://www.transparency.org/en/news/cpi-2020-eastern-europe-central-asia#United Nations.Business Ombudsman Institute [Internet]. Policy brief: COVID-19 and the need for action on mental health [cited 19 May 2022]. Available from: https://unsdg.un.org/sites/default/files/2020-05/UN-Policy-Brief-COVID-19-and-mental-health.pdfCity University London [Internet]. Schonau B. The paradox of the ‘wounded healer’. [Unpublished doctoral dissertation]. City University London, 2012 [cited 19 May 2022]. Available from: https://openaccess.city.ac.uk/id/eprint/2993/Guggenbuhl-Craig A. [Power of the archetype in psychotherapy and medicine]. Saint Petersburg; 1997. Russian.Williams GH. The determinants of health: structure, context and agency. Sociology of Health & Illness. 2003;25(3):131–154. doi: 10.1111/1467-9566.00344.Marshall EM, Frazier P, Frankfurt S, Kuijer RG. Trajectories of posttraumatic growth and depreciation after two major earthquakes. Psychol Trauma. 2015 Mar;7(2):112–121. doi: 10.1037/tra0000005.