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Capturing the experiences of UK healthcare workers during the COVID-19 pandemic: A structural topic modelling analysis of 7412 free-text survey responses

Research output: Contribution to journalArticlepeer-review

Danielle Lamb, Liam Wright, Hannah Scott, Bethany Croak, Sam Gnanapragasam, Mary Docherty, Neil Greenberg, Matthew Hotopf, Sharon A. M. Stevelink, Rosalind Raine, Simon Wessely

Original languageEnglish
Article numbere0275720
JournalPLoS One
Volume17
Issue number10 October
DOIs
Accepted/In press21 Sep 2022
Published7 Oct 2022

Bibliographical note

Funding Information: Funding for NHS CHECK has been received from the following sources: Medical Research Council (MR/V034405/1); UCL/Wellcome (ISSF3/ H17RCO/C3); Rosetrees (M952); NHS England and Improvement; Economic and Social Research Council (ES/V009931/1); as well as seed funding from National Institute for Health Research Maudsley Biomedical Research Centre, King’s College London, National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response at King’s College London. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We wish to acknowledge the National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) National NHS and Social Care Workforce Group, with the following ARCs: East Midlands, East of England, South West Peninsula, South London, West, North West Coast, Yorkshire and Humber, and North East and North Cumbria. They enabled the set-up of the national network of participating hospital sites and aided the research team to recruit effectively during the COVID-19 pandemic. The NHS CHECK consortium includes the following site leads: Sean Cross, Amy Dewar, Chris Dickens, Frances Farnworth, Adam Gordon, Charles Goss, Jessica Harvey, Nusrat Husain, Peter Jones, Damien Longson, Richard Morriss, Jesus Perez, Mark Pietroni, Ian Smith, Tayyeb Tahir, Peter Trigwell, Jeremy Turner, Julian Walker, Scott Weich, Ashley Wilkie. The NHS CHECK consortium includes the following co-investigators and collaborators: Peter Aitken, Anthony David, Sarah Dorrington, Rosie Duncan, Cerisse Gunasinghe, Stephani Hatch, Daniel Leightley, Ira Madan, Isabel McMullen, Martin Parsons, Paul Moran, Dominic Murphy, Catherine Polling, Alexandra Pollitt, Danai Serfioti, Chloe Simela, Charlotte Wilson Jones. Publisher Copyright: © 2022 Lamb et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background
Healthcare workers (HCWs) have provided vital services during the COVID-19 pandemic, but existing research consists of quantitative surveys (lacking in depth or context) or qualitative interviews (with limited generalisability). Structural Topic Modelling (STM) of large-scale free-text survey data offers a way of capturing the perspectives of a wide range of HCWs in their own words about their experiences of the pandemic.

Methods
In an online survey distributed to all staff at 18 geographically dispersed NHS Trusts, we asked respondents, “Is there anything else you think we should know about your experiences of the COVID-19 pandemic?”. We used STM on 7,412 responses to identify topics, and thematic analysis on the resultant topics and text excerpts.

Results
We identified 33 topics, grouped into two domains, each containing four themes. Our findings emphasise: the deleterious effect of increased workloads, lack of PPE, inconsistent advice/guidance, and lack of autonomy; differing experiences of home working as negative/positive; and the benefits of supportive leadership and peers in ameliorating challenges. Themes varied by demographics and time: discussion of home working decreasing over time, while discussion of workplace challenges increased. Discussion of mental health was lowest between September-November 2020, between the first and second waves of COVID-19 in the UK.

Discussion
Our findings represent the most salient experiences of HCWs through the pandemic. STM enabled statistical examination of how the qualitative themes raised differed according to participant characteristics. This relatively underutilised methodology in healthcare research can provide more nuanced, yet generalisable, evidence than that available via surveys or small interview studies, and should be used in future research.

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