Theory Development – PHENOMENON OF CARING


Theory Development

Theory Development

The phenomenon of fear:

A strategic effort to combat Covid-19 as frontline hospital staff struggle with treating patients at the bedside.


Pandemics have enormous implications on the workforce.

Reports show a high rate of Covid-19 infections among care professionals (Hu et al., 2020).

There is a phenomenon of fear, especially among the nurses attending to the Covid-19 patients at the bedside.

Fear of developing the infections, failing to give adequate care due to limited resources, stigmatization, and fear of taking the virus home.

The central concepts are Person (stressed care professional in a hospital setting) and the Environment, which is the hospital and Covid situation.

The phenomenon is concrete since the nurses experience fear in the hospital environment handling the Covid-19 patients.


The care professionals’ fears are fear of infection, death, and spreading the disease to their loved ones.

The environment that is the hospital setting is also increasing fear among the care professionals due to the high spread, death rates, and lack of essential resources like the PPEs (Hu et al., 2020).

Lack of managerial support entails providing the care professionals with the relevant information and monitoring their training, enhancing their confidence.

Why Is The Fear of Phenomenon a Problem?

The phenomenon of fear is a powerful element, and its influence on health care should not be underestimated.

The phenomenon is a problem since the nurse’s fear fails to provide adequate care due to the limited resources and fear of stigmatization.

Unfamiliar items like the PPEs or other prevention practices increase the self-contamination risk and risk of acquiring the disease (Hu et al., 2020).

The environment where the nurses are working in the Covid situation increases the fear.

Concepts and Definitions

To develop a theory, the usage of concepts is essential; many conceptual methods can be applied, but we chose to incorporate the nursing metaparadigm

Following a stepwise model helps to illustrate the entire process to be accomplished.

The derivation of concept introduced two factors, the person and the environment.

Person: Stress of nurses (stress factor) and mental and physical being of the person (nurses)

Environment: The hospital settings–Covid-19 as the situational environment

Concepts and Definitions

Concept can be defined in two parts as it pertains to this development:

Theoretical: “The theoretical framework provides a general representation of relationships between things in a given phenomenon”. (Ruto, Enock (2016))

The nurse and patients infected with Covid-19 virus and fear phenomenon that comes with treating said patients

Rational: The word rational is a derivative of the latin word, ration. This gives rise to the meaning of reasoning in reference to “ a decision-making process that is based on making choices that result in the optimal level of benefit or utility for an individual”. (A. Hayes (2020)).

Relational statement: Theoretical

Correlational / Associational


Increased exposure to virus results in increased levels of fear.

Bearing witness to higher rates of death causes a fear of dying

Prolonged isolation enhances fear of spreading disease


Limited PPE availability decreases sense of safety

The inability to social distance increases the sense of fear

Lack of clear policy increases fear

Relational Statement: Theoretical

Healthcare workers are performing their duties in high stress situations, which is causing increased levels of fear.

There are a variety of stress factors in the workplace of healthcare workers that have been shown to increase the risk of burnout, such as increasing workload, emotional response to contact with suffering and dying patients, and organizational problems and conflict. (Ruotsalainen, et al 2015)

Stress can cause fear, anger…..worry….. (CDC, 2020)

Relational Statement: Operational

Relational Statement: Operational, 2020

Relational Statement: Operational

Due to the:

lack of adequate PPE

Lack of unified strategy from the Government

Lack of clear policy and procedures in the Hospital setting

Lack of adequate staffing

The Hospital worker experiences high levels of stress, which enhances feelings of fear for

Their life

The health of their patients

The health of their loved ones

Linkages and ordering

It has been revealed that the fear phenomenon among frontline workers in regard to taking care of patients who present to the hospitals with Covid-19 occurs as a result of a number of factors.

–These include:

Fear of being infected with the virus while taking care of patients

Limited resources which leads to provision of unsatisfactory services


Fear of spreading the virus to one’s loved ones

Fear of death.

Linkages and ordering

Frontline workers also feel that they are not adequately supported by the management in terms of being provided with relevant information and receiving adequate training on how to handle patients presenting with the Covid-19 disease.

Linkages and ordering

This makes it imperative to find ways to deal with this fear phenomenon.

It is important that frontline workers receive adequate training on how to care for Covid-19 patients.

Frontline workers should be provided with appropriate personal protective equipment and be trained on how to use them properly.

This will reduce their chances of getting infected and/or death as well as infecting their loved ones.

Rigorous public education should also be conducted in order to address the issue of stigmatization of frontline workers.


The Covid-19 pandemic has led to phenomena of fear among the nurses since they fear developing the disease, stigma, and spreading the virus to their friends and families.

The hospital environment also increases the fear due to the experiences they witness every day.

Consequently, this impacts the effectiveness of care delivery and quality of the care.

The phenomena is a problem since it has affected the nurses personally while also affecting their care practices.


Alligood, M. (2018). Nursing Theorists and Their Work 9th Edition.

Fofana, N. K., Latif, F., Sarfraz, S., Bashir, M. F., & Komal, B. (2020). Fear and agony of the pandemic

leading to stress and mental illness: an emerging crisis in the novel coronavirus (COVID-19)

outbreak. Psychiatry Research, 291, 113230.

Hu, D., Kong, Y., Li, W., Han, Q., Zhang, X., & Zhu, L. et al. (2020). Frontline nurses’ burnout,

anxiety, depression, and fear statuses and their associated factors during the COVID-19

outbreak in Wuhan, China: A large-scale cross-sectional study. Clinical medicine, 24,


Ruotsalainen, J.H., Verbeek, J.H., Marine, A., (2015). Preventing occupational stress in healthcare

workers. The Cochrane database of systematic reviews, 2015(4), SC002892.


Ruto, Enock. (2016). Re: What are the differences between conceptual framework and theoretical


Szmyd, B., Karuga, F. F., Bartoszek, A., Staniecka, K., Siwecka, N., Bartoszek, A., … & Radek, M.

(2021). Attitude and Behaviors towards SARS-CoV-2 Vaccination among Healthcare Workers: A

Cross-Sectional Study from Poland. Vaccines, 9(3), 218.

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