Abstract:
Introduction: Covid-19, caused by the novel SARS-CoV-2, brought significant challenges to the health care
delivery system. The pandemic impacted care delivery not only due to the severity of the disease and the high
mortality rate but also because of its consequences on the management of patients. However, little is known about
how Covid-19 affected patient care delivery, particularly in relation to the five major concepts highlighted in the
Adaptation Model of Nursing: Person, Environment, Health, Nursing, and Adaptation. The aim of this study was
to assess the impact of Covid-19 on patient care delivery among nurses at Mzuzu Central Hospital in northern
Malawi.
Methods: The study employed mixed methods, utilizing both quantitative and qualitative approaches. Analytical
cross-sectional and phenomenological study design strategies were used. Purposive sampling targeted frontline
nurse caregivers for qualitative data, while simple random sampling was used for quantitative data. Eleven
participants were involved in qualitative interviews, and 208 nurses participated in the quantitative survey.
Qualitative data were analyzed using NVivo for thematic analysis, while SPSS was used for quantitative analysis,
including chi-square tests and logistic regression.
Results: The study revealed enormous changes in patient care delivery due to Covid-19. Key challenges included
lack of PPE (76.44%), exhaustion (76%), fear of infection (83.3%), and fear of seeking care (87%). Chi-square
analysis identified significant associations with exhaustion (p = 0.004), fear of infection (p = 0.019), and resource
scarcity (p = 0.0005). In the multivariate analysis, the adjusted Odds Ratios (aORs) were calculated to control for
potential confounding factors. Some variables continued to demonstrate significant associations with
compromised care delivery. This included exhaustion; (aOR = 1.984, 95% CI: 1.159-3.398 p= 0.014), fear of
infection; (aOR = 1.778, 95% CI: 1.010-3.128 p= 0.045) and resource scarcity; (aOR = 2.349, 95% CI: 1.303-
4.230 p= 0.004), all of which remained significant predictors of compromised care delivery during the pandemic.
Qualitative findings echoed these issues but also highlighted nurses' motivation driven by duty, patient recovery,
and faith.
Conclusion: The study concludes that Covid-19 significantly impacted on patient care delivery. Strengthening
healthcare infrastructure, improving resources, and training are essential to enhance care quality and resilience
during future health pandemic crises.
Keywords: Mzuzu Central Hospital, Nurses, frontline, Covid-19, Impact, care delivery
