Introduction
An unfortunate implication of the current interconnectedness of the world is that health concerns have also become international. As much as people are able to quickly travel around the world, so can infections spread extremely quickly across borders. The current pandemic has showcased how devastating the spread of infectious diseases can be. Within these conditions, two important trends have to be closely studied: the growing influence of China on global health and the growing responsibility of advanced practice registered nurses (APRNs) to adopt a global healthcare perspective.
Global Issues
The first issue affecting all healthcare workers in most countries is migration-driven diseases. The vast diversity of geographic conditions determine the wide range of individual health specifics. Arriving in a new environment exposes people to previously unknown stimuli, potentially threatening their immune system. Combined with the fact that many migrants live in poor areas with insufficient hygiene, the exposure to infections increases the risk of contaminating an illness (Seedat et al., 2018). Not only do they have to survive in the environment filled with viruses, but they might also endanger the well-being of local population. In both cases, healthcare systems around the world have to manage public health issues caused by migration.
The second issue is vaccination reluctance, which has always been a cause for concern, yet the recent years have transformed it into a full public health problem. Although populations of nations, which are usual hosts of migrants, are protected against the onslaught of infections brought by migrants due to vaccination, the COVID-19 pandemic has shown that diseases can affect nations quickly. However, the response to the coronavirus outbreak has also raised concerns regarding vaccine safety among both healthcare workers and people who are not involved in healthcare. As a result, the reluctance to vaccinate leaves substantial quantities of people around the world vulnerable to infectious diseases.
The third global issue is the increasing prevalence of mental health problems. As threatening as the COVID-19 is, its psychological influence is no less dangerous. It is natural that constant exposure to news regarding pandemic-related mortality, disease complications, and quarantine measures has increased the overall level of depression (Kola et al., 2021). Even people who have not been directly affected by the COVID-19 infection have their mental health compromised due to stress and anxiety. In fact, the World Health Organization (2022) specifically points out a “25% increase in prevalence of anxiety and depression worldwide” (para 1). Subsequently, healthcare systems have to manage the mental health crisis as well.
China’s Healthcare, Global Involvement and Influence
Unsurprisingly, China receives substantial media attention regarding its approaches to managing public health issues. Chinese healthcare differs from a healthcare system typically found in Western countries. The majority of the population has basic insurance, although it is not sufficient for covering the costs of highly expensive medicine and treatment. The system itself is strictly hierarchical – any data surrounding emerging issues has to be passed from sentinel hospitals to higher instances, which in turn make their own analysis and report to the Ministry of Health (Sun et al., 2021). This is one of the reasons why China’s first response to COVID was disproportionate to the threat – the lack of flexibility impeded timely measures.
Naturally, the country, where the pandemic originated, became more involved in global health affairs. Husain and Bloom (2020) report growing Chinese investments into the construction of health facilities, Africa Center for Disease Control and Prevention, as well as Chinese commitment to strengthening partnership with the World Health Organization. Another way China attempts to affect global health is via distribution of its own national vaccines (Kobierecka, 2022). Furthermore, Chinese government works to organize joint production of vaccines with other countries, such as Mexico, Brazil, and Turkey. All these initiatives signify a continued tendency of growing Chinese influence in global health affairs.
The most influential aspect of Chinese healthcare is its management of the first wave of the pandemic. Although the first weeks of the outbreak were characterized by an uncontrolled disease spread, later Chinese measures proved to be effective. Essentially, by instituting strict quarantine measures during the early stage, China managed to contain COVID transmission. As Lu et al. (2021) have noted: “while countries in Europe and the Americas are now waiting for the vaccines, China has demonstrated that SARS-CoV-2 elimination is feasible even in a 1.4 billion population country” (p. 5). This observation was noted by many governments that have also opted for stricter quarantine control.
Role of APRN
Whether the problem is vaccine anxiety, infections originating with migrants, or mental health issues, nurses are at the forefront of healthcare delivery. The first issue they have to handle is infectious diseases that migrants are exposed to. Aside from medical competence, APRNs need to take cultural diversity into consideration. For instance, Chinese people have been widely criticized for the origin of COVID, which has caused considerable xenophobia. The purpose of nurses is to remember such culture-specific nuances and approach their patients with appropriate respect. Wherever the migrant hails from, it is crucial that APRNs consider the larger context when communicating and delivering treatment.
The second issue that require APRNs’ involvement is vaccination acceptance. It is expected that nurses convince patients of the necessity of certain treatment. However, a larger problem affecting healthcare is the reluctance of medical professionals to vaccinate (Rabi et al., 2021). It is extremely important that APRNs are acquainted with the current developments in the field of COVID vaccines, as well as common believes regarding the safety and effectiveness of certain vaccines. It will allow nurses to understand which aspects worry a hesitant patient or a healthcare worker and either corroborate their assumptions or disprove them entirely.
The third area, where nurse involvement is more important than ever is mental health. APRNs need to recognize the current mental health crisis that causes numerous psychiatric issues, compromises immune response, and negatively affects overall well-being. Once again, nurses have to be cognizant of the reasons behind a certain person’s anxieties. Considering that one’s mental state is a decisive factor in patient’s recovery, it is crucial that APRNs can recognize certain psychological anomalies and address them accordingly. By combining awareness of cultural diversity with knowledge of mental health issues, nurses can deliver high-quality healthcare services, as well as culturally sensitive care.
Future Development
The future of migrant mobility is debatable as there are different outlooks. Benton (2021) has outlined several scenarios, which describe various possible world states. They range from extremely restrictive, in which people can only cross the border if they possess a vaccine passport, to chaotic, in which there are no universal rules of travel. In addition, there is a possibility that countries will reach an agreement and international travel will return to pre-pandemic levels. However, in all cases, APRNs need to be prepared that migrant vulnerability to infectious diseases will remain as will the necessity to consider cultural diversity.
The future of vaccination acceptance will depend on the prevalence of the coronavirus. Each historic epidemic had people that protested against the involvement of vaccines and COVID is no exception. The difference is that vaccine hesitancy transpires on a larger scale. Nevertheless, nurses will have to maintain their awareness of vaccination trends and attitudes, as it is also likely that worldwide hysteria spearheaded by numerous misconceptions that encourage people to avoid or favor a particular medical involvement.
Mental health issues are likely to remain in the future due to a large percentage of current population being or having been exposed to pandemic-related anxieties. Memories of traumas can linger for decades, thus increasing the importance of mental health awareness (Kola et al., 2021). Therefore, it is reasonable to expect that knowledge of psychiatric conditions and the influence of psychological well-being on physical health will become a staple of nurse education.
Conclusion
Altogether, it should be evident that the role and responsibilities of APRNs have increased dramatically in the context of COVID-19 outbreak. Currently, nurses have to understand the cultural aspects of patient care, common believes and misconceptions regarding vaccination, and the prevalence of mental health concerns. Meanwhile, the influence of China on global health increases and demands adopting a wider perspective from frontline medical workers. The more culturally sensitive and aware of global health developments APRNs will be, the faster society will be able to recuperate from the coronavirus outbreak and return to pre-pandemic life.
References
Benton, M. (2021). Future scenarios for global mobility in the shadow of pandemic. Migration Policy Institute.
Husain, L., & Bloom, G. (2020). Understanding China’s growing involvement in global health and managing processes of change. Globalization and Health, 16(1), 1-10.
Kobierecka, A. (2022). Post-covid China:‘Vaccine diplomacy’and the new developments of Chinese foreign policy. Place Branding and Public Diplomacy, 1-14.
Kola, L., Kohrt, B. A., Hanlon, C., Naslund, J. A., Sikander, S., Balaji, M., & Patel, V. (2021). COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. The Lancet Psychiatry, 8(6), 535-550.
Lu, G., Razum, O., Jahn, A., Zhang, Y., Sutton, B., Sridhar, D., & Müller, O. (2021). COVID-19 in Germany and China: Mitigation versus elimination strategy. Global Health Action, 14(1), 1-12.
Rabi, R., Maraqa, B., Nazzal, Z., & Zink, T. (2021). Factors affecting nurses’ intention to accept the COVID‐19 vaccine: A cross‐sectional study. Public Health Nursing, 38(5), 781-788.
Seedat, F., Hargreaves, S., Nellums, L. B., Ouyang, J., Brown, M., & Friedland, J. S. (2018). How effective are approaches to migrant screening for infectious diseases in Europe? A systematic review. The Lancet Infectious Diseases, 18(9), 259-271.
Sun, S., Xie, Z., Yu, K., Jiang, B., Zheng, S., & Pan, X. (2021). COVID-19 and healthcare system in China: Challenges and progression for a sustainable future. Globalization and Health, 17(1), 1-8.
World Health Organization (2022). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide.