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COVID-19 大流行期间的妇产科服务提供情况:英国国民保健制度中初级医生的调查。

Provision of obstetrics and gynaecology services during the COVID-19 pandemic: a survey of junior doctors in the UK National Health Service.

机构信息

UK Audit and Research Collaborative in Obstetrics and Gynaecology, London, UK.

出版信息

BJOG. 2020 Aug;127(9):1123-1128. doi: 10.1111/1471-0528.16313. Epub 2020 May 27.

Abstract

OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic is disrupting health services worldwide. We aimed to evaluate the provision of obstetrics and gynaecology services in the UK during the acute phase of the COVID-19 pandemic.

DESIGN

Interview-based national survey.

SETTING

Women's healthcare units in the National Health Service.

POPULATION

Junior doctors in obstetrics and gynaecology.

METHODS

Participants were interviewed by members of the UK Audit and Research in Obstetrics and Gynaecology trainees' collaborative between 28 March and 7 April 2020. We used a quantitative analysis for closed-ended questions and a thematic framework analysis for open comments.

RESULTS

We received responses from 148/155 units (95%), most of the participants were in years 3-7 of training (121/148, 82%). Most completed specific training drills for managing obstetric and gynaecological emergencies in women with COVID-19 (89/148, 60.1%) and two-person donning and doffing of Personal Protective Equipment (PPE) (96/148, 64.9%). The majority of surveyed units implemented COVID-19-specific protocols (130/148, 87.8%), offered adequate PPE (135/148, 91.2%) and operated dedicated COVID-19 emergency theatres (105/148, 70.8%). Most units reduced face-to-face antenatal clinics (117/148, 79.1%) and suspended elective gynaecology services (131/148, 88.5%). The 2-week referral pathway for oncological gynaecology was not affected in half of the units (76/148, 51.4%), but half reported a planned reduction in oncology surgery (82/148, 55.4%).

CONCLUSION

The provision of obstetrics and gynaecology services in the UK during the acute phase of the COVID-19 pandemic seems to be in line with current guidelines, but strategic planning is needed to restore routine gynaecology services and ensure safe access to maternity care in the long term.

TWEETABLE ABSTRACT

Provision of obstetrics and gynaecology services during the acute phase of COVID-19 is in line with current guidelines, strategic planning is needed to restore routine services and ensure safe access to care in the long term.

摘要

目的

2019 年冠状病毒病(COVID-19)大流行正在扰乱全球卫生服务。本研究旨在评估 COVID-19 大流行急性阶段英国的妇产科服务提供情况。

设计

基于访谈的全国性调查。

地点

英国国民保健署下属的妇女保健单位。

人群

妇产科初级医生。

方法

2020 年 3 月 28 日至 4 月 7 日期间,由英国妇产科审计和研究培训生合作组织的成员对参与者进行了访谈。我们对封闭式问题进行了定量分析,并对开放式评论进行了主题框架分析。

结果

我们收到了 155 个单位中的 148 个(95%)的回复,大多数参与者处于培训的第 3-7 年(121/148,82%)。大多数人完成了针对 COVID-19 女性的妇产科急症管理的专项培训演练(89/148,60.1%)和双人穿戴和脱下个人防护设备(PPE)(96/148,64.9%)。接受调查的大多数单位实施了 COVID-19 专项方案(130/148,87.8%),提供了充足的 PPE(135/148,91.2%),并设有专用的 COVID-19 急症手术室(105/148,70.8%)。大多数单位减少了面对面的产前检查(117/148,79.1%)和暂停了选择性妇科服务(131/148,88.5%)。在一半的单位(76/148,51.4%)中,两周的肿瘤妇科转诊途径未受影响,但一半的单位报告计划减少肿瘤手术(82/148,55.4%)。

结论

在 COVID-19 大流行的急性阶段,英国的妇产科服务提供情况似乎符合当前指南,但需要进行战略规划,以恢复常规妇科服务并确保长期安全获得产妇护理。

推文摘要

COVID-19 急性阶段的妇产科服务提供符合当前指南,需要进行战略规划,以恢复常规服务并确保长期安全获得护理。

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