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探讨冠状病毒大流行对儿科姑息治疗临床医生个人和职业健康的影响:美国调查数据的定性分析。

Exploring the Impact of the Coronavirus Pandemic on Pediatric Palliative Care Clinician Personal and Professional Well-Being: A Qualitative Analysis of U.S. Survey Data.

机构信息

Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence at the University of Washington, Seattle, Washington, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.

Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska, USA.

出版信息

J Pain Symptom Manage. 2021 Apr;61(4):805-811. doi: 10.1016/j.jpainsymman.2020.09.037. Epub 2020 Sep 30.

Abstract

CONTEXT

The COVID-19 pandemic has had a dramatic impact on palliative care delivery and patient experiences. Less is known about the experiences and responses of palliative care clinicians.

OBJECTIVE

We aimed to describe the pandemic's impact on pediatric palliative care clinicians' personal and professional well-being.

METHODS

The Palliative Assessment of Needed DEvelopments & Modifications In the Era of Coronavirus (PANDEMIC) cross-sectional online survey was posted on 7 professional listservs between May and June 2020. We conducted a conventional content analysis of written responses to three open-ended questions regarding the lasting impact of COVID-19.

RESULTS

Of 207 multidisciplinary respondents from 80 US cities, 148 (71%) provided written responses to open-ended questions, and 62 responses (42%) were related to personal, professional, or existential well-being. These responses were sorted into 4 major categories: personal burdens, professional burdens, personal benefits, and professional benefits. Respondents described burdens more commonly than they did benefits (67% vs. 33% of comments, respectively). Personal burdens related to increased fear and uncertainty, fear of bringing the virus home, and a sense of collective grief. Professional burdens included a sense of exhaustion, a challenge with work-life balance, personal experiences with colleagues infected with the virus, and considerations of leaving health care altogether. Personal benefits included lessons learned, an evolving sense of what matters, and improved work-life balance. Professional benefits included opportunities for professional development and a sense of professional purpose.

CONCLUSION

Pediatric palliative care clinicians perceive a breadth of impacts from the COVID-19 pandemic. Ongoing clinician assessment is important as the pandemic continues.

摘要

背景

COVID-19 大流行对姑息治疗的实施和患者体验产生了巨大影响。对于姑息治疗临床医生的经验和反应,人们知之甚少。

目的

我们旨在描述大流行对儿科姑息治疗临床医生个人和职业健康的影响。

方法

2020 年 5 月至 6 月,我们在 7 个专业电子邮件列表上发布了姑息治疗需求评估与发展及大流行时代修改(PANDEMIC)的横断面在线调查。我们对关于 COVID-19 持续影响的三个开放式问题的书面答复进行了常规内容分析。

结果

在来自美国 80 个城市的 207 名多学科应答者中,有 148 名(71%)对开放式问题提供了书面答复,有 62 条答复(42%)与个人、专业或存在有关。这些答复分为 4 个主要类别:个人负担、专业负担、个人利益和专业利益。与利益相比,应答者更多地描述了负担(分别为 67%和 33%)。个人负担与增加的恐惧和不确定性、担心将病毒带回家以及集体悲痛感有关。专业负担包括疲惫感、工作与生活平衡的挑战、与感染病毒的同事的个人经历以及考虑完全离开医疗保健行业。个人利益包括吸取的教训、对重要事物的不断发展的认识以及工作与生活平衡的改善。专业利益包括专业发展的机会和专业目标感。

结论

儿科姑息治疗临床医生感知到 COVID-19 大流行的广泛影响。随着大流行的持续,对临床医生的持续评估很重要。

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