Ayub Maheen, Arshad Daneyal, Maqbool Naheed, Zahid Mahnoor, Malik Rabia S, Rizvi Zuhair Ali, Arshad Usman, Khan Saleem Ullah
Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
Anesthesiology, Shifa International Hospital, Islamabad, PAK.
Cureus. 2020 Sep 9;12(9):e10331. doi: 10.7759/cureus.10331.
Background and objectives Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been the cause of a worldwide outbreak of respiratory illness, which has been declared as coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization (WHO). The outbreak has posed a huge challenge to countries around the world and has resulted in a global lockdown. The pandemic has especially overburdened the healthcare sector, resulting in a shortage of personnel and equipment. Along with many other manifestations, it has resulted in stress and anxiety for the physicians as well. Furthermore, many healthcare workers have been reluctant in treating COVID-19 patients. This study aimed to explore the concerns of physicians in the context of the COVID-19 pandemic and to evaluate the reasons for their reluctance to treat the patients. Methodology This descriptive cross-sectional study included 235 physicians from seven hospitals of Pakistan who were actively working amid the COVID-19 pandemic. Data were collected from March 1, 2020, to May 30, 2020, using a structured online questionnaire. Participants were approached via non-probability convenient sampling. Two hundred and eight respondents were included in the data analysis. SPSS Statistics version 23.0 (IBM Corp., Armonk, NY) was used for data entry and analysis. Results A striking 83.7% (n=174) of the respondents expressed their reluctance to treat patients with COVID-19. Concerns they raised included one or more of the following four reasons; lack of proper personal protective equipment (PPE), fear of self-infection, excessive workload, and fear of transmitting the infection to their family members. Of note, 92% (n=161) of the respondents reported a lack of PPE while 74.1% (n=129) reported fear of transmitting the infection to their family members as reasons for their reluctance. The vast majority of the participants reported the need for psychological training to treat the patients' anxiety (95.2%, n=198). Many participants were afraid that their own anxiety might be affecting the quality of care patients were receiving (67.3%, n=140). Hence, most of the participants reported that psychological counseling should be provided (93.3%, n=194). Participants with family members older than 60 years were found to be reluctant to treat patients due to the risk of transmitting the infection to them (69.7%, n=145, p=0.001). Therefore, a major proportion of the participants (96.2%, n=200) felt that the hospitals should provide a place for them to rest and temporarily isolate themselves to avoid coming into contact with their family members. Conclusions We conclude that a major proportion of physicians is reluctant to treat their patients due to multiple factors. The grave situation of the pandemic has taken a toll on their mental health, which could be affecting the quality of care that the patients receive. Their concerns should be addressed to not only provide them with support and improve their working environment but also to ensure that they are fully equipped to provide state-of-the-art care to the patients in these grave times.
背景与目的 严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发了全球范围的呼吸道疾病大流行,世界卫生组织(WHO)已将其宣布为2019冠状病毒病(COVID-19)大流行。此次疫情给世界各国带来了巨大挑战,导致全球封锁。这场大流行尤其使医疗保健部门不堪重负,造成人员和设备短缺。除了许多其他表现外,它还给医生带来了压力和焦虑。此外,许多医护人员不愿治疗COVID-19患者。本研究旨在探讨COVID-19大流行背景下医生的担忧,并评估他们不愿治疗患者的原因。
方法 本描述性横断面研究纳入了来自巴基斯坦七家医院的235名医生,他们在COVID-19大流行期间积极工作。数据收集时间为2020年3月1日至2020年5月30日,使用结构化在线问卷。通过非概率方便抽样的方式联系参与者。数据分析纳入了208名受访者。使用SPSS Statistics 23.0(IBM公司,纽约州阿蒙克)进行数据录入和分析。
结果 高达83.7%(n=174)的受访者表示不愿治疗COVID-19患者。他们提出的担忧包括以下四个原因中的一个或多个;缺乏适当的个人防护装备(PPE)、害怕自我感染、工作量过大以及害怕将感染传播给家人。值得注意的是,92%(n=161)的受访者报告缺乏PPE,而74.1%(n=129)的受访者报告害怕将感染传播给家人是他们不愿治疗的原因。绝大多数参与者报告需要心理培训来治疗患者的焦虑(95.2%,n=198)。许多参与者担心自己的焦虑可能会影响患者接受的护理质量(67.3%,n=140)。因此,大多数参与者报告应提供心理咨询(93.3%,n=194)。发现有60岁以上家庭成员的参与者因有将感染传播给他们的风险而不愿治疗患者(69.7%,n=145,p=0.001)。因此,很大一部分参与者(96.2%,n=200)认为医院应为他们提供一个休息和临时隔离的地方,以避免与家人接触。
结论 我们得出结论,由于多种因素,很大一部分医生不愿治疗患者。大流行的严峻形势对他们的心理健康造成了影响,这可能会影响患者接受的护理质量。应解决他们的担忧,不仅为他们提供支持并改善他们的工作环境,还要确保他们在这些严峻时期有充分的装备为患者提供最先进的护理。