Section of Geriatrics, Palliative Medicine, and Hospice, School of Medicine, 53422West Virginia University, Morgantown, WV, USA.
Department of Medicine, School of Medicine, 53422West Virginia University, Morgantown, West Virginia, WV, USA.
Am J Hosp Palliat Care. 2021 May;38(5):521-527. doi: 10.1177/1049909121989987. Epub 2021 Jan 27.
Hospice agencies face unique challenges during times of widespread public health emergencies. The pandemic of novel coronavirus disease COVID-19 is widely affecting global healthcare systems.
This study assesses effects of the COVID-19 pandemic on U.S. hospice agencies, staff, and patients as reported by hospice agency staff.
An anonymous electronic survey was developed. Free-text comments were assessed for impacts on hospice agencies, staff, and patients and their families.
SETTING/PARTICIPANTS: The target audience was members of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association who self-identified as being active with hospice agencies in the United States.
Reported impacts include inadequate supplies of personal protective equipment, changes in hospice services, and decreased access by hospice personnel to patients in long term care facilities. Flow of patients through hospice care settings was impeded. Agencies experienced changes in workforce availability and increased emotional support needs of staff. Patient and families experienced increased bereavement needs. Nearly one-third of respondents reported negative effects on patient outcomes, such as inadequate symptom management and negative psychosocial effects.
Respondents indicate that the COVID-19 pandemic had negative effects on both hospice patient care and hospice agency functioning. Hospice agencies appear to face challenges unique among U.S. healthcare agencies due to their service delivery model and focus on interdisciplinary care. There is need for further exploration of the effects that the COVID-19 pandemic has on hospice agencies in order to improve care for their patient population during public health emergencies.
在公共卫生突发事件频发时期，临终关怀机构面临着独特的挑战。新型冠状病毒疾病（COVID-19）大流行广泛影响着全球医疗保健系统。
本研究评估了 COVID-19 大流行对美国临终关怀机构、工作人员和患者的影响，这些影响是由临终关怀机构工作人员报告的。
开发了一份匿名电子调查。对临终关怀机构、工作人员和患者及其家属的影响进行了自由文本评论评估。
设置/参与者：目标受众是美国临终关怀医学学会和姑息护士协会的成员，他们自认为在美国与临终关怀机构有密切联系。
报告的影响包括个人防护设备供应不足、临终关怀服务的变化，以及临终关怀人员对长期护理设施中患者的访问减少。患者通过临终关怀护理环境的流动受到阻碍。机构经历了劳动力可用性的变化和工作人员情绪支持需求的增加。患者和家属经历了更多的丧亲之痛。近三分之一的受访者报告对患者结局产生负面影响，如症状管理不足和负面心理社会影响。
受访者表示，COVID-19 大流行对临终关怀患者护理和临终关怀机构运作都产生了负面影响。临终关怀机构由于其服务提供模式和对跨学科护理的关注，似乎面临着美国医疗保健机构特有的挑战。需要进一步探讨 COVID-19 大流行对临终关怀机构的影响，以便在公共卫生紧急情况下改善对其患者群体的护理。
