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因新冠疫情导致的择期手术延误:患者的生活体验

Elective Surgical Delays Due to COVID-19: The Patient Lived Experience.

作者信息

Byrnes Mary E, Brown Craig S, De Roo Ana C, Corriere Matthew A, Romano Matthew A, Fukuhara Shinichi, Kim Karen M, Osborne Nicholas H

机构信息

Center for Healthcare Outcomes and Policy.

Department of Surgery.

出版信息

Med Care. 2021 Apr 1;59(4):288-294. doi: 10.1097/MLR.0000000000001503.

Abstract

BACKGROUND

This qualitative research explored the lived experiences of patients who experienced postponement of elective cardiac and vascular surgery due to coronavirus disease 2019 (COVID-19). We know very little about patients during the novel coronavirus pandemic. Understanding the patient voice may play an important role in prioritization of postponed cases and triage moving forward.

METHODS

Utilizing a hermeneutical phenomenological qualitative design, we interviewed 47 individuals who experienced a postponement of cardiac or vascular surgery due to the COVID-19 pandemic. Data were analyzed and informed by phenomenological research methods.

RESULTS

Patients in our study described 3 key issues around their postponement of elective surgery. Patients described robust narratives about the meanings of their elective surgeries as the chance to "return to normal" and alleviate symptoms that impacted everyday life. Second, because of the meanings most of our patients ascribed to their surgeries, postponement often took a toll on how patients managed physical health and emotional well-being. Finally, paradoxically, many patients in our study were demonstrative that they would "rather die from a heart attack" than be exposed to the coronavirus.

CONCLUSIONS

We identified several components of the patient experience, encompassing quality of life and other desired benefits of surgery, the risks of COVID, and difficulty reconciling the 2. Our study provides significant qualitative evidence to inform providers of important considerations when rescheduling the backlog of patients. The emotional and psychological distress that patients experienced due to postponement may also require additional considerations in postoperative recovery.

摘要

背景

这项定性研究探讨了因2019年冠状病毒病(COVID-19)而经历择期心脏和血管手术延期的患者的生活经历。在新型冠状病毒大流行期间,我们对患者了解甚少。了解患者的声音可能在确定延期病例的优先级和未来的分诊中发挥重要作用。

方法

采用诠释现象学定性设计,我们采访了47名因COVID-19大流行而经历心脏或血管手术延期的个体。数据采用现象学研究方法进行分析。

结果

我们研究中的患者描述了围绕择期手术延期的3个关键问题。患者讲述了关于择期手术意义的丰富故事,将其视为“恢复正常”和缓解影响日常生活症状的机会。其次,由于我们大多数患者赋予手术的意义,延期往往对患者管理身体健康和情绪幸福产生影响。最后,矛盾的是,我们研究中的许多患者表明,他们“宁愿死于心脏病发作”也不愿接触冠状病毒。

结论

我们确定了患者体验的几个组成部分,包括生活质量和手术的其他预期益处、感染COVID的风险以及协调这两者的困难。我们的研究提供了重要的定性证据,为医疗服务提供者在重新安排积压患者手术时提供重要考虑因素。患者因延期而经历的情绪和心理困扰在术后恢复中也可能需要额外考虑。

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