DiGiovanni Madeline, Weller Indigo, Martin Andres
Yale School of Medicine: Yale University School of Medicine.
Harvard University.
Res Sq. 2021 Mar 4:rs.3.rs-287057. doi: 10.21203/rs.3.rs-287057/v1.
Objectives We examined the personal and professional impacts of the COVID-19 pandemic on the development, practice, and shifting values of child and adolescent psychiatrists (CAP), in order to inform how the field may move forward post-pandemic. Methods We conducted individual semi-structured interviews of child and adolescent psychiatrists (n = 24) practicing in the US. Participants were selected as a diverse purposive sample of active members of the American Academy of Child and Adolescent Psychiatry (AACAP). We analyzed anonymized transcripts through iterative coding using thematic analysis aided by NVivo software. Results We identified three main thematic domains within participants' response to the pandemic, which have engendered a reevaluation of and a recommitment to the aims of each clinician and the field of CAP more broadly. These domains, paired with representative questions, include: 1) , or "who have we been?" (identifying discontents such as daily inefficiencies and intraprofessional loss of trust); 2) , or "who are we now?" (exploring affordances and limitations of virtual work, and the evolution of personal and professional identity); and 3) , or "who will we become?" (renewing a commitment to psychiatry as advocacy). Even as we identified a collective agreement toward the need for implementing change, just what needs to change, and how that change will be realized, remain contested. Conclusion These three thematic domains, augmented by a national confrontation with race and equity, have engendered a field-wide reckoning with known inequities. They have reinvigorated collective responses and calls to action. The divergent mindsets to change and leadership have provided an aperture for what values and practices the field might instill in its next generation of practitioners.
目标 我们研究了新冠疫情对儿童和青少年精神科医生（CAP）的发展、实践及价值观转变所产生的个人和职业影响，以便为该领域在疫情后如何向前发展提供参考。方法 我们对在美国执业的儿童和青少年精神科医生（n = 24）进行了个人半结构化访谈。参与者是从美国儿童和青少年精神医学学会（AACAP）的活跃成员中进行有目的抽样选取的多样化样本。我们使用NVivo软件辅助的主题分析，通过迭代编码对匿名访谈记录进行分析。结果 我们在参与者对疫情的回应中确定了三个主要主题领域，这些领域促使每位临床医生以及更广泛的儿童和青少年精神医学领域对自身目标进行重新评估并再次做出承诺。这些领域及其代表性问题包括：1） ，即“我们过去是怎样的人？”（识别诸如日常效率低下和专业内部信任丧失等不满）；2） ，即“我们现在是谁？”（探索虚拟工作的优势和局限性，以及个人和职业身份的演变）；3） ，即“我们将成为怎样的人？”（重新致力于将精神病学作为一种倡导）。尽管我们确定了实施变革的必要性达成了集体共识，但具体需要改变什么以及如何实现这种改变仍存在争议。结论 这三个主题领域，再加上全国范围内对种族和公平问题的正视，引发了该领域对已知不平等现象的全面反思。它们重振了集体回应和行动呼吁。对于变革和领导力的不同思维方式为该领域可能向下一代从业者灌输的价值观和实践提供了一个切入点。
