School of Medicine, University of California San Francisco (UCSF), San Francisco, California.
Department of Surgery, University of California San Francisco (UCSF), San Francisco, California.
J Surg Res. 2021 Aug;264:30-36. doi: 10.1016/j.jss.2021.01.028. Epub 2021 Feb 6.
The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic.
We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted.
One hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns.
Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
COVID-19 大流行的爆发导致低危手术被推迟，以节约资源并确保患者安全。本研究旨在描述患者对大流行期间接受手术的担忧。
我们对大流行期间推迟了普通和整形手术的患者进行了横断面调查，询问了他们在获得手术护理方面的障碍。问题涉及到依赖护理、交通、就业和保险状况，以及对 COVID-19 的看法和担忧。采用混合方法和归纳主题分析进行分析。
共采访了 135 名患者。我们确定了以下患者的担忧：在医院感染 COVID-19（46%）、住院期间独自一人（40%）、面临经济压力（29%）、组织交通（28%）、经历健康保险覆盖范围的变化（25%）以及安排家属护理（18%）。非白人参与者在儿童护理和交通方面的担忧分别是白人的 5 倍和 2.5 倍。对医院安全性降低和可能的 COVID-19 感染后果的看法导致了重新安排手术的延迟。有关安全措施的教育和有关安排手术的沟通部分减轻了对 COVID-19 的担忧。但是，重新安排手术的时间表和大流行的解决的不确定性导致了持续的担忧。
在这个前所未有的时期提供有效的手术护理，不仅需要了解影响手术患者的社会变化，还需要系统层面的改变以解决新的护理障碍。了解患者的观点，调整流程以解决潜在的障碍，并向患者有效教育有关机构措施以最大程度地减少 COVID-19 在医院内的传播，应纳入手术护理中。
