Department of Medicine, Division of Nephrology and the Kidney Research Institute, University of Washington, Seattle, Washington, USA
Department of Hospital and Specialty Medicine, Nephrology Section and Health Services Research & Development, Seattle-Denver Center of Innovation, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
BMJ Open. 2021 Mar 25;11(3):e047782. doi: 10.1136/bmjopen-2020-047782.
The COVID-19 pandemic has transformed healthcare delivery in the USA, but there has been little empirical work describing the impact of these changes on clinicians. We conducted a study to address the following question: how has the pandemic impacted US clinicians' professional roles and relationships?
Inductive thematic analysis of semi-structured interviews.
Clinical settings across the USA in April and May of 2020.
Clinicians with leadership and/or clinical roles during the COVID-19 pandemic.
Emergent themes related to professional roles and relationships.
Sixty-one clinicians participated in semi-structured interviews. Study participants were practising in 15 states across the USA, and the majority were White physicians from large academic centres. Three overlapping and inter-related themes emerged from qualitative analysis of interview transcripts: (1) disruption: boundaries between work and home life became blurred and professional identity and usual clinical roles were upended; (2) constructive adaptation: some clinicians were able to find new meaning in their work and described a spirit of collaboration, shared goals, open communication and mutual respect among colleagues; and (3) discord and estrangement: other clinicians felt alienated from their clinical roles and experienced demoralising work environments marked by division, value conflicts and mistrust.
Clinicians encountered marked disruption of their professional roles, identities and relationships during the pandemic to which they and their colleagues responded in a range of different ways. Some described a spirit of collaboration and camaraderie, while others felt alienated by their new roles and experienced work environments marked by division, value conflicts and mistrust. Our findings highlight the importance of effective teamwork and efforts to support clinician well-being during the COVID-19 pandemic.
新冠疫情改变了美国的医疗服务模式,但很少有实证研究描述这些变化对临床医生的影响。我们开展了一项研究,旨在回答以下问题:疫情如何影响美国临床医生的专业角色和关系?
对半结构化访谈进行归纳主题分析。
2020 年 4 月至 5 月,美国各地的临床环境。
在新冠疫情期间具有领导和/或临床角色的临床医生。
与专业角色和关系相关的主题。
61 名临床医生参与了半结构化访谈。研究参与者分布在美国 15 个州,大多数是来自大型学术中心的白人医生。从访谈记录的定性分析中得出了三个重叠且相互关联的主题:(1)混乱:工作和家庭生活之间的界限变得模糊,职业身份和通常的临床角色被颠覆;(2)建设性适应:一些临床医生能够在工作中找到新的意义,并描述了一种合作精神、共同目标、开放沟通和同事之间的相互尊重;(3)不和与疏远:其他临床医生感到与他们的临床角色疏远,并经历了充满分裂、价值冲突和不信任的士气低落的工作环境。
临床医生在疫情期间经历了其专业角色、身份和关系的显著混乱,他们和他们的同事以不同的方式做出了回应。一些人描述了合作和友谊的精神,而另一些人则对他们的新角色感到疏远,并经历了充满分裂、价值冲突和不信任的工作环境。我们的研究结果强调了在新冠疫情期间,有效团队合作和支持临床医生福祉的重要性。