Mitchinson Lucy, Dowrick Anna, Buck Caroline, Hoernke Katarina, Martin Sam, Vanderslott Samantha, Robinson Hannah, Rankl Felicia, Manby Louisa, Lewis-Jackson Sasha, Vindrola-Padros Cecilia
Marie Curie Palliative Care Research Department, University College London, London, UK.
Institute of Population Health Science, Queen Mary University of London, London, UK.
Palliat Med. 2021 May;35(5):852-861. doi: 10.1177/02692163211004228. Epub 2021 Mar 29.
During infectious epidemics, healthcare workers are required to deliver traditional care while facing new pressures. Time and resource restrictions, a focus on saving lives and new safety measures can lead to traditional aspects of care delivery being neglected.
Identify barriers to delivering end-of-life care, describe attempts to deliver care during the COVID-19 pandemic, and understand the impact this had on staff.
A rapid appraisal was conducted incorporating a rapid review of policies from the United Kingdom, semi-structured telephone interviews with healthcare workers, and a review of mass print media news stories and social media posts describing healthcare worker's experiences of delivering care during the pandemic. Data were coded and analysed using framework analysis.
SETTING/PARTICIPANTS: From a larger ongoing study, 22 interviews which mentioned death or caring for patients at end-of-life, eight government and National Health Service policies affecting end-of-life care delivery, eight international news media stories and 3440 publicly available social media posts were identified. The social media analysis centred around 274 original tweets with the highest reach, engagement and relevance. Incorporating multiple workstreams provided a broad perspective of end-of-life care during the COVID-19 pandemic in the United Kingdom.
Three themes were developed: (1) restrictions to traditional care, (2) striving for new forms of care and (3) establishing identity and resilience.
The COVID-19 pandemic prohibited the delivery of traditional care as practical barriers restricted human connections. Staff prioritised communication and comfort orientated tasks to re-establish compassion at end-of-life and displayed resilience by adjusting their goals.
在传染病流行期间，医护人员在面临新压力的同时仍需提供传统护理。时间和资源限制、对挽救生命的关注以及新的安全措施可能导致护理服务的传统方面被忽视。
确定临终护理提供的障碍，描述在新冠疫情期间提供护理的尝试，并了解这对工作人员的影响。
进行了一项快速评估，包括对英国政策的快速审查、对医护人员的半结构化电话访谈，以及对描述医护人员在疫情期间提供护理经历的大众印刷媒体新闻报道和社交媒体帖子的审查。使用框架分析对数据进行编码和分析。
背景/参与者：从一项正在进行的更大规模研究中，确定了22次提及死亡或临终护理患者的访谈、八项影响临终护理提供的政府和国民保健服务政策、八篇国际新闻媒体报道以及3440条公开可用的社交媒体帖子。社交媒体分析围绕274条传播范围最广、参与度最高且相关性最强的原创推文展开。整合多个工作流程提供了英国在新冠疫情期间临终护理的广泛视角。
形成了三个主题：（1）传统护理的限制，（2）寻求新的护理形式，（3）确立身份认同和恢复力。
新冠疫情阻碍了传统护理的提供，因为实际障碍限制了人际联系。工作人员将沟通和以舒适为导向的任务列为优先事项，以在临终时重新建立同情心，并通过调整目标展现出恢复力。
