Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.
Br J Gen Pract. 2021 Jul 29;71(709):e634-e642. doi: 10.3399/BJGP.2020.1112. Print 2021 Aug.
Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care.
To gain an understanding of the experiences of European primary care professionals (PCPs) working during the first peak of the COVID-19 pandemic.
An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece, and Sweden, between April and July 2020.
Interviews were audiorecorded, transcribed, and analysed using a combination of inductive and deductive thematic analysis techniques.
Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and to deal with uncertainty.
PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions are needed to facilitate easy and coordinated access to practical information on how to adapt services, ongoing training, and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.
初级保健在应对 COVID-19 大流行方面发挥着至关重要的作用，是患者护理的第一站和二级保健的把关者。探索医疗保健专业人员在 COVID-19 大流行期间的经验的定性研究主要集中在二级保健上。
了解在 COVID-19 大流行的第一个高峰期工作的欧洲初级保健专业人员（PCP）的经验。
这是一项探索性定性研究，于 2020 年 4 月至 7 月在英国、比利时、荷兰、爱尔兰、德国、波兰、希腊和瑞典的初级保健机构中使用半结构化访谈进行。
访谈进行了录音、转录，并使用归纳和演绎主题分析技术的组合进行了分析。
对 80 名 PCP 进行了采访。PCP 必须就如何快速改变与 COVID-19 和非 COVID-19 护理相关的服务做出自己的决定。尽管他们被大量的指导所淹没，但他们往往无法获得实际的培训。因此，PCP 向同事寻求道义上的支持和信息，试图快速适应远程护理等新的工作方式，并应对不确定性。
尽管面临诸多挑战，PCP 仍迅速改变了初级保健的提供方式。需要在政策层面上代表初级保健，并与当地初级保健拥护者合作，以便方便且协调地获取有关如何调整服务、持续培训以及为 PCP 提供适当的心理健康支持服务的实用信息。保持初级保健的自主性和响应性对于保持在任何未来的医疗保健提供危机中快速转型的能力至关重要。
