Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK.
Palliative Care Institute Liverpool, University of Liverpool, North West Cancer Research Centre, Liverpool, UK.
Palliat Med. 2021 Jul;35(7):1249-1257. doi: 10.1177/02692163211017808. Epub 2021 May 18.
Health and social care professionals' ability to address the needs of patients and their relatives at end of life is likely to have been impacted by the COVID-19 pandemic.
To explore health and social care professionals' experiences of providing end of life care during the COVID-19 pandemic to help inform current/future clinical practice and policy.
A qualitative interview study. Data were analysed using thematic analysis.
SETTING/PARTICIPANTS: Sixteen health and social care professionals working across a range of clinical settings in supporting dying patients during the first wave (March-June 2020) of the COVID-19 pandemic in the United Kingdom.
Participants reported emotional and practical challenges to providing end of life care during the pandemic, including increases in patient numbers, reduced staffing levels and relying on virtual platforms for sensitive, emotive conversations with relatives. Participants were central to promoting connections between patients and their families at end of life and creating opportunities for a final contact before the death. However, the provision of support varied as a consequence of the pressures of the pandemic. Results are discussed under two themes: (1) challenges and facilitators to providing end of life care, and (2) support needs of relatives when a family member was dying during the COVID-19 pandemic.
There is a need for flexible visiting arrangements at end of life during a pandemic. A systems-level approach is necessary to promote the wellbeing of health and social care professionals providing end of life care during and after a pandemic.
在 COVID-19 大流行期间，卫生和社会保健专业人员满足患者及其家属临终需求的能力可能已经受到影响。
探讨卫生和社会保健专业人员在 COVID-19 大流行期间提供临终关怀的经验，以帮助为当前/未来的临床实践和政策提供信息。
定性访谈研究。使用主题分析对数据进行分析。
地点/参与者：16 名卫生和社会保健专业人员在英国 COVID-19 大流行的第一波（2020 年 3 月至 6 月）期间在各种临床环境中工作，为临终患者提供支持。
参与者报告在大流行期间提供临终关怀存在情感和实际挑战，包括患者人数增加、工作人员减少以及依赖虚拟平台进行与亲属的敏感、情感对话。参与者是促进患者和他们的家人在临终时建立联系并为在死亡前提供最后一次联系的机会的核心。然而，由于大流行的压力，提供的支持各不相同。结果在两个主题下进行了讨论：（1）提供临终关怀的挑战和促进因素，以及（2）在 COVID-19 大流行期间家庭成员死亡时亲属的支持需求。
在大流行期间临终时需要灵活的探视安排。需要采取系统方法来促进在大流行期间和之后提供临终关怀的卫生和社会保健专业人员的福祉。
