巴基斯坦卡拉奇在 COVID-19 大流行期间医护人员的看法和经验：一项探索性定性研究。
Perceptions and experiences of healthcare providers during COVID-19 pandemic in Karachi, Pakistan: an exploratory qualitative study.
机构信息
Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan.
出版信息
BMJ Open. 2021 Aug 3;11(8):e048984. doi: 10.1136/bmjopen-2021-048984.
OBJECTIVE
To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
DESIGN AND SETTING
We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
PARTICIPANTS
Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
RESULTS
A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced by front-line healthcare providers working in COVID-19 wards. Healthcare workers experienced increased anxiety due to the fear of acquiring infection and transmitting it to their family members. They felt overwhelmed due to the exhaustive donning and doffing process, intense work and stigmatisation. The second theme was 'enablers supporting healthcare providers to deal with the COVID-19 pandemic'. Front liners pointed out several enabling factors that supported hospital staff including a safe hospital environment, adequate training, a strong system of information sharing and supportive management. The third theme was 'recommendations to support the healthcare workforce during the COVID-19 crisis'. Healthcare workers recommended measures to mitigate current challenges including providing risk allowance to front-line healthcare providers, preparing a backup health workforce, and establishing a platform to address the mental health needs of the healthcare providers.
CONCLUSION
This study provides an initial evidence base of healthcare providers' experiences of managing patients with COVID-19 in the early stage of the pandemic and highlights measures needed to address the encountered challenges. It offers lessons for hospitals in low-income and middle-income countries to ensure a safe working environment for front-line workers in their fight against COVID-19.
目的
探索医疗保健提供者在治疗和管理 COVID-19 病例方面面临的障碍和促进因素的观点和经验。
设计和设置
我们在巴基斯坦卡拉奇的一家私立三级保健教学医院进行了一项探索性定性研究，采用了目的抽样方法。使用常规内容分析技术对手动研究数据进行了分析。
参与者
对高级管理人员和医院领导进行了关键信息人员访谈（KII），并对一线医疗保健提供者进行了深入访谈（IDIs）。
结果
2020 年 4 月至 5 月期间共进行了 31 次访谈（KII=19；IDI=12）。出现了三个总体主题。第一个主题是“在 COVID-19 病房工作的一线医疗保健提供者面临的挑战”。医护人员因担心感染和将其传染给家人而感到焦虑不安。由于穿脱过程、高强度工作和污名化而感到不知所措。第二个主题是“支持医疗保健提供者应对 COVID-19 大流行的因素”。一线人员指出了支持医院工作人员的几个有利因素，包括安全的医院环境、充足的培训、强大的信息共享系统和支持性的管理。第三个主题是“在 COVID-19 危机期间支持医疗保健劳动力的建议”。医护人员建议采取措施缓解当前的挑战，包括向一线医护人员提供风险津贴、准备后备医疗人员，并建立一个平台来满足医护人员的心理健康需求。
结论
本研究提供了医疗保健提供者在大流行早期管理 COVID-19 患者的经验的初步证据基础，并强调了需要采取措施来应对所遇到的挑战。它为低收入和中等收入国家的医院提供了经验，以确保前线工作人员在抗击 COVID-19 时拥有安全的工作环境。
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