Plessas Anastasios, Paisi Martha, Baines Rebecca, Wheat Hannah, Delgado Maria Bernardes, Mills Ian, Witton Robert
University of Plymouth, Peninsula Dental School, Plymouth, UK.
University of Plymouth, Centre for Health Technology, Plymouth, UK.
Br Dent J. 2021 Sep 6:1-10. doi: 10.1038/s41415-021-3375-3.
Introduction Following the World Health Organisation declaration of COVID-19 as a global pandemic, routine dental care in the UK ceased, and Urgent Dental Care centres (UDCs) were established to offer remote and face-to-face urgent dental treatment for those in need.Aim To explore perceptions and psychosocial experiences of frontline staff providing care at UDCs in England during COVID-19.Method A qualitative research study using a phenomenological approach. Semi-structured interviews were conducted remotely. Using line-by-line coding, data were analysed using a hybrid approach that incorporated both a deductive, theoretical process and an inductive, data-driven process.Results Participants included 29 dentists and nine dental nurses from UDCs across England. Twelve themes were identified and grouped into positive and negative experiences. Positive experiences were: role fulfilment and having a sense of purpose; team unity and collective coping strategies; and strategic teamwork and preparedness for effective organisation of care. Negative experiences included: feeling undervalued and frustrated due to fragmented guidance and communication; sense of unfairness generated by relational challenges; patient demand outstripping UDC capacity; complex decision-making; uncertainty over safety; suffocating PPE hindering effective communication; ineffective communication channels across healthcare sectors; lack of commitment to remote video consultations; and variable referral quality.Conclusions Participants reported experiencing a number of emotional challenges that appeared to be exacerbated by an unsupportive environment, often due to lack of leadership. However, positive experiences and coping strategies were also identified. Collective and sustained efforts at system level to improve the resilience and mental wellbeing of the current and future dental workforce and integration of dentistry into wider healthcare infrastructures are needed.
引言 在世界卫生组织宣布新冠疫情为全球大流行之后，英国的常规牙科护理停止，紧急牙科护理中心（UDCs）得以设立，为有需要的人提供远程和面对面的紧急牙科治疗。
目的 探讨在新冠疫情期间，在英格兰紧急牙科护理中心提供护理的一线工作人员的认知和社会心理体验。
方法 采用现象学方法进行定性研究。通过远程进行半结构化访谈。使用逐行编码，采用一种混合方法对数据进行分析，该方法结合了演绎性的理论过程和归纳性的数据驱动过程。
结果 参与者包括来自英格兰各地紧急牙科护理中心的29名牙医和9名牙科护士。确定了12个主题，并分为积极和消极体验。积极体验包括：角色实现和使命感；团队团结和集体应对策略；以及战略团队合作和有效组织护理的准备情况。消极体验包括：由于指导和沟通零散而感到被低估和沮丧；关系挑战产生的不公平感；患者需求超过紧急牙科护理中心的能力；复杂的决策；安全方面的不确定性；令人窒息的个人防护装备阻碍有效沟通；医疗保健部门之间无效的沟通渠道；对远程视频咨询缺乏投入；以及转诊质量参差不齐。
结论 参与者报告称经历了一些情绪挑战，这些挑战似乎因缺乏支持的环境而加剧，这往往是由于缺乏领导力所致。然而，也发现了积极体验和应对策略。需要在系统层面做出集体和持续的努力，以提高当前和未来牙科工作人员的适应能力和心理健康，并将牙科纳入更广泛的医疗保健基础设施。
