Division of Palliative Care, 1867Tufts Medical Center, Boston, MA, USA.
12261Tufts University School of Medicine, Boston, MA, USA.
Am J Hosp Palliat Care. 2022 Oct;39(10):1236-1243. doi: 10.1177/10499091211055900. Epub 2021 Dec 13.
Palliative care offers a unique skill set in response to challenges posed by the COVID-19 pandemic, with expertise in advance care planning, symptom management, family communication, end-of-life care, and bereavement. However, few studies have explored palliative care's role during the pandemic and changes in perceptions and utilization of the specialty among health and spiritual care providers and hospital leaders.
To explore the utilization, perceptions, and understanding of palliative care among critical care clinicians, hospital leaders, and spiritual care providers during the pandemic.
We conducted a qualitative study employing semi-structured, in-depth interviews.
SETTING/PARTICIPANTS: We conducted the study at a tertiary academic medical center in Boston, Massachusetts, USA. Between August and October 2020, we interviewed 25 participants from 3 informant groups: (1) critical care physicians, (2) hospital leaders, and (3) spiritual care providers.
Respondents recognized that palliative care's role increased in importance during the pandemic. Palliative care served as a bridge between providers, patients, and families; supported provider well-being; and contributed to hospital efficiency. The pandemic reinforced participants' positive perceptions of palliative care, increased their understanding of the scope of the specialty's practice, and inspired physicians to engage more with palliative care. Respondents indicated the need for more palliative care providers and advocated for their role in bereavement support and future pandemic response.
Findings highlight evolving and increased utilization of palliative care during the pandemic, suggesting a need for greater investment in palliative care programs and for palliative care involvement in public health emergency preparedness and response.
在应对 COVID-19 大流行带来的挑战方面，姑息治疗提供了独特的技能，包括预先护理计划、症状管理、家庭沟通、临终关怀和丧亲之痛等方面的专业知识。然而，很少有研究探讨大流行期间姑息治疗的作用，以及卫生和精神保健提供者以及医院领导对该专业的看法和利用的变化。
探讨大流行期间重症监护临床医生、医院领导和精神保健提供者对姑息治疗的利用、看法和理解。
我们进行了一项定性研究，采用半结构式深入访谈。
地点/参与者：我们在美国马萨诸塞州波士顿的一家三级学术医疗中心进行了这项研究。在 2020 年 8 月至 10 月期间，我们采访了来自 3 个信息组的 25 名参与者：（1）重症监护医生，（2）医院领导，和（3）精神保健提供者。
受访者认识到，姑息治疗在大流行期间的重要性增加了。姑息治疗作为提供者、患者和家属之间的桥梁；支持提供者的幸福感；并有助于提高医院的效率。大流行加强了参与者对姑息治疗的积极看法，增加了他们对该专业实践范围的理解，并激发了医生更多地参与姑息治疗。受访者表示需要更多的姑息治疗提供者，并倡导他们在丧亲之痛支持和未来的大流行应对方面发挥作用。
研究结果强调了姑息治疗在大流行期间的利用不断发展和增加，表明需要更多地投资于姑息治疗项目，并需要姑息治疗参与公共卫生应急准备和应对。
