General Surgery, Boston Medical Center, Boston, Massachusetts, USA
Department of Surgery, Connaught Hospital, Freetown, Sierra Leone.
BMJ Open. 2022 Feb 1;12(2):e052972. doi: 10.1136/bmjopen-2021-052972.
This study aimed to use qualitative interviews with surgical providers to explore challenges and solutions to providing surgical and anaesthesia care in Sierra Leone's hospitals.
Data were collected through anonymous, semistructured interviews. We used a qualitative framework approach to analyse interview data and determine themes relating to challenges that were reported.
A purposive sample of 12 hospitals was selected throughout Sierra Leone to include district and referral hospitals of varying ownership (private, non-governmental organisation and government).
The most senior surgical provider available during each hospital site visit participated in a semistructured interview. A total of 12 interviews were conducted.
Providers described both challenges and solutions relating to the following categories: equipment and supplies, access to services, human resources, infrastructure, management and patient factors. These challenges were found to affect surgical care in hospitals by delaying surgical care, decreasing operative capacity and decreasing quality of care. Providers identified not only the root causes of these challenges, but also the varied workarounds and solutions they employ to overcome them.
Surgical providers can offer important insights into challenges affecting surgical services in hospitals. Despite working in challenging environments with limited resources, providers have developed innovative solutions to improve surgical and anaesthesia care in hospitals in Sierra Leone. Qualitative research has an important role to play in improving understanding of the challenges facing surgeons in low-income countries.
本研究旨在通过对外科医务人员进行定性访谈，探讨塞拉利昂医院提供外科和麻醉护理所面临的挑战和解决方案。
数据收集采用匿名半结构化访谈。我们使用定性框架方法分析访谈数据，并确定与所报告的挑战相关的主题。
在塞拉利昂各地选择了 12 家医院，包括不同所有制（私营、非政府组织和政府）的地区和转诊医院。
每次医院现场访问时，选择可获得的最高级别的外科医务人员参加半结构化访谈。共进行了 12 次访谈。
提供者描述了与以下类别的挑战和解决方案：设备和用品、服务获取、人力资源、基础设施、管理和患者因素。这些挑战被发现通过延迟外科护理、降低手术能力和降低护理质量来影响医院的外科护理。提供者不仅确定了这些挑战的根本原因，还确定了他们用来克服这些挑战的各种变通办法和解决方案。
外科医务人员可以提供有关影响医院外科服务的挑战的重要见解。尽管在资源有限的挑战性环境中工作，但提供者已制定创新解决方案，以改善塞拉利昂医院的外科和麻醉护理。定性研究在增进对低收入国家外科医生所面临挑战的理解方面发挥着重要作用。
