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全科医生在新冠疫情期间的挑战和经验:意大利北部的一项观察性研究——初级保健中两次调查的横断面分析和比较。

Challenges and experiences of general practitioners during the course of the Covid-19 pandemic: a northern Italian observational study-cross-sectional analysis and comparison of a two-time survey in primary care.

机构信息

Institute of General Practice and Public Health, College of Health Care Professions, Bolzano, Italy.

Department of Public Health, Medical Decision Making and HTA, University of Health Sciences, Medical Informatics and Technology, Hall, Tyrol, Austria.

出版信息

Fam Pract. 2022 Nov 22;39(6):1009-1016. doi: 10.1093/fampra/cmac025.

Abstract

BACKGROUND

General practitioners (GPs) have been among the frontline workers since the outbreak of the Covid-19 pandemic. Reflecting and analyzing the ongoing pandemic response of general practice provides essential information and serves as a precondition for outlining future health policy strategies.

OBJECTIVE

To investigate the effects of the pandemic on GPs' daily work and well-being and to describe needs for improvement in primary care highlighted by the pandemic.

METHODS

A 2-time cross-sectional online survey involving GPs in a northern Italian region was conducted in September 2020 and March/April 2021.

RESULTS

Eighty-four GPs (29.6% of invited GPs) participated in the first survey, and 41 GPs (14.4%) in the second survey. Most GPs experienced a notable workload increase which was tendentially higher during the advanced stages of the pandemic. A notable increase between the first and the second survey was noted regarding the frequency of Covid-related patient contacts and phone calls. Communication with health authorities and hospitals was rated as improvable. Psychological distress among GPs tended to increase over time; female GPs were more affected in the first survey. Most practices introduced major changes in their workflow, mainly appointment-based visits and separating Covid-19-suspected patients. Availability of protective equipment considerably increased over time. In the second survey, the GPs felt more prepared to self-protection and outpatient treatment of Covid-affected patients.

CONCLUSION

The work of GPs has been substantially impacted by the ongoing Covid-19 pandemic. Efforts should be undertaken to efficiently strengthen primary care which plays an important role in pandemic events.

摘要

背景

自新冠疫情爆发以来,全科医生一直是抗疫一线的工作者。反思和分析全科医学对疫情的持续反应提供了重要信息,也是制定未来卫生政策策略的前提。

目的

调查疫情对全科医生日常工作和福祉的影响,并描述疫情凸显的初级保健工作需要改进的地方。

方法

在意大利北部地区,于 2020 年 9 月和 2021 年 3 月/4 月,进行了两次跨时间点的全科医生在线调查。

结果

84 名全科医生(受邀全科医生的 29.6%)参加了第一次调查,41 名全科医生(14.4%)参加了第二次调查。大多数全科医生的工作量显著增加,在疫情的后期阶段,工作量呈上升趋势。与第一次调查相比,第二次调查中与新冠相关的患者接触和电话咨询的频率明显增加。与卫生当局和医院的沟通被认为有待改进。全科医生的心理困扰随着时间的推移而增加;在第一次调查中,女全科医生受影响更大。大多数诊所都对其工作流程进行了重大调整,主要是预约就诊和对新冠疑似患者进行隔离。防护设备的供应情况在一段时间内有了显著改善。在第二次调查中,全科医生对自我防护和对新冠患者的门诊治疗感到更有准备。

结论

全科医生的工作受到了持续新冠疫情的重大影响。应努力有效地加强在疫情期间发挥重要作用的初级保健。

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