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法国 COVID-19 大流行期间临时重症监护病房麻醉师的体验:一项定性研究。

The experience of anaesthesiology care providers in temporary intensive care units during the COVID-19 pandemic in France: a qualitative study.

机构信息

University of Paris, Psychologie Clinique, Psychopathologie, Psychanalyse, EA4056, Boulogne-Billancourt, France; Service de Médecine de l'Adolescent (Maison des Adolescents - Maison de Solenn), University Hospital Cochin, AP-HP, Paris, France; University Paris-Saclay, UVSQ, Inserm U1018, CESP, Team DevPsy, Villejuif, France.

University of Paris, Psychologie Clinique, Psychopathologie, Psychanalyse, EA4056, Boulogne-Billancourt, France.

出版信息

Anaesth Crit Care Pain Med. 2022 Jun;41(3):101061. doi: 10.1016/j.accpm.2022.101061. Epub 2022 Apr 25.

Abstract

BACKGROUND

During the COVID-19 pandemic, care providers (CPs) worldwide grappled with the extraordinary number of severely ill patients with high fatality rates. The objective of this study is to explore the experience of anaesthesiology CPs in temporary intensive care units during the COVID-19 pandemic's first wave.

METHODS

CPs were interviewed at a university hospital in Paris, France. We conducted a qualitative study using interpretative phenomenological analysis.

RESULTS

Fifteen participants were included (five nurses, three nurse managers, and seven physicians). The analysis uncovered four themes: 1. Overworked care providers in an intensive care unit under pressure; 2. The disrupted relationship among patients, their families, and end-of-life care; 3. Short-term coping strategies; 4. A long-term transformative experience for care providers.

DISCUSSION

The COVID-19 pandemic has drained CPs physically and emotionally. Infection control protocols, lack of knowledge about this new disease, the establishment of open-space care settings, and the disruption of relationships have posed ethical dilemmas, leading CPs to question the meaning of their profession, and their future professional involvement. CPs at both an individual and institutional level employed numerous coping strategies, relying on a strong team spirit and a reinforced sense of duty. Nevertheless, after the end of the first wave, participants described the long-lasting psychological impact of this experience and frustration at the lack of recognition from their institutions and from policymakers. This study can inform institutional interventions and public health policy to support CPs during and after such a crisis to ensure their well-being and high standards of care.

摘要

背景

在 COVID-19 大流行期间,全球的医护人员(CPs)面临着大量高死亡率的重症患者。本研究旨在探讨 COVID-19 大流行第一波期间麻醉科医护人员在临时重症监护病房的经历。

方法

在法国巴黎的一家大学医院对医护人员进行了访谈。我们使用解释性现象学分析进行了定性研究。

结果

共纳入 15 名参与者(5 名护士、3 名护士长和 7 名医生)。分析揭示了四个主题:1. 重症监护室中工作过度的医护人员面临压力;2. 患者、其家属和临终关怀之间关系的破裂;3. 短期应对策略;4. 对医护人员的长期变革性体验。

讨论

COVID-19 大流行使医护人员身心疲惫。感染控制方案、对这种新疾病缺乏了解、开放式护理环境的建立以及关系的破裂带来了伦理困境,使医护人员质疑自己职业的意义以及未来的职业参与。医护人员在个人和机构层面都采用了多种应对策略,依赖于强大的团队精神和增强的责任感。然而,在第一波疫情结束后,参与者描述了这种经历的长期心理影响以及对机构和政策制定者缺乏认可的沮丧。本研究可以为机构干预和公共卫生政策提供信息,以在危机期间和之后支持医护人员,确保他们的福祉和高标准的护理。

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