Vélez Christopher, Paz Mary, Skarbinski Kristina, Minami Christina, Murray Helen Burton, Bergmark Regan, Staller Kyle, Kuo Braden
Department of Medicine, , Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
PEC Innov. 2022 Dec;1:100048. doi: 10.1016/j.pecinn.2022.100048. Epub 2022 May 14.
Normal elective outpatient care has been impacted during the COVID-19 pandemic, due to limitations imposed by healthcare systems. Clear communication is necessary to address patient concerns as resumption of elective care gains pace.
Thirty patients who had diagnostic gastrointestinal (GI) testing within our motility lab during the initial viral surge in our state spring 2020 underwent semi-structured interviews. Codes were derived from transcripts using the constant comparative method.
Framework analysis revealed several patient themes, including (1) patient specific factors such as age and comorbidity; (2) pandemic-related evolution including case surges; and (3) healthcare related function - or dysfunction - that directly influenced patient perceptions of disrupted gastrointestinal care. These themes provide areas in which to focus communication using the shared decision making model to achieve resumption of delayed care.
When communicating with patients, it is difficult to predict patient preferences and as much flexibility as possible should be offered. Concrete steps of (1) identification of patient barriers; (2) intervening upon then, and (3) having concrete plans to influence care will need to guide such communication.
Our patients' perspectives during the first viral surge can guide new communication strategies should healthcare delivery be compromised in the future.
在新型冠状病毒肺炎大流行期间,由于医疗系统的限制,正常的择期门诊护理受到了影响。随着择期护理恢复步伐的加快,进行清晰的沟通对于解决患者的担忧至关重要。
对2020年春季本州病毒首次激增期间在我们的动力实验室进行诊断性胃肠(GI)检查的30名患者进行了半结构化访谈。使用持续比较法从访谈记录中得出编码。
框架分析揭示了几个患者主题,包括(1)患者的特定因素,如年龄和合并症;(2)与大流行相关的演变,包括病例激增;以及(3)直接影响患者对中断的胃肠护理认知的医疗保健相关功能——或功能障碍。这些主题提供了使用共同决策模型来集中沟通的领域,以实现恢复延迟的护理。
在与患者沟通时,很难预测患者的偏好,应尽可能提供灵活性。(1)识别患者障碍;(2)对其进行干预;以及(3)制定具体计划以影响护理的具体步骤将指导此类沟通。
如果未来医疗服务受到损害,我们的患者在首次病毒激增期间的观点可以指导新的沟通策略。