Curnow Eleanor, Tyagi Vaibhav, Salisbury Lisa, Stuart Kim, Melville-Jóhannesson Barbara, Nicol Kath, McCormack Brendan, Dewing Jan, Magowan Ruth, Sagan Olivia, Bulley Cathy
Division of Dietetics, Nutrition and Biological Sciences, Physiotherapy, Podiatry and Radiography, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom.
Division of Nursing and Paramedic Science, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom.
Front Rehabil Sci. 2021 Sep 1;2:726210. doi: 10.3389/fresc.2021.726210. eCollection 2021.
The recent COVID-19 pandemic increased pressure upon healthcare resources resulting in compromised health services. Enforced national lockdown led to people being unable to access essential services in addition to limiting contact with social support networks. The novel coronavirus, and subsequent condition known as long covid were not well-understood and clinicians were not supported by existing guidelines or pathways. Our study explored people's experiences of healthcare during this period with a person-centered "lens." Ninety-seven people participated in our online survey about their experiences of the pandemic, particularly while socially isolated and their experiences of healthcare. Following completion of the survey, 11 of these participants agreed to further semi-structured interviews to explore this further in their own words. Interview conversations were transcribed, checked; together with the responses to open questions in the survey. The data were then analyzed thematically by members of the research team. We conducted framework analysis from a post-positivist perspective, using the Person-centered Practice Framework to explore participants' experiences. There were few examples of people describing person-centered care. People experienced barriers to accessing support, and negative experiences of care that represented complexities enacting person-centered care at each level of the framework (processes, practice environment, prerequisites, and macro context). These barriers were influenced greatly by the pandemic, for example, with health professionals being harder to access. Some experiences related to the ways in which health professionals responded to the context, for example, positive examples included active listening, recognition of people's experiences, seeking to find out more, and engaging in collaborative problem-solving. People want to feel heard, supported to navigate healthcare systems, source trustworthy information, find appropriate services, and collaborate in learning and problem-solving with healthcare professionals. There have been enormous challenges to the provision of healthcare throughout the pandemic. Moving forward is crucial with emphasis on overcoming barriers to person-centered healthcare. This should focus on steps now and also in planning for the possibility of further rapid changes in the demand for and provision of healthcare.
近期的新冠疫情给医疗资源带来了压力，导致医疗服务受到影响。国家强制实施的封锁措施，除了限制人们与社会支持网络的接触外，还使人们无法获得基本服务。新型冠状病毒以及随后出现的“长新冠”状况尚未得到充分了解，临床医生也缺乏现有的指南或路径支持。我们的研究以以人为本的视角，探讨了人们在此期间的就医经历。97人参与了我们关于疫情经历的在线调查，特别是在社交隔离期间的经历以及他们的就医体验。调查完成后，其中11名参与者同意接受进一步的半结构化访谈，以便用他们自己的话进一步探讨这一问题。访谈对话被转录、核对，并与调查问卷中开放性问题的回答一起进行分析。然后，研究团队成员对数据进行了主题分析。我们从后实证主义的角度进行框架分析，使用以人为本的实践框架来探究参与者的经历。很少有人描述以人为本的护理。人们在获得支持方面遇到障碍，并且在护理过程中经历了负面体验，这些体验在框架的各个层面（过程、实践环境、前提条件和宏观背景）都体现了实施以人为本护理的复杂性。这些障碍受到疫情的极大影响，例如，更难接触到医疗专业人员。一些经历与医疗专业人员应对这种情况的方式有关，例如，积极的例子包括积极倾听、认可人们的经历、寻求更多了解以及参与协作解决问题。人们希望自己的声音被听到，在医疗系统中得到支持，获取可靠信息，找到合适的服务，并与医疗专业人员合作进行学习和解决问题。在整个疫情期间，提供医疗服务面临着巨大挑战。向前发展至关重要，重点是克服以人为本医疗的障碍。这应关注当下的步骤，同时也要为医疗需求和供应可能进一步快速变化做好规划。
