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COVID-19 大流行期间艾伯塔省延迟手术的影响:一项定性研究。

The impact of delaying surgery during the COVID-19 pandemic in Alberta: a qualitative study.

机构信息

Department of Community of Health Sciences and O'Brien Institute for Public Health (Sauro, Smith, Kersen, Schalm, Jaworska, Roach, Brindle), Cumming School of Medicine; Department of Surgery (Sauro, Brindle), Cumming School of Medicine; Department of Oncology and Arnie Charbonneau Cancer Institute (Sauro), Cumming School of Medicine; Department of Critical Care Medicine (Schalm, Jaworska), Cumming School of Medicine; Department of Family Medicine (Roach, Brindle), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Surgery Strategic Clinical Network (Beesoon), Alberta Health Services, Edmonton, Alta.

出版信息

CMAJ Open. 2023 Jan 31;11(1):E90-E100. doi: 10.9778/cmajo.20210330. Print 2023 Jan-Feb.

Abstract

BACKGROUND

The COVID-19 pandemic overwhelmed health care systems, leading many jurisdictions to reduce surgeries to create capacity (beds and staff) to care for the surge of patients with COVID-19; little is known about the impact of this on patients whose surgery was delayed. The objective of this study was to understand the patient and family/caregiver perspective of having a surgery delayed during the COVID-19 pandemic.

METHODS

Using an interpretative descriptive approach, we conducted interviews between Sept. 20 and Oct. 8, 2021. Adult patients who had their surgery delayed or cancelled during the COVID-19 pandemic in Alberta, Canada, and their family/caregivers were eligible to participate. Trained interviewers conducted semistructured interviews, which were iteratively analyzed by 2 independent reviewers using an inductive approach to thematic content analysis.

RESULTS

We conducted 16 interviews with 15 patients and 1 family member/caregiver, ranging from 27 to 75 years of age, with a variety of surgical procedures delayed. We identified 4 interconnected themes: individual-level impacts on physical and mental health, family and friends, work and quality of life; system-level factors related to health care resources, communication and perceived accountability within the system; unique issues related to COVID-19 (maintaining health and isolation); and uncertainty about health and timing of surgery.

INTERPRETATION

Although the decision to delay nonurgent surgeries was made to manage the strain on health care systems, our study illustrates the consequences of these decisions, which were diffuse and consequential. The findings of this study highlight the need to develop and adopt strategies to mitigate the burden of waiting for surgery during and after the COVID-19 pandemic.

摘要

背景

COVID-19 大流行使医疗系统不堪重负,导致许多司法管辖区减少手术,以腾出病床和人员来照顾 COVID-19 患者的激增;但对于手术被推迟的患者的影响却知之甚少。本研究的目的是了解在 COVID-19 大流行期间手术被推迟的患者及其家属/照顾者的观点。

方法

我们采用解释性描述方法,于 2021 年 9 月 20 日至 10 月 8 日期间进行了访谈。在加拿大艾伯塔省,因 COVID-19 大流行而手术被推迟或取消的成年患者及其家属/照顾者有资格参加。经过培训的访谈者进行了半结构化访谈,由 2 名独立评审员使用归纳法对主题内容分析进行迭代分析。

结果

我们对 15 名患者和 1 名家属/照顾者进行了 16 次访谈,年龄在 27 至 75 岁之间,手术被推迟的类型多种多样。我们确定了 4 个相互关联的主题:个人层面上对身心健康、家庭和朋友、工作和生活质量的影响;与医疗资源、系统内沟通和感知问责制相关的系统层面因素;与 COVID-19 相关的独特问题(保持健康和隔离);对健康和手术时间的不确定性。

解释

尽管推迟非紧急手术的决定是为了应对医疗系统的压力,但我们的研究说明了这些决策的后果是广泛而深远的。本研究的结果强调了在 COVID-19 大流行期间和之后,需要制定和采用策略来减轻等待手术的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e94c/9894654/2add4adacbf4/cmajo.20210330f1.jpg

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