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新冠疫情期间非新冠重症慢性病患者的护理挑战:对韩国急症医院周边医护人员的定性研究

Challenges in Care for Non-COVID-19 Patients with Severe Chronic Illnesses during COVID-19 Pandemic: A Qualitative Study of Healthcare Providers Working around Acute Care Hospitals in South Korea.

作者信息

Kim Yejin, Shin Jeong Mi, Yoo Shin Hye, Keam Bhumsuk

机构信息

Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul 03080, Republic of Korea.

Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Republic of Korea.

出版信息

Healthcare (Basel). 2023 Feb 17;11(4):611. doi: 10.3390/healthcare11040611.

Abstract

BACKGROUND

The COVID-19 epidemic has afflicted patients with severe chronic illnesses who need continuous care between home and hospitals. This qualitative study examines the experiences and challenges of healthcare providers around acute care hospitals who have cared for patients with severe chronic illness in non-COVID-19 situations during the pandemic.

METHODS

Eight healthcare providers, who work in various healthcare settings around acute care hospitals and frequently care for non-COVID-19 patients with severe chronic illnesses, were recruited using purposive sampling from September to October 2021 in South Korea. The interviews were subjected to thematic analysis.

RESULTS

Four overarching themes were identified: (1) deterioration in the quality of care at various settings; (2) new emerging systemic problems; (3) healthcare providers holding on but reaching their limit; and (4) a decline in the quality of life of patients at the end of their lives, and their caregivers.

CONCLUSION

Healthcare providers of non-COVID-19 patients with severe chronic illnesses reported that the quality of care was declining due to the structural problems of the healthcare system and policies centered solely on the prevention and control of COVID-19. Systematic solutions are needed for appropriate and seamless care for non-infected patients with severe chronic illness in the pandemic.

摘要

背景

新冠疫情给患有严重慢性疾病、需要在家庭和医院之间持续接受护理的患者带来了困扰。本定性研究调查了急症医院周边的医护人员在疫情期间照顾非新冠情况下患有严重慢性疾病患者的经历和挑战。

方法

2021年9月至10月,在韩国采用目的抽样法招募了8名医护人员,他们在急症医院周边的各种医疗环境中工作,经常照顾患有严重慢性疾病的非新冠患者。对访谈内容进行了主题分析。

结果

确定了四个总体主题:(1)各环境下护理质量的下降;(2)新出现的系统性问题;(3)医护人员坚持但已达到极限;(4)患者及其照顾者生命末期生活质量的下降。

结论

照顾患有严重慢性疾病的非新冠患者的医护人员报告称,由于医疗系统的结构问题以及仅以新冠防控为中心的政策,护理质量正在下降。在疫情期间,需要系统性解决方案来为患有严重慢性疾病的未感染患者提供适当且无缝衔接的护理。

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