Corona Lauren E, Rosoklija Ilina, Walton Ryan F, Matoka Derek J, Seager Catherine M, Holl Jane L, Johnson Emilie K
Division of Urology, Department of Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
Department of Urology, Northwestern Feinberg School of Medicine, Chicago, IL, United States.
Front Health Serv. 2022 Jan 17;1:799647. doi: 10.3389/frhs.2021.799647. eCollection 2021.
Over half of boys in the United States undergo circumcision, which has its greatest health benefits and lowest risks when performed during the newborn period under local anesthesia. The COVID-19 pandemic has affected delivery of patient care in many ways and likely also influenced the provision of newborn circumcisions. Prior to the pandemic, we planned to conduct a qualitative study to ascertain physician perspectives on providing newborn circumcision care. The interviews incidentally coincided with the onset of the pandemic and thus, pandemic-related changes emerged as a theme. We elected to analyze this theme in greater detail. Semi-structured interviews were conducted with perinatal physicians in a large urban city from 4/2020 to 7/2020. Physicians that perform or counsel regarding newborn circumcision and physicians with knowledge of or responsibility for hospital policies were eligible. Interviews were transcribed verbatim and qualitative coding was performed. Twenty-three physicians from 11 local hospitals participated. Despite no specific COVID-19 related questions in the interview guide, nearly half of physicians identified that the pandemic affected delivery of newborn circumcision care with 8 pandemic-related sub-themes. The commonest sub-themes included COVID-19 related changes in: (1) workflow processes, (2) staffing and availability of circumcision proceduralists, and (3) procedural settings. In summary, this qualitative study revealed unanticipated COVID-19 pandemic-related changes with primarily adverse effects on the provision of desired newborn circumcisions. Some of these changes may become permanent resulting in broad implications for policy makers that will likely need to adapt and redesign the processes and systems for the delivery of newborn circumcision care.
美国超过半数的男孩接受包皮环切术，在新生儿期进行局部麻醉下的包皮环切术，其健康益处最大且风险最低。新冠疫情在许多方面影响了患者护理的提供，也可能影响了新生儿包皮环切术的实施。在疫情之前，我们计划进行一项定性研究，以确定医生对提供新生儿包皮环切护理的看法。访谈恰巧与疫情爆发同时进行，因此，与疫情相关的变化成为了一个主题。我们选择更详细地分析这个主题。2020年4月至7月，我们对一个大城市的围产期医生进行了半结构式访谈。进行或咨询新生儿包皮环切术的医生以及了解或负责医院政策的医生符合条件。访谈内容逐字记录并进行了定性编码。来自11家当地医院的23名医生参与了访谈。尽管访谈指南中没有具体的与新冠疫情相关的问题，但近一半的医生认为疫情影响了新生儿包皮环切护理的提供，出现了8个与疫情相关的子主题。最常见的子主题包括新冠疫情在以下方面的变化：（1）工作流程，（2）包皮环切手术医生的人员配备和可用性，以及（3）手术环境。总之，这项定性研究揭示了与新冠疫情相关的意外变化，主要对提供理想的新生儿包皮环切术产生了不利影响。其中一些变化可能会成为永久性的，这将对政策制定者产生广泛影响，他们可能需要调整和重新设计新生儿包皮环切护理的流程和系统。
