新冠疫情期间，卫生不公平对医生职业健康的影响：来自美国四个城市的定性分析。
The impact of health inequities on physicians' occupational well-being during COVID-19: A qualitative analysis from four US cities.
机构信息
Department of Sociology, UNC-Chapel Hill, Chapel Hill, North Carolina, USA.
The Hastings Center, Philipstown, New York, USA.
出版信息
J Hosp Med. 2023 Jul;18(7):595-602. doi: 10.1002/jhm.13107. Epub 2023 Apr 18.
OBJECTIVE
The aim of this study is to describe frontline physicians' perceptions of the impact of racial-ethnic and socioeconomic disparities in COVID-19 infection and mortality on their occupational well-being.
METHODS
One hundred and forty-five qualitative, semistructured interviews were conducted between February 2021 and June 2022 with hospital medicine, emergency medicine, pulmonary/critical care, and palliative care physicians caring for hospitalized COVID-19 patients in four US cities.
RESULTS
Physicians reported encountering COVID-related health disparities and inequities at the societal, organizational, and individual levels. Encountering these inequities, in turn, contributed to stress among frontline physicians, whose concerns revealed how structural conditions both shaped COVID disparities and constrained their ability to protect populations at risk from poor outcomes. Physicians reported feeling complicit in the perpetuation of inequities or helpless to mitigate observed inequities and experienced feelings of grief, guilt, moral distress, and burnout.
CONCLUSIONS
Health inequities are an under-acknowledged source of physicians' occupational stress that requires solutions beyond the clinical context.
目的
本研究旨在描述一线医生对 COVID-19 感染和死亡率中存在的种族和社会经济差异对其职业健康的影响的看法。
方法
2021 年 2 月至 2022 年 6 月，在四个美国城市，对从事医院内科、急诊医学、肺病/重症监护和姑息治疗的医生进行了 145 次定性、半结构化访谈，这些医生照顾的是住院的 COVID-19 患者。
结果
医生们报告说，在社会、组织和个人层面都遇到了与 COVID 相关的健康差距和不平等。反过来，遇到这些不平等也导致了一线医生的压力，他们的担忧揭示了结构性条件如何塑造 COVID 差异，并限制了他们保护高危人群免受不良结果的能力。医生们报告说，他们感到自己是不平等现象持续存在的同谋，或者对减轻所观察到的不平等现象感到无助，并感到悲伤、内疚、道德困境和倦怠。
结论
健康不平等是医生职业压力的一个未被充分认识的来源，需要在临床环境之外寻找解决方案。
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