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“你知道你必须在那里,这是必须要做的”:西班牙一家公立医院应对 COVID-19 大流行的卫生专业人员的经历。

"You knew you had to be there, it had to be done": Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain.

机构信息

Programa de Doctorado en Ciencias de la Salud, Universidad de Sevilla, Seville, Spain.

Escuela Andaluza de Salud Pública, Granada, Spain.

出版信息

Front Public Health. 2023 Apr 20;11:1089565. doi: 10.3389/fpubh.2023.1089565. eCollection 2023.

Abstract

INTRODUCTION

The COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned.

METHODS

We carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi's 7-step data analysis method.

RESULTS

During the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic.

CONCLUSION

In the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic.

摘要

简介

COVID-19 大流行凸显出政府缺乏应对突发卫生危机的有效应急计划。本研究采用现象学方法,探讨了西班牙瓦伦西亚地区一家公立卫生医院的医疗保健专业人员在 COVID-19 大流行的前三个波次期间的经历。评估了对其健康、应对策略、机构支持、组织变革、护理质量和经验教训的影响。

方法

我们对预防医学、急诊和内科以及重症监护病房的医生和护士进行了一项半结构化访谈的定性研究,采用了 Colaizzi 的 7 步数据分析方法。

结果

在第一波疫情中,缺乏信息和领导力导致了不确定性、感染恐惧和向家庭成员传播的风险。持续的组织变革和缺乏物质及人力资源带来了有限的结果。缺乏容纳患者的空间,以及对重症患者治疗的培训不足,以及医疗工作者频繁调动,降低了护理质量。尽管报告了高水平的情绪压力,但没有人请病假;高水平的敬业精神和职业使命感有助于适应紧张的工作节奏。医疗服务和支持单位的医疗保健专业人员报告的压力水平更高,比担任管理角色的同事更感到被机构忽视。家庭、社会支持和工作中的友情是有效的应对策略。卫生专业人员表现出强烈的集体精神和团结感。这有助于他们应对伴随大流行而来的额外压力和工作量。

结论

在这次经历之后,他们强调需要制定适应每个组织背景的应急计划。该计划应包括心理咨询和对重症患者护理的持续培训。最重要的是,它需要利用从 COVID-19 大流行中获得的宝贵知识。

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