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在 COVID-19 大流行期间,延迟非紧急手术对艾伯塔省外科医生的影响:一项定性访谈研究。

The impact of delayed nonurgent surgery during the COVID-19 pandemic on surgeons in Alberta: a qualitative interview study.

机构信息

Alberta Health Services (Jaworska, Brindle); Departments of Critical Care Medicine (Jaworska, Schalm) and Community Health Sciences (Jaworska, Schalm, Kersen, Smith, Brindle, Sauro), and O'Brien Institute for Public Health (Sauro), University of Calgary; Department of Surgery (Brindle, Dort, Sauro), and Department of Oncology and Arnie Charbonneau Cancer Institute (Sauro), Cumming School of Medicine, University of Calgary; Faculty of Nursing (Dorman), University of Calgary, Calgary, Alta.

出版信息

CMAJ Open. 2023 Jul 4;11(4):E587-E596. doi: 10.9778/cmajo.20220188. Print 2023 Jul-Aug.

Abstract

BACKGROUND

During the COVID-19 pandemic, nonurgent surgeries were delayed to preserve capacity for patients admitted with COVID-19; surgeons were challenged personally and professionally during this time. We aimed to describe the impact of delays to nonurgent surgeries during the COVID-19 pandemic from the surgeons' perspective in Alberta.

METHODS

We conducted an interpretive description qualitative study in Alberta from January to March 2022. We recruited adult and pediatric surgeons via social media and through personal contacts from our research network. Semistructured interviews were conducted via Zoom, and we analyzed the data via inductive thematic analysis to identify relevant themes and subthemes related to the impact of delaying nonurgent surgery on surgeons and their provision of surgical care.

RESULTS

We conducted 12 interviews with 9 adult surgeons and 3 pediatric surgeons. Six themes were identified: accelerator for a surgical care crisis, health system inequity, system-level management of disruptions in surgical services, professional and interprofessional impact, personal impact, and pragmatic adaptation to health system strain. Participants also identified strategies to mitigate the challenges experienced due to nonurgent surgical delays during the COVID-19 pandemic (i.e., additional operating time, surgical process reviews to reduce inefficiencies, and advocacy for sustained funding of hospital beds, human resources and community-based postoperative care).

INTERPRETATION

Our study describes the impacts and challenges experienced by adult and pediatric surgeons of delayed nonurgent surgeries because of the COVID-19 pandemic response. Surgeons identified potential health system-, hospital- and physician-level strategies to minimize future impacts on patients from delays of nonurgent surgery.

摘要

背景

在 COVID-19 大流行期间,为了为 COVID-19 入院患者保留容量,非紧急手术被推迟;外科医生在此期间面临个人和专业上的挑战。我们旨在从艾伯塔省外科医生的角度描述 COVID-19 大流行期间非紧急手术延迟的影响。

方法

我们于 2022 年 1 月至 3 月在艾伯塔省进行了一项解释性描述定性研究。我们通过社交媒体以及我们的研究网络中的个人联系,招募成年和儿科外科医生。通过 Zoom 进行半结构化访谈,我们通过归纳主题分析对数据进行分析,以确定与延迟非紧急手术对外科医生及其提供手术护理的影响相关的主题和子主题。

结果

我们进行了 12 次访谈,受访者为 9 名成年外科医生和 3 名儿科外科医生。确定了 6 个主题:手术护理危机的加速器、卫生系统不公平、手术服务中断的系统层面管理、专业和专业间影响、个人影响以及对卫生系统压力的务实适应。参与者还确定了减轻 COVID-19 大流行期间非紧急手术延迟带来的挑战的策略(即增加手术时间、审查手术流程以减少效率低下、倡导持续为医院床位、人力资源和社区术后护理提供资金)。

解释

我们的研究描述了 COVID-19 大流行应对措施导致的成年和儿科外科医生非紧急手术延迟的影响和挑战。外科医生确定了潜在的卫生系统、医院和医生层面的策略,以最大程度地减少非紧急手术延迟对患者的未来影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4534/10325580/209e930de265/cmajo.20220188f1.jpg

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