Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 6N5, Canada.
BMC Health Serv Res. 2023 Oct 4;23(1):1057. doi: 10.1186/s12913-023-10079-5.
The COVID-19 pandemic has produced widespread disruptions for healthcare systems across Canada. Perinatal care in Ontario, Canada was subject to province-wide public health restrictions, reallocation of hospital beds and human health resources. To better understand the impacts of the pandemic on Ontario perinatal care, this study explored the perspectives of perinatal care providers about their clinical COVID-19 pandemic experiences.
Semi-structured key informant virtual interviews were conducted between August 2021 and January 2022 with 15 Ontario-based perinatal care providers. Recorded interviews were transcribed, and thematic content analysis used to identify major themes and subthemes.
Participants were mainly women, practicing in Eastern and Central Ontario as health providers (obstetricians, nurses, midwives), allied regulated health professionals (social worker, massage therapist), and perinatal support workers (doula, lactation consultant). Major themes and subthemes were identified inductively as follows: (1) Impacts of COVID-19 on providers (psychosocial stress, healthcare system barriers, healthcare system opportunities); (2) Perceived impacts of COVID-19 on pregnant people (psychosocial stress, amplification of existing healthcare barriers, influences on reproductive decision making; minor theme- social and emotional support roles); (3) Vaccine discourse (provider empathy, vaccines and patient family dynamics, minor themes- patient vaccine hesitancy, COVID-19 misinformation); and (4) Virtual pregnancy care (benefits, disadvantages, adaptation of standard care practices).
Perinatal care providers reported significant stress and uncertainty caused by the COVID-19 pandemic and evolving hospital protocols. Providers perceived that their patients were distressed by both the pandemic and related reductions in pregnancy healthcare services including hospital limits to support companion(s). Although virtual pregnancy care impaired patient-provider rapport, most providers believed that the workflow efficiencies and patient convenience of virtual care is beneficial to perinatal healthcare.
COVID-19 大流行给加拿大各地的医疗系统带来了广泛的干扰。加拿大安大略省的围产期保健受到全省范围的公共卫生限制、医院床位和人力资源的重新分配的影响。为了更好地了解大流行对安大略省围产期保健的影响，本研究探讨了围产期保健提供者对其临床 COVID-19 大流行经验的看法。
2021 年 8 月至 2022 年 1 月期间，与 15 名安大略省的围产期保健提供者进行了半结构化关键信息提供者虚拟访谈。对记录的访谈进行了转录，并使用主题内容分析来确定主要主题和子主题。
参与者主要是女性，在安大略省东部和中部作为医疗保健提供者（产科医生、护士、助产士）、联合监管的健康专业人员（社会工作者、按摩治疗师）和围产期支持工作者（导乐、哺乳顾问）执业。主要主题和子主题如下：（1）COVID-19 对提供者的影响（心理社会压力、医疗保健系统障碍、医疗保健系统机会）；（2）COVID-19 对孕妇的感知影响（心理社会压力、现有医疗保健障碍的放大、对生殖决策的影响；次要主题-社会和情感支持角色）；（3）疫苗讨论（提供者的同理心、疫苗和患者家庭动态、次要主题-患者疫苗犹豫、COVID-19 错误信息）；和（4）虚拟妊娠护理（益处、缺点、标准护理实践的调整）。
围产期保健提供者报告说，COVID-19 大流行和不断变化的医院协议导致他们压力很大，不确定。提供者认为他们的患者既受到大流行的困扰，也受到妊娠保健服务减少的困扰，包括医院对支持伴侣的限制。虽然虚拟妊娠护理损害了患者与提供者的关系，但大多数提供者认为虚拟护理的工作流程效率和患者便利性对围产期医疗保健有益。
