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一项定性研究,探讨医护人员对英国新冠疫情政策和指南对孕产妇及生殖健康护理服务影响的亲身经历。

A qualitative study exploring healthcare workers' lived experiences of the impacts of COVID-19 policies and guidelines on maternal and reproductive healthcare services in the United Kingdom.

作者信息

Chaloner Jonathan, Qureshi Irtiza, Gogoi Mayuri, Ekezie Winifred C, Al-Oraibi Amani, Wobi Fatimah, Agbonmwandolor Joy O, Nellums Laura B, Pareek Manish

机构信息

Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom.

Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.

出版信息

Eur J Midwifery. 2023 Nov 8;7:30. doi: 10.18332/ejm/171802. eCollection 2023.

Abstract

INTRODUCTION

During the COVID-19 pandemic, pregnant women were regarded as vulnerable to poor health outcomes if infected with the SARS-CoV-2 (COVID-19) virus. To protect the United Kingdom's (UK) National Health Service (NHS) and pregnant patients, strict infection control policies and regulations were implemented. This study aimed to understand the impact of the COVID-19 policies and guidelines on maternal and reproductive health services during the pandemic from the experiences of healthcare workers (HCWs) caring for these patients.

METHODS

This qualitative study involved HCWs from the United Kingdom Research study into Ethnicity and COVID-19 outcomes in Healthcare workers (UK-REACH) project. Semi-structured interviews and focus groups were conducted online or by telephone with 44 diverse HCWs. Transcripts were thematically analyzed following Braun and Clarke's principles of qualitative analysis.

RESULTS

Three key themes were identified during analysis. First, infection control policies impacted appointment availability, resulting in many cancellations and delays to treatment. Telemedicine was also used extensively to reduce risks from face-to-face consultations, disadvantaging patients from minoritized ethnicities. Secondly, staff shortages and redeployments reduced availability of consultations, appointments, and sonography scans. Finally, staff and patients reported challenges accessing timely, reliable and accurate information and guidance.

CONCLUSIONS

COVID-19 demonstrated how a global health crisis can impact maternal and reproductive health services, leading to reduced service quality and surgical delays due to staff redeployment policies. Our findings underscore the implications of policy and future health crises preparedness. This includes tailored infection control policies, addressing elective surgery backlogs early and improved dissemination of relevant vaccine information.

摘要

引言

在新冠疫情期间,如果感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新冠病毒),孕妇被视为健康状况易受影响的群体。为保护英国国家医疗服务体系(NHS)和孕妇患者,实施了严格的感染控制政策和规定。本研究旨在通过照顾这些患者的医护人员的经历,了解新冠疫情期间相关政策和指南对孕产妇及生殖健康服务的影响。

方法

这项定性研究涉及参与英国医护人员种族与新冠疫情结果研究(UK-REACH)项目的医护人员。通过在线或电话方式,对44名不同的医护人员进行了半结构化访谈和焦点小组讨论。按照布劳恩和克拉克的定性分析原则,对访谈记录进行了主题分析。

结果

分析过程中确定了三个关键主题。首先,感染控制政策影响了预约安排,导致许多预约取消和治疗延误。远程医疗也被广泛使用,以降低面对面咨询带来的风险,但这对少数族裔患者不利。其次,人员短缺和调配导致咨询、预约和超声扫描的可及性降低。最后,医护人员和患者表示在获取及时、可靠和准确的信息及指导方面存在困难。

结论

新冠疫情表明,全球健康危机如何影响孕产妇及生殖健康服务,因人员调配政策导致服务质量下降和手术延误。我们的研究结果强调了政策的影响以及对未来健康危机的准备工作。这包括制定针对性的感染控制政策、尽早解决择期手术积压问题以及改善相关疫苗信息的传播。

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