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“我们真的是在停车场、车里、车库里工作,另外还单独搭建了聚会帐篷”:奥地利 SARS-CoV-2 大流行期间全科医生经历的定性研究。

"We literally worked in parking lots, cars, garages, and separately set up party tents": qualitative study on the experiences of GPs in the frame of the SARS-CoV-2 pandemic in Austria.

机构信息

Division General and Family Medicine, Department of General Health Studies, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, Krems, 3500, Austria.

Department of Primary Care Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.

出版信息

BMC Health Serv Res. 2023 Dec 12;23(1):1394. doi: 10.1186/s12913-023-10363-4.

Abstract

BACKGROUND

Primary care is internationally recognised as one of the cornerstones of health care. During the COVID-19 pandemic, primary care physicians were assigned a variety of tasks and thus made a significant contribution to a country's pandemic response. They were expected to perform a variety of tasks, such as diagnosing and treating people with COVID-19, maintaining health care for all other patients, as well as several public health tasks, such as diagnostic testing and vaccination, protecting patients and staff from infection, and serving as community trusted persons. In Austria, there are no structured levels of care, no definition of the role of the general practitioner during a pandemic is given, and no specific support structures are present. The aim of this study was to assess the views and experiences of primary care physicians regarding supportive and hindering factors for pandemic preparedness in Austria.

METHODS

Qualitative study using semi-structured interviews. A total of 30 general practitioners were interviewed, with particular attention to an equitable distribution in small, medium and large primary care facilities. Qualitative content analysis was performed.

RESULTS

Interviewees described a wide range of infection control, organisational and communication measures that they had implemented. They made changes to practise equipment, found makeshift solutions when supplies were scarce, and established communication and information pathways when official communication lines were inadequate.

CONCLUSION

General practitioners took on essential tasks and showed a high level of understanding of their role in the pandemic response. This was achieved mainly at an informal level and with high personal commitment. Their functioning in the absence of structural regulations and support shows that they had a clear intrinsic understanding of their responsibilities. To ensure reliability and sustainability and to reduce their burden, it will be necessary to clarify the role and tasks of a general practitioner and to provide the necessary support. This concerns both infrastructural support and communication and information strategies. As part of the reform to strengthen primary care, primary care needs to be seen, valued and involved in decision-making processes.

摘要

背景

初级保健在国际上被公认为医疗保健的基石之一。在 COVID-19 大流行期间,初级保健医生承担了各种任务,为国家的大流行应对做出了重大贡献。他们被期望执行各种任务,例如诊断和治疗 COVID-19 患者、为所有其他患者提供医疗保健,以及执行多项公共卫生任务,如诊断测试和接种疫苗、保护患者和员工免受感染,以及充当社区信任的人。在奥地利,没有结构化的护理级别,没有规定大流行期间全科医生的角色,也没有特定的支持结构。本研究旨在评估初级保健医生对奥地利大流行准备工作的支持和阻碍因素的看法和经验。

方法

使用半结构式访谈进行定性研究。共访谈了 30 名全科医生,特别关注小型、中型和大型初级保健机构的公平分配。进行了定性内容分析。

结果

受访者描述了他们实施的广泛的感染控制、组织和沟通措施。他们改变了实践设备,在供应短缺时找到了临时解决方案,并在官方沟通渠道不足时建立了沟通和信息渠道。

结论

全科医生承担了基本任务,并表现出对其在大流行应对中的角色的高度理解。这主要是在非正规层面和高度的个人承诺下实现的。他们在没有结构法规和支持的情况下运作,表明他们对自己的责任有明确的内在理解。为了确保可靠性和可持续性并减轻他们的负担,有必要明确全科医生的角色和任务,并提供必要的支持。这既涉及基础设施支持,也涉及沟通和信息策略。作为加强初级保健改革的一部分,需要看到、重视和参与初级保健的决策过程。

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