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一项针对维多利亚时代医疗工作者及其组织在 COVID-19 期间不断变化的观点和经验的纵向定性探索。

A longitudinal qualitative exploration of victorian healthcare workers' and organisations' evolving views and experiences during COVID-19.

机构信息

School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.

Alfred Health, Melbourne, VIC, Australia.

出版信息

BMC Health Serv Res. 2024 May 7;24(1):596. doi: 10.1186/s12913-024-11067-z.

Abstract

BACKGROUND

The COVID-19 pandemic has profoundly impacted individuals, society, and healthcare organisations worldwide. Recent international research suggests that concerns, needs, and experiences of healthcare workers (HCWs) have evolved throughout the pandemic. This longitudinal qualitative study explored the evolving views and experiences of Victorian healthcare workers (HCWs) and organisational key personnel during the coronavirus disease (COVID-19) pandemic.

METHODS

We recruited participants from the Coronavirus in Victorian Health and Aged care workers (COVIC-HA) study cohort. We conducted two rounds of semi-structured interviews with HCWs and organisational key personnel from three different healthcare settings (hospital, aged care and primary care) in Victoria, Australia, in May-July 2021 and May-July 2022. Data were analysed thematically using trajectory and recurrent cross-sectional approaches, guided by a temporal change framework.

RESULTS

Twelve HCWs and five key personnel from various professional roles participated in interviews at both timepoints. Expected themes derived from mid-2021 interviews (navigating uncertainty, maintaining service delivery, and addressing staff needs) evolved over time. Concerns shifted from personal health and safety to workforce pressures, contributing to HCW burnout and fatigue and ongoing mental health support needs. New themes emerged from mid-2022 interviews, including managing ongoing COVID-19 impacts and supporting the healthcare workforce into the future. Clear and consistent communication, stable guidelines and forward-looking organisational responses were considered crucial.

CONCLUSIONS

Our longitudinal qualitative study highlighted the evolving impact of the COVID-19 pandemic on HCWs' perceptions, health and wellbeing and uncovered long-term sector vulnerabilities. Analysing HCW experiences and key personnel insights over time and across different pandemic phases provided crucial insights for policymakers to protect the healthcare workforce. Findings emphasise the need for proactive strategies that prioritise HCWs' wellbeing and workforce sustainability. Policy makers must invest in HCW health and wellbeing initiatives alongside healthcare system improvements to ensure resilience and capacity to meet future challenges.

TRIAL REGISTRATION

This study was approved through the Victorian Streamlined Ethical Review Process (SERP: Project Number 68,086) and registered with ANZCTR (ACTRN12621000533897) on 6 May 2021.

摘要

背景

COVID-19 大流行深刻影响了全球个人、社会和医疗保健组织。最近的国际研究表明,医疗保健工作者(HCWs)的关注点、需求和体验在整个大流行期间都发生了变化。这项纵向定性研究探讨了在冠状病毒病(COVID-19)大流行期间,维多利亚州医疗保健工作者(HCWs)和组织关键人员不断变化的观点和经历。

方法

我们从维多利亚州冠状病毒健康和老年护理工作者(COVIC-HA)研究队列中招募参与者。我们在 2021 年 5 月至 7 月和 2022 年 5 月至 7 月期间,在澳大利亚维多利亚州的三个不同医疗保健环境(医院、老年护理和初级保健)中,对 HCWs 和组织关键人员进行了两轮半结构化访谈。使用轨迹和反复横断面方法对数据进行了主题分析,该方法受时间变化框架的指导。

结果

在两个时间点,12 名 HCWs 和 5 名来自不同专业角色的关键人员参加了访谈。2021 年中期访谈中得出的预期主题(应对不确定性、维持服务交付和满足员工需求)随着时间的推移而演变。关注点从个人健康和安全转移到劳动力压力,导致 HCW 倦怠和疲劳以及持续的心理健康支持需求。2022 年中期访谈中出现了新的主题,包括管理持续的 COVID-19 影响和为未来支持医疗保健劳动力。明确和一致的沟通、稳定的指导方针和前瞻性的组织反应被认为是至关重要的。

结论

我们的纵向定性研究强调了 COVID-19 大流行对 HCWs 的看法、健康和福利的不断影响,并揭示了长期的部门脆弱性。随着时间的推移和不同的大流行阶段分析 HCW 经验和关键人员的见解,为政策制定者提供了保护医疗保健劳动力的重要见解。研究结果强调了优先考虑 HCW 福祉和劳动力可持续性的积极策略的必要性。政策制定者必须投资于 HCW 健康和福利倡议以及医疗保健系统的改善,以确保有应对未来挑战的弹性和能力。

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