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一项关于印度奥里萨邦医生在 COVID-19 大流行期间管理多种疾病的经验的纵向定性研究。

A longitudinal qualitative study on physician experience in managing multimorbidity across the COVID-19 pandemic in Odisha, India.

机构信息

Department of Psychiatry, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India.

Department of Health Research, Health Technology Assessment in India (HTAIn), Ministry of Health and Family Welfare, New Delhi, 110001, India.

出版信息

Sci Rep. 2024 Jun 4;14(1):12866. doi: 10.1038/s41598-024-60473-0.

Abstract

While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana's longitudinal qualitative data analysis method was employed for data analysis. COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises. The findings underscore the transformative potential of physician resilience and adaptation during the COVID-19 pandemic, emphasizing the importance of prioritizing patients with multimorbidity, incorporating teleconsultation, and implementing digital health records in healthcare systems to enhance chronic illness care and preparedness for future public health crises.

摘要

虽然许多研究已经记录了多种慢性疾病或多种合并症对 COVID-19 患者结局的不利影响,但关于医生如何管理这些患者的报告却很少。我们调查了印度奥里萨邦的临床医生在 COVID-19 大流行期间管理患有多种合并症的患者的经验和挑战。为了了解影响疾病管理的因素以及医生在不断变化的大流行中的适应反应,我们采用了纵向定性研究设计。我们对包括全科医生、专家和重症监护医生在内的 23 名医生进行了电话深度访谈。采用 Saldana 的纵向定性数据分析方法进行数据分析。COVID-19 大流行最初分散了卫生系统的注意力,导致医疗服务减少。随着时间的推移,医生克服了对 COVID-19 的恐惧、焦虑和脆弱感,开始优先为患有多种合并症的患者治疗和接种疫苗。所有医生都建议在未来的公共卫生危机中使用远程咨询和电子健康记录来改善慢性病护理。研究结果强调了 COVID-19 大流行期间医生的韧性和适应能力的变革潜力,强调了在医疗系统中优先考虑患有多种合并症的患者、采用远程咨询和实施电子健康记录的重要性,以加强慢性病护理和为未来的公共卫生危机做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a992/11150371/b3711c8a963a/41598_2024_60473_Fig1_HTML.jpg

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