Mussie Kirubel Manyazewal, Setchell Jenny, Kaba Mirgissa, Elger Bernice Simone
Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
SAGE Open Med. 2024 Jul 30;12:20503121241263305. doi: 10.1177/20503121241263305. eCollection 2024.
The COVID-19 pandemic has brought severe health consequences among older adults and posed ethical challenges. The aim of this study was to explore the impacts of COVID-19 on the health and medical care of older adults in Ethiopia and associated ethical implications, regardless of older adults' COVID-19 infection status.
In this qualitative study, we followed an inductive exploratory approach based on reflexive thematic analysis. We conducted semistructured interviews between March 2021 and November 2021 with 20 older adults and 26 health professionals who were selected from healthcare facilities and communities in Ethiopia using purposive and snowball sampling techniques. We audio-recorded, transcribed, translated, and inductively analyzed the interviews using thematic analysis.
Participants reported that the pandemic compromised the accessibility and quality of both COVID and non-COVID healthcare services for older adults, which negatively impacted older adults' health conditions and medical care. Moreover, participants elaborated on the health conditions and care of older patients with COVID-19 and highlighted that older COVID-19 patients often have severe health conditions, do not get adequate COVID-19 care, and may receive lower priority for admission to intensive care units compared to younger patients when resources are limited.
Results of this study showed that practices of COVID-19 care and measures may have led to adverse consequences such as limited availability and access to aged care in Ethiopia, which could have further health consequences on older patients. Our results contribute to a better understanding of ethical issues such as distributive justice and prioritization arising in the healthcare of older patients in times of global pandemic. It is imperative for local and international health policymakers and ethicists to further analyze and address the challenges that compromise the accessibility and continuity of quality care for older persons during a public healthcare crisis.
新冠疫情给老年人带来了严重的健康后果，并引发了伦理挑战。本研究的目的是探讨新冠疫情对埃塞俄比亚老年人健康和医疗护理的影响以及相关伦理问题，无论老年人的新冠感染状况如何。
在这项定性研究中，我们采用基于反思性主题分析的归纳探索方法。2021年3月至2021年11月期间，我们使用目的抽样和滚雪球抽样技术，对从埃塞俄比亚的医疗机构和社区中挑选出的20名老年人和26名卫生专业人员进行了半结构化访谈。我们对访谈进行了录音、转录、翻译，并使用主题分析进行归纳分析。
参与者报告称，疫情影响了老年人获得新冠和非新冠医疗服务的可及性和质量，对老年人的健康状况和医疗护理产生了负面影响。此外，参与者详细阐述了新冠老年患者的健康状况和护理情况，并强调新冠老年患者往往健康状况严重，得不到充分的新冠护理，在资源有限时，与年轻患者相比，入住重症监护病房可能获得较低优先级。
本研究结果表明，新冠护理措施可能导致了一些不良后果，如埃塞俄比亚老年护理服务的可及性有限，这可能对老年患者造成进一步的健康影响。我们的研究结果有助于更好地理解全球大流行期间老年患者医疗保健中出现的分配正义和优先排序等伦理问题。地方和国际卫生政策制定者及伦理学家必须进一步分析并应对在公共卫生危机期间影响老年人获得优质护理的可及性和连续性的挑战。
