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医疗保健提供者对COVID-19大流行期间职业倦怠和道德困扰的看法:来自加拿大萨斯喀彻温省的一项定性研究。

Health care providers' perceptions of burnout and moral distress during the COVID-19 pandemic: A qualitative study from Saskatchewan, Canada.

作者信息

Alhassan Jacob Albin Korem, Rohatinsky Noelle, Peru Taylor, Levandoski Carmen, Kendel Dennis, Dmytrowich Jeff, Lafontaine Tenille, Cardinal Matthew, Peña-Sánchez Juan Nicolás

机构信息

Assistant Professor, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.

Associate Professor, College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

J Health Serv Res Policy. 2025 Apr;30(2):109-116. doi: 10.1177/13558196241287336. Epub 2024 Oct 1.

Abstract

OBJECTIVES

This study sought to describe feelings and perceptions of burnout and moral distress experienced by health care providers in the Canadian province of Saskatchewan during the COVID-19 pandemic.

METHODS

This study was part of a larger mixed methods project, and we here report on the qualitative results relating to burnout and moral distress experienced by medical doctors, registered nurses and respiratory therapists. We used an exploratory, qualitative descriptive design involving one-one-one interviews with 24 health care providers. Interview data were analysed using a reflexive thematic analysis approach.

RESULTS

We identified three overarching themes each for health care provider burnout and moral distress. Interviews revealed that providers experienced burnout through (i) increased expectations and (ii) unfavourable work environments, which led most of them to recognise (iii) a need to step back. Regarding moral distress, key themes were: (i) a sense of compromised care, (ii) feelings of bumping heads with authorities and patient families, and (iii) seeing patients make difficult decisions.

CONCLUSION

Our study found that medical doctors, registered nurses and respiratory therapists working during the COVID-19 pandemic experienced and continue to experience significant burnout and moral distress. This was often driven by both institution- and system-level factors. There is a need for sustained investment to build and support a motivated health care workforce to prepare for future pandemics and health emergencies.

摘要

目的

本研究旨在描述加拿大萨斯喀彻温省的医疗服务提供者在新冠疫情期间所经历的职业倦怠和道德困扰的感受与认知。

方法

本研究是一个更大的混合方法项目的一部分,我们在此报告与医生、注册护士和呼吸治疗师所经历的职业倦怠和道德困扰相关的定性研究结果。我们采用探索性定性描述设计,对24名医疗服务提供者进行一对一访谈。访谈数据采用反思性主题分析法进行分析。

结果

我们分别为医疗服务提供者的职业倦怠和道德困扰确定了三个总体主题。访谈显示,提供者经历职业倦怠的原因包括:(i)期望增加和(ii)不利的工作环境,这导致他们中的大多数人认识到(iii)需要退后一步。关于道德困扰,关键主题有:(i)护理质量受损的感觉,(ii)与当局和患者家属意见不合的感觉,以及(iii)目睹患者做出艰难的决定。

结论

我们的研究发现,在新冠疫情期间工作的医生、注册护士和呼吸治疗师经历了且仍在经历严重的职业倦怠和道德困扰。这往往是由机构和系统层面的因素共同驱动的。需要持续投入,以建立和支持一支积极主动的医疗服务队伍,为未来的大流行和卫生紧急情况做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f684/11877978/f1e44c63cb54/10.1177_13558196241287336-fig1.jpg

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