“强烈反对！”？对临终关怀姑息治疗工作人员“与新冠共存”的持续经历的质性探索。
"Backlash!"? A qualitative exploration of hospice palliative care staff's ongoing experiences of "living with covid".
作者信息
Evans Rebecca, MacArtney John
机构信息
Warwick Medical School, University of Warwick, Coventry, UK.
Warwick Medical School, University of Warwick, Medical School Building, Coventry, West Midlands CV4 7AL, UK.
出版信息
Palliat Care Soc Pract. 2024 Sep 30;18:26323524241283064. doi: 10.1177/26323524241283064. eCollection 2024.
BACKGROUND
"Living with covid" has meant that the SARS-CoV-2 virus has become a background concern for many in the United Kingdom. However, people with terminal conditions remain some of those at higher risk of Covid-19 affecting the quality-of-life left, as well as the amount of life. Little is known about how staff manage the ongoing risks and challenges-to themselves and those they seek to support-when providing palliative care in the context of an airborne transmissible virus.
OBJECTIVE
To explore the experiences of UK hospice staff of "living with covid" to identify how Covid-19 continues to affect their work and well-being.
DESIGN
An interpretivist qualitative interview study.
METHODS
Reflexive thematic analysis of semi-structured online interviews with 12 staff recruited from three hospices in the West Midlands, UK.
RESULTS
We explored how participants' accounts of "living with covid" included several ambivalences: Participants not only sought to assert the importance of not forgetting that time but also wished to "move-on." This included moving Covid-19 to the "background" through embedding systemic adaptions and lessons learnt, while also recognizing that they had to address issues relating to Covid-19 "case-by-case." Finally, participants' wish to move-on and a mostly reactive approach to mitigations meant that they were unable to meaningfully reconcile how asymptomatic transmission promotes patients' quality-of-life left.
CONCLUSION
Recollections of the difficulties of the Covid-19 public health emergency were part of a "backlash" to any future consideration of mitigations for airborne transmissible viruses and helped justify a "living with (getting) covid" approach. However, this also created uncertainty of how best to support patients who are vulnerable to having the quality and amount of life left compromised by viral infection. The pandemic has brought renewed impetus to re-examine hospice palliative care's ideals and practices in the context of airborne transmissible viruses.
背景
“与新冠共存”意味着严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒已成为英国许多人日常担忧的问题。然而，患有绝症的人仍然是感染新冠病毒风险较高的人群，这会影响他们剩余的生活质量以及寿命。对于在空气传播病毒背景下提供姑息治疗时，工作人员如何应对自身以及他们试图支持的患者所面临的持续风险和挑战，我们知之甚少。
目的
探讨英国临终关怀机构工作人员“与新冠共存”的经历，以确定新冠病毒如何持续影响他们的工作和幸福感。
设计
一项诠释主义定性访谈研究。
方法
对从英国西米德兰兹郡三家临终关怀机构招募的12名工作人员进行半结构化在线访谈，并进行反思性主题分析。
结果
我们探讨了参与者对“与新冠共存”的描述如何包含几种矛盾情绪：参与者不仅试图强调不忘那段时间的重要性，还希望“向前看”。这包括通过融入系统性调整和吸取的经验教训，将新冠病毒问题“置于背景中”，同时也认识到他们必须逐案处理与新冠病毒相关的问题。最后，参与者向前看的愿望以及大多是被动的缓解措施意味着他们无法有意义地协调无症状传播如何提升患者剩余的生活质量。
结论
对新冠疫情公共卫生紧急情况困难的回忆，是对未来任何空气传播病毒缓解措施考虑的“反弹”的一部分，并有助于为“与新冠共存”的方法提供正当理由。然而，这也造成了不确定性，即如何最好地支持那些容易因病毒感染而使剩余生活质量和寿命受到影响的患者。这场大流行给在空气传播病毒背景下重新审视临终关怀姑息治疗的理念和实践带来了新的动力。
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