Van Druten Vera P, Rozema Andrea D, Hendriksen Tessel H G, de Vries Esther, van de Mheen Dike, Keijsers Carolina J P W, van der Zwaard Babette C, Scheffelaar Aukelien, Nahar-van Venrooij Lenny M W
Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, NLD.
Jeroen Bosch Academy Research, Jeroen Bosch Hospital, 's-Hertogenbosch, NLD.
Cureus. 2025 Feb 3;17(2):e78470. doi: 10.7759/cureus.78470. eCollection 2025 Feb.
Introduction Quality of care may have been compromised during the exceptionally hectic period of the COVID-19 waves, including isolation precautions. Aims Experiences with person-centred care and wellbeing of COVID-19 patients admitted to a cohort isolation nursing ward during the first pandemic wave were explored, including differences between the acute phase (March 2020) and semi-acute phase (April-June 2020). Methods A convergent parallel mixed-method design was used. Adult no post-ICU patients visiting the outpatient clinic for COVID-19 aftercare between May and September 2020 six to eight weeks after discharge from the COVID-19 hospital ward were asked to participate. Part 1 comprised Patient Reported Experience Measure (PREM) questionnaires (n=134) and part 2 semi-structured interviews (n=30). Thematic analysis was performed, and themes were linked to the domains of the person-centred care framework. Results Part 1: Median scores on all the questions of the PREM were high. The lowest scores on the PREM questionnaire were seen on shared decision-making during the acute phase. Part 2: In line with this, the interviews also indicated that the majority of patients had positive experiences regarding person-centred care and that patients felt a limited need for interaction in shared decision-making. Additionally, it was learned from the interviews that the domain care environment was affected most by the pandemic: the isolation precautions had an impact on patients' wellbeing, although they understood the necessity for isolation precautions to protect others. Patients felt lonely, missed physical contact with family and friends, and felt that contact with healthcare professionals was influenced by isolation clothes. Although some still felt isolated, the cohort department contributed to a feeling of engagement with other patients having the same illness. Conclusion Delivered care was positively experienced by patients despite the hectic outbreak period. Patients understood and adapted their preferences to the circumstances. However, patients' wellbeing was influenced by the circumstances in which care was received. To improve patients' wellbeing during isolation, recognisability of healthcare workers should be stimulated, visits from family and friends should be allowed, and no use of single-room isolation is advised.
引言 在新冠疫情极为繁忙的时期，包括隔离预防措施期间，医疗服务质量可能受到了影响。
目的 探讨在第一波疫情期间入住队列隔离护理病房的新冠患者以患者为中心的护理体验和福祉，包括急性期（2020年3月）和半急性期（2020年4月至6月）之间的差异。
方法 采用了收敛平行混合方法设计。邀请了2020年5月至9月从新冠医院病房出院六至八周后到门诊进行新冠康复治疗的成年非重症监护后患者参与。第一部分包括患者报告体验量表（PREM）问卷（n = 134），第二部分是半结构化访谈（n = 30）。进行了主题分析，并将主题与以患者为中心的护理框架的领域联系起来。
结果 第一部分：PREM所有问题的中位数得分都很高。PREM问卷得分最低的是急性期的共同决策。
与此一致，访谈还表明，大多数患者对以患者为中心的护理有积极体验，并且患者在共同决策中感到互动需求有限。此外，从访谈中了解到，护理环境领域受疫情影响最大：隔离预防措施对患者的福祉有影响，尽管他们理解隔离预防措施对保护他人的必要性。患者感到孤独，想念与家人和朋友的身体接触，并感到与医护人员的接触受到隔离服的影响。尽管有些人仍然感到孤立，但队列科室有助于患者与其他患有相同疾病患者产生一种参与感。
结论 尽管疫情爆发期间很忙乱，但患者对所提供的护理体验良好。患者理解并根据情况调整了自己的偏好。然而，患者的福祉受到接受护理的环境的影响。为了在隔离期间改善患者的福祉，应提高医护人员的可识别性，允许家人和朋友探访，不建议使用单人房间隔离。
