Hedin Erin, Nicholas David B, Mantulak Andrew, Tonelli Marcello, Zulla Rosslynn T, Alexander R Todd
Faculty of Medicine and Dentistry, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada.
Can J Kidney Health Dis. 2025 Jul 27;12:20543581251355024. doi: 10.1177/20543581251355024. eCollection 2025.
The COVID-19 pandemic significantly disrupted health care delivery; however, limited research attention has addressed the impacts of the pandemic specifically on renal-based health care.
The aim of the study was to understand the health and psychosocial impacts of the COVID-19 pandemic on care delivery as well as on health care providers (HCPs).
A qualitative Interpretive Description approach was used.
Participants were recruited from kidney care units in Alberta and Ontario, Canada.
46 interdisciplinary HCPs providing kidney care during the pandemic participated in the study. Participants comprised pediatric (n=9) and adult (n=37) HCPs.
Qualitative focus groups were facilitated. They were conducted using Zoom (Version 6.3.11).
Research results indicated substantial strain on patients and HCPs during the COVID-19 pandemic, including mental health difficulties. For HCPs, moral distress was experienced from witnessing negative impacts of the pandemic and care shifts on patients. HCPs were further deleteriously affected by staffing shortages, facility limitations due to care interruptions and resource gaps in health and community systems. Conversely, participants identified concurrent benefits from pandemic-related shifts such as the rapid transition to virtual care. While virtual care imposed challenges for physical assessment of patients, patient convenience and increased access to HCPs were noted. With training, support and experience, HCPs and patients reported an appreciation for communication offered by virtual care where appropriate. Supportive unit leaders and peer support from HCP colleagues were viewed to make this difficult experience of the pandemic more manageable. HCPs drew strength in being able to support their patients despite the difficulties of the pandemic.
Firsthand experiences of patients and families were not offered in this article, although their perspectives were elicited in another arm of this study. A more specific focus on pediatric versus adult systems of care, and the impacts of the pandemic on various disciplines, would add depth to understanding the unique impacts of the pandemic on various areas of care and across disciplines.
Study results call for the advancement of clinical care and heightened consideration of HCP needs in a pandemic. Included recommendations are ensuring sufficient resources, prudent use of communication technology, and optimizing support to HCPs.
2019年冠状病毒病（COVID-19）大流行严重扰乱了医疗服务的提供；然而，针对该大流行对肾脏相关医疗保健的具体影响的研究关注有限。
本研究的目的是了解COVID-19大流行对医疗服务提供以及医疗保健提供者（HCPs）的健康和心理社会影响。
采用定性解释性描述方法。
参与者从加拿大艾伯塔省和安大略省的肾脏护理单位招募。
46名在大流行期间提供肾脏护理服务的跨学科HCPs参与了本研究。参与者包括儿科（n = 9）和成人（n = 37）HCPs。
组织了定性焦点小组讨论。使用Zoom（版本6.3.11）进行。
研究结果表明，在COVID-19大流行期间，患者和HCPs承受了巨大压力，包括心理健康问题。对于HCPs来说，目睹大流行和护理转变对患者的负面影响会产生道德困扰。人员短缺、护理中断导致的设施限制以及健康和社区系统中的资源缺口进一步对HCPs产生了有害影响。相反，参与者发现与大流行相关的转变带来了一些好处，比如迅速转向虚拟护理。虽然虚拟护理给患者的身体评估带来了挑战，但注意到它为患者提供了便利，增加了患者与HCPs的接触机会。通过培训、支持和经验积累，HCPs和患者表示在适当情况下对虚拟护理提供的沟通表示赞赏。支持性的科室领导以及HCP同事之间的同伴支持被认为使大流行期间这段艰难经历更易于应对。尽管大流行带来诸多困难，HCPs仍能为患者提供支持，从中汲取力量。
本文未呈现患者和家庭的第一手经历，尽管在本研究的另一部分中收集了他们的观点。更具体地关注儿科与成人护理系统，以及大流行对各个学科的影响，将有助于更深入地理解大流行对不同护理领域和跨学科领域的独特影响。
研究结果呼吁在大流行期间推进临床护理，并更多地考虑HCPs的需求。包括确保充足资源、谨慎使用通信技术以及优化对HCPs的支持等建议。
