The impact of delaying surgery during the COVID-19 pandemic in Alberta: a qualitative study.

CMAJ open Pub Date : 2023-01-01 DOI:10.9778/cmajo.20210330
Khara M Sauro, Christine Smith, Jaling Kersen, Emma Schalm, Natalia Jaworska, Pamela Roach, Sanjay Beesoon, Mary E Brindle
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引用次数: 3

Abstract

Background: The COVID-19 pandemic overwhelmed health care systems, leading many jurisdictions to reduce surgeries to create capacity (beds and staff) to care for the surge of patients with COVID-19; little is known about the impact of this on patients whose surgery was delayed. The objective of this study was to understand the patient and family/caregiver perspective of having a surgery delayed during the COVID-19 pandemic.

Methods: Using an interpretative descriptive approach, we conducted interviews between Sept. 20 and Oct. 8, 2021. Adult patients who had their surgery delayed or cancelled during the COVID-19 pandemic in Alberta, Canada, and their family/caregivers were eligible to participate. Trained interviewers conducted semistructured interviews, which were iteratively analyzed by 2 independent reviewers using an inductive approach to thematic content analysis.

Results: We conducted 16 interviews with 15 patients and 1 family member/caregiver, ranging from 27 to 75 years of age, with a variety of surgical procedures delayed. We identified 4 interconnected themes: individual-level impacts on physical and mental health, family and friends, work and quality of life; system-level factors related to health care resources, communication and perceived accountability within the system; unique issues related to COVID-19 (maintaining health and isolation); and uncertainty about health and timing of surgery.

Interpretation: Although the decision to delay nonurgent surgeries was made to manage the strain on health care systems, our study illustrates the consequences of these decisions, which were diffuse and consequential. The findings of this study highlight the need to develop and adopt strategies to mitigate the burden of waiting for surgery during and after the COVID-19 pandemic.

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阿尔伯塔省COVID-19大流行期间延迟手术的影响:一项定性研究
背景:COVID-19大流行使卫生保健系统不堪重负,导致许多司法管辖区减少手术,以创造能力(床位和工作人员)来照顾激增的COVID-19患者;对于手术被推迟的病人来说,这对他们的影响知之甚少。本研究的目的是了解在COVID-19大流行期间延迟手术的患者和家属/护理人员的观点。方法:采用解释性描述性方法,于2021年9月20日至10月8日进行访谈。在加拿大阿尔伯塔省COVID-19大流行期间延迟或取消手术的成年患者及其家人/护理人员有资格参加。训练有素的采访者进行半结构化访谈,由2名独立审稿人使用归纳方法对主题内容进行迭代分析。结果:我们对15名患者和1名家庭成员/照顾者进行了16次访谈,年龄从27岁到75岁不等,延迟了各种手术。我们确定了4个相互关联的主题:个人层面对身心健康、家庭和朋友、工作和生活质量的影响;与卫生保健资源、沟通和系统内可感知的问责制有关的系统级因素;与COVID-19相关的独特问题(保持健康和隔离);健康和手术时机的不确定性。解释:虽然推迟非紧急手术的决定是为了管理医疗保健系统的压力,但我们的研究说明了这些决定的后果,这些决定是分散的和重要的。本研究结果强调,有必要制定和采取战略,减轻COVID-19大流行期间和之后等待手术的负担。
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