COVID-19 大流行对使用无创通气的儿童的影响:对护理人员回答调查研究的专题分析

Lauren Dobson, Ella Milne, Heather Halperin, Deborah Olmstead, Shannon D. Scott, M. Castro-Codesal
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摘要

COVID-19 大流行给人们的生活带来了巨大的变化,对于患有慢性疾病的人来说更是如此,比如患有慢性呼吸系统疾病、需要家庭无创通气的儿童。我们的研究问题是在 2020 年 9 月至 2021 年 9 月期间,我们对在加拿大艾伯塔省斯托勒里儿科 NIV 项目中使用家庭 NIV 的儿科患者的护理人员进行了匿名在线调查。为确定新出现的主题,我们进行了主题分析:确定了四个主题:(1) 积极影响;(2) 消极影响;(3) 中性影响;(4) 对坚持 NIV 的影响。55 位受访者(回复率为 57%)报告了 COVID-19 对儿童和家庭的影响。积极影响包括生活节奏放慢、家庭时间增多、急性呼吸道疾病复发减少。负面影响包括增加了父母的焦虑、延长了社会隔离,超出了强加的限制,以及获得医疗用品的机会有限。尽管存在这些负面影响,但 90% 的受访者表示,他们的孩子仍能适当维持甚至增加使用 NIV。COVID-19 对使用 NIV 的儿童的生活造成了不同程度的影响,这一点与普通人群并无二致。然而,负面影响似乎在这些依赖技术的儿童中加剧。然而,在 COVID-19 期间,坚持使用 NIV 被家庭列为优先事项,甚至有所增加。还需要进一步的研究来分析专业护理虚拟模式的潜在益处。
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Impact of COVID-19 pandemic in children using non-invasive ventilation: a thematic analysis of caregivers answers to a survey study
The COVID-19 pandemic has resulted in drastic changes in people's lives, more so in individuals with chronic conditions, such as children with chronic respiratory disorders requiring home non-invasive ventilation. Our research question was: How has the COVID-19 pandemic affected the daily lives of children using home NIV and their families and their NIV adherence?An anonymous online survey was administered to caregivers of pediatric patients using home NIV followed at the Stollery's Pediatric NIV Program in Alberta, Canada, between September 2020 and September 2021. Thematic analysis was conducted for the identification of emerging themes.Four themes were identified: (1) positive effects, (2) negative effects, (3) neutral effects, and (4) impact on NIV adherence. Effects of COVID-19 on children and families were reported by 55 respondents (57% response rate). Positive effects included a slower lifestyle, more family time, and less recurrent acute respiratory illness. Negative effects included increased parental anxiety, prolonged social isolation beyond imposed restrictions, and limited access to health supplies. Despite these negative effects, 90% of respondents reported adequate maintenance or even increases in their child's NIV use. A general sense of benefit in the virtual specialized care model was also highlighted.COVID-19 resulted in varying levels of impact on the lives of children using NIV, not unlike the general population. Negative effects, however, appeared to intensify in these technology-dependent children. NIV adherence, however, was prioritized by families and even increased during COVID-19. Further research is needed to analyse the potential benefits of virtual models of specialized care.
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