COVID-19大流行期间延迟非紧急手术对艾伯塔省外科医生的影响:一项定性访谈研究

CMAJ open Pub Date : 2023-07-01 DOI:10.9778/cmajo.20220188
Natalia Jaworska, Emma Schalm, Jaling Kersen, Christine Smith, Jennifer Dorman, Mary Brindle, Joseph Dort, Khara M Sauro
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摘要

背景:在COVID-19大流行期间,非紧急手术被推迟,以保留收治COVID-19患者的能力;外科医生在这段时间受到了个人和专业的挑战。我们旨在从艾伯塔省外科医生的角度描述COVID-19大流行期间非紧急手术延误的影响。方法:我们于2022年1月至3月在阿尔伯塔省进行了解释性描述定性研究。我们通过社交媒体和我们研究网络中的个人联系招募了成人和儿科外科医生。通过Zoom进行半结构化访谈,我们通过归纳主题分析来分析数据,以确定延迟非紧急手术对外科医生及其提供外科护理的影响的相关主题和子主题。结果:对9名成人外科医生和3名儿科外科医生进行了12次访谈。确定了六个主题:加速外科护理危机、卫生系统不公平、系统层面对外科服务中断的管理、专业和专业间影响、个人影响以及对卫生系统压力的务实适应。与会者还确定了减轻因COVID-19大流行期间非紧急手术延误所带来的挑战的战略(即,增加手术时间,审查手术流程以减少效率低下,以及倡导持续为医院床位、人力资源和社区术后护理提供资金)。解释:我们的研究描述了成人和儿科外科医生因COVID-19大流行应对而延迟的非紧急手术所经历的影响和挑战。外科医生确定了潜在的卫生系统、医院和医生层面的策略,以尽量减少非紧急手术延误对患者的未来影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The impact of delayed nonurgent surgery during the COVID-19 pandemic on surgeons in Alberta: a qualitative interview study.

Background: During the COVID-19 pandemic, nonurgent surgeries were delayed to preserve capacity for patients admitted with COVID-19; surgeons were challenged personally and professionally during this time. We aimed to describe the impact of delays to nonurgent surgeries during the COVID-19 pandemic from the surgeons' perspective in Alberta.

Methods: We conducted an interpretive description qualitative study in Alberta from January to March 2022. We recruited adult and pediatric surgeons via social media and through personal contacts from our research network. Semistructured interviews were conducted via Zoom, and we analyzed the data via inductive thematic analysis to identify relevant themes and subthemes related to the impact of delaying nonurgent surgery on surgeons and their provision of surgical care.

Results: We conducted 12 interviews with 9 adult surgeons and 3 pediatric surgeons. Six themes were identified: accelerator for a surgical care crisis, health system inequity, system-level management of disruptions in surgical services, professional and interprofessional impact, personal impact, and pragmatic adaptation to health system strain. Participants also identified strategies to mitigate the challenges experienced due to nonurgent surgical delays during the COVID-19 pandemic (i.e., additional operating time, surgical process reviews to reduce inefficiencies, and advocacy for sustained funding of hospital beds, human resources and community-based postoperative care).

Interpretation: Our study describes the impacts and challenges experienced by adult and pediatric surgeons of delayed nonurgent surgeries because of the COVID-19 pandemic response. Surgeons identified potential health system-, hospital- and physician-level strategies to minimize future impacts on patients from delays of nonurgent surgery.

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