Patient Perceptions on Barriers and Facilitators to Accessing Low-acuity Surgery During COVID-19 Pandemic.
Patient Perceptions on Barriers and Facilitators to Accessing Low-acuity Surgery During COVID-19 Pandemic.
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DOI：
10.1016/j.jss.2021.01.028
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Roman SA
中科院分区：
文献类型：
--
作者：
Johnson CL;Schwartz H;Greenberg A;Hernandez S;Nnamani Silva ON;Wong LE;Martins DB;Broering JM;Kumar SB;Bongiovanni T;Wick EC;Roman SA
COVID-19 大流行的爆发导致低敏锐度外科手术被推迟，以节省资源并确保患者安全。这项研究旨在描述患者报告的对大流行期间接受外科手术的担忧。我们对在大流行开始时推迟普通外科手术和整形外科手术的患者进行了一项横断面调查，询问获得外科护理的障碍。问题涉及家属护理、交通、就业和保险状况，以及对 COVID-19 的看法和担忧。进行了混合方法和归纳主题分析。一百三十五名患者接受了采访。我们确定了以下患者担忧的问题：在医院感染 COVID-19（46%）、住院期间独自一人（40%）、面临经济压力（29%）、组织交通（28%）、经历健康保险覆盖范围的变化（25%）以及安排家属护理（18%）。非白人参与者担心儿童保育和交通的可能性分别高出 5 倍和 2.5 倍。由于认为医院安全性下降以及可能感染 COVID-19 的后果，导致重新安排时间被推迟。有关安全措施的教育和有关日程安排的沟通部分缓解了人们对 COVID-19 的担忧。然而，重新安排和解决大流行的时间表的不确定性加剧了持续的担忧。在这个前所未有的时期提供有效的外科护理需要认识到影响外科患者的社会变化以及系统层面的变革以解决新的护理障碍。应将征求患者的观点、调整流程以解决潜在障碍以及有效地教育患者了解尽量减少 COVID-19 院内传播的制度措施等措施纳入外科护理中。
The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted. One hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns. Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients’ perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
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