The Challenges of Caring for People Dying From COVID-19: A Multinational, Observational Study (CovPall).
The Challenges of Caring for People Dying From COVID-19: A Multinational, Observational Study (CovPall).
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关心Covid-19死亡的人的挑战：一项跨国，观察性研究（Covpall）。
DOI：
10.1016/j.jpainsymman.2021.01.138
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发表时间：
2021-09
影响因子：
4.7
通讯作者：
CovPall study team
中科院分区：
文献类型：
--
作者：
Oluyase AO;Hocaoglu M;Cripps RL;Maddocks M;Walshe C;Fraser LK;Preston N;Dunleavy L;Bradshaw A;Murtagh FEM;Bajwah S;Sleeman KE;Higginson IJ;CovPall study team
有关新冠肺炎患者死亡护理的系统数据很少。了解新冠肺炎疫情期间姑息关怀服务的反应和面临的挑战，并确定相关因素。我们调查了姑息治疗和临终关怀服务，并通过相关组织进行了联系。多变量Logistic回归确定了与挑战的关联。内容分析探索了自由文本的回应。共有458家服务机构做出回应；277个英国、85个欧洲其他地区、95个世界其他地区；81%护理疑似或确诊新冠肺炎患者，77%有疑似或确诊新冠肺炎患者的工作人员；48%报告个人防护装备短缺，40%人手短缺，24%药品短缺，14%其他设备短缺。服务提供症状管理和沟通方面的直接护理和教育；91%的服务改变了他们的工作方式。护理通常转向增加社区和医院护理，住院姑息护理单位的入院人数较少。与PPE短缺风险增加相关的因素有：慈善机构而不是公共管理机构(OR 3.07，95%CI 1.81-5.20)，住院姑息治疗单位而不是其他环境(OR 2.34，95%CI 1.46-3.75)。在英国以外的地区与员工短缺的几率较低(OR为0.44，95%CI为0.26-0.76)。工作人员描述了工作量的增加，对生病的同事的担忧，同时花费时间努力获得必要的设备和药品，因为他们认为这不是一线服务。姑息治疗服务往往不堪重负，但在新冠肺炎的回应中却感到被忽视了。在规划和应对未来的流行病/大流行时，姑息治疗需要更好地与卫生保健系统相结合。
Systematic data on the care of people dying with COVID-19 are scarce. To understand the response of and challenges faced by palliative care services during the COVID-19 pandemic, and identify associated factors. We surveyed palliative care and hospice services, contacted via relevant organizations. Multivariable logistic regression identified associations with challenges. Content analysis explored free text responses. A total of 458 services responded; 277 UK, 85 rest of Europe, 95 rest of the world; 81% cared for patients with suspected or confirmed COVID-19, 77% had staff with suspected or confirmed COVID-19; 48% reported shortages of Personal Protective Equipment (PPE), 40% staff shortages, 24% medicines shortages, 14% shortages of other equipment. Services provided direct care and education in symptom management and communication; 91% changed how they worked. Care often shifted to increased community and hospital care, with fewer admissions to inpatient palliative care units. Factors associated with increased odds of PPE shortages were: charity rather than public management (OR 3.07, 95% CI 1.81–5.20), inpatient palliative care unit rather than other settings (OR 2.34, 95% CI 1.46–3.75). Being outside the UK was associated with lower odds of staff shortages (OR 0.44, 95% CI 0.26–0.76). Staff described increased workload, concerns for their colleagues who were ill, whilst expending time struggling to get essential equipment and medicines, perceiving they were not a front-line service. Palliative care services were often overwhelmed, yet felt ignored in the COVID-19 response. Palliative care needs better integration with health care systems when planning and responding to future epidemics/pandemics.
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影响因子：
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通讯作者：
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