The Influence of the COVID-19 Pandemic on Intensivists' Well-Being: A Qualitative Study.
The Influence of the COVID-19 Pandemic on Intensivists' Well-Being: A Qualitative Study.
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DOI：
10.1016/j.chest.2022.05.003
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发表时间：
2022-08
期刊：
影响因子：
9.6
通讯作者：
Mathews, Kusum S.
中科院分区：
文献类型：
--
作者：
Vranas, Kelly C.;Golden, Sara E.;Nugent, Shannon;Valley, Thomas S.;Schutz, Amanda;Duggal, Abhijit;Seitz, Kevin P.;Chang, Steven Y.;Slatore, Christopher G.;Sullivan, Donald R.;Hough, Catherine L.;Mathews, Kusum S.
关键词：
COVID-19大流行使卫生保健系统紧张，导致重症监护人员普遍短缺，对所提供的护理质量产生了负面影响。医院对大流行的应急反应如何影响一线重症监护人员的福祉，是否存在任何潜在的战略来改善他们的福祉并帮助保留重症监护人员？我们在2020年8月至11月期间对美国六个地区的三级医院和社区医院集群的重症医师进行了半结构化访谈，采用急性激增计划的“四个S”框架（即空间、人员、物资和系统）组织访谈指南。然后，我们使用归纳主题分析来确定描述医院应急响应对重症医师福祉影响的主题。来自7所三级医院和6所社区医院的33名重症医生参与了调查。重症监护医生报告说，他们经历了严重的道德困扰，特别是由于限制探视的政策及其对患者、家属和工作人员的负面影响。重症监护医师还经常报告由于他们经历过病人死亡、在大流行期间精疲力竭以及感觉到缺乏同事和医院的支持而出现的倦怠症状。我们确定了几个潜在的可修改的因素，可以提高士气，包括积极提供心理健康资源，为医生建立正式的后备计划，以及明确的行动表明临床医生受到其机构的重视。据专家报告，限制性探视政策造成了道德困境，强调需要重新考虑这些政策的风险和益处。我们还确定了重症监护医师认为的几种干预措施，这些干预措施可能有助于减轻道德困扰，改善倦怠，作为保护重症监护人员的一部分。
The COVID-19 pandemic has strained health care systems and has resulted in widespread critical care staffing shortages, negatively impacting the quality of care delivered. How have hospitals’ emergency responses to the pandemic influenced the well-being of frontline intensivists, and do any potential strategies exist to improve their well-being and to help preserve the critical care workforce? We conducted semistructured interviews of intensivists at clusters of tertiary and community hospitals located in six regions across the United States between August and November 2020 using the “four S” framework of acute surge planning (ie, space, staff, stuff, and system) to organize the interview guide. We then used inductive thematic analysis to identify themes describing the influence of hospitals’ emergency responses on intensivists’ well-being. Thirty-three intensivists from seven tertiary and six community hospitals participated. Intensivists reported experiencing substantial moral distress, particularly because of restricted visitor policies and their perceived negative impacts on patients, families, and staff. Intensivists also frequently reported burnout symptoms as a result of their experiences with patient death, exhaustion over the pandemic’s duration, and perceived lack of support from colleagues and hospitals. We identified several potentially modifiable factors perceived to improve morale, including the proactive provision of mental health resources, establishment of formal backup schedules for physicians, and clear actions demonstrating that clinicians are valued by their institutions. Restrictive visitation policies contributed to moral distress as reported by intensivists, highlighting the need to reconsider the risks and benefits of these policies. We also identified several interventions as perceived by intensivists that may help to mitigate moral distress and to improve burnout as part of efforts to preserve the critical care workforce.
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影响因子：
9.6
作者：
Azoulay E;Pochard F;Reignier J;Argaud L;Bruneel F;Courbon P;Cariou A;Klouche K;Labbé V;Barbier F;Guitton C;Demoule A;Kouatchet A;Guisset O;Jourdain M;Papazian L;Van Der Meersch G;Reuter D;Souppart V;Resche-Rigon M;Darmon M;Kentish-Barnes N;FAMIREA Study Group
通讯作者：
FAMIREA Study Group
DOI：
10.1097/phh.0000000000001320
发表时间：
2022-01-01
影响因子：
3.3
作者：
Jaswaney, Rohit;Davis, Arlene;Joyner, Benny L., Jr.
通讯作者：
Joyner, Benny L., Jr.
DOI：
10.1164/rccm.201604-0708st
发表时间：
2016-07-01
影响因子：
24.7
作者：
Moss, Marc;Good, Vicki S.;Sessler, Curtis N.
通讯作者：
Sessler, Curtis N.
影响因子：
3.8
作者：
Elo, Satu;Kyngaes, Helvi
通讯作者：
Kyngaes, Helvi
影响因子：
3.3
作者：
Anzaldua, Adrian;Halpern, Jodi
通讯作者：
Halpern, Jodi