Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic: A Qualitative Analysis.
Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic: A Qualitative Analysis.
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DOI：
10.1001/jamanetworkopen.2021.18425
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发表时间：
2021-07-01
影响因子：
13.8
通讯作者：
Abbey SE
中科院分区：
文献类型：
--
作者：
Berkhout SG;Sheehan KA;Abbey SE
随着COVID-19大流行的演变，加拿大医护人员的担忧范围和痛苦来源是什么？在这项针对一所大学健康网络的21 555名员工的公共在线COVID-19论坛的定性研究中，与大流行有关的常见问题包括污染风险、适当的个人防护设备和工人安全。虽然这些问题表现为个人的痛苦，他们也符合并反映了有关医疗机构的政策，沟通的做法，和政治的关注。研究结果表明，关注的机构来源和个人层面的干预措施之间的不匹配可能会影响心理健康支持的摄取，即使痛苦的水平仍然很高。据报道，在大流行期间，特别是在COVID-19大流行期间，卫生保健工作者（HCW）的心理健康和应对困难。研究2019冠状病毒病大流行期间加拿大医护人员的痛苦和担忧来源。在这项定性研究中，通过在线员工论坛对HCWs在2020年3月16日至2020年12月1日期间向医院高级领导提出的问题进行了批判性话语分析，作为加拿大最大的医疗机构之一的HCWs阶梯式护理心理健康支持计划的更大混合方法评估的一部分。大学健康网络的21 555名员工中的任何一名都可以在COVID-19虚拟论坛之前在线匿名提交问题，工作人员可以通过投票来匿名支持问题，表明已经提出的问题是感兴趣的。主题，文本结构和修辞手段中使用的问题进行了分析，考虑到他们更大的机构和社会背景。在研究期间，论坛的独特个人观点从2062到7213不等。与感染风险相关的主要个人层面的担忧以及应对因大流行而增加的工作量的挑战与机构层面的挑战相结合，例如在医疗保健环境中的感受或被重视以及长期存在的不同类型的医务工作者之间的分层。经常报告的关切是，要求机构领导人澄清或要求透明度。这项定性研究的结果表明，更大的机构层面和结构性的问题需要得到解决，如果HCWs是从事支持和应对方案。潜在的服务使用者可能会被劝阻，不认为他们的需求是通过工作场所的心理健康干预措施得到满足的，这些干预措施只涉及个人层面的问题。此定性分析使用一家大型医疗机构员工可使用的在线COVID-19论坛，以研究COVID-19大流行期间加拿大医护人员的痛苦和担忧来源。
What have been the range of concerns and the sources of distress among health care workers in Canada as the COVID-19 pandemic has evolved? In this qualitative study of a public online COVID-19 forum available for 21 555 employees in a university health network, common concerns relating to the pandemic included risks of contamination, appropriate personal protective equipment, and worker safety. Although these concerns manifested as individual distress, they also intersected with and were reflective of concerns relating to health care institutions’ policies, communication practices, and politics. The findings suggest that a mismatch between institutional sources of concern and individual-level interventions may affect the uptake of mental health supports even as the level of distress remains high. Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic. To examine sources of distress and concern for HCWs in Canada during the COVID-19 pandemic. In this qualitative study, a critical discourse analysis was performed of questions posed by HCWs to hospital senior leadership between March 16, 2020, and December 1, 2020, through an online employee forum as part of a larger mixed-methods evaluation of a stepped-care mental health support program for HCWs at 1 of Canada’s largest health care institutions. Questions could be submitted online anonymously in advance of the virtual forums on COVID-19 by any of the University Health Network’s 21 555 employees, and staff members were able to anonymously endorse questions by upvoting, indicating that an already posed question was of interest. Themes, text structure, and rhetorical devices used within the questions were analyzed, taking into consideration their larger institutional and societal context. Unique individual views of the forums ranged from 2062 to 7213 during the study period. Major individual-level concerns related to risks of contamination and challenges coping with increased workloads as a result of the pandemic intersected with institutional-level challenges, such as feeling or being valued within the health care setting and long-standing stratifications between types of HCWs. Concerns were frequently reported in terms of calls for clarity or demands for transparency from the institutional leadership. The findings of this qualitative study suggest that larger institutional-level and structural concerns need to be addressed if HCWs are to be engaged in support and coping programs. Potential service users may be dissuaded from seeing their needs as being met by workplace mental health interventions that solely relate to individual-level concerns. This qualitative analysis uses an online COVID-19 forum available to employees at a large health care institution to examine sources of distress and concern for health care workers in Canada during the COVID-19 pandemic.
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