PDF(Pubmed)
Abstract：
BACKGROUND: The COVID-19 pandemic resulted in extreme strain on health systems including the health workforce, essential health services and vaccination coverage. We examined disruptions to immunisation and maternal and child health (MCH) services, concerns of personal well-being and delivery of healthcare during the pandemic as well as factors associated with self-reported trauma or burnout among healthcare providers (HCPs).
METHODS: In March-April 2022, we conducted a cross-sectional survey among HCPs in two provinces of Indonesia. HCPs involved in COVID-19 or routine immunisation and MCH services were randomly selected from district/city health office registration lists. We descriptively analysed service disruptions experienced by HCPs as well as trauma, burnout and concerns of personal well-being and delivery of healthcare during the pandemic. Multivariate logistic regression analyses were undertaken to identify factors associated with trauma or burnout.
RESULTS: We recruited 604 HCPs. Mobilisation of staff from routine health services to COVID-19 response duties was a key reason for service disruptions (87.9%). Strategies such as community outreach and task shifting were implemented to overcome disruptions. Trauma or burnout during the pandemic was reported by 64.1% HCPs, with 23.5% reporting worse mental or emotional health.Factors associated with trauma or burnout included delivery of COVID-19 immunisation (adjusted OR (aOR) 2.54, 95% CI 1.08 to 5.94); and delivery of both COVID-19 immunisation and routine immunisation compared with no involvement in vaccination programmes (aOR 2.42, 95% CI 1.06 to 5.52); poor treatment in the workplace (aOR 2.26, 95% CI 1.51 to 3.38) and lower confidence to respond to patient queries on COVID-19 immunisation (aOR 1.51, 95% CI 1.03 to 2.22).
CONCLUSIONS: HCPs experienced service disruptions, trauma and burnout and implemented strategies to minimise disruptions to service delivery and improve patient experiences. Our study highlights the need to ensure that workforce resilience and strategies to protect and support HCPs are considered for pandemic planning, preparedness and management.
METHODS: In March-April 2022, we conducted a cross-sectional survey among HCPs in two provinces of Indonesia. HCPs involved in COVID-19 or routine immunisation and MCH services were randomly selected from district/city health office registration lists. We descriptively analysed service disruptions experienced by HCPs as well as trauma, burnout and concerns of personal well-being and delivery of healthcare during the pandemic. Multivariate logistic regression analyses were undertaken to identify factors associated with trauma or burnout.
RESULTS: We recruited 604 HCPs. Mobilisation of staff from routine health services to COVID-19 response duties was a key reason for service disruptions (87.9%). Strategies such as community outreach and task shifting were implemented to overcome disruptions. Trauma or burnout during the pandemic was reported by 64.1% HCPs, with 23.5% reporting worse mental or emotional health.Factors associated with trauma or burnout included delivery of COVID-19 immunisation (adjusted OR (aOR) 2.54, 95% CI 1.08 to 5.94); and delivery of both COVID-19 immunisation and routine immunisation compared with no involvement in vaccination programmes (aOR 2.42, 95% CI 1.06 to 5.52); poor treatment in the workplace (aOR 2.26, 95% CI 1.51 to 3.38) and lower confidence to respond to patient queries on COVID-19 immunisation (aOR 1.51, 95% CI 1.03 to 2.22).
CONCLUSIONS: HCPs experienced service disruptions, trauma and burnout and implemented strategies to minimise disruptions to service delivery and improve patient experiences. Our study highlights the need to ensure that workforce resilience and strategies to protect and support HCPs are considered for pandemic planning, preparedness and management.
摘要：
背景：COVID-19大流行对包括卫生人力在内的卫生系统造成了极大的压力，基本卫生服务和疫苗接种覆盖率。我们检查了免疫接种和妇幼保健（MCH）服务的中断，大流行期间对个人福祉和医疗保健服务的关注，以及与医疗保健提供者(HCP)自我报告的创伤或倦怠相关的因素。
方法：在2022年3月至4月，我们对印度尼西亚两个省的HCP进行了横断面调查。参与COVID-19或常规免疫和MCH服务的HCP是从区/市卫生局登记名单中随机选择的。我们描述性地分析了HCP经历的服务中断以及创伤，大流行期间的倦怠和对个人福祉和医疗保健提供的担忧。进行多变量逻辑回归分析以确定与创伤或倦怠相关的因素。
结果：我们招募了604名HCPs。将工作人员从常规卫生服务调动到COVID-19应对职责是服务中断的关键原因(87.9%)。实施了社区外联和任务转移等战略，以克服干扰。64.1%的HCP报告了大流行期间的创伤或倦怠，23.5%的人报告精神或情绪健康状况恶化。与创伤或倦怠相关的因素包括COVID-19免疫接种（调整OR（aOR）2.54，95％CI1.08至5.94）；与未参与疫苗接种计划相比，COVID-19免疫接种和常规免疫接种的交付（aOR2.42，95％CI1.06至5.52）；工作场所治疗不良（aOR2.26，95％CI1.51至3.38），患者对免疫应答较低。
结论：HCP经历了服务中断，创伤和倦怠以及实施的策略，以最大程度地减少对服务提供的干扰并改善患者体验。我们的研究强调需要确保在大流行规划中考虑员工的应变能力以及保护和支持HCP的战略，准备和管理。
方法：在2022年3月至4月，我们对印度尼西亚两个省的HCP进行了横断面调查。参与COVID-19或常规免疫和MCH服务的HCP是从区/市卫生局登记名单中随机选择的。我们描述性地分析了HCP经历的服务中断以及创伤，大流行期间的倦怠和对个人福祉和医疗保健提供的担忧。进行多变量逻辑回归分析以确定与创伤或倦怠相关的因素。
结果：我们招募了604名HCPs。将工作人员从常规卫生服务调动到COVID-19应对职责是服务中断的关键原因(87.9%)。实施了社区外联和任务转移等战略，以克服干扰。64.1%的HCP报告了大流行期间的创伤或倦怠，23.5%的人报告精神或情绪健康状况恶化。与创伤或倦怠相关的因素包括COVID-19免疫接种（调整OR（aOR）2.54，95％CI1.08至5.94）；与未参与疫苗接种计划相比，COVID-19免疫接种和常规免疫接种的交付（aOR2.42，95％CI1.06至5.52）；工作场所治疗不良（aOR2.26，95％CI1.51至3.38），患者对免疫应答较低。
结论：HCP经历了服务中断，创伤和倦怠以及实施的策略，以最大程度地减少对服务提供的干扰并改善患者体验。我们的研究强调需要确保在大流行规划中考虑员工的应变能力以及保护和支持HCP的战略，准备和管理。
