目的:在大流行的背景下,尚未探讨公共疫苗犹豫对医护人员的影响。目前缺乏研究患者对一般疾病预防的抵抗力如何影响从业者的文献。
目标:COVID-19大流行带来了前所未有的医疗保健挑战,对医护人员的福祉产生了影响。疫苗犹豫增加了为未接种疫苗的患者提供护理的复杂性。我们的研究定性地探索了医疗机构在重症监护环境中照顾未接种疫苗的严重COVID-19感染患者的经验。
方法:我们使用基于访谈的建构主义基础理论方法来探索医疗服务提供者治疗重症未接种COVID-19患者的经验。
方法:从位于两个大型学术中心和一个社区医院的七个ICU中招募了医疗保健提供者,他们在使用严重急性呼吸道综合症冠状病毒2疫苗后照顾未接种疫苗的严重COVID-19呼吸衰竭患者。我们采访了24名参与者,由八名主治医生组成,七名注册护士,六个重症监护研究员,一位呼吸治疗师,一位理疗师,和一名社会工作者在2022年3月至2022年9月之间(加拿大提供COVID-19疫苗后约1.5年)。
方法:记录访谈,转录,去识别,并编码以识别新兴主题。对最终数据进行分析以生成主题框架。反身性被用来反思和讨论可能影响数据收集和解释的个人预先概念和意见。
结果:医疗保健提供者在提供护理期间一直致力于专业精神,以遭受大流行和COVID-19疫苗犹豫的情绪动荡为代价。不断发展的与疫苗犹豫相关的压力源包括持续大量的危重病人,资源短缺,和探视限制,这导致了感知到的情绪困扰,移情损失,专业的不满。因此,对医疗保健专业人员的个人和职业影响深远,对患者护理的感知影响。
结论:我们的研究强调了医疗保健提供者在履行专业职责方面的挣扎,同时应对疫苗犹豫所特有的情绪压力。应探索基于系统的干预措施,以帮助提供者克服偏见和道德困扰,并为下一个主要的医疗保健系统压力培养韧性。
OBJECTIVE: In the setting of an active pandemic the impact of public vaccine hesitancy on healthcare workers has not yet been explored. There is currently a paucity of literature that examines how patient resistance to disease prevention in general impacts practitioners.
OBJECTIVE: The COVID-19 pandemic created unprecedented healthcare challenges with impacts on healthcare workers\' wellbeing. Vaccine hesitancy added complexity to providing care for unvaccinated patients. Our study qualitatively explored experiences of healthcare providers caring for unvaccinated patients with severe COVID-19 infection in the intensive care setting.
METHODS: We used interview-based constructivist grounded theory methodology to explore experiences of healthcare providers with critically ill unvaccinated COVID-19 patients.
METHODS: Healthcare providers who cared for unvaccinated patients with severe COVID-19 respiratory failure following availability of severe acute respiratory syndrome coronavirus 2 vaccines were recruited from seven ICUs located within two large academic centers and one community-based hospital. We interviewed 24 participants, consisting of eight attending physicians, seven registered nurses, six critical care fellows, one respiratory therapist, one physiotherapist, and one social worker between March 2022 and September 2022 (approximately 1.5 yr after the availability of COVID-19 vaccines in Canada).
METHODS: Interviews were recorded, transcribed, de-identified, and coded to identify emerging themes. The final data was analyzed to generate the thematic framework. Reflexivity was employed to reflect upon and discuss individual pre-conceptions and opinions that may impact collection and interpretation of the data.
RESULTS: Healthcare providers maintained dedication toward professionalism during provision of care, at the cost of suffering emotional turmoil from the pandemic and COVID-19 vaccine hesitancy. Evolving sources of stress associated with vaccine hesitancy included ongoing high volumes of critically ill patients, resource shortages, and visitation restrictions, which contributed to perceived emotional distress, empathy loss, and professional dissatisfaction. As a result, there were profound personal and professional consequences for healthcare professionals, with perceived impacts on patient care.
CONCLUSIONS: Our study highlights struggles of healthcare providers in fulfilling professional duties while navigating emotional stressors unique to vaccine hesitancy. System-based interventions should be explored to help providers navigate biases and moral distress, and to foster resilience for the next major healthcare system strain.