摘要
目的了解我国基层医疗卫生机构对新型冠状病毒肺炎(新冠肺炎)防控工作的情况及存在的困难,为下一步基层防控工作和应对未来公共卫生疫情提供借鉴。方法 2020年2月6—16日,采用目的抽样方法,在来自全国不同等级医疗卫生机构从事全科医学领域的医务人员微信群中招募疫情期间在基层医疗卫生机构参与新冠肺炎防控工作的全科医生、管理者、辅助科室医生等人员共30名为研究对象,采用线上个人访谈的方式进行资料收集。访谈提纲包括:(1)在此次疫情中承担的工作;(2)抗疫过程中面临的困难与挑战;(3)对本次疫情防控工作的看法;(4)对未来疾病疫情防控的建议。应用NVivo 12.0软件,采用主题框架分析法对资料进行整理和分析,提炼访谈主题。结果基于访谈资料共提炼出6个主题:(1)基层医疗卫生机构根据抗疫工作需要进行工作部署,但工作分配和防控流程不完善,全科医生工作量较大;(2)基层医疗卫生机构开展预检分诊工作,全科门诊持续开放,积极推进线上诊疗、咨询,以减少人员流动及接触;(3)全科医生发挥专业技术优势,深入参与联防联控工作;(4)全科医生开展多种形式的健康教育活动,提高居民防护意识;(5)基层全科医生能力不足,需要加强培训,但目前培训有时流于形式;(6)基层用于防护和诊疗的物资不足,全科医生担心自身感染风险增加。基层医生在疫情期间承担了社区管理、门诊诊疗、联防联控和健康教育等工作,同时存在物资不足,能力不足等问题。结论基层医生在新冠肺炎防控中发挥重要的作用,建议进一步规范基层医疗卫生机构预检分诊和发热门诊等的设置,加强基层医生传染病防控知识培训。
Objective To analyze the status of prevention and control of COVID-19 in primary care institutions at the early stage of the epidemic.Methods Thirty healthcare professionals from various places of China were recruited in the study from 6thto 16th February 2020 through WeChat platform advertising and by purposive sampling method.They were general practitioners(GPs),administrators,and other specialists,all of whom were involved in the prevention and control of COVID-19.Personal interview and focus group discussion were conducted online.The topic guide was as follows:(1)Introduction of the work that primary healthcare professionals carried out during the outbreak of COVID-19.(2)Difficulties and challenges that healthcare professionals encountered.(3)Opinions on the prevention and control of COVID-19.(4)Advices on future outbreak of similar epidemics or disease.NVivo 12 software system was used to code and classify the interview content,and thematic framework analysis was used to sort out and analyze the data and extract the interview themes.Results Six themes were extracted:(1)The community hospital leaders led the work in time but job distribution and prevention procedures were insufficient;and the workload of GPs was heavy.(2)Primary care settings had carried out pre-screening and triage;while outpatient clinic continued to provide health care service for local residents,especially stressing online service and consultation to reduce the population mobility.(3)GPs should make full use of technical advantages and participate in joint prevention and control.(4)GPs offered various health education to residents to improve their awareness of self-protection.(5)GPs lacked professional skills and needed more related training,while the current training were still insufficient.(6)There were not enough supplies and GPs had increasing worries about the infection risks.Conclusions GPs play an important role in effectively curbing the spread of the epidemic.It is suggested that the setting of triage and fever clinic in primary care institutions need to be readjusted;and the training of prevention and control knowledge and skill for GPs need to be strengthened in the future.
作者
逄慧
刘妍萌
姚弥
迟春花
Pang Hui;Liu Yanmeng;Yao Mi;Chi Chunhua(Department of General Practice,Peking University First Hospital,Beijing 100034,China;Department of General Practice,Aerospace Central Hospital,Beijing 100049,China;Institute of Applied Health Research,University of Birmingham,Birmingham B152TT,UK)
出处
《中华全科医师杂志》
2021年第4期446-451,共6页
Chinese Journal of General Practitioners
关键词
冠状病毒感染
新型冠状病毒肺炎
定性研究
基层
Coronavirus infection
Coronavirus disease 2019
Qualitative research
Primary care
作者简介
通信作者:迟春花,Email:chichunhua2012@qq.com。
