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Basic Needs of the First Batch of Medical Staff in the Fever Clinic of Peking Union Medical College Hospital during Coronavirus Disease 2019 Outbreak: A Qualitative Study
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摘要:
目的 探讨新型冠状病毒肺炎疫情期间发热门诊医务人员的基本需求，为全球抗疫医疗队提供借鉴。 方法 设计半结构式定性访谈提纲，包括：(1)工作层面：发热门诊工作时间、工作强度和安全保障; (2)生活层面：饮食、睡眠和身体舒适度; (3)心理层面：情绪、压力、应对方式和人际资源等开放式问题。采取整群抽样方法对北京协和医院首批发热门诊医务人员的基本需求进行开放式电话访谈。 结果 共37名医务人员接受访谈，其中男性8人(21.6%)，女性29人(78.4%); 医生16人(43.2%)，护士19人(51.4%)，医技2人(5.4%)。工作层面，建议抗疫一线医务人员的连续工作时间为4~6 h，可设定备班岗应对不同工作强度，应准备充足的防护物资以保障其生命安全; 生活层面，根据班次时间提供工作餐是保证饮食的关键，提供临时助眠药可保证其充分的休息; 心理层面，医务人员的紧张、担忧等负面情绪反应较常见，家人和同伴支持是重要资源，运动有助于缓解身体不适和不良情绪，心理支持有助于减轻医务人员的情绪反应。 结论 满足发热门诊医务人员的基本需求对疫情防控意义重大，保证医务人员得到充分休息，提供足够的防护物资，合理安排饮食和运动，同时关注其心理状态并主动提供心理支持是取得抗击新型冠状病毒肺炎疫情胜利的保障。 Abstract:Objective The objective of this study was to investigate the basic needs of medical staff during the coronavirus disease 2019 pandemic in a fever clinic, so as to provide a reference for the global epidemic medical teams. Methods A semi-structured qualitative interview outline was designed, including: (1) work level: working hours, working intensity, and safety guarantee in a fever clinic; (2)life level: diet, sleep, and physical comfort; (3)psychological level: emotion, pressure, coping style, and interpersonal resources. The basic needs of the first batch of the fever clinic in Peking Union Medical College Hospital was studied by open telephone interviews. Results A total of 37 medical staff were interviewed, including 8 males (21.6%) and 29 females (78.4%). Among them, there were 16 doctors (43.2%), 19 nurses (51.4%), and 2 medical technicians (5.4%). In terms of work settings, the ideal continuous working time was 4-6 hours per shift. There should be pro re nata positions during extremely high workload, and sufficient personal protective equipment was the key to safety. In terms of living conditions, providing meals according to different shifts was important for dietary needs, and sleeping pills were temporarily needed for sleep. In terms of psychological reactions, nervousness and worrying were relatively common. Family and colleagues were important resources of support. Sport could help relieve physical and psychological stress, and psychological support from psychologists was helpful in reducing their negative emotions. Conclusions The basic needs of medical staff should be respected so as to keep the efficacy of their work. We suggest that medical staff can rest after each 4-6 h working shift. Personal protective equipment should be sufficient. Psychological support should be noted in all of them and provided when necessary. -
Key words:
- coronavirus diseas 2019 /
- fever clinic /
- medical staff /
- basic needs /
- psychological support
利益冲突 无 -
表 1 新冠肺炎疫情期间首批发热门诊医务人员工作层面现状
工作类别 医务人员 医生(n=16) 护士(n=19) 医技(n=2) 工作时间 从12 h/d逐步调整为8 h/d，目前调整为工作4 h后休息4 h，每天工作8 h 从12 h/d逐步调整为工作6 h后休息6 h，目前调整为工作4 h后休息工作4 h，每天工作8 h 3人轮替，每天工作8 h 工作强度 不稳定，工作强度最大时接诊患者10例/h 工作强度大，负责的工作种类多，解释工作较多，每天管理近200例患者 可承受 安全保障 安全之处 有专人负责监督; 二级防护规范，工作流程清晰，区域分配合理 有专职督导岗，负责监督穿脱防护服; 先培训后上岗; 分区合理 定期消毒 不安全之处 防护物资不足; 有护目镜“起雾”、防护面屏模糊现象; 抢救人力和设备不足 空间较小; 物质不足，缺少隔离服，防护服不合身 无 
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表 2 新冠肺炎疫情期间首批发热门诊医务人员生活层面现状
生活类别 医务人员 医生(n=16) 护士(n=19) 医技(n=2) 食欲 18.9%(3/16)报告“一般” 21.1%(4/19)报告“食欲差、恶心、没有胃口”，15.8%(3/19)报告“一般、还行” 报告“还行” 睡眠 31.3%(5/16)报告“睡眠质量欠佳”，如易醒、多梦等，6.3%(1/16)报告“入睡困难” 26.3%(5/19)报告“入睡困难”，31.6%(6/19)报告“易醒” 报告“挺好” 身体舒适度 6.3%(1/16)报告“累、疲乏”，6.3%(1/16)报告“嗓子疼”，12.5%(2/16)报告“咳嗽”，12.5%(2/16)报告“肩颈部疼痛” 15.9%(3/19)报告“劳累、疲倦”，31.6%(6/19)报告“腰背酸痛”，5.3%(1/19)报告“头痛，恶心”，5.3%(1/19)报告“尿频、出现皮疹” 未报告躯体不适
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表 3 新冠肺炎疫情期间首批发热门诊医务人员心理层面现状
心理类别 医务人员 医生(n=16) 护士(n=19) 医技(n=2) 情绪 6.3%(1/16)报告“感到紧张” 52.6%(10/19)报告“感到紧张、担心、委屈或自责” 报告“挺好” 压力来源 牵挂家人、担心被感染、担心感染家人和同事; 感到临床经验不足; 担心伤医事件等 应对方式 与家人视频、电话聊天; 与上级领导、同事沟通和聊天; 自我调节，如运动、唱歌、写日记、看视频、倾诉等 人际资源 家人、领导、老师、同学、同事等
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