在公共卫生紧急情况期间,为医护人员提供道德困扰和保护性的工作环境
K Bondjers1, Alve K Glad2, H Wøien3
1Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway. kristina.bondjers@nkvts.no.
BMC medical ethics
|October 1, 2024
概括
在COVID-19大流行期间,医疗保健工作者经历了道德挑战性情况 (ECS),导致道德困境. 改善工作负载管理和遵守最佳实践可以减轻这些影响.
科学领域:
- 公共卫生 公共卫生
- 职业健康 职业健康 职业健康
- 医学伦理 医学伦理
背景情况:
- 像COVID-19这样的公共卫生紧急情况对医疗保健工作者 (HCW) 造成了巨大的压力,增加了道德上具有挑战性的情况 (ECS).
- 在危机期间,经历ECS对于HCW来说往往是不可避免的,需要对诸如道德困境等不良影响采取缓解策略.
- 工作环境因素被确定为减轻ECS对HCW负面影响的潜在途径.
研究的目的:
- 在疫情期间,确定与在HCW中经历ECS相关的风险因素.
- 评估与ECS相关的道德痛苦的强度,跨不同职业因素,包括职业和COVID-19患者暴露.
- 调查工作环境因素对ECS和HCW中的道德痛苦之间的关系的影响.
主要方法:
- 使用多重逻辑和线性回归分析.
- 收集了来自挪威四家医院的977名HCW的自我报告数据.
- 在COVID-19大流行第四波期间进行的调查.
主要成果:
- 大约50%的HCW报告经历了ECS;道德困境水平高于之前的研究.
- 年龄较小,女性性别,特定的地理区域,护士职业和与COVID-19患者直接接触与经历ECS的更高几率有关.
- 可管理的工作量和遵守最佳实践与较低的道德痛苦强度有关,男性报告的痛苦水平略低.
结论:
- 在HCW中的道德困境可以通过专注于可管理的工作负载,并使最佳实践的遵守,在组织层面上减轻.
- 医疗保健组织应实施措施,支持HCW的工作环境,以建立抵御未来公共卫生紧急情况的弹性.
- 可持续的医疗保健系统需要积极的战略来应对HCW在危机期间面临的伦理挑战.
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