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      A qualitative study of physician perceptions and experiences of caring for critically ill patients in the context of resource strain during the first wave of the COVID-19 pandemic

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          Abstract

          Background

          The COVID-19 pandemic has led to global shortages in the resources required to care for critically ill patients and to protect frontline healthcare providers. This study investigated physicians’ perceptions and experiences of caring for critically ill patients in the context of actual or anticipated resource strain during the COVID-19 pandemic, and explored implications for the healthcare workforce and the delivery of patient care.

          Methods

          We recruited a diverse sample of critical care physicians from 13 Canadian Universities with adult critical care training programs. We conducted semi-structured telephone interviews between March 25–June 25, 2020 and used qualitative thematic analysis to derive primary themes and subthemes.

          Results

          Fifteen participants (eight female, seven male; median age = 40) from 14 different intensive care units described three overarching themes related to physicians’ perceptions and experiences of caring for critically ill patients during the pandemic: 1) Conditions contributing to resource strain (e.g., continuously evolving pandemic conditions); 2) Implications of resource strain on critical care physicians personally (e.g., safety concerns) and professionally (e.g. practice change); and 3) Enablers of resource sufficiency (e.g., adequate human resources).

          Conclusions

          The COVID-19 pandemic has required health systems and healthcare providers to continuously adapt to rapidly evolving circumstances. Participants’ uncertainty about whether their unit’s planning and resources would be sufficient to ensure the delivery of high quality patient care throughout the pandemic, coupled with fear and anxiety over personal and familial transmission, indicate the need for a unified systemic pandemic response plan for future infectious disease outbreaks.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12913-021-06393-5.

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          Most cited references70

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          Using thematic analysis in psychology

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            Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges

            Highlights • Emergence of 2019 novel coronavirus (2019-nCoV) in China has caused a large global outbreak and major public health issue. • At 9 February 2020, data from the WHO has shown >37 000 confirmed cases in 28 countries (>99% of cases detected in China). • 2019-nCoV is spread by human-to-human transmission via droplets or direct contact. • Infection estimated to have an incubation period of 2–14 days and a basic reproduction number of 2.24–3.58. • Controlling infection to prevent spread of the 2019-nCoV is the primary intervention being used.
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              How Many Interviews Are Enough?: An Experiment with Data Saturation and Variability

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                Author and article information

                Contributors
                J.ParsonsLeigh@dal.ca
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                22 April 2021
                22 April 2021
                2021
                : 21
                : 374
                Affiliations
                [1 ]GRID grid.55602.34, ISNI 0000 0004 1936 8200, Faculty of Health, School of Health Administration, , Dalhousie University, ; Halifax, Nova Scotia Canada
                [2 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Department of Critical Care Medicine, , University of Calgary, ; Calgary, Alberta Canada
                [3 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Department of Community Health Sciences, , University of Calgary, ; Calgary, Alberta Canada
                [4 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, O’Brien Institute for Public Health, , University of Calgary, ; Calgary, Alberta Canada
                Author information
                http://orcid.org/0000-0002-8408-674X
                Article
                6393
                10.1186/s12913-021-06393-5
                8061878
                33888096
                4769459b-1105-4721-8872-0be3e817b299
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 8 December 2020
                : 14 April 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: RN420046-439965
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Health & Social care
                qualitative research,resource strain,covid-19,critical care physicians
                Health & Social care
                qualitative research, resource strain, covid-19, critical care physicians

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