학술논문
Caregiver perceptions and experiences of paediatric emergency department attendance during the COVID-19 pandemic: A mixed-methods study.
Document Type
Academic Journal
Author
Appleby G; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Papageorgiou V; School of Public Health, Imperial College London, London, United Kingdom.; Horter S; London School of Hygiene and Tropical Medicine, London, United Kingdom.; Wharton-Smith A; London School of Hygiene and Tropical Medicine, London, United Kingdom.; Sajjanhar T; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Hemeson A; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Singogo E; University of North Carolina Project-Lilongwe, Lilongwe, Malawi.; Cahill B; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Keers S; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Wicksey L; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Emedo M; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Yim A; Lewisham and Greenwich NHS Trust, London, United Kingdom.; Nyirenda-Nyang'wa M; Lewisham and Greenwich NHS Trust, London, United Kingdom.; The Infection, Immunity and Inflammation Research and Teaching Department, University College London, London, United Kingdom.
Source
Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
Subject
Language
English
Abstract
Background: During the early stages of the COVID-19 pandemic, concerns were raised about reduced attendance at hospitals, particularly in paediatric emergency departments, which could result in preventable poorer outcomes and late presentations among children requiring emergency care. We aimed to investigate the impact of COVID-19 on health-seeking behaviour and decision-making processes of caregivers presenting to paediatric emergency services at a National Health Service (NHS) Trust in London.
Materials and Methods: We conducted a mixed-methods study (survey and semi-structured interviews) across two hospital sites between November-December 2020. Data from each study were collected concurrently followed by data comparison.
Results: Overall, 100 caregivers participated in our study; 80 completed the survey only, two completed the interview only and 18 completed both. Our quantitative study found that almost two-thirds (63%, n = 62) of caregivers attended the department within two days of their child becoming ill. Our qualitative study identified three major themes which were underpinned by concepts of trust, safety and uncertainty and were assessed in relation to the temporal nature of the pandemic and the caregivers' journey to care. We found most caregivers balanced their concerns of COVID-19 and a perceived "overwhelmed" NHS by speaking to trusted sources, predominantly general practitioners (GPs).
Conclusion: Caregivers have adapted their health-seeking behaviour throughout the pandemic as new information and guidance have been released. We identified several factors affecting decisions to attend; some existed before the pandemic (e.g., concerns for child's health) whilst others were due to the pandemic (e.g., perceived risks of transmission when accessing healthcare services). We recommend trusted medical professionals, particularly GPs, continue to provide reassurance to caregivers to seek emergency paediatric care when required. Communicating the hospital safety procedures and the importance of early intervention to caregivers could additionally provide reassurance to those concerned about the risks of accessing the hospital environment.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2022 Appleby et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Materials and Methods: We conducted a mixed-methods study (survey and semi-structured interviews) across two hospital sites between November-December 2020. Data from each study were collected concurrently followed by data comparison.
Results: Overall, 100 caregivers participated in our study; 80 completed the survey only, two completed the interview only and 18 completed both. Our quantitative study found that almost two-thirds (63%, n = 62) of caregivers attended the department within two days of their child becoming ill. Our qualitative study identified three major themes which were underpinned by concepts of trust, safety and uncertainty and were assessed in relation to the temporal nature of the pandemic and the caregivers' journey to care. We found most caregivers balanced their concerns of COVID-19 and a perceived "overwhelmed" NHS by speaking to trusted sources, predominantly general practitioners (GPs).
Conclusion: Caregivers have adapted their health-seeking behaviour throughout the pandemic as new information and guidance have been released. We identified several factors affecting decisions to attend; some existed before the pandemic (e.g., concerns for child's health) whilst others were due to the pandemic (e.g., perceived risks of transmission when accessing healthcare services). We recommend trusted medical professionals, particularly GPs, continue to provide reassurance to caregivers to seek emergency paediatric care when required. Communicating the hospital safety procedures and the importance of early intervention to caregivers could additionally provide reassurance to those concerned about the risks of accessing the hospital environment.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2022 Appleby et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)