학술논문

Experiences and Insights from the Early US COVID-19 Epicenter: A Rapid Assessment Procedure Informed Clinical Ethnography Case Series
Document Type
article
Source
Psychiatry. 83(2)
Subject
Biomedical and Clinical Sciences
Health Services and Systems
Clinical Sciences
Health Sciences
Psychology
Clinical Trials and Supportive Activities
Prevention
Clinical Research
Good Health and Well Being
Accidents
Traffic
Adolescent
Aged
80 and over
Anthropology
Cultural
Betacoronavirus
COVID-19
Community Health Services
Coronavirus Infections
Female
Femoral Fractures
Fractures
Multiple
Humans
Infection Control
Male
Middle Aged
Pandemics
Patient Care Team
Peer Group
Pneumonia
Viral
Primary Health Care
Quadriplegia
Randomized Controlled Trials as Topic
Risk Assessment
SARS-CoV-2
Spinal Cord Injuries
Washington
Wounds and Injuries
Wounds
Gunshot
Medical and Health Sciences
Psychology and Cognitive Sciences
Biomedical and clinical sciences
Health sciences
Language
Abstract
ObjectiveThe Coronavirus disease (COVID-19) outbreak has evolved into a pandemic crisis, with King County in Washington State emerging as the early US epicenter. A literature review revealed few reports providing front-line clinical and research teams guidance related to multilevel, rapidly evolving COVID-19 directives.MethodThe Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) method was used to develop a clinical case series and conduct participant observation during an ongoing comparative effectiveness trial of peer-integrated, patient-centered interventions after traumatic injury. Participants were patients enrolled in the intervention arm of the ongoing trial, as well as front-line clinicians, patient peer interventionists, and clinical research team members implementing the trial. All participants were exposed to the Washington State COVID-19 outbreak.ResultsPrimary and secondary COVID-19 prevention strategies were feasibly integrated into ongoing care coordination and behavioral interventions for at-risk patients. Beyond the compilation of case studies, as an iterative method, RAPICE data collection naturalistically evolved to include observations of intervention team activity occurring within the larger pandemic epicenter context. A daily clinical research team huddle that flexibly accommodated virtual participation was also feasibly implemented.ConclusionsPrimary and secondary COVID-19 prevention strategies can be feasibly integrated into ongoing clinical interventions during the pandemic. Routine, proactive clinical and research team communication that transparently addresses ethical tensions and health-sustaining activities may promote well-being for providers grappling with rapidly evolving pandemic directives. Proactive assessments of individual provider vulnerabilities for severe COVID-19 related respiratory illness may also be a crucial element of the health care system pandemic responses.