“It was horrible for that community, but not for the way we had imagined”: A qualitative study of family physicians’ experiences of caring for communities experiencing marginalisation during COVID-19

Spencer, Sarah; Hedden, Lindsay; Vaughan, Crystal; Marshall, Emily Gard; Lukewich, Julia; Asghari, Shabnam; Gill, Paul; Buote, Richard; Meredith, Leslie; Moritz, Lauren; Ryan, Dana; Mathews, Maria

doi:10.1016/j.ssmqr.2022.100176

Cited by 5 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PPE shortages impacted the delivery of health services and population health surveillance in Canada [4]. Specifically, PPE shortages in primary care led to reductions in the provision of preventative care [16][17][18], care for individuals experiencing marginalization [19], assessment and testing of patients with influenza-like illnesses [20], and in-person care [21]. We examine family physicians' (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning.…”

Section: Introductionmentioning

confidence: 99%

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians’ (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning. Methods As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE. Results A total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response. Conclusions During the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic.

show abstract

Section: Introductionmentioning

confidence: 99%

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…For FPs with heightened personal health concerns, including those who were immunocompromised and/or older, virtual modalities did provide them opportunities to continue working and seeing patients throughout the pandemic while minimising their exposure risks. There are limitations, however, to the utility of virtual modalities in providing care to patients and not all patients are comfortable with or have access to the requisite technologies [ 39 ]. Recognising this limitation, many FPs continued to provide in-person care throughout the pandemic but did so in the face of COVID-19 exposure concerns for both them and their family members [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“Family doctors are also people”: a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic

Spencer,

Lukewich,

Marshall

et al. 2024

Hum Resour Health

Self Cite

View full text Add to dashboard Cite

Background Family physicians (FPs) fill an essential role in public health emergencies yet have frequently been neglected in pandemic response plans. This exclusion harms FPs in their clinical roles and has unintended consequences in the management of concurrent personal responsibilities, many of which were amplified by the pandemic. The objective of our study was to explore the experiences of FPs during the first year of the COVID-19 pandemic to better understand how they managed their competing professional and personal priorities. Methods We conducted semi-structured interviews with FPs from four Canadian regions between October 2020 and June 2021. Employing a maximum variation sampling approach, we recruited participants until we achieved saturation. Interviews explored FPs’ personal and professional roles and responsibilities during the pandemic, the facilitators and barriers that they encountered, and any gender-related experiences. Transcribed interviews were thematically analysed. Results We interviewed 68 FPs during the pandemic and identified four overarching themes in participants’ discussion of their personal experiences: personal caregiving responsibilities, COVID-19 risk navigation to protect family members, personal health concerns, and available and desired personal supports for FPs to manage their competing responsibilities. While FPs expressed a variety of ways in which their personal experiences made their professional responsibilities more complicated, rarely did that affect the extent to which they participated in the pandemic response. Conclusions For FPs to contribute fully to a pandemic response, they must be factored into pandemic plans. Failure to appreciate their unique role and circumstances often leaves FPs feeling unsupported in both their professional and personal lives. Comprehensive planning in anticipation of future pandemics must consider FPs’ varied responsibilities, health concerns, and necessary precautions. Having adequate personal and practice supports in place will facilitate the essential role of FPs in responding to a pandemic crisis while continuing to support their patients’ primary care needs.

show abstract

“…FPs viewed centralized services positively when they facilitated the operation of family practices, enabled them to conserve PPE and promoted continuity of care but were critical of centralized services if they delivered mixed messages or conflicting advice or created barriers to access. These findings suggest the need to balance centralized and tailored approaches to reach populations facing intersecting vulnerabilities ( Embrett et al 2022 ; Gagnon-Dufresne et al 2022 ; Seto et al 2020 ; Spencer et al 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Practice- and System-Based Interventions to Reduce COVID-19 Transmission in Primary Care Settings: A Qualitative Study

Mathews,

Liu,

Ryan

et al. 2023

hcpol

Self Cite

View full text Add to dashboard Cite

Using qualitative interviews with 68 family physicians (FPs) in Canada, we describe practice- and system-based approaches that were used to mitigate COVID-19 exposure in primary care settings across Canada to ensure the continuation of primary care delivery. Participants described how they applied infection prevention and control procedures (risk assessment, hand hygiene, control of environment, administrative control, personal protective equipment) and relied on centralized services that directed patients with COVID-19 to settings outside of primary care, such as testing centres. The multi-layered approach mitigated the risk of COVID-19 exposure while also conserving resources, preserving capacity and supporting supply chains.

show abstract

“It was horrible for that community, but not for the way we had imagined”: A qualitative study of family physicians’ experiences of caring for communities experiencing marginalisation during COVID-19

Cited by 5 publications

References 35 publications

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

“Family doctors are also people”: a qualitative analysis of how family physicians managed competing personal and professional responsibilities during the COVID-19 pandemic

Practice- and System-Based Interventions to Reduce COVID-19 Transmission in Primary Care Settings: A Qualitative Study

Contact Info

Product

Resources

About