Neurological

Neurologists discuss the greatest patient care challenges during COVID-19

According to a study published in Neurology, community neurologists reported that their biggest challenges from the COVID-19 pandemic are isolation, trust, and quality care.

Neurologists, along with other health care providers, have quickly adopted strategies from the World Health Organization and the Institute of Medicine to care for patients during the pandemic while limiting the spread of the virus. The researchers in the current study (ClinicalTrials.gov Identifier: NCT03076671) sought to learn directly from community neurologists what they were experiencing on the front lines.

From July to November 2020, researchers individually surveyed 20 community-based neurologists who provided outpatient palliative care for patients with Parkinson’s disease and were willing to refer at least 6 patients per year over 3.5 years of study enrollment and receive 8-hour additional training in palliative care clinical nursing Education. Neurologists who worked primarily in academic medical institutions were excluded from the study.

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Researchers conducted the interviews over the phone or conference call and performed a matrix analysis of the responses to their questions about the impact of the pandemic on them, their practice, and the lives of their patients.

Four topics emerged: political and pandemic-specific stressors, stressors in connection with increased telemedicine, hopelessness and limited means of coping with stress.

During the pandemic, clinical hours decreased and patients experienced more stress, isolation, and confusion. Part of this confusion was the limited knowledge of caregivers about the well-being of their loved ones who were in nursing homes.

As health systems moved to remote care, neurologists adapted to use the technology in question, separate from colleagues and patients, with no training or institutional support, they said. There were often adjustments to procedures and patients who needed help navigating the virtual care.

The effects of social isolation on patient health are “worrying and worrying” for neurologists. Neurologists experienced increased burnout during the pandemic because their responsibilities increased, their opportunities for self-care decreased, and they felt isolated from their colleagues.

“In an age of politicized medicine and misinformation, neurology providers find it difficult to maintain therapeutic relationships with patients and they feel that there is a lack of support for new models of care,” the researchers said.

Limitations of the study included generalization to areas outside of Colorado, changes in the pandemic and institutional response, and the method of conducting interviews.

“Our study suggests that strategies to increase engagement and reduce the systematic causes of burnout are essential to maintain quality of care and support neurological staff during and after the pandemic,” the researchers concluded.

reference

Ayele, R., Macchi ZA, Dini M., et al. Experience of community neurologists caring for patients with neurodegenerative diseases during the COVID-19 pandemic. Neurology. Published June 14, 2021. doi: 10.1212 / WNL.0000000000012363

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