Source avec lien : JAMA Internal Medicine, , 8/4/2020. 10.1001/jamainternmed.2020.3930
Importance Les travailleurs de santé à domicile s’occupent des adultes vivant dans la communauté et jouent un rôle important dans le soutien aux patients atteints d’une maladie à coronavirus 2019 (COVID-19) confirmée ou suspectée qui restent à la maison. Ces travailleurs sont pour la plupart des femmes d’âge moyen et des minorités raciales/ethniques qui gagnent généralement de faibles salaires. Bien qu’ils fassent partie intégrante des soins aux patients, ces travailleurs sont souvent négligés par la communauté médicale et la société dans son ensemble ; ainsi, le développement d’un système de soins de santé capable de faire face à la crise COVID-19 et aux futures pandémies nécessite une meilleure compréhension des expériences des travailleurs de soins de santé à domicile. Objectif Comprendre les expériences des travailleurs de santé à domicile qui s’occupent des patients à New York pendant la pandémie COVID-19.
Importance Home health care workers care for community-dwelling adults and play an important role in supporting patients with confirmed and suspected coronavirus disease 2019 (COVID-19) who remain at home. These workers are mostly middle-aged women and racial/ethnic minorities who typically earn low wages. Despite being integral to patient care, these workers are often neglected by the medical community and society at large; thus, developing a health care system capable of addressing the COVID-19 crisis and future pandemics requires a better understanding of the experiences of home health care workers. Objective To understand the experiences of home health care workers caring for patients in New York City during the COVID-19 pandemic. Design, Setting, and Participants From March to April 2020, a qualitative study with 1-to-1 semistructured interviews of 33 home health care workers in New York City was conducted in partnership with the 1199SEIU Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest health care union in the US. Purposeful sampling was used to identify and recruit home health care workers. Main Outcomes and Measures Audio-recorded interviews were professionally transcribed and analyzed using grounded theory. Major themes and subthemes were identified. Results In total, 33 home health care workers employed by 24 unique home care agencies across the 5 boroughs of New York City participated. Participants had a mean (SD) age of 47.6 (14.0) years, 32 (97%) were women, 21 (64%) were Black participants, and 6 (18%) were Hispanic participants. Five major themes emerged: home health care workers (1) were on the front lines of the COVID-19 pandemic but felt invisible; (2) reported a heightened risk for virus transmission; (3) received varying amounts of information, supplies, and training from their home care agencies; (4) relied on nonagency alternatives for support, including information and supplies; and (5) were forced to make difficult trade-offs in their work and personal lives. Conclusions and Relevance In this qualitative analysis, home health care workers reported providing frontline essential care, often at personal risk, during the COVID-19 pandemic. They experienced challenges that exacerbated the inequities they face as a marginalized workforce. Interventions and policies to better support these frontline health care professionals are urgently needed.