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| 題名: | Preparedness and Response to Combat COVID-19 in Taiwan: A Qualitative Inquiry to Study Perspectives from the Government, Hospital Managers, and Physicians |
| 作者: | SHISKO, ALEXANDRA FRANCE |
| 貢獻者: | 醫務管理學系碩士班
邱瓊萱 |
| 關鍵詞: | covid-19, Taiwan, preparedness, infection control, vaccination, qualitative study |
| 日期: | 2023-07-19 |
| 上傳時間: | 2023-12-11 13:21:37 (UTC+8) |
| 摘要: | Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in Wuhan, China in December 2019 and quickly spread globally, causing 767.7 million confirmed cases and more than 6.9 million deaths as of July 5, 2023. Government officials, hospital managers, and healthcare workers (HCWs) have been forced to assume great amounts of responsibility and pressure in handling the COVID-19 pandemic. Taiwan’s experience has been unique – while many faced the effects and consequences of this virus throughout 2020, Taiwan remained safe within its closed borders, and citizens continued a relatively ‘normal’ life until its first outbreak occurred in May 2021. Since then, Taiwan’s government has faced many challenges as it has evolved from a zero-COVID approach learning to live with the virus.
Preparedness includes many elements – past experience and anticipation, culture, trust, communication and collaboration, a legal framework, adaptability, leadership and responsibility, infection control, and resources and their allocation. The stresses of handling the pandemic have led to burnout of people in specific areas, notably healthcare professionals. Various solutions have been suggested, including several with an emphasis on mental health. Taiwan’s previous experience with SARS created a legal framework for the Central Epidemic Command Center (CECC) to mobilize resources and implement policies, and for other governing bodies to follow them. Hospital managers played an important role in addressing the needs of the public while balancing those of HCWs who have been indispensable in the fight against COVID-19. Their role is to bridge the gap between policy makers and HCWs, and ensure that hospitals are safe places, for patients and workers.
Purpose: This study has two aims – first, to better understand Taiwan’s COVID-19 preparedness and response over the past three years, at the government, hospital management, and physician levels; and to understand the connections between these three bodies. Second, to uncover the successes and shortcomings of Taiwan’s preparedness and response measures, to help inform policy makers, and strengthen the country’s future preparedness measures.
Methods: A qualitative and phenomenological approach was undertaken for the purposes of this exploratory research. Semi-structured and in-depth interviews were conducted between March 2023 and May 2023. The participants in the study covered three levels – the government, hospital management, and physicians – with a total of n=7. One member of the Central Government (a member of the CECC); a senior manager of the Joint Commission of Taiwan; two Commissioners from the Department of Health at the local government level – one in Northern Taiwan, and one in Southern Taiwan; a manager of the Department of Infectious Diseases; a physician working in Family Medicine, and at a VIP clinic; and a junior physician working in the ER were interviewed. Data were collected and then transcribed verbatim. Coding was conducted using grounded theory, with ATLAS.ti software. Secondary analysis followed this, to extract dimensions and sub-dimensions from the data. IRB and ethical considerations have been included in this research.
Results: A strong, rapid, and unified network response and previous SARS experience demonstrated a good level of preparedness during Taiwan’s initial success. Complacency, fatigue, and quarantine and vaccination complications led to a lack of preparedness when Taiwan had its first outbreak, highlighting weaknesses in handling a crisis of this scale. Continued collaboration and support, humanity and culture, technology and strong leadership were instrumental in Taiwan’s continued response. A culture of compliance, self-sacrifice, and community orientation over the individual, in addition to cross-collaborations between the governments, hospital managers and physicians led to adaptations which ultimately resulted in Taiwan’s progress towards a post-COVID era.
Conclusion: Taiwan’s preparedness with infection control and in terms of government and hospital collaboration was generally good; the communication channels between these bodies is strong. The country’s vaccination campaign, and reversal of zero-COVID policies produced many challenges, and communication with the public must be carefully evaluated moving forward. Assessing vaccine hesitancy and misinformation among the elderly population must be addressed to formulate legal documents supporting them. Taiwan’s culture played an important role in the success of its policy implementation. A rapid response, openness, trust and transparency, public-private partnerships, and telemedicine are factors other countries may look at adopting and adapting from the Taiwanese context. |
| 描述: | 碩士
指導教授:邱瓊萱
委員:邱瓊萱
委員:石崇良
委員:SHAW |
| 資料類型: | thesis |
| 顯示於類別: | [醫務管理學系暨研究所] 博碩士論文
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