Supplementary Material for: Facing the Unknown: An Inductive Analysis of the Lived Experience of Medical Residents During the COVID-19 Pandemic.

Abstract:

Introduction: The COVID-19 pandemic had significant repercussions not only for public health but also for the everyday life of individuals and societies. Healthcare professionals were particularly vulnerable as they were impacted both personally and professionally. Here we interviewed medical residents about their lived experiences during the pandemic to offer a phenomenological analysis. To this end, we discuss their pandemic experiences considering Jaspers’ “limit situation” concept; that is, a radical shift from their everyday experiences to one causing them to question the basis of their very existence.

Methods: We interviewed 33 medical residents from psychiatry and other specialties from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) who either a) worked directly with COVID-19 patients and/or b) provided psychiatric care to other health care professionals. Semi-structured interviews were developed using the Inductive Process to analyze the Structure of lived Experience (IPSE).

Results: The descriptions of the lived experiences of medical residents during the pandemic were organized into four content themes: (a) Existential defense, (b) Limit situations during the COVID-19 pandemic, (c) Changes in lived experience and (d) New world meanings through lived experience.

Conclusion: During the COVID-19 pandemic, medical residents experienced what can be thought of as a “limit situation,” as they encountered the healthcare delivery challenges coupled with the social isolation imposed by the COVID-19 pandemic. These challenges included fear of infection and potential death, uncertainty about the future, and the emotional overload caused by the sharp increase in patient deaths. That said, after facing such a limit situation, residents reported feeling strengthened by this experience. This is consistent with the notion that when confronted with limit situations, we draw on our resources to overcome adversity and, in turn, reap existential gains. These data, collected during the pandemic, show how healthcare providers can use their professional and personal struggles to re-energize their approach to their profession. This applies especially to young professionals when confronted with limit situations such as the COVID-19 pandemic.

摘要：
引言：新型冠状病毒肺炎（COVID-19）大流行不仅对公共卫生造成了显著冲击，更深刻影响了个体与社会的日常生活。医疗工作者群体尤为脆弱，其个人与职业层面均受到波及。本研究针对住院医师展开访谈，旨在对其大流行期间的亲历体验开展现象学分析。为此，我们结合雅斯贝尔斯（Jaspers）的"极限处境"概念探讨其疫情经历——即个体从日常经验发生根本性转向，进而开始质疑自身存在的根基。

方法：我们采访了来自圣保罗大学医学院临床医院（Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, HCFMUSP）精神科及其他专科的33名住院医师，这些医师要么直接接诊新型冠状病毒肺炎患者，要么为其他医疗工作者提供精神心理照护。本研究采用"亲历体验结构分析归纳法"（Inductive Process to analyze the Structure of lived Experience, IPSE）编制半结构化访谈提纲。

结果：研究将住院医师在大流行期间的亲历体验描述归纳为四大核心主题：（a）存在性防御，（b）新型冠状病毒肺炎大流行期间的极限处境，（c）亲历体验的转变，以及（d）基于亲历体验构建的新世界意义。

结论：在新型冠状病毒肺炎大流行期间，住院医师经历了可被视为"极限处境"的体验：他们既要应对医疗照护体系的重重挑战，又要承受大流行带来的社交隔离。这些挑战包括对感染与死亡的恐惧、对未来的不确定感，以及患者死亡率激增引发的情绪过载。尽管如此，经历此类极限处境后，住院医师均表示自身从该体验中获得了成长。这与"当个体面对极限处境时，会调动自身资源克服逆境，并进而获得存在层面的收获"这一观点相符。本研究在大流行期间收集的数据表明，医疗服务提供者可借助自身的职业与个人困境，重新焕发出对职业的投入热情。这一点在年轻专业人员面对诸如新型冠状病毒肺炎大流行这类极限处境时尤为适用。