ABSTRACT
Em março de 2020 a situação causada pela covid-19 foi elevada à categoria de pandemia, impactando de inúmeras formas a vida em sociedade. O objetivo deste estudo foi compreender os impactos da pandemia na atuação e saúde mental do psicólogo hospitalar, profissional que atua nos espaços de saúde e tem experienciado mais de perto o sofrimento dos doentes e dos profissionais de saúde frente à covid-19. Trata-se de um estudo exploratório-descritivo com 131 psicólogos que atuam em hospitais. Os profissionais foram convidados a participar através de redes sociais e redes de contatos das pesquisadoras, utilizando-se a técnica Bola de Neve. Foram utilizados dois questionários, disponibilizados na plataforma Google Forms, um abordando os impactos da pandemia sentidos pelos profissionais e outro referente ao sofrimento psíquico. Os dados foram analisados a partir de estatísticas descritivas e inferenciais. Foram observados impactos na atuação de quase a totalidade dos participantes, constatada a necessidade de preparação dos profissionais para o novo cenário, a percepção de pouco apoio institucional e quase metade da população estudada referiu-se a sintomas de sofrimento psíquico considerável desde o início da pandemia. É fundamental dar atenção a sinais e sintomas de sofrimento psíquico, procurando evitar o adoecimento de uma categoria profissional que se encontra na linha de frente do combate aos danos psicológicos da pandemia e cuja própria saúde mental é pouco abordada na literatura.(AU)
In March 2020, the COVID-19 pandemic breakout hugely impacted life in society. This study analyzes how the pandemic impacted hospital psychologists' mental health and performance, professional who more closely experienced the suffering of patients and health professionals in this period. An exploratory and descriptive study was conducted with 131 hospital psychologists. Professionals were invited to participate through the researchers' social and contact networks using the Snowball technique. Data were collected by two questionnaires available on the Google Forms platform, one addressing the impacts felt by professionals and the other regarding psychic suffering, and analyzed by descriptive and inferential statistics. Results showed that almost all participants had their performance affected by the need to prepare for the new scenario, the perceived little institutional support. Almost half of the study sample reported considerable psychological distress symptoms since the beginning of the pandemic. Paying attention to signs and symptoms of psychic suffering is fundamental to avoid compromising a professional category that is on the front line of combating the psychological damage caused by the pandemic and whose own mental health is little addressed by the literature.(AU)
En marzo de 2020, la situación provocada por el COVID-19 se caracterizó como pandemia e impactó el mundo de diversas maneras. El objetivo de este estudio fue comprender los impactos de la pandemia en la salud mental y la actuación del psicólogo en los hospitales, uno de los profesionales que trabaja en espacios sanitarios y que ha experimentado más de cerca el sufrimiento de pacientes y profesionales sanitarios frente al COVID-19. Este es un estudio exploratorio descriptivo, realizado con 131 psicólogos que trabajan en hospitales. Los profesionales recibieron la invitación a participar a través de las redes sociales y redes de contactos de las investigadoras, mediante la técnica snowball. Se utilizaron dos cuestionarios disponibles en la plataforma Google Forms: uno sobre los impactos de la pandemia en los profesionales y el otro sobre el sufrimiento psíquico. Los datos se analizaron a partir de estadísticas descriptivas e inferenciales. Se observaron impactos en el trabajo de casi todos los participantes, la necesidad de preparación de los profesionales para este nuevo escenario, la percepción de poco apoyo institucional, y casi la mitad de la población estudiada reportaron sentir síntomas de considerable angustia psicológica desde el inicio de la pandemia. Es esencial prestar atención a los signos y síntomas del sufrimiento psíquico, buscando evitar la enfermedad de una categoría profesional que está a la vanguardia de la lucha contra el daño psicológico de la pandemia y cuya propia salud mental se aborda poco en la literatura.(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Young Adult , Psychology , Mental Health , Coronavirus Infections , Pandemics , Anxiety , Orientation , Physicians , Protective Clothing , Respiration , Respiratory Tract Infections , Safety , Attention , Set, Psychology , Social Adjustment , Social Isolation , Stress, Physiological , Stress, Psychological , Awareness , Software , Immunoglobulin M , Adaptation, Psychological , Pharmaceutical Preparations , Irritable Mood , Family , Carrier State , Epidemiologic Factors , Public Health Practice , Quarantine , Sanitation , Hygiene , Public Health , Epidemiology , Risk , Disease Outbreaks , Data Collection , Survival Rate , Mortality , Transportation of Patients , Triage , Contact Tracing , Occupational Health , Immunization , Universal Precautions , Infection Control , Immunization Programs , Infectious Disease Transmission, Professional-to-Patient , Infectious Disease Transmission, Patient-to-Professional , Coronavirus , Comprehensive Health Care , Disease Transmission, Infectious , Remote Consultation , Containment of Biohazards , Pulmonary Ventilation , Emergency Plans , Disaster Vulnerability , Declaration of Emergency , Disaster Planning , Death , Trust , Air Pollution , Ethanol , Economics , Emergencies , Emergency Services, Psychiatric , Empathy , Ethics, Professional , Professional Training , Surveillance of the Workers Health , Family Relations , Family Therapy , Resilience, Psychological , Infectious Disease Incubation Period , Fear , Epidemics , Social Networking , Binge Drinking , Epidemiological Monitoring , Personal Protective Equipment , Emotional Adjustment , Emergency Medical Dispatch , Survivorship , Family Separation , Posttraumatic Growth, Psychological , Embarrassment , Sadness , Teleworking , Physical Distancing , COVID-19 Nucleic Acid Testing , SARS-CoV-2 , Sociodemographic Factors , Suicide Prevention , Post-Acute COVID-19 Syndrome , Health Services Research , Immune System , Sleep Initiation and Maintenance Disorders , Anger , Loneliness , Masks , Mass Media , Negativism , Nurses, Male , Nursing AssessmentSubject(s)
Humans , Transportation of Patients , Ultrasonography , Prehospital Care , Point-of-Care TestingABSTRACT
Abstract Objectives: to analyze abortions provided by law (APL) carried out in Brazil between 2010 and 2019 regarding the need for travel of users, as well as the expenditure of time and money on these trips. Methods: descriptive study of records of outpatient care and hospitalizations for APL between 2010 and 2019. The municipal provision and the inter-municipal flows for the realization of the APL, the availability of public transportation for this travel, as well as its cost and time, were identified. Results: 2.6% of Brazilian municipalities had a sustained provision of APL between 2010 and 2019. Of the 15,889 APL performed, 14.8% occurred in municipalities other than those where the user lived. The smaller the population size of the municipality of residence, the higher the percentage of the need for travel. Of these inter-municipal trips, 16.0% had regular round-trip links by public transport. The total travel time ranged from 26 minutes to 4 and a half days, and the cost from R$2.70 to R$1,218.06; the highest medians were among residents of the Midwest region. Conclusions: the concentration of services, the deficiency of inter-municipal public transport, and the expenditure on travel to access the APL are barriers to users that need the health service, demanding public policies to overcome them.
Resumo Objetivos: analisar as restrições aos abortos previstos em lei (APL) realizados no Brasil entre 2010 e 2019 quanto à necessidade de deslocamento das usuárias, bem como quanto ao dispêndio de tempo e dinheiro nessas viagens. Métodos: estudo descritivo dos registros de atendimentos ambulatoriais e internações para APL entre 2010 e 2019. Foram identificados a oferta municipal e os fluxos intermunicipais para realização dos APL, a disponibilidade de transporte coletivo para esse deslocamento, bem como seu custo e tempo. Resultados: 2,6% dos municípios brasileiros tiveram oferta sustentada de APL entre 2010 e 2019. Dos 15.889 APL realizados, 14,8% se deram em municípios diferentes daqueles de residência da usuária. Quanto menor o porte populacional do município de residência, maior o percentual com necessidade de viajar. Desses deslocamentos intermunicipais, 16,0% tinham ligações regulares de ida e retorno em transporte público. O tempo de viagem total variou de 26 minutos a quatro dias e meio, e o custo de R$ 2,70 a R$ 1.218,06; as maiores medianas estiveram entre as residentes da região Centro-Oeste. Conclusões: a concentração de serviços, a deficiência de transporte público intermunicipal, bem como o dispêndio com a viagem para acesso ao APL são barreiras às usuárias que precisam do serviço de saúde, demandando políticas públicas para sua superação.
Subject(s)
Humans , Female , Pregnancy , Transportation of Patients/economics , Transportation of Patients/statistics & numerical data , Abortion, Legal/statistics & numerical data , Equity in Access to Health Services , Health Services Accessibility , Hospitalization , Brazil , Cross-Sectional Studies , Reproductive Health ServicesABSTRACT
RESUMO Objetivo Analisar como intervenções da equipe multiprofissional promovem a segurança no transporte de pacientes em estado crítico. Método Revisão sistemática de métodos mistos elaborada com as recomendações do Joanna Briggs Institute, seguindo uma abordagem integrada convergente. A pesquisa foi realizada nas bases de dados MEDLINE, CINAHL, Cochrane Database of Systematic Reviews e Cochrane Central Register of Controlled Trials, resultando em 107 estudos. Após a remoção de estudos duplicados e a aplicação de critérios de inclusão e exclusão, 17 estudos foram avaliados quanto à sua qualidade metodológica, havendo 15 estudos na amostra final. A extração dos dados foi realizada por um instrumento em forma de tabela e sintetizada por meio de análise temática. Resultados A decisão ponderada, o planejamento, a atuação na resolução de problemas e a ação para a melhoria são intervenções que a equipe multiprofissional promove na segurança do transporte de pacientes em estado crítico. Conclusão e implicações para a prática A padronização do transporte (criação de protocolos institucionais, check-list e adequação de equipamentos), a educação permanente e o treinamento de competências na capacitação das equipes fomentam uma cultura de segurança que evita o dano ao paciente. Sugerem-se pesquisas sobre a dimensão subjetiva e a inclusão da família no transporte.
RESUMEN Objetivo Analizar cómo las intervenciones del equipo multidisciplinario promueven la seguridad en el transporte de pacientes en estado crítico. Método Revisión sistemática de métodos mixtos, elaborada según el Instituto Joanna Briggs, siguiendo un enfoque convergente integrado. La investigación se realizó utilizando las bases de datos electrónicas MEDLINE, CINAHL, Cochrane Database of Systematic Reviews y Cochrane Central Register of Controlled Trials, las cuales generaron 107referencias. Después de eliminar los duplicados y aplicación de criterios de inclusión y exclusión, se evaluó la calidad metodológica de 17 artículos, resultando en 15 artículos como muestra final. La extracción de datos se realizó mediante una herramienta en forma de tabla, y sintetizados mediante análisis temático. Resultados La toma de decisiones reflexivas, la planificación, la acción para la resolución de problemas y la acción para la mejora son intervenciones del equipo multidisciplinario que promueven la seguridad en el transporte de pacientes en estado crítico. Conclusión e implicaciones para la práctica La estandarización del transporte (creación de protocolos institucionales, checklist y adecuación del equipo), la educación continua y el entrenamiento de habilidades en la capacitación de los equipos fomentan una cultura de seguridad que previene daños al paciente. Se sugiere investigar sobre la dimensión subjetiva y la inclusión de la familia en el transporte.
ABSTRACT Aim To analyze how interventions of a multidisciplinary team promote the safe transportation of critically ill patients. Method A systematic mixed-methods review was developed using an integrated convergent approach according to the Joanna Briggs Institute. This study was conducted using MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials electronic databases, which generated 107 references. After removing duplicates and applying inclusion and exclusion criteria, 17 articles were evaluated for methodological quality, resulting in 15 articles as the final sample. Data extraction was performed using a tool in the form of a table and synthesized through thematic analysis. Results Thoughtful decision, planning, problem-solving action and action for improvement are interventions that the multiprofessional team promotes the safe transportation of critically ill patients. Conclusion and implications for practice The standardization of transport (institutional protocols, a checklist, and equipment adequacy), continuing education, and skills training in the capacitation of teams foster a culture of safety that prevents harm to the patient. Further research is suggested on the subjective dimension and with the family in transportation.
Subject(s)
Humans , Patient Care Team , Transportation of Patients , Clinical Competence , Critical Illness , Patient SafetySubject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Transportation of Patients , Patient Transfer , Critical IllnessABSTRACT
Background: Neonatal care is provided by various levels of healthcare facilities in South Africa. Intensive care for neonates is only provided at the higher levels, hence the need for transfers from lower-level to higher-level facilities (e.g. primary hospitals to tertiary hospitals) or across levels of facilities, particularly when life-threatening situations arise (e.g. cardiac deterioration, respiratory deterioration and desaturation). Aim: The aim of the study was to explore neonatologists' views regarding the neonatal transfer process and to describe the preparedness of advanced life support (ALS) paramedics to undertake such transfers. Setting: The setting consisted of neonatologists from three provinces i.e. KwaZulu-Natal, Gauteng and Western cape. Method: A qualitative descriptive design was utilised in this study. Semistructured interviews were conducted on the public health hospitals in three provinces (N = 9; n = 3) with neonatologists (N = 7; n = 7) who were involved in the transfers of critically ill neonates. The process of thematic analysis was used. Results: The themes that emerged in this study were: an awareness of local contextual realities related to neonatal transfers, challenges evident within the context of neonatal transfers, decision-making around the transfer of ill neonates, ALS paramedic preparedness for transfers and good clinical governance Conclusion: The study found that there was a need to be aware of local contextual realities confronting neonatal transfers, a need for greater preparedness for paramedics to undertake these transfers, a need for a sound referral processes and a need for coordinated transfer effort between paramedics, hospital staff and transport team members for the successful transfer of critically ill neonates. Contribution: The findings highlight the challenges confronting the neonatal transfer process in South Africa through the lens of neonatologist at public hospitals. Hence, the study reinforces the preparedness and coordination of the transfer process, along with more efficient communication between paramedics, hospital staff and the transfer team.