Depression in healthcare workers: influence of Fear of Death, Spirituality, and Religion / Depresión en trabajadores de la salud: influencia del Miedo a la Muerte, la espiritualidad y la religiosidad

The COVID-19 pandemic has increased deaths worldwide, with Argentina registering an excess of mortality from all causes of 10.6%, which has generated a considerable workload in the health sector, with workers being the most affected. One of the major consequences to which they were exposed has been the development of symptoms of depression. To observe how the variables of Fear of death, Spirituality, and Religiosity influence the possibility of developing symptoms of depression in the population of health workers, a quantitative, cross-sectional, and regression approach was used in a population of 200 healthcareworkers, with Fear of death being the most relevant explanatory variable, followed by Religiosity and Spirituality respectively to understand the model AU

La pandemia de COVID-19 ha incrementado las muertes alrededor del mundo, siendo el caso de Argentina el cual registra un exceso de mortalidad por todas las causas del 10,6%, lo que ha generado una carga de trabajo considerable en el sector salud, siendo los trabajadores los más afectados. Una de las principales consecuencias a las que estuvieron expuestos ha sido el desarrollo de síntomas de depresión. Para observar cómo las variables Miedo a la muerte, Espiritualidad y Religiosidad influyen en la posibilidad de desarrollar síntomas de depresión en la población de trabajadores de la salud, se utilizó un enfoque cuantitativo, transversal y de regresión en una población de 200 trabajadores de la salud, siendo el Miedo a la muerte la variable explicativa más relevante, seguida de la Religiosidad y la Espiritualidad respectivamente para entender el modelo AU

Contextos de saúde e trabalho de profissionais de enfermagem em tempos de pandemia de COVID-19 / Health and work contexts of nursing professionals during the pandemic of COVID-19 / Contextos de salud y trabajo de profesionales de enfermería en tiempos de pandemia por COVID-19

Introdução: Ao desempenhar e promover práticas que visam a melhoria da saúde, a equipe de enfermagem se assumiu como protagonista e linha de frente em tempos de pandemia de COVID-19. Logo, fica evidente a exposição pessoal-profissional-familiar; a carência de pessoal e a insegurança laboral-emocional, além das consequências que vão recair sobre os contextos de saúde e de trabalho destes profissionais. Objetivo: Analisar os contextos de saúde e trabalho de profissionais de enfermagem durante a pandemia de COVID-19. Metodologia: Estudo de método misto, combinando as abordagens por meio da estratégia de incorporação concomitante - QUAN(qual), realizado em Minas Gerais, Brasil, entre agosto e dezembro de 2020. Aplicou-se, via ligação telefônica, um roteiro de perguntas a 58 profissionais enfermeiros, técnicos e auxiliares de enfermagem. O roteiro continha perguntas abertas e fechadas ligadas a questões sociodemográficas e aos contextos e condições de saúde, trabalho e COVID-19. Realizou-se análise quantitativa descritiva e Análise de Conteúdo Temática. Resultados: A maioria mulheres (93,1%) técnicas de enfermagem (69%). 39,7% trabalhavam em plantão noturno; 58,6% relataram terem sofrido violências no trabalho e 48,3% relataram diagnósticos de transtorno mental. Os contextos de trabalho na pandemia evidenciaram necessidade de estímulos e valorização profissional e relações com fatores institucionais, a dinâmica e organização do trabalho, condições adequadas de trabalho e ao favorável relacionamento interpessoal, enquanto que contextos de saúde evidenciaram relação com interesses, oportunidades, rotina, normalidade, esperança e tenacidade que seriam trazidos pelo fim da COVID-19. Conclusão: A pandemia de COVID-19 fortaleceu um contexto de saúde e de trabalho crítico, amedrontado e inseguro da equipe de Enfermagem brasileira, exacerbando a necessidade de providências, ações e políticas que considerem a Saúde do Trabalhador como estruturantes para a organização dos serviços.

Introducción: Al realizar y promover prácticas que tienen como objetivo la mejora de la salud, el equipo de enfermería asumió el protagonismo en los tiempos de la pandemia por COVID-19. Por tanto, es evidente la exposición personal-profesional-familiar, la falta de personal y la inseguridad laboral-emocional, además de las consecuencias que recaerán sobre la salud y los contextos laborales de este grupo profesional. Objetivo: Analizar el contexto sanitario y laboral de profesionales de enfermería durante la pandemia por COVID-19. Metodología: Estudio de método mixto, combinando los abordajes a través de la estrategia de incorporación concomitante - QUAN(qual), realizado en Minas Gerais, Brasil, entre agosto y diciembre de 2020. Se aplicó un guion de preguntas, mediante llamada telefónica, a 58 profesionales, personal técnico y auxiliares de enfermería. El guion contenía preguntas abiertas y cerradas relacionadas con cuestiones sociodemográficas y los contextos y condiciones de salud, trabajo y COVID-19. Se realizó un análisis cuantitativo descriptivo y un análisis de contenido temático. Resultados: La mayor parte de la muestra estuvo compuesta por mujeres (93.1 %) y personal técnico de enfermería (69 %). El 39.7 % trabajaba en turno de noche, el 58.6 % declaró haber sufrido violencia en el trabajo y el 48.3 % informó de diagnósticos de trastorno mental. Los contextos de trabajo en la pandemia mostraron la necesidad de estímulo y valoración profesional y las relaciones con los factores institucionales, la dinámica y la organización del trabajo, las condiciones adecuadas de trabajo y la relación interpersonal favorable. Los contextos de salud, mientras tanto, mostraron una relación con los intereses, las oportunidades, la rutina, la normalidad, la esperanza y la tenacidad que se produciría al final de la COVID-19. Conclusión: La pandemia de la COVID-19 fortaleció un contexto de salud y trabajo crítico, atemorizado e inseguro del equipo de enfermería brasileño, exacerbando la necesidad de providencias, acciones y políticas que consideren la salud de la persona trabajadora como estructurante para la organización de los servicios.

Introduction: By performing and promoting practices that aim to improve health, the nursing team has assumed itself as a protagonist during the COVID-19 pandemic. Therefore, the personal, professional, and family exposure is evident; the lack of personnel and occupational security, in addition to the consequences on the health and work contexts of these professionals. Objective: To analyze the health and work contexts of nursing professionals during the pandemic of COVID-19. Methodology: This is a mixed-method study that combines approaches through the concurrent incorporation strategy - QUAN(qual), conducted in Minas Gerais, Brazil, between August and December 2020. A script of questions was applied over the phone to 58 professional nurses, nursing technicians, and nursing assistants. The script included open and closed questions related to sociodemographic issues and health, work, and COVID-19 contexts and conditions. A descriptive quantitative analysis and thematic content analysis were performed. Results: The majority were women (93.1%) nursing technicians (69%). The 39.7% of the participants worked the night shift; the 58.6% reported experiencing violence at work and the 48.3% was diagnosed with mental disorders. The work contexts during the pandemic showed that there was a need for encouragement and professional evaluation; they also portrayed the relationships with the institutional factors, the work dynamics and the organization, the appropriate working conditions and the favorable interpersonal relationships. On the other hand, health contexts showed the relationship between interests, opportunities, routine, normality, hope and tenacity that would occur at the end of COVID-19. Conclusion: The pandemic of COVID-19 strengthened a critical, fearful, and insecure health and work context of the Brazilian nursing team, exacerbating the need for provisions, actions and policies that consider worker's health crucial for the organization of services.

Síntomas depresivos, ansiosos e insomnio, y posibles factores asociados en personal de salud, en un Hospital General en Suramérica, durante la pandemia por COVID-19 en 2020 / Depressive and anxious symptoms and insomnia, and possible associated factors in health workers, in a General Hospital in South America, during the COVID-19 pandemic in 2020

La pandemia por el nuevo coronavirus COVID- 19 ha tenido impacto en la salud mental del personal médico y de enfermería en todo el mundo. Objetivo: identificar la frecuencia de síntomas depresivos, ansiosos e insomnio y los factores posiblemente relacionados con estos desenlaces en el personal sanitario de un hospital de Suramérica durante el primer pico de la pandemia. Materiales y métodos: se aplicaron las escalas PHQ-9 para depresión, GAD- 7 para ansiedad, ISI - 7 para insomnio en 876 trabajadores de la salud del Hospital Pablo Tobón Uribe en la ciudad de Medellín. Resultados: de los 876 participantes (29,2% médicos, 21.2% profesionales de enfermería y 49,5% auxiliares de enfermería), 357 (40.8%) presentaron síntomas depresivos, 300 (34.2%) síntomas ansiosos y 317 (36.2%) insomnio. Se observaron síntomas de depresión, ansiedad e insomnio, con mayor frecuencia en quienes no tenían las necesidades básicas satisfechas y en quienes se sentían estigmatizados por ser personal de salud. Además, la depresión se presentó con más frecuencia en mujeres, la ansiedad en menores de 44 años y el insomnio en personas separadas. Conclusiones: la frecuencia de problemas de salud mental en el personal de salud es considerable. Estos hallazgos demuestran la necesidad de atención en la salud mental de los profesionales médicos y de enfermería durante la pandemia por COVID-19 y la búsqueda de estrategias para mitigar el riesgo en esta población.

Background: pandemic due to novel coronavirus COVID-19 has impacted on the mental health of health care workers all around the world. Material and Methods: this is a cross sectional study in which questionnaires PHQ-9 for depression, GAD-7 for anxiety, ISI-7 for insomnia were virtually and self administered by 876 health care workers laboring in hospital Pablo Tobón Uribe in Medellin city. Results: from 876 participants (29.2% physicians, 21.2% nurses and 49.5% technical nurses), 357 (40.8%) developed depressive symptoms, 300 (34.2%) anxious symptoms and 317 (36.2%) insomnia. Symptoms of depression, anxiety and insomnia were more frequently found in those who did not have basic needs satisfied and in those who felt stigmatized due to being health personal. Besides, depressive symptoms were more frequent in women, anxious symptoms in people younger than 44 years old and insomnia in divorced people. Conclusions: the frequency of mental health problems in health care workers is significant, these findings bring to light the needs for mental health attention in nurses and doctors during COVID-19 pandemic and the research of strategies to mitigate the risk on this population. Feeling stigmatized and not having basic needs satisfied were associated with symptoms of anxiety, depression and insomnia.

Análisis bioético (subjetivismo moral) desde la percepción de los clínicos sobre la situación de los embriones sometidos a fecundación in vitro. Quito-Ecuador / Bioethical analysis (moral subjectivism) from the perception of clinicians on the situation of embryos subjected to in vitro fertilization. Quito-Ecuador / Análise bioética (subjetivismo moral) a partir da percepção dos médicos sobre a situação dos embriões submetidos à fertilização in vitro. Quito-Equador

Resumen: Objetivo. Analizar las percepciones y prácticas de los clínicos en relación con el manejo del embrión sometido a técnicas de fecundación in vitro. Metodología. Cualitativa (subjetivista y fenomenológico). Se realizaron 15 las entrevistas semiestructuradas aplicando un muestreo por saturación dirigidas a personal clínico que haya participado en procedimientos de fecundación in vitro. Los datos se analizaron con el programa Atlas Ti 8.0®. Resultado. Los clínicos consideran al embrión como un ser humano o futuro ser humano y, además, merecedor de respeto y consideración, proponiendo incluso mejoras en los procesos de manipulación y almacenaje. Conclusión. Los embriones no son considerados como entes susceptibles de recibir daño, desde argumentos no solo técnicos sino éticos. Desde la corriente principialista, se describe la necesidad de promover actitudes de responsabilidad y prudencia para evitar el dogmatismo (objetivismo moral) proponiendo una postura deliberativa.

Abstract: The objective of this paper is to analyze the perceptions and practices of clinicians in relation to the management of embryos subjected to in vitro fertilization techniques. Methodology is Qualitative (subjectivist and phenomenological). A total of 15 semi-structured interviews were conducted using saturation sampling for clinical personnel who have participated in vitro fertilization procedures. The data is analyzed with the Atlas Ti 8.0® program. Results: Clinicians consider the embryo as a Human being or future human being, in addition, deserving of respect and consideration even proposing improvements in the processes of handling and storage. Conclusion. Embryos are not considered as entities susceptible of damage from not only technical but ethical arguments. From the principialist current, the need to promote attitudes of responsibility and prudence to avoid dogmatism (moral objectivism) is described, proposing a deliberative position.

Resumo: Objetivo. Analisar as percepções e práticas dos médicos em relação ao manejo do embrião submetido a técnicas de fertilização in vitro. Metodologia. Qualitativo (subjetivo e fenomenológico). Foram realizadas 15 entrevistas semiestruturadas por amostragem de saturação para pessoal clínico que participou de procedimentos de fertilização in vitro. Os dados são analisados com o programa Atlas Ti 8.0®. Resultado. Os médicos consideram o embrião como um ser humano ou futuro, além de merecer respeito e consideração, propondo até melhorias nos processos de manuseio e armazenamento. Conclusão. Os embriões não são considerados como entidades suscetíveis a receber danos não apenas de argumentos técnicos, mas éticos. A partir da corrente principialista, descreve-se a necessidade de promover atitudes de responsabilidade e prudência para evitar o dogmatismo (objetivismo moral), propondo uma posição deliberativa.

Management-service relationship in the SUS based on Morin's Theory of Complexity / Relação gestão-serviços no SUS a partir da Teoria da Complexidade de Morin / Relación gestión-servicio del SUS a partir de la Teoría del Pensamiento Complejo de Morin

The present study aimed to analyze the conceptions of a health management team about their relationship with professionals in the services offered by a municipal healthcare network. The Focus Groups technique was used for data collection: three groups were conducted with an average of 12 participants each and an approximate duration of two hours. The IRAMUTEQ software was used for data analysis, which allows a lexical analysis of the Descending Hierarchical Classification type. Five distinct classes were found. The theoretical-philosophical framework of Edgar Morin's Theory of Complexity was used to discuss the results, which proposes the aspiration to non-reductionist knowledge and the recognition of the incompleteness of any type of knowledge. As final considerations, we understand that the phenomenon addressed in this study consists of multiple factors that recursively affect each other. We stress the discussion about the intersection of the territory in the work dynamics of management teams. In addition, we highlight the value of the meeting between different actors as a possibility of genuine openness to difference, toward the collective construction of this health system. (AU)

Objetivou-se analisar as concepções de uma equipe gestora em saúde sobre sua relação com profissionais dos serviços de uma rede municipal. Aplicou-se a técnica de Grupos Focais: foram três grupos, com 12 participantes cada e duração aproximada de duas horas. Para a análise empregou-se o software IRAMUTEQ que permite uma análise lexical do tipo Classificação Hierárquica Descendente, que resultou em cinco classes distintas. Para discussão dos resultados utilizou-se referencial teórico-filosófico da Teoria da Complexidade de Edgar Morin, que traz a aspiração a um saber não reducionista e o reconhecimento da incompletude de qualquer conhecimento. Entende-se que o fenômeno aqui abordado é constituído por múltiplos fatores que se afetam mútua e recursivamente. Destaca-se a discussão dos atravessamentos do território na dinâmica de trabalho da equipe gestoras. Reforça-se o valor do encontro entre diversos atores enquanto possibilidade de abertura genuína à diferença, na direção de uma construção coletiva do sistema de saúde. (AU)

El presente estudio tuvo como objetivo analizar las concepciones de un equipo de gestión de salud sobre su relación con los profesionales de los servicios ofrecidos por una red municipal de salud. Para la recolección de datos se utilizó la técnica de Grupos Focales: se realizaron tres grupos, con una media de 12 participantes cada uno y una duración aproximada de dos horas. Para el análisis de datos se empleó el software IRAMUTEQ que permite realizar análisis léxicos del tipo Clasificación Jerárquica Descendente, resultando en cinco clases distintas. Para la discusión de los resultados se utilizó el referencial teórico-filosófico de la Teoría del Pensamiento Complejo de Edgar Morin, que propone la aspiración a un conocimiento no reduccionista y el reconocimiento de la incompletud de cualquier conocimiento. Como consideraciones finales se entiende que el fenómeno abordado es constituido por múltiples factores que se afectan mutua y recursivamente entre sí. Se destaca la discusión sobre la intersección del territorio en las dinámicas de trabajo de los equipos de gestión. Además, se refuerza el valor del encuentro entre los diversos actores como una posibilidad de verdadera apertura a la diferencia, hacia la construcción colectiva de este sistema de salud. (AU)

Síndrome de Burnout en trabajadores de salud del Hospital de Arequipa (Perú) durante la pandemia / Burnout syndrome in health care workers of the Hospital Arequipa (Peru) during the pandemic

RESUMEN: Introducción: a finales del año 2019, la comunidad global era sorprendida con la aparición de un brote de coronavirus en China. Se plantea que la exposición crónica a factores de riesgo psicosocial durante varios meses y de manera constante, podrían desencadenar el síndrome de burnout en el personal de salud que atiende pacientes con COVID-19. Objetivo: determinar la frecuencia y severidad del síndrome de burnout en personal de salud que labora en el Hospital II Goyeneche del Ministerio de Salud en Arequipa en el contexto durante la pandemia. Material y Métodos: estudio descriptivo transeccional, en el que se registraron las características sociodemográficas de 147 trabajadores de salud del Hospital II Goyeneche un hospital del Ministerio de Salud y se aplicó el Inventario de Burnout de Maslach. Resultados: el 70,7% del personal de salud del Hospital II Goyeneche de Arequipa presenta síndrome de burnout, y de este porcentaje, la mayoría tiene preocupación por atender pacientes con COVID-19, no se siente capacitado para ello, le preocupa no contar con Equipos de Protección Personal y desconoce los protocolos de seguridad. Conclusión: existe una asociación significativa entre la presencia de síndrome de burnout y la atención de pacientes con COVID-19.

ABSTRACT Introduction: At the end of 2019, the global community was surprised by the new outbreak of coronavirus in China. We argued that the chronic exposure to psychosocial risk factors during four months, could precipitate the burnout syndrome among the healthcare workers who attend patients with COVID-19. Objective: To determine the frequency and severity of burnout syndrome in healthcare personnel who working Goyeneche Hospital from Ministry of Health Hospital from Arequipa City along the COVID-19 pandemic. Material and Methods: Descriptive transectional study, in which there were registered the sociodemographic characteristics of 147 healthcare workers in Goyeneche Hospital and there was applied the Burnout Maslach Inventory. Results: The 70.7% of the Goyeneche Hospital health care personnel presents burnout syndrome, and major part of the percentage have concerns about the attention of patients with COVID-19, also they don't feel trained enough for this, they also are concern because don´t have the Personal protective equipment and they don't know the safety attention protocols. Conclusion: There is a significant association among the burnout syndrome punctuation and the attention of patients with COVID-19.

Validez del cuestionario PHQ-2 para la detección de depresión en personal sanitario colombiano durante Covid-19 / Validity of the PHQ-2 questionnaire for the detection of depression in Colombian health personnel during Covid-19

RESUMEN: Introducción: La sintomatologia depresiva en profesionales de la salud asociado a crisis virales es de alta prevalencia a nivel global, siendo su detección una prioridad por lo cual, el objetivo de esta investigación fue analizar la validez convergente y consistencia interna del cuestionario de salud del paciente-2 (PHQ-2) en profesionales sanitarios. Método: Estudio eSalud donde se recopilaron datos transversales en línea (n=725), de 281 médicos generales, 237 médicos especialistas y 207 enfermeras durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Edad promedio 41,3 años (± 8,76). El 38,4% eran hombres (278) y el 61.6% mujeres (447). El 66.1% del personal sanitario atendió pacientes contagiados por coronavirus y el 33,9% no prestó estos servicios. Se administró la versión de 9 ítems del PHQ, validada en población colombiana junto a la versión de 2 ítems del PHQ. Resultados: Se encontró una alta correlación entre las escalas (r=.860, P<0.001), demostrando la validez convergente del PHQ-2 para medir la sintomatología depresiva. La consistencia interna del PHQ-2 fue adecuada, con un Alpha de Cronbach de 0.80 (I.C.= 0.76 - 0.83). Conclusiones: El PHQ-2 presenta adecuados estándares psicométricos de confiabilidad y validez, por lo que su rápida administración, fácil calificación e interpretación, lo convierte en un instrumento confiable y valido para la detección rápida, sin sobrecargas laborales, de los síntomas depresivos en médicos y enfermeras que atiendan o no pacientes en condiciones de brotes virales.

ABSTRACT Background: Depressive symptomatology in health professionals associated with viral crises is highly prevalent globally, being its detection a priority. Therefore, the objective of this research was to analyze the convergent validity and internal consistency of the Patient Health Questionnaire (PHQ-2) in healthcare professionals. Method: E-Health study where cross-sectional data was collected online (n = 725), from 281 general practitioners, 237 specialist doctors and 207 nurses during the Colombian quarantine, between April 20 and August 10, 2020. Average age 41.3 years (± 8.76). 38.4% were men (278) and 61.6% women (447). 66.1% of health personnel treated patients infected with coronavirus and 33.9% did not provide these services. The 9-item version of the PHQ was administered, validated in the Colombian population together with the 2-item version of the PHQ. Results: A high correlation was found between the scales (r = .860, P <0.001), demonstrating the convergent validity of the PHQ-2 to measure depressive symptomatology. The internal consistency of the PHQ-2 was adequate, with a Cronbach's Alpha of 0.80 (I.C. = 0.76 - 0.83). Conclusions: The PHQ-2 has adequate psychometric standards of reliability and validity, so its rapid administration, easy qualification and interpretation, makes it a reliable and valid instrument for the rapid detection, without work overload, of depressive symptoms in doctors and nurses whether or not they care for patients with viral outbreaks.

Abordar a la persona entre trayectorias alcohólicas y tratamientos / Approaching the person between alcoholic trajectories and treatments

Este artículo es un trabajo de investigación etnográfica en el campo sanitario. Sus objetivos son reconstruir trayectorias de personas con trastornos mentales y de comportamiento por uso de alcohol y visibilizar representaciones y prácticas en los tratamientos brindados en el Hospital Vilardebó (Uruguay), en torno a dichos itinerarios. Las narrativas de los pacientes estudiados dan cuenta de una ruptura biográfica ocurrida mayoritariamente en la adolescencia, cuando comienza un consumo problemático de alcohol que lleva a una reorganización de la identidad social de orden simbólico; refirieren también, la mayoría de ellos, estar disconformes con la asistencia que se les brinda, y reclaman ser más escuchados. Por otra parte, en lo referente a las representaciones formuladas por los funcionarios entrevistados, a mayor formación y experiencia de ejercicio profesional, hay mayores críticas a la atención que se brinda a estos usuarios. De ahí que la confluencia de Antropología y Salud, ensamblando cultura y cuidado, permite integrar a las dimensiones físicas los aspectos emocionales, familiares, culturales y sociales.

This article is carries out ethnographic research in the sanitary field. Its objectives are to reconstruct the trajectories of people with mental and behavioral disorders due to alcohol use and to make visible representations and practices in treatments provided at Hospital Vilardebó (Uruguay). Patients' narratives show a biographical rupture occurring mainly during adolescence. Problematic alcohol use begins soon after, leading to a reorganization of symbolic social identity. Most patients are not satisfied with care provided, and demand to be listened to more extensively. As for health care workers' representations, the greater the training and professional expertise, the greater the criticism of provided care. Hence, the confluence of Anthropology and Health, combining culture and care, makes possible the emotional, family, cultural and social aspects to be integrated into the physical ones.

Actitudes y vivencias sobre la diversidad sexual de profesionales de salud de la zona centro-sur de Chile / Attitudes and experiences about sexual diversity of health professionals in the central-south zone of Chile

Resumen Antecedentes: Les profesionales de salud establecen una relación con personas LGBTIQA+ desde sus propios significados que se manifiestan en actitudes negativas o positivas en cada encuentro con estas personas. Objetivo: Describir las actitudes hacia la diversidad sexual de profesionales de salud del centro-sur de Chile. Método: Estudio cualitativo realizado en cinco ciudades del centro-sur de Chile. Se realizaron entrevistas en profundidad y grupos de discusión a 41 profesionales, en su mayoría de género femenino y matronas. Se realizó un análisis fenomenológico para la descripción de las actitudes y vivencias asociadas con la diversidad sexual. La validez de los datos se aseguró a través de la auditoría durante el proceso investigativo y la triangulación de analistas. Resultados: Les profesionales de la salud entrevistades usan definiciones basadas en el conocimiento popular y la cultura predominante para estructurar sus vivencias personales y profesionales hacia la diversidad sexual. Conclusiones: Las vivencias tienen en común una percepción favorable en el recambio generacional, motivación al aprendizaje de competencias culturales que valoricen la diversidad sexual y una baja o nula formación profesional; en este sentido, el rol del Estado y de las universidades es muy importante en la formación inicial y continua en este tema.

Abstract Background: Health professionals establish a relationship with LGBTIQA+ users from their own meanings that are manifested in negative or positive attitudes in each encounter with them. Objective: To describe the attitudes towards sexual diversity of health professionals in South-Central Chile. Method: Qualitative study conducted in five cities in Central-Southern Chile. In depth interviews and discussion groups were conducted with 41 professionals, mostly women and midwives. A phenomenological analysis was carried out to describe the attitudes and experiences associated with sexual diversity. The validity of the data was ensured through the audit during the research process and the triangulation of analysts. Results: The health professionals interviewed use definitions based on popular knowledge and predominant culture to structure their personal and professional experiences of sexual diversity. Conclusions: The experiences have a favorable perception of generational change in common, motivation to learn cultural competences that value sexual diversity and low or no professional training; in the sense, the role of the State and universities play an important role in the initial and continuous training on this issue

Atención de las necesidades espirituales y religiosas de pacientes por personal de salud: un modelo basado en el acompañamiento espiritual / Attention to the spiritual and religious needs of patients by health personnel: a model based on spiritual accompaniment

Resumen Los aspectos espirituales y religiosos han retomado su importancia en la atención de salud, en la búsqueda de una atención integral, digna y más humana, teniendo en cuenta además, los múltiples beneficios clínicos asociados. Sin embargo, el cuidado de las necesidades espirituales y religiosas, históricamente asumidas por capellanes religiosos y guías espirituales, actualmente, en forma paulatina, son considerados parte de las obligaciones de los equipos de salud, no sin la reticencia de los mismos y sin una manera clara de cómo hacerlo. El objetivo del presente trabajo es presentar la importancia de la atención de las necesidades espirituales y religiosas en el cuidado de salud y un modelo de atención basado en el acompañamiento espiritual.

In the search for comprehensive, dignified and more humane care, the spiritual and religious aspects have regained their importance in health care. Furthermore, the múltiple associated clinical benefits must also be taken into account. However, the care of spiritual and religious needs, historically undertaken by religious chaplains and spiritual guides, have gradually become considered part of the obligations of the health teams, in spite of their reluctance and without a clear way on how to do it. The objective of this work is to present the importance of attending to the spiritual and religious needs in health care and a care model based on spiritual accompaniment.

Adaptación de la imagen corporal en personal de salud durante la COVID-19 / Body image adaptation in health personnel during COVID-19

Introducción: todo lo que tiene contacto con el cuerpo también se integra como parte de la imagen corporal del individuo; el equipo de protección personal (EPP) podría integrarse a la imagen corporal. Objetivo: describir las características del dibujo de la figura humana como herramienta proyectiva de la imagen corporal en el personal de salud. Material y métodos: se realizó un estudio descriptivo longitudinal retrospectivo, que consistió en la recopilación y análisis de los test de dibujo de la figura humana realizado al personal de salud en la contingencia por COVID-19. Se realizó un análisis descriptivo de las variables cualitativas y un análisis inferencial con prueba de McNemar para comparar proporciones entre grupos. Resultados: se incluyeron 147 dibujos en contexto previo y sus respectivos dibujos en contexto durante la contingencia. Al comparar ambos grupos, en el contexto pandémico se observó un incremento en las distorsiones u omisiones (p = 0.013), principalmente localizadas en manos y brazos (p < 0.001). También, se observaron trazos sugerentes de aislamiento (p = 0.039), dibujos con poca definición de los ojos (p = 0.69), inclusión del EPP (p < 0.001) y omisión de nariz (p = 0.011) y boca (p < 0.001). Conclusiones: el incremento en las distorsiones u omisiones puede estar relacionado con la reconstrucción de la parte social. Seis meses posteriores al inicio de la contingencia, el 40% del personal de salud ya había incorporado el EPP a su dibujo proyectivo de imagen corporal.

Background: Everything that has contact with the body is also integrated as part of the individual's body image; Personal Protective Equipment (PPE) could be integrated into body image. Objective: To describe the characteristics of the drawing of the human figure as a projective tool of body image in health personnel. Material and methods: A retrospective longitudinal descriptive study was carried out, which consisted of the compilation and analysis of the drawing tests of the human figure performed on health personnel in the contingency of COVID-19. A descriptive analysis of the qualitative variables and an inferential analysis with McNemar's test were carried out to compare proportions between groups. Results: 147 drawings in the previous context and their respective drawings in context during the contingency were included. When comparing both groups, in the pandemic context an increase in distortions or omissions was observed (p = 0.013), mainly located in the hands and arms (p < 0.001). Also, traces suggestive of isolation (p = 0.039), drawings with poor definition of the eyes (p = 0.69), inclusion of PPE (p < 0.001), and omission of the nose (p = 0.011) and mouth (p < 0.001) were observed). Conclusions: The increase in distortions or omissions maybe related to reconstructing the social part. Six months after the start of the contingency, 40% of the health personnel had already incorporated the PPE into their projective drawing of body image.

Estresse ocupacional relacionado à pandemia de covid-19: o cotidiano de uma unidade de pronto atendimento / Estrés ocupacional relacionado con la pandemia covid-19: la vida diaria de una unidad de atención de emergencia / Occupational stress related to the covid-19 pandemic: the daily life of an emergency care unit

RESUMO Objetivo: analisar o cotidiano de trabalho dos profissionais de saúde de uma Unidade de Pronto Atendimento (UPA), com ênfase nos estressores ocupacionais relacionados à pandemia de COVID-19. Método: estudo de caso qualitativo, fundamentado no referencial teórico-metodológico de Michel de Certeau acerca do cotidiano, realizado em uma UPA porte II do interior de Minas Gerais, Brasil. Foi realizada triangulação de dados, com observações, entrevistas com 31 profissionais e análise documental. Os dados foram organizados no MAXQDA2020® e submetidos à análise de conteúdo de Bardin. Resultados: o cotidiano da UPA foi alterado pela pandemia e a instituição passou por adaptações para atender os casos suspeitos ou confirmados de COVID-19, com novas estratégias de funcionamento e redefinição do mapa da assistência. Os estressores ocupacionais identificados foram falta de clareza nas informações iniciais sobre a doença, medo de se contaminarem ou a familiares, uso de equipamentos de proteção individual (EPIs), testagem, afastamento e sobrecarga de profissionais, risco de falta de medicamentos e estigmatização dos profissionais de saúde. Por outro lado, disponibilidade de EPIs, queda do número de atendimentos, orientações e treinamentos foram fatores protetores contra o estresse. Ademais, alguns profissionais adotaram táticas para amenizar os estressores decorrentes da pandemia. Conclusão: o cotidiano da UPA foi alterado e o estresse ocupacional relacionado à pandemia acomete profissionais de saúde. Medidas de proteção da saúde mental são necessárias para que possam enfrentar a grave crise sanitária, com vistas à prevenção do sofrimento, melhor qualidade de vida no trabalho e melhores condições laborais e de atendimento aos usuários.

RESUMEN Objetivo: analizar el trabajo diario de los profesionales de la salud en una Unidad de Cuidados de Emergencia (UPA), con énfasis en los estresores ocupacionales relacionados con la pandemia de COVID-19. Método: estudio de caso cualitativo, basado en el marco teórico-metodológico de Michel de Certeau sobre la vida cotidiana, realizado en una UPA tamaño II en el interior de Minas Gerais, Brasil. Se realizó triangulación de datos, con observaciones, entrevistas a 31 profesionales y análisis de documentos. Los datos se organizaron en MAXQDA2020® y sometidos al análisis de contenido de Bardin. Resultados: la vida cotidiana de la UPA fue modificada por la pandemia y la institución fue adaptada para atender casos sospechosos o confirmados de COVID-19, con nuevas estrategias operativas y redefinición del mapa de atención. Los estresores ocupacionales identificados fueron falta de claridad en la información inicial sobre la enfermedad, miedo a contaminarse o de familiares, uso de equipo de protección personal (EPI), pruebas, baja y sobrecarga de profesionales, riesgo de falta de medicación y estigmatización de los profesionales de la salud. Por otro lado, la disponibilidad de EPP, la disminución del número de consultas, la orientación y la formación fueron factores protectores frente al estrés. Además, algunos profesionales adoptaron tácticas para aliviar los factores estresantes resultantes de la pandemia. Conclusión: la vida diaria de la UPA cambió y el estrés laboral relacionado con la pandemia afecta a los profesionales de la salud. Las medidas de protección de la salud mental son necesarias para que puedan afrontar la grave crisis sanitaria, con el fin de prevenir el sufrimiento, mejorar la calidad de vida en el trabajo y mejores condiciones de trabajo y servicio para los usuarios.

ABSTRACT Objective: to analyze the daily work of health professionals in an Emergency Care Unit (ECU), with an emphasis on occupational stressors related to the COVID-19 pandemic. Method: qualitative case study, based on Michel de Certeau's theoretical-methodological framework about everyday life, carried out in a ECU size II in the countryside of Minas Gerais, Brazil. Data triangulation was performed, with observations, interviews with 31 professionals and document analysis. Data were organized in MAXQDA2020® and submitted to Bardin's content analysis. Results: the daily life in the ECU was changed by the pandemic and the institution underwent adaptations to attend to suspected or confirmed cases of COVID-19, with new operating strategies and redefinition of the assistance map. The occupational stressors identified were lack of clarity in the initial information about the disease, fear of contaminating themselves or family members, use of personal protective equipment (PPE), testing, removal and overload of professionals, risk of lack of medication and stigmatization of professionals of health. On the other hand, availability of PPE, drop in the number of visits, guidance and training were protective factors against stress. In addition, some professionals have adopted tactics to alleviate the stressors arising from the pandemic. Conclusion: the routine of the ECU has changed and the occupational stress related to the pandemic affects health professionals. Mental health protection measures are necessary so that they can face the serious health crisis, with a view to preventing suffering, better quality of life at work and better working conditions and service to users.

"Pegar" ou "passar ": medos entre profissionais da linha de frente da COVID-19 / "To Catch" or "to give": fears among frontline professionals at COVID-19

OBJETIVO: Investigar a relação entre a realização de testes para detectar COVID-19 e indícios de sofrimento psíquico, estresse e burnout entre profissionais de saúde da linha de frente da pandemia em um hospital geral. MÉTODOS: Estudo prospectivo de abordagem mista usando SRQ-20, PSS, OBI e entrevistas em profundidade em série de três entrevistas em 2020. RESULTADOS: Prevalências preocupantes de escores elevados de SRQ20, Burnout e Estresse Percebido ocorreram nas três entrevistas, e o registro de testes realizados foi crescente no período estudado, mas não houve associação entre desfechos e realização de testes para detectar COVID-19. Os temores de contrair a doença e de ser transmissor do vírus apareceram como os principais estressores para profissionais de saúde, mantidos apesar da realização de testes. CONCLUSÃO: Nesse grupo, testes realizados não se mostraram suficientes para modificar os efeitos psicossociais da atividade em linha de frente sobre profissionais de saúde.

OBJECTIVE: To investigate the relationship between the performance of tests to detect COVID-19 and signs of psychological distress, perceived stress and burnout among health professionals on the frontline of the pandemic in a general hospital. METHODS: Prospective mixed-approach study using SRQ-20, PSS, OBI and in-depth interviews in a series of 3 interviews throughout 2020. RESULTS: Worrying prevalences of high scores of SRQ20, Burnout and Perceived Stress occurred on the three interviews and the number of tests performed increased during the study period, but there was no association between outcomes and testing to detect COVID- 19. Fear of contracting the disease or being a transmitter of the virus appeared as the main stressors for health professionals, maintained despite testing. CONCLUSION: In this group, tests performed were not sufficient to modify the psychosocial effects of the front line activity on health professionals.

Más allá de la "falla hormonal": concepciones de profesionales de atención primaria sobre el climaterio en Santiago, Chile / Beyond the "ovarian failure": primary healthcare practitioners' views on climacteric in Santiago, Chile

OBJETIVO: El presente artículo busca conocer cómo los profesionales conciben la sexualidad de mujeres en etapa de climaterio, enfatizando aspectos relativos a la salud sexual, al deseo sexual y a los problemas de la sexualidad. MÉTODOS: Enfoque cualitativo basado en la Teoría Fundamentada (Grounded Theory). Se realizaron diez entrevistas en profundidad a profesionales de dos Centros de Salud Familiar (CESFAM) del sector sur de Santiago. RESULTADOS: Los resultados muestran que, si bien existe cierta tendencia a concebir el climaterio desde un punto de vista biologicista centrada principalmente en la "falla hormonal", los/as profesionales muestran diversos grados de reflexividad respecto a cómo aspectos socioculturales, económicos y de género moldean la sexualidad de mujeres en la etapa de climaterio. CONCLUSIONES: Los/as profesionales asumen posturas críticas respecto al rol de las instituciones y programas en salud, a las limitaciones laborales en los centros de salud (por ej. materiales, tiempo, etc.) y a la formación profesional. Este artículo promueve la formulación de políticas de salud en la materia, así como la revisión de los planes de estudio de las carreras de la salud.

OBJECTIVE: This article aims to examine how professional practitioners view womens sexuality in the climacteric stage, emphasizing aspects related to sexual health, sexual desire, and sexual disorders. METHODS: Qualitative approach based on the Grounded Theory. Ten in-depth interviews were conducted with professionals from two Family Health Centers (CESFAM) in southern Santiago. RESULTS: The results show that, although there is a certain tendency to approach the climacteric from a biological viewpoint focused mainly on the “ovarian failure”, practitioners show different degrees of reflexivity regarding how sociocultural, economic and gender aspects shape womens sexuality in the climacteric stage. CONCLUSIONS: Practitioners adopt critical positions regarding the role of health institutions and programs, work limitations in health centers, and the practitioners training. This article promotes the development of health policies in the matter, as well as the revision of study plans of health careers.

Autocuidado espiritual da equipe de enfermagem de um hospital oncológico / Spiritual self-care of the nursing staff of an oncology hospital / Autocuidado espiritual del personal de enfermería de un hospital de oncología

Objetivo: compreender as ações realizadas pela equipe de Enfermagem de um hospital oncológico para o desenvolvimento do autocuidado espiritual. Métodos: estudo descritivo-exploratório de abordagem qualitativa, realizado num hospital oncológico brasileiro. Foram entrevistados 12 profissionais de Enfermagem do hospital em janeiro de 2018. Os dados foram analisados através da Análise de Conteúdo. O estudo respeitou os aspectos éticos, parecer 2.415.223. Resultados: as cinco categorias desvelaram que o desenvolvimento da espiritualidade ocorre por meio do auxílio ao próximo e ato de cuidar; da interação social e do diálogo; do exercício de práticas religiosas; pela composição de canções; e ainda uma que revelou a negação de práticas relacionadas ao desenvolvimento espiritual. Conclusão: cuidado ao próximo, interação social, práticas religiosas e lúdicas foram apontadas como promotoras do autocuidado espiritual. Sugere-se a potencialização destas atividades, visto a importância da espiritualidade para pacientes e familiares, reverberando positivamente no cuidado prestado pela equipe de Enfermagem

Objective: to understand the actions performed by the nursing team of an oncology hospital for the development of spiritual self-care. Methods: descriptive-exploratory study with a qualitative approach, carried out in a Brazilian oncologic hospital. Twenty-two nursing professionals from the hospital were interviewed in January 2018. The data were analyzed through Content Analysis. The study respected ethical aspects, legal opinion 2.415.223. Results: the five categories showed that the development of spirituality occurs through the help of others and the act of caring; social interaction and dialogue; the exercise of religious practices; by the composition of songs; and one that revealed the denial of practices related to spiritual development. Conclusion: care for others, social interaction, religious and playful practices were identified as promoters of spiritual self-care. The enhancement of these activities is suggested, given the importance of spirituality for patients and families, positively reverberating in the care provided by the Nursing team

Objetivo: comprender las acciones realizadas por el equipo de enfermería de un hospital oncológico para el desarrollo del autocuidado espiritual. Métodos: estudio descriptivo-exploratorio con abordaje cualitativo, realizado en un hospital oncológico brasileño. Veintidós profesionales de enfermería del hospital fueron entrevistados en enero de 2018. Los datos fueron analizados a través del Análisis de Contenido. El estudio respetó aspectos éticos, opinión 2.415.223. Resultados: las cinco categorías mostraron que el desarrollo de la espiritualidad se produce a través de la ayuda de otros y el acto de cuidar; interacción social y diálogo; el ejercicio de prácticas religiosas; por la composición de canciones; y uno que reveló la negación de prácticas relacionadas con el desarrollo espiritual. Conclusión: el cuidado de los demás, la interacción social, las prácticas religiosas y lúdicas se identificaron como promotores del autocuidado espiritual. Se sugiere la potenciación de estas actividades, dada la importancia de la espiritualidad para los pacientes y sus familias, repercutiendo positivamente en los cuidados brindados por el equipo de Enfermería

Pandemia da Covid-19: reflexões para a vigilância em saúde / Covid-19 pandemic: reflections for health surveillance

A doença causada pelo novo coronavírus (COVID-19) é atualmente o mais grave problema de saúde pública no mundo. Avaliar a distribuição temporal e os fatores associados com a mortalidade por COVID-19 em públicos distintos pode fornecer evidências sobre a dinâmica temporal e os grupos com maior risco de óbito. Ademais, com as medidas adotadas para o enfrentamento da pandemia, foram verificadas mudanças na prática profissional de profissionais de saúde e professores, sendo importante avaliar o impacto na saúde mental. Nesse contexto, o objetivo deste estudo foi avaliar a morbidade e mortalidade por COVID-19 no Brasil e o impacto da pandemia na saúde mental de profissionais de saúde e professores. Para responder a este objetivo, foram desenvolvidos quatro estudos. No primeiro, de corte transversal, foram incluídos 8.402 crianças e adolescentes de 0 a 19 anos com SRAG por COVID-19. A taxa de incidência e de mortalidade foi 13,74 e 1,35 por 100.000, respectivamente, com letalidade de 9,81%. Na análise multivariada pela Regressão de Poisson com variância robusta, os fatores associados com maior risco de óbito foram faixa etária < 1 ano, cardiopatia, doenças imunossupressoras, doenças neurológicas e síndrome de Down. No segundo artigo, de revisão sistemática, foi identificado que os instrumentos Mini Nutritional Assessment (MNA), MNA-short form, o Geriatric Nutrition Risk Index, o Nutritional Risk Screening 2002, o Malnutrition Universal Screening Tool, o modified Nutrition Risk in Critically Ill (NUTRIC) score e o Subjective Global Assessmen apresentam elevada sensibilidade para identificação de risco nutricional em idosos com COVID-19. No terceiro artigo, de revisão sistemática sobre a saúde mental de professores em tempos de COVID-19, foi verificado que a prevalência de ansiedade variou de dez a 49,4%, para depressão, de 15,9 a 28,9%, e, para estresse, de 12,6 a 50,6%. Atuar em escolas (em comparação com universidades), ser do sexo feminino e estar vivenciando retorno às aulas presenciais foram fatores relacionados com maior risco de alterações emocionais. No quarto artigo, uma revisão sistemática com metanálise sobre a ansiedade em profissionais de saúde, foi identificada prevalência de 35% (IC95%: 29-40), sendo maior nas mulheres e nos enfermeiros. Atuar na linha de frente, estar infectado com coronavírus e apresentar doenças crônicas também foram fatores associados com maior risco de ansiedade. Os resultados desta tese evidenciam que apesar de menos prevalência que em idosos, a COVID-19 também acomete considerável quantidade de crianças e adolescentes no Brasil. Para os idosos, foi verificado que os instrumentos de triagem nutricional são úteis para a identificação de risco nutricional. Foi registrada elevada prevalência de alterações do estado emocional em profissionais de saúde e professores, havendo a necessidade de medidas em saúde coletiva que visem à prevenção destas alterações nestes profissionais. Há a necessidade de inclusão desta pauta em Vigilância em Saúde, especificamente Saúde do Trabalhador (AU).

The disease caused by the new coronavirus (COVID-19) is currently the most serious public health problem in the world. Considering the magnitude of the disease, as well as the psychosocial and economic impacts, assessing the temporal distribution and factors associated with mortality from COVID-19 in different publics can provide evidence about the temporal dynamics and the groups with the highest risk of death. With the measures adopted to face the pandemic, changes were observed in the professional practice of health professionals and teachers, and it is important to assess the impact on mental health. In this context, the aim of this study was to assess morbidity and mortality from COVID-19 in Brazil and the impact of the pandemic on the mental health of health professionals and teachers. To respond to this objective, four studies were developed. In the first, a cross-sectional study, 8,402 children and adolescents aged 0 to 19 years with Severe Acute Respiratory Syndrome (SARS) due to COVID-19 were included. The incidence and mortality rates were 13.74 and 1.35 per 100,000, respectively, with a mortality rate of 9.81%. In the multivariate analysis using Poisson Regression with robust variance, the factors associated with a higher risk of death were age group < 1 year, heart disease, immunosuppressive diseases, neurological diseases and Down syndrome. In the second article, a systematic review, it was identified that the instruments Mini Nutritional Assessment (MNA), MNA-short form, the Geriatric Nutrition Risk Index, the Nutritional Risk Screening 2002, the Malnutrition Universal Screening Tool, the modified Nutrition Risk in Critically Ill (NUTRIC) score and the Subjective Global Assessmen have high sensitivity for identifying nutritional risk in older adults with COVID19. In the third article, a systematic review on the mental health of teachers in times of COVID-19, it was found that the prevalence of anxiety ranged from ten to 49.4%, for depression, from 15.9 to 28.9%, and, for stress, from 12.6 to 50.6%. Working in schools (compared to universities), being female and experiencing a return to face-to-face classes were factors related to a higher risk of emotional changes. In the fourth article, a systematic review with meta-analysis on anxiety in health professionals, a prevalence of 35% (95%CI: 29-40) was identified, being higher in women and nurses. Working on the front lines, being infected with the coronavirus and having chronic illnesses were also factors associated with a higher risk of anxiety. The results of this thesis show that despite being less prevalent than in the elderly, COVID-19 also affects a considerable number of children and adolescents in Brazil, with a higher prevalence ratio for death in those with heart disease, immunosuppressive diseases, neurological diseases and Down syndrome. A high prevalence of alterations in the emotional state was registered in health professionals and teachers, with the need for collective health measures aimed at preventing these alterations in these professionals. There is a need to include this agenda in Health Surveillance, specifically Occupational Health (AU).

Psychological demands of health professionals in the initial phase of the COVID-19 pandemic

Abstract Recent literature emphasizes how the specific stressors of the COVID-19 outbreak affect the general population and frontline professionals, including those conducting support or backup activities in health units, which can lead to vicarious traumatization. Vicarious traumatization has been used to describe negative emotional reactions in mental health professionals who assist or treat victims of traumatic events. Thus, the aim of this article is to report the actions used in the face of the psychological demands of professionals in a hospital, who were not on the frontline of COVID-19. We collected their sociodemographic information and checked the psychological impact using the depression, anxiety, and stress scale (DASS-21), which was followed by a psychoeducational program (topics related to COVID-19 control and prevention), and individual psychological care for the most severe cases. A total of 118 professionals participated in this study; they were between 20 and 67 years old. Mild to moderate anxiety was observed in 36.5% of the medical teams, 83.3% of the administrative staff, and 65.7% of general service workers, while stress symptoms were observed in 80.2%, 83.3%, and 59.9%, respectively. Depressive symptoms (35.3%) were more frequent in general service workers. The medical teams reported the benefits of primary psychological care, while the other professionals demanded more institutional support services related to the prevention and use of personal protective equipment. This study highlights relevant psychological demands that have repercussions on the daily lives of professionals. The psychoeducational program was considered positive regarding clarification actions. However, it was not perceived as effective in reducing fear, which may result from vicarious traumatization and requires other intervention modalities.

La seguridad psicológica del personal de salud durante la pandemia por COVID-19: aproximación epistemológica y sociológica / The psychological safety of health personnel during the COVID 19 pandemic: epistemological and sociological approach

La pandemia de COVID-19 pone en evidencia la importancia de los aspectos psicológicos y de salud mental para la prevención y afrontamiento de sus consecuencias. En este contexto se requiere de un modelo de Seguridad Psicológica (SP) que fundamente teórica y metodológicamente su gestión en una situación de emergencia sanitaria. El problema de la SP, visto desde una perspectiva transdisciplinar, intercepta aspectos relacionados con la epistemología y la sociología de la ciencia: análisis crítico del concepto a la luz de los aportes de otras disciplinas; relaciones entre el nivel de acceso al conocimiento y el funcionamiento de los equipos de trabajos; y contradicción entre la gestión neoliberal de la pandemia y la necesidad de un afrontamiento humanista. El objetivo del artículo es analizar, desde la perspectiva sociológica y epistemológica, la SP del personal de la salud en emergencias sanitarias, para lo cual se desarrolló una revisión narrativa. Como resultado, se presentan las reflexiones desarrolladas acerca del tema estructuradas en dos momentos: la aproximación crítica a la epistemología del concepto de SP y el impacto de la SP en los equipos de trabajo visto desde la concepción de la sociedad del conocimiento. Se enfoca la SP como un campo transdisciplinario y se valoran los antecedentes y aportes de otras disciplinas para su empleo en situaciones de emergencia y desastres. También se contrasta el afrontamiento a la COVID-19 desde la gestión neoliberal con su afrontamiento humanista. Finalmente, se presenta una nueva perspectiva de la SP para la gestión de la salud mental del personal de la salud involucrado en la respuesta a emergencias y desastres

The COVID-19 pandemic highlights the importance of psychological and mental health aspects for preventing and coping with its consequences. In this context, a model of Psychological Safety (PS) is required that theoretically and methodologically bases its management in a health emergency situation. The problem of PS, seen from a transdisciplinary perspective, intercepts aspects related to the epistemology and sociology of science: the critical analysis of the concept in light of the contributions of other disciplines; the relationships between the level of access to knowledge and the functioning of work teams and the contradiction between the neoliberal management of the pandemic and the need for a humanistic approach. The objective of the article is to analyze, from the sociological and epistemological perspective, the PS of health personnel in health emergencies, for which a narrative review was developed. As a result, the reflections developed on the subject structured in various moments are presented: the critical approach to the epistemology of the concept of PS; the impact of PS on work teams seen from the conception of the knowledge society. PS is approached as a transdisciplinary field and the antecedents and contributions of other disciplines are valued for its use in emergency situations and disasters. The coping with COVID-19 is also contrasted from that of neoliberal management with its humanistic coping. Finally, a new perspective of the PS is presented for the management of the mental health of the health personnel involved in the response to emergencies and disasters

Síndrome de Burnout y desempeño laboral del personal de salud durante la pandemia COVID 19 / Burnout syndrome and work performance of health personnel during the COVID 19 pandemic

La investigación tiene como objetivo contrastar el síndrome de Burnout con el desempeño laboral en el contexto del Covid-19. Se desarrolla un estudio descriptivo transversal de tipo cuantitativo, se utilizan dos encuestas validadas: escala de Maslach Burnout Inventory y desempeño laboral, la población corresponde al personal de salud que labora en la unidad de cuidados intensivos. Los resultados determinan que existe mediana prevalencia en padecer síndrome de burnout en relación al desempeño laboral, el mayor porcentaje se encuentra con una evaluación alta caracterizando a los profesionales casados con un mejor desempeño laboral que los solteros, la mayor fuerza laboral se sitúa en la población adulta madura en rangos de 30 a 40 años, se obtiene correlación significativa entre el síndrome de burnout y desempeño laboral, no existe relación significativa entre las variables sociodemográficas y el síndrome de burnout.

The objective of the research is to contrast the Burnout syndrome with work performance in the context of Covid-19. A cross-sectional descriptive study of quantitative type is developed using two validated surveys: the Maslach Burnout Inventory scale and work performance, the population corresponds to health personnel who work in the intensive care unit. The results determine that there is a medium prevalence of suffering from burnout syndrome in relation to work performance, the highest percentage is found with a high evaluation, characterizing married professionals with better work performance than single ones, the highest workforce is located in the mature adult population in the 30 to 40 years age range, there is a significant correlation between burnout syndrome and work performance, there is no significant relationship between sociodemographic variables and burnout syndrome.

Prevalence of burnout among healthcare professionals in Singapore

INTRODUCTION@#The aim was to study the prevalence of burnout among various groups of healthcare professionals in Singapore.@*METHODS@#An anonymous online survey questionnaire was conducted using the Maslach Burnout Inventory - Human Services to measure three categories of burnout: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) from July 2019 to January 2020 in a healthcare cluster in Singapore.@*RESULTS@#The survey was completed by 6,048 healthcare professionals out of a target survey population of 15,000 (response rate 40.3%). The study revealed 37.8% of respondents had high EE score ≥27, 29.7% of respondents had high DP score ≥10, and 55.3% of respondents had low PA score ≤33. Respondents with either high EE score or high DP score constituted 43.9% (n=2,654). The Allied Health group had the highest mean EE score, which was significantly higher than those of Medical, Nursing and Non-clinical groups (P<0.05). The Medical group had the highest mean DP score and this was significantly higher than the Nursing, Allied Health and Non-clinical groups (P<0.05). The Non-clinical group had the lowest PA, which was significantly lower than the Medical, Nursing and Allied Health groups (P<0.005).@*CONCLUSION@#There was high prevalence of burnout among healthcare professionals in Singapore, especially the allied health professionals. There were significant differences in the 3 categories of burnout (EE, DP and PA) among the different groups of healthcare professionals. There is an urgent need to address the high burnout rate.