FINANCIAL STRESS AS PERCEIVED JOB LOSS POTENTIAL IN PERU DURING THE COVID-19 PANDEMIC.

Introduction: The COVID-19 pandemic has caused insecurity in many aspects, mainly because of the possibility of losing one's job. Objective(s): To determine whether financial stress was associated with the perception of losing one's job in Peru during the COVID-19 pandemic. Material(s) and Method(s): Analytical cross-sectional study, in which 507 respondents participated. The main variable was obtained from a validated survey measuring job insecurity, which was crossed with financial stress and other socio-labor variables. Result(s): In the multivariate analysis, those with financial stress had greater job insecurity (RPa: 2.46;95%CI: 2.20-2.75;p-value<0.001), while the younger the age, the greater the job insecurity (RPa: 0.992;95%CI: 0.985-0.999;p-value=0.024), adjusted for marital status and type of work. Conclusion(s): The strong association between financial stress and job insecurity is confirmed. This finding may have repercussions on the occupational health of workers, generating an inadequate work environment.Copyright © 2022, Accion Medica S.A.. All rights reserved.

Socio-occupational factors associated with psychological distress in healthcare workers during the COVID-19 pandemic

Introduction: Psychological distress due to the context of the COVID-19 pandemic has become very common, especially in health care workers, who have been one of the most affected populations. Objective: To determine the socio-occupational factors associated with psychological distress in health care workers during the COVID-19 pandemic in the Peruvian highlands. Methods: Cross-sectional design study, where 3 previously validated scales measuring psychological distress, fear of being infected with COVID-19 and workload were applied (alpha values: 0.79, 0.91 and 0.83, respectively). These were added to other socio-occupational variables;descriptive and analytical statistics were obtained. Results: When multivariate analysis was performed, it was found that those who had a higher score of fear of contagion by COVID-19 (RPa: 1.45;IC95%: 1.12-1.87;valor p= 0.005) and those who had a higher perception of work overload (RPa: 1.45;IC95%: 1.12-1.87;valor p= 0.005) were those who had greater perception of psychological distress, moreover, compared to physicians, psychologists had more psychological distress (RPa: 2.73;IC95%: 1.67-4.46;valor p< 0.001). Conclusion: Significant associations were found, with the predominant finding being that there is a strong association between psychological distress and fear of possible infection with COVID-19, as well as with the perception of work overload, mainly in professional psychologists. © 2022, Editorial Ciencias Medicas. All rights reserved.

Worldwide Scientific Production on Teleworking in Scopus in Times of COVID-19

Given the impact of COVID-19, teleworking has become an alternative work modality, so it is important to evaluate the scientific activity on the subject. Thus, the objective was to analyze the global scientific production on teleworking in times of COVID-19. Retrospective and descriptive study, whose unit of analysis was the publications on teleworking in journals indexed in the Scopus database between January 2020 and December 2021. The search was performed using the fields Article Title, s, Keywords, where 24 search terms were applied: teleworking, telecommuting, work from home, teleworking, telecommuting, work from home, online work, e-work, telecommuting, teletrabajo, trabado desde casa, trabajo online, e-trabajo, trabajo a distancia, teletrabalho, trabalho a partir de casa, trabalho em linha, trabalho electrónico, trabalho à distancia, and their relation with the term Covid-19. Likewise, 995 articles were found and 75.38% of them were original manuscripts. United States is the country with the largest scientific production with 21.21%. The Università degli Studi di Torino of Italy has published 10 papers and 80% of the articles on teleworking in times of COVID-19 have been published in quartile 1 and 2 journals. Teleworking in times of COVID-19 has been studied in several countries around the world as well as in different academic disciplines, which allows us to know progress on the subject, thereby generating policies and lines of research for the prevention of occupational hazards. © 2022 Mamani-Benito et al.

Benefits Of An Interdisciplinary Nurse Practitioner And Clinical Pharmacy Specialist Heart Failure Access Clinic

Background: : To help reduce heart failure (HF) readmissions and improve patient outcomes, the Madison VA established a Nurse Practitioner (NP) led Heart Failure Access Clinic (HFAC) to provide patient follow-up within 4-7 days of discharge. Studies have demonstrated medication discrepancies and delayed implementation of guideline-directed medical therapy as potential contributors to 30-day hospital readmission. Thus, a clinical pharmacy specialist (CPS) was incorporated into the Madison VA HFAC model to focus on optimizing medication regimens. The purpose of this project is to evaluate the impact of an interdisciplinary NP-CPS HFAC versus a NP HFAC on 30-day patient outcomes. Methodology: A retrospective chart review was completed for all patients hospitalized with a primary discharge diagnosis of acute on chronic systolic heart failure (ADHF) at the Madison VA and seen in a HFAC after discharge between November 2019 and November 2020. Patients with LVEF greater than 50% and those discharged to hospice were excluded. During the early period of the COVID-19 pandemic (mid-March through July 2020), patients were seen by the NP only. Outcomes and interventions for patients who attended an interdisciplinary NP-CPS HFAC were compared to those who attended the NP HFAC. Primary outcomes included rehospitalization, emergency department (ED) visit, and all-cause mortality at 30 days. Secondary outcomes included HF medication adjustments, identification of inappropriate medications in patients with HF, medication discrepancies, alerts to another provider for follow up, referral to another service, or referral to HF CPS for continued optimization of GDMT. Results: A total of 90 veterans met the inclusion criteria;43 were seen in the NP HFAC and 47 were seen in the interdisciplinary NP-CPS HFAC. The incidence of adverse 30-day outcomes in this patient cohort was very low (readmission 5.6%, ED visit 1.1%, death 1.1%) and there were no significant between group differences. Statistically significant secondary outcomes favoring the interdisciplinary HF clinic included identification of medication discrepancies (P=<0.0001), alert to another providers for follow up (P=0.004), as well as referral to the HF CPS for continued medication titration (P=0.02). Conclusion: Patients seen in the interdisciplinary NP-CPS HFAC and HP HFAC had similarly low 30-day hospital readmission rates, ED visits and mortality. Involvement of a CPS in the HFAC led to more frequent identification of medication discrepancies, notification to providers regarding medication issues, and referral to a HF CPS for timely GDMT optimization. Further analysis is warranted to assess the impact of these early CPS interventions on long-term patient outcomes.

FINANCIAL STRESS SCALE (EFEMP-COV19): INITIAL EVIDENCE OF VALIDITY AND RELIABILITY IN SMALL AND MEDIUM PERUVIAN ENTREPRENEURS

Objective:To design and validate a scale of financial stress due to the impact of COVID-19 for Peruvian entrepreneurs. Material and Methods: Instrumental and cross-sectional study, carried out in 278 small and medium Peruvian entrepreneurs.The instrument was designed taking indicators found in the scientific literature. Results: The items show Aiken V indicators with values > 0,70. The Exploratory Factor Analysis was justified, with a KMO (0.853) and Bartlett (3459.6;gl = 55;p < 0.001). Product of the robust analyses (X2 = 125.436;p < 0.001;TLI = 0.957;CFI = 0.965 and GFI = 0.986);a single factor was found that explains 68.21% of the total variance of the test and its factor loadings range between 0.673 and 0.920, in addition, the reliability is very acceptable;α = 0.952 (CI95% = 0.93-0.96). Conclusion: The scale proves to be valid and reliable for measuring financial stress in Peruvian entrepreneurs.

FINANCIAL STRESS AND FEAR OF COVID-19 AS PREDICTORS OF PSYCHOLOGICAL DISTRESS IN SMALL AND MEDIUM-SIZED PERUVIAN ENTREPRENEURS

Objective: To determine whether financial stress and fear of COVID-19 are predictors of psychological distress in small and medium Peruvian entrepreneurs. Material and methods: A cross-sectional, predictive study in which 305 Peruvian entrepreneurs from sectors such as education, transportation, infrastructure, commerce, food, automotive and tourism voluntarily participated. Data were collected through a scale of financial stress, a scale of fear of COVID-19 and a scale of psychological distress. Results: The results of the multiple regression analysis show an adequate model fit (F-test=168,842, p<0,001), where financial stress (β=0,48, p<0,01) and fear of COVID-19 (β=0,31, p<0,01), are variables that significantly predict psychological distress (adjusted R2=0,52). Conclusion: Financial stress and fear by COVID-19 are predictors of psychological distress in small and medium Peruvian entrepreneurs. © 2021, Accion Medica S.A.. All rights reserved.

Factors associated with worry and fear during COVID-19 in preprofessional health practitioners

Introduction: Preprofessional health care practitioners were also mentally affected by COVID-19. Objectives: To determine the factors associated with having more worry and fear during COVID-19 in Peruvian pre-professional health care practitioners. Methods: Cross-sectional study with analytical methods, with the participation of 285 students from different health careers in southern Peru, to whom 2 locally validated tests were applied and crossed with different socio-educational variables. Results: The main concerns were that they could not help worrying despite the measures taken, the uncertainty of being an unpredictable disease, the fact that their workplace has many risks and the perception that their ability to work would be affected by being infected. The main fears were the perception that their heart was racing or that their hands were sweating. Those who were in an I-3 facility (without hospitalization) were less worried than those in other facilities (RPa: 0.56;95 % CI: 0.43-0.72;p-value< 0.001), adjusted for sex and educational career. In addition, the older the age, the more fear (RPa: 1.76;95 % CI: 1.46-2.11;p-value< 0.001), adjusted for 4 variables. Conclusions: The practitioners showed concern in relation to the unpredictability of the disease, occupational hazards and the fact that they could be infected;in addition, fear that caused a very strong cardiac acceleration and sweating in the hands. Associated with the concern was the level of the health facility where they worked. Associated with fear was the age of the respondents. © 2022, Editorial Ciencias Medicas. All rights reserved.

Family medicine during and after covid-19

The pandemic caused by the sars- CoV-2 virus has shown the urgent need to advance from the biomedical model towards Patient-Centered Medicine (pcm), which involves an approach to the health-disease process from the social determinants of health, the syndemic theoretical framework and the paradigm of Evidence-Based Medicine (ebm). The integration of administrative, research and health training allows the family physician to design and coordinate promotion and prevention programs, as well as to suggest changes in public health policies on a small and large scale. This document seeks to describe the importance of Family Medicine to strengthen Primary Health Care (phc).