ABSTRACT
Background: The COVID-19 pandemic has forced the reorganisation of healthcare services, and the implementation of contingency plans impacted Primary Health Care (PHC) workers' daily demands. The training and support of health workers staff, its clinical, psychological and social support are additional challenges. Research question: How have PHC services responded to the pandemic and how has this impacted PHC workers regarding anxiety levels? Methods: We conducted a cross-sectional survey with a convenience sample of Primary Care Services workers from 7 European countries (Portugal, Spain, Bosnia, Italy, Turkey, Ukraine and France) using an online questionnaire. Ethical aspects were guaranteed. We collected information on gender, age, professional group, perceived support, access to personal protective equipment (PPE), overall pressure felt by professionals and their anxiety levels by March 2020 and May 2021. The association between each variable and anxiety were estimated through multivariate logistic regression. Result(s): Our sample comprised 1045 PHC workers (73.8% female, mean age 44.8 years;49.6% doctors). Almost 70% of participants claimed to monitor suspected COVID-19 patients and 66.5% reported a risk management protocol was in place. In March 2020, 54% of participants reported little/no PPEs availability, whereas in May 2021 76% stated PPEs were available/very available. About 65% of the participants feel high/extreme pressure at their work. High/extreme anxiety levels were reported by 54.1% in March 2020 and 38.3% in May 2021. Multivariate logistic regression analysis showed that feeling supported regarding personal problems and encouraged to maintain social interactions was associated with lower anxiety levels (adjusted OR =0.292, p=0.009;adjusted OR =0.390, p=0.012). Conclusion(s): Despite perceived high work-related pressure levels, PHC services adapted to the pandemic demands by implementation of risk management plans. PHC workers anxiety levels reduced from March 2020 to May 2021. Feeling encouraged to maintain social interactions and supported regarding personal problems decreased the likelihood of anxiety.
ABSTRACT
Background: With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. Research question: We explored GPs' perspectives on digital remote care's main benefits and challenges. Method(s): GPs across 20 countries completed an online questionnaire between June and September 2020. GPs' perceptions of main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. Result(s): In our survey 1605 respondents participated. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and the accompanying legal frameworks. Main challenges included patient's preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues and regulatory weaknesses. Conclusion(s): At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how. Lessons learned during the emergency phase can inform the stable adoption of virtual care solutions and co-design processes and platforms that are technologically robust, secure, and supported by a long-term strategic plan.