How to be a hospital psychologist in the covid-19 pandemic in Brasil? A documental research / Como ser psicólogo hospitalar na pandemia de covid-19 no Brasil? Uma pesquisa documental

Resumo Com alta transmissibilidade e demanda por atendimento hospitalar, a covid-19 teve impactos (como ansiedade, medo e insegurança) sobre o equilíbrio psicológico de pacientes, seus familiares e profissionais da saúde. Diante disso, o objetivo deste artigo é mapear intervenções psicológicas no contexto hospitalar frente à covid-19, a fim de subsidiar a constituição de protocolos. Observou-se que visitas virtuais, trabalho de luto antecipatório e técnicas de psicoeducação, através de psicoterapia breve, mostram-se necessários dentro do contexto de unidades fechadas, Unidades de Terapia Intensiva (UTIs) e emergências, como forma de enfrentamento que permite a elaboração de sentimentos, como medo, angústia e ansiedade. Para ambulatórios, destacam-se os plantões psicológicos, através de videochamadas, de demanda espontânea, além de encaminhamento para psicoterapia externa, voltados a profissionais com sintomas de pânico, ansiedade, depressão e exaustão. Mesmo com intervenções psicológicas originadas a partir desse contexto, evidencia-se a falta de protocolos com abrangência nacional e eficazes para o ambiente hospitalar, tanto para pacientes e familiares como para profissionais que atuam diretamente com o vírus. Portanto, cabe ao Brasil aperfeiçoar o modelo apresentado pela Comissão Nacional de Saúde da China, ou construir protocolos próprios de acordo com o contexto sociocultural, compreendendo suas diferentes formas de comunicação e enfrentamento. É essencial considerar sentimentos de cansaço dos profissionais da saúde, de forma que se sugerem ações como grupo de acolhimento de demandas emocionais geradas nesta pandemia.

Abstract With high transmission and demand for hospital care, COVID-19 caused impacts (such as anxiety fear, and insecurity) on the psychological balance of patients, family members, and health professionals. Therefore, the objective of this article is to map psychological interventions in the hospital context against COVID-19, to support the constitution of protocols in this environment. We observed that virtual visits, anticipatory mourning work, and psychoeducational techniques, via brief psychotherapy are necessary within the context of closed units, Intensive Care Units (ICU's), and emergencies, as a way of coping that allow the elaboration of feelings such as fear, anguish , and anxiety. For outpatient clinics, psychological shifts in hospitals, via video calls, of spontaneous demand, in addition to referral to external psychotherapy, for professionals with symptoms of panic, anxiety, depression, and exhaustion stand out. Even with psychological interventions originating from this context, the lack of protocols with national coverage and effectiveness for the hospital environment is evident, both for patients and families and for professionals who work directly with the virus. Therefore, it is up to Brazil to improve the model presented by the National Health Commission for the People's Republic of China, or build our own protocols according to the sociocultural context, comprising their different forms of communication and confrontation. In addition, it to Considering the feelings of tiredness of health professionals is essential, so that actions such as a group to acknowledge emotional demands generated in this pandemic are suggested.

Weekly updating of guideline recommendations was feasible: the Australian National COVID-19 clinical evidence Taskforce.

OBJECTIVES: To investigate how quickly evidence was incorporated into the Australian living guidelines for COVID-19 during the first 12 months of the pandemic. STUDY DESIGN AND SETTING: For each study concerning drug therapies included in the guideline from April 3, 2020 to April 1, 2021, we extracted the publication date of the study, and the guideline version the study was included in. We analyzed two subgroups of studies as follows: those published in high impact factor journals and those with 100 or more participants. RESULTS: In the first year, we published 37 major versions of the guidelines, incorporating 129 studies that investigated 48 drug therapies informing 115 recommendations. The median time from first publication of a study to incorporation in the guideline was 27 days (interquartile range [IQR], 16 to 44), ranging from 9 to 234 days. For the 53 studies in the highest impact factor journals, the median was 20 days (IQR 15 to 30), and for the 71 studies with 100 or more participants the median was 22 days (IQR 15 to 36). CONCLUSION: Developing and sustaining living guidelines where evidence is rapidly incorporated is a resource- and time-intensive undertaking; however, this study demonstrates that it is feasible, even over a long period.