Conocimientos, habilidades, actitudes y prácticas en telesalud de los profesionales de la salud durante la pandemia de COVID-19

Introducción: La pandemia por el SARS-CoV-2 estableció desafíos para los sistemas de salud en función de dar continuidad a la atención de los pacientes por medio de la rápida adopción de la telesalud. Esto conllevó retos para los profesionales que se enfrentaron a las tecnologías de la información y la comunicación. Objetivos: Identificar conocimientos, habilidades, actitudes y prácticas de los profesionales de la salud que emplearon la telesalud en el ámbito ambulatorio durante la pandemia y analizar los posibles factores relacionados con las barreras que presentan los profesionales para implementar de forma efectiva los servicios de telesalud. Métodos: Estudio descriptivo de corte transversal analítico. Se aplicó una encuesta electrónica a profesionales de salud de tres centros médicos de Colombia. Resultados: Se aplicaron 430 encuestas. La mediana de edad fue de 39 años y el 79 % fueron mujeres. El 57 % no habían sido capacitados en aspectos técnicos, normativos y éticos de la telesalud; el 46 % reportó dificultad para administrar el tiempo; el 81 % manifestó el aumento en su carga laboral. La dificultad para emplear las herramientas tecnológicas se asoció 4,67 veces más a la percepción de alteración de su propio estado de salud; sin embargo, el 92 % manifestó que seguiría usando la telesalud. Conclusiones: La actitud frente al uso de la telesalud fue positiva; el conocimiento, habilidades y entrenamiento en telesalud parece determinar su aceptabilidad. Esta es una primera evaluación que revela los puntos a trabajar en el caso de los profesionales, en función de la permanencia de la telesalud como herramienta para la atención de pacientes.

Introduction: The SARS-CoV-2 pandemic posed challenges for health systems in terms of providing continuity of patient care through the rapid adoption of telehealth. This brought challenges for professionals who dealt with information and communication technologies. Objectives: To identify knowledge, skills, attitudes, and practices of health professionals who used telehealth in the outpatient setting during the pandemic and to analyze possible factors related to the barriers that professionals present to effectively implement telehealth services. Methods: This is a descriptive analytical cross-sectional study. An electronic survey was used on health professionals from three medical centers in Colombia. Results: Four hundred thirty (430) surveys were used. The median age was 39 years and 79% were women. 57% had not been trained in technical, regulatory and ethical aspects of telehealth; 46% reported difficulty managing time; 81% reported an increase in their workload. The difficulty in using technological tools was associated 4.67 times more with the perception of alteration of their own state of health; however, 92% said they would continue to use telehealth. Conclusions: The attitude towards the use of telehealth was positive; knowledge, skills, and training in telehealth seem to determine its acceptability. This is a first evaluation that reveals the points to work on in the case of professionals, based on the permanence of telehealth as a tool for patient care.

Design and Development of a Risk Classification Instrument for Virological Failure in HIV, Using Psychosocial Determinants of Health: Preliminary Evidence from a South American Country.

Predictive approaches in HIV to estimate a patient's risk to present with relevant health outcomes, such as hospitalizations and AIDS-related death, long before they happen, could be highly useful. We aimed to develop a risk classification instrument for virological failure through a scoring system that identifies patients with a low, medium, and high risk after six months of ART treatment. A case-control design was implemented through 355 HIV-positive Colombian adults who were assessed using the designed instrument. The variables with independent predictive values were selected using logistic regression analysis, and the diagnostic performance of the prediction score was evaluated using the area under the curve. The prediction score included relevant psychosocial and biological risk factors, some of them modifiable variables like substance use and low health literacy. The area under the curve value for the total prediction score was 0.85 (CI 0.80-0.90). Therefore, this instrument could be a valuable tool to identify at-risk patients of virological failure. In low and middle-income countries, the associated risk factors of virological failure are little known. Assessing such risk would lead to make individualized decisions regarding the patient's management and minimize the chance of non-desirable outcomes.