Afrontamiento de enfermeras en Unidades de cuidados intensivos durante la pandemia: Una mirada interdisciplinaria / Coping de enfermeiros em unidades assistenciais terapia intensiva durante a pandemia: um olhar interdisciplinario / Coping of nurses in care units intensive care during the pandemic: An interdisciplinary look

Introduction: The COVID-19 pandemic, in its beginnings, caused a great impact with ahigh morbidity and mortality in which health teams, especially nursing, had to face great vitalorganizational changes in the way of caring. Objective: To understand from an interdisciplinaryperspective the coping of nurses in an Adult Intensive Care Unit of a public hospital in Valparaíso, Chile, when caring for people diagnosed with COVID-19 during the year 2020 of the pandemic. Methodology: Qualitative study with a narrative design, which convenience sampling allowed the selection of 8 nurses who participated voluntarily after signing the informed consent.The collection of information was carried out through a semi-structured interview recorded virtually by videoconference, with prior authorization from the hospital's Scientific Ethics Committee. Results: The stressors were identified: Seeing people die, fear of infecting others, organizational changes and the uncertainty about the disease. To deal with them, they had personal andenvironmental resources, using coping strategies focused on the problem and emotion, whichallowed them to adapt and focus the care of the person served. Conclusions: Nurses faced caring with emotional intelligence and resilience, which added to structural changes and the restructuring of their role, allowing them to adapt to overcome the contingency situation.(AU)

Introducción: La pandemia por COVID-19 en sus comienzos, causó un gran impactocon una elevada morbimortalidad en que los equipos de salud, especialmente enfermería, debieron enfrentar grandes cambios vitales, organizacionales y en la forma de cuidar. Objetivo: Comprender desde una mirada interdisciplinaria el afrontamiento de enfermeras de una Unidad deCuidados Intensivos del Adulto de un hospital público de Valparaíso, Chile, al cuidar personasdiagnosticadas con COVID-19 durante el año 2020 de la pandemia. Metodología: Estudio cualitativo de diseño narrativo, cuyo muestreo por conveniencia permitió seleccionar 8 enfermerasque participaron voluntariamente, previa firma del consentimiento informado. La recolección deinformación se realizó mediante una entrevista semiestructurada grabada de manera virtual porvideoconferencia, previa autorización del Comité Ético Científico del hospital. Resultados: Seidentificaron los estresores: Ver gente morir, temor a contagiar a otros, cambios organizacionalese incertidumbre ante la enfermedad; para afrontarlos, contaron con recursos personales y ambientales, utilizando estrategias de afrontamiento centradas en el problema y la emoción, lo queles permitió adaptarse y centrar el cuidado de la persona atendida. Conclusiones: Las enfermerasafrontaron el cuidado con inteligencia emocional y resiliencia, lo que sumado a cambios estructurales y la reestructuración de su rol, les permitió lograr la adaptación para superar la situaciónde contingencia.(AU)

Introdução: A pandemia de COVID-19 em seus primórdios, causou grande impactocom alta morbimortalidade onde as equipes de saúde principalmente a enfermagem, tiveram queenfrentar grandes mudanças vitais, organizacionais e na forma de cuidar. Objetivo: Compreender a partir de uma perspectiva interdisciplinar, o enfrentamento dos enfermeiros de uma Unidade de Terapia Intensiva Adulto de um hospital público de Valparaíso, Chile, ao cuidar de pessoas diagnosticadas com COVID-19 durante o ano de 2020 da pandemia. Metodologia: Estudoqualitativo de desenho narrativo, cuja amostragem por conveniência permitiu a seleção de 8 enfermeiros que participaram voluntariamente após assinatura do consentimento informado. A coleta de informações foi realizada por meio de entrevista semiestruturada gravada virtualmentepor videoconferência, com autorização prévia do Comitê de Ética Científica do hospital. Resultados: Foram identificados os estressores: Ver pessoas morrerem, medo de infectar outras pessoas, mudanças organizacionais e incerteza sobre a doença. Para lidar com eles, dispunham derecursos pessoais e ambientais, utilizando estratégias de enfrentamento centradas no problema ena emoção, o que lhes permitia adaptar e focar o cuidado da pessoa atendida. Conclusões: Osenfermeiros enfrentaram o cuidado com inteligência emocional e resiliência, o que somado àsmudanças estruturais e à reestruturação do seu papel, permitiu que se adaptassem para superara situação de contingência.(AU)

Management of unexplained: poly-consultation and hyperfrequency on Primary Health Chilean Attention. A qualitative and exploratory study.

BACKGROUND: In Europe, Latin-America, and Asia, poly-consultation has become a complex problem for managing different healthcare systems. However, in the current literature, little attention has been paid to exploring territorial and critical analysis perspectives to manage unexplained symptoms. The purpose of this study is to analyze the socio-structural elements that underlie the users' phenomenon of poly-consultation or hyperfrequency in the Chilean primary healthcare system (PHCS). METHODS: This paper represents qualitative data collected as part of an exploratory study that used mixed methods across three metropolitan areas of Santiago, Valparaíso, and Concepción, Chile. The study involved a sample of 24 subjects from administrative and management positions in PHC who were recruited from Family Health Care Centers, considering urban municipalities from the low, medium, and high stratum. The study collected data using one set of semi-standardized interviews during a year-data analysis using qualitative content analysis. RESULTS: This article shows that poly-consultant patients provide a critical clinic category to management that cannot be cover by current biomedical models. Data showed the strain of a somatoform category, especially in the clinic and epistemological exercise. Precisely, the relevance of Chile's case, a mixed health system, and their effects: the naturalization of collective problems managed as individual problems. CONCLUSIONS: The study results can inform healthcare professionals and managers of developing practical and territorially based. We conclude that hyperfrequency and poly-consultation in Chile reveal relevant stratification in the territory. Those particularities open an opportunity to study quantitative methods, including current analysis categories, to develop new research.