Percepciones y experiencias de la población ante la transformación de la modalidad de las consultas en atención primaria durante la pandemia / Population's perceptions and experiences of the changing pattern of primary care consultations during the pandemic

Objetivo: Explorar las percepciones y experiencias de la población general ante el impacto de la implementación de la teleconsulta en atención primaria durante la pandemia.DiseñoMetodología cualitativa con un enfoque descriptivo-interpretativo, cuyo trabajo de campo se realizó entre mayo y noviembre de 2020.EmplazamientoEstudio realizado en Navarra y Euskadi.Participantes y/o contextosColectivos poblacionales con distintos perfiles de ciudadanía asociada y no asociada de ambas comunidades autónomas. En total participaron 62 personas usuarias de atención primaria y se realizaron 10 grupos focales.MétodoLos grupos focales siguieron un guion semiestructurado elaborado a partir de las variables de análisis y dimensiones de interés en función de los distintos perfiles de participantes y los objetivos. Las sesiones fueron grabadas y transcritas realizándose un análisis de contenido de carácter inductivo. Se llevó a cabo la triangulación de los datos para asegurar la validez.ResultadosLa percepción de la teleconsulta por parte de la población ha ido variando a lo largo de la pandemia y ha sido heterogénea. Los/las participantes consideran que la modalidad no presencial puede repercutir en la calidad asistencial, así como amplificar las desigualdades de acceso a atención primaria.ConclusionesResulta indispensable la realización de análisis y evaluaciones desde la perspectiva de equidad en salud para la toma de decisiones relacionadas con el uso de la tecnología en general y la teleconsulta en particular, en el futuro post-pandémico de la atención primaria.(AU)

Aim: To explore the perceptions and experiences of the general population regarding the impact of the implementation of teleconsultation in primary health care during the pandemic.Designmethodology with a descriptive–interpretative approach, whose fieldwork was carried out between May and November 2020.PlaceStudy conducted in Navarra and Euskadi. Population groups with different profiles of associated and non-associated citizenship in both Autonomous Communities. A total of 62 primary health care users have participated and 10 focus groups were carried out.MethodThe focus groups followed a semi-structured script based on the variables of analysis and dimensions of interest according to the different participant profiles and objectives. The sessions were recorded and transcribed. An inductive content analysis was performed. Data triangulation was realized in order to ensure validity.ResultsThe perception of teleconsultation by the population has varied throughout the pandemic and has been heterogeneous. The participants consider that the non-face-to-face modality may have repercussions on the quality of care, as well as amplifying inequalities in access to primary health care.ConclusionsIt is essential to carry out analyses and evaluations from a health equity perspective in order to make decisions related to the use of technology in general and teleconsultation in particular, in the post-pandemic future of primary health care.(AU)

Desde un diagnóstico de salud participativo en época de sindemia, a iniciativas de promoción de la salud en un municipio del País Vasco / From a participatory health diagnosis in times of syndemics, to health promotion initiatives in a municipality in the Basque Country

La sindemia por coronavirus ha producido un gran impacto en la salud de la población y ha aumentado aún más las desigualdades sociales. Es precisamente por eso por lo que resulta más necesario que nunca impulsar iniciativas de promoción de la salud orientadas a mejorar la salud y reducir dichas desigualdades. Los diagnósticos participativos pueden contribuir a generar y reforzar la consciencia colectiva acerca de los activos y necesidades relativas a la salud y el bienestar. El objetivo principal de este trabajo fue impulsar un proceso de acción comunitaria en el municipio de Arrigorriaga (País Vasco) con el fin de mejorar la salud en época de pandemia por COVID-19. Para ello, se realizó un diagnóstico de salud con un componente cualitativo y otro cuantitativo. Para el primero, se identificaron activos y necesidades en salud percibidos por diversos grupos de población del municipio. Para el segundo, se analizaron indicadores demográficos, relacionados con la salud y los determinantes sociales de la salud disponibles de los barrios y del municipio. La iniciativa surgió del Foro Sociosanitario del municipio. Para el diagnóstico cualitativo, se hizo un análisis de contenido de cuatro grupos focales con distintos colectivos del municipio, relacionados con labores de cuidados y personas en situación de vulnerabilidad, los cuales identificaron entre otros la soledad en personas mayores como una de las principales necesidades en salud, y como principal activo, el movimiento asociativo en el municipio. Para el diagnóstico cuantitativo, se hizo una revisión de indicadores en fuentes secundarias sobre la salud y los determinantes sociales de la salud del municipio.(AU)

The coronavirus syndemic has had a great impact on the health of the population, further increasing social inequalities. That is the reason why it is now more necessary than ever to promote health promotion initiatives aimed at improving health and reducing health inequalities. Participatory diagnostics can contribute to generating and reinforcing collective awareness of health assets and needs, and also wellbeing. The main objective of this process was to promote a process of community action in the municipality of Arrigorriaga (Basque Country) in order to improve health during the Covid-19 pandemic. To this end, a health diagnosis was carried out with a qualitative and a quantitative component. In the first instance, health assets and needs perceived by different population groups in the municipality were identified. In the second instance, demographic, health-related indicators and the social determinants of health available in the neighbourhoods and municipality were analysed. The initiative came from the municipality’s Social and Health Forum. For the qualitative diagnosis, a content analysis of four focus groups was carried out among different groups in the municipality, related to care work and people in vulnerable situations, which identified, among others, loneliness in the elderly as one of the main health needs and the main asset of the associative movement in the municipality. For the quantitative diagnosis, a review of indicators in secondary sources on health and the social determinants of health in the municipality was conducted. (AU)

Incorporando las narrativas y las percepciones en los diagnósticos de salud locales: el caso de Bilbao / Incorporating narratives and perceptions into local health diagnoses: the case of Bilbao

La subjetividad de multitud de dimensiones que inciden en la salud requiere abordajes sistémicos, diseños de estudios que integren datos de salud poblacionales y las narrativas de la población, así como abordajes metodológicos específicos que permitan capturar la evidencia procedente de procesos sociales y comunitarios. El uso de metodologías participativas en los diagnósticos de salud urbana es clave para capturar las diferentes perspectivas y conocimientos del contexto local, contribuyendo a un análisis más completo de la realidad. Esta nota metodológica expone el desarrollo del proceso participativo realizado como parte del diagnóstico de salud de Bilbao: la identificación de agentes participantes y criterios de selección, la invitación a participar y las dinámicas desarrolladas. Compartir experiencias que hayan incorporado procesos participativos es necesario para favorecer su desarrollo metodológico, y así, impulsar su práctica. (AU)

The subjectivity of a multitude of dimensions that affect health requires systemic approaches, study designs that integrate population health data and the narratives of the population, as well as specific methodological approaches that allow the capture of evidence from social and community processes. The use of participatory methodologies in urban health diagnoses is key to capturing the different perspectives and knowledge of the local context, contributing to a more complete analysis of reality. This methodological note presents the development of the participatory process carried out as part of the Bilbao health diagnosis; the identification of participating agents and selection criteria, the invitation to participate and the dynamics developed. Sharing experiences that have incorporated participatory processes is necessary to foster its methodological development, and thus, to promote it practice. (AU)

[Population's perceptions and experiences of the changing pattern of primary care consultations during the pandemic]. / Percepciones y experiencias de la población ante la transformación de la modalidad de las consultas en atención primaria durante la pandemia.

AIM: To explore the perceptions and experiences of the general population regarding the impact of the implementation of teleconsultation in primary health care during the pandemic. DESIGN: methodology with a descriptive-interpretative approach, whose fieldwork was carried out between May and November 2020. PLACE: Study conducted in Navarra and Euskadi. Population groups with different profiles of associated and non-associated citizenship in both Autonomous Communities. A total of 62 primary health care users have participated and 10 focus groups were carried out. METHOD: The focus groups followed a semi-structured script based on the variables of analysis and dimensions of interest according to the different participant profiles and objectives. The sessions were recorded and transcribed. An inductive content analysis was performed. Data triangulation was realized in order to ensure validity. RESULTS: The perception of teleconsultation by the population has varied throughout the pandemic and has been heterogeneous. The participants consider that the non-face-to-face modality may have repercussions on the quality of care, as well as amplifying inequalities in access to primary health care. CONCLUSIONS: It is essential to carry out analyses and evaluations from a health equity perspective in order to make decisions related to the use of technology in general and teleconsultation in particular, in the post-pandemic future of primary health care.

[Incorporating narratives and perceptions into local health diagnoses: the case of Bilbao]. / Incorporando las narrativas y las percepciones en los diagnósticos de salud locales: el caso de Bilbao.

The subjectivity of a multitude of dimensions that affect health requires systemic approaches, study designs that integrate population health data and the narratives of the population, as well as specific methodological approaches that allow the capture of evidence from social and community processes. The use of participatory methodologies in urban health diagnoses is key to capturing the different perspectives and knowledge of the local context, contributing to a more complete analysis of reality. This methodological note presents the development of the participatory process carried out as part of the Bilbao health diagnosis; the identification of participating agents and selection criteria, the invitation to participate and the dynamics developed. Sharing experiences that have incorporated participatory processes is necessary to foster its methodological development, and thus, to promote it practice.

Aportaciones de la arteterapia a la atención a la salud en personas que han vivido procesos migratorios / Contribution of Art Therapy to healthcare in persons who have experienced migration processes

La salud de las personas migrantes se ve amenazada por múltiples factores, entre los que se encuentran los relacionados con las condiciones de vida y trabajo desfavorables a las que se ven expuestas, experiencias de discriminación y bajo apoyo social, así como con el propio proceso migratorio. La arteterapia constituye un enfoque que puede contribuir a mejorar el bienestar de las personas que han vivido procesos de migración, ya que aporta vías y espacios de expresión y de relación a través del arte, así como la identificación y puesta en juego de recursos individuales y grupales para la salud. Su aplicación en el ámbito de la atención sanitaria puede contribuir al abordaje biopsicosocial de este colectivo, a la vez que permite avanzar en el empoderamiento de estas personas para la mejora de su salud. El presente artículo, sexto de la serie Arteterapia, tiene como objetivo explorar las posibilidades que dicha terapia puede aportar en personas que han vivido procesos migratorios, ofreciendo en primera instancia una contextualización acerca de la intervención arterapeútica en estas personas y mostrando una experiencia a través del programa "Tu barrio, tu casa" de Médicos del Mundo Navarra, y concluir con unas consideraciones finales en torno al tema

The health of migrant persons is threatened by multiple factors, including those associated with the exposure to unfavorable life and work conditions, discriminatory experiences and low social support, as well as the migration process itself. Art Therapy represents an approach that can contribute to the improvement in wellbeing for persons who have experienced migration processes, because it offers forms and spaces of expression and connection through art, as well as the identification and implementation of individual and group resources for heath. Its application in the healthcare setting can contribute to the biopsychosocial approach of this group, as well as allowing to move forward in terms of empowering these people for their health improvement. This is the sixth article in the Art Therapy series, and its objective is to explore the possibilities that said therapy can offer to persons who have experiences migration processes, first offering a contextualization about the Art Therapy intervention in these people, and showing an experience through the "Tu barrio, tu casa" ("Your neighbourhood, your home") by Médicos del Mundo ("Doctors of the World") from Navarra, and to end up with some final considerations regarding the subject