[Shortage of nurses in Spain: from the global case to particular situation. SESPAS Report 2024]. / Escasez de enfermeras en España: del caso global a la situación particular. Informe SESPAS 2024.

The nursing shortage is a multi-causal phenomenon that affects all countries and currently a global concern. The shortage of nurses jeopardizes the sustainability of health systems and the population health outcomes. Spain has historically had no difficulties in attracting new generations of nurses. The shortage of nurses is caused by the precarious working conditions and lack of professional development that have led to episodes of high international migration and abandonment of the profession. In this paper we focus on the evolution of different indicators of the working conditions of non-specialist nurses, who make up the bulk of the profession. These indicators allow us to analyse the abandonment of the profession, the duration of contracts, their full-time or part-time dedication and the excessive hiring. We have analysed the effect of COVID-19 and the labour reform on these indicators. COVID-19 reduced the abandonment of the profession and is currently at its lowest level, it has also accelerated the need to improve working conditions by increasing the percentage of permanent contracts and reducing the multiplicity of contracts in the same month. The labour reform has helped reduce the percentage of temporary contracts until reaching around 80% of the total contracts, and has reduced the number of nurses in Spain with more than one contract in the same month to below 3000 nurses on a sustained basis.

Mexican Quality of Work Life Scale in healthcare personnel: development and validation / Escala Mexicana de Calidad de Vida Laboral en personal sanitario: desarrollo y validación

Existe poca evidencia de escalas de medición con propiedades psicométricas adecuadas respecto a la Calidad de Vida Laboral en el personal sanitario, por lo que el objetivo fue desarrollar y examinar las propiedades psicométricas de la Escala Mexicana de Calidad de Vida Laboral (EMCVL). Se realizó un estudio instrumental y transversal. Fase 1) desarrollo de la escala y validez de contenido; Fase 2) validación con dos muestras diferentes [n = 293] y [n = 300] a través de un cuestionario en línea. Se obtuvo validez de contenido para 60 ítems (V de Aiken > .90); los análisis factoriales exploratorio y confirmatorio arrojaron una estructura de seis dimensiones; los índices de ajuste de la escala final con 24 ítems fueron aceptables (χ2[257] = 540.277; CMIN/DF = 2.102; NFI = .914; CFI = .953; GFI = .877, AGFI = .845; SRMR = .047; RMSEA = .061 [.054-.069] p <.001), con buenos índices de confiabilidad (α = .949, ω = .982). La EMCVL demostró confiabilidad en la consistencia interna, varias evidencias de validez y una invarianza configuracional y métrica aceptable con un modelo que confirma la existencia de seis dimensiones que explican el constructo a través de 24 ítems.(AU)

There is little evidence of measurement scales with appropriate psychometric properties regard Quality of Work-Life in health personnel, so the objective was to develop and examine psychometric properties of Mexican Quality of Work Life Scale (MQWLS). An instrumental, cross-sectional study was conducted. Phase 1) development of the scale and con-tent validity; Phase 2) validation with two different samples [n= 293] and [n = 300] through an online questionnaire. Content validity was obtained for 60 items (Aiken's V>.90); exploratory and confirmatory factor analyz-es yielded a six-dimension structure; the fit indexes from the final scale with 24 items were acceptable (χ2[257]=540.277; CMIN/DF=2.102; NFI=.914; CFI=.953; GFI=.877, AGFI=.845; SRMR=.047; RMSEA=.061 [.054-.069] p <.001), with good reliability indices (α =.949,ω=.982). MQWLS proved internal consistency reliability, several ev-idences of validity and acceptable configurational and metric invariance with a model that confirms the existence of six dimensions that explain the construct through 24 items.(AU)

Exploring healthcare workers' experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis.

ABSTRACTBackground: Many healthcare workers (HCWs) endured psychologically traumatic events at work during the coronavirus disease 2019 (COVID-19) pandemic. For some, these events are re-experienced as unwanted, recurrent, and distressing intrusive memories. Simple psychological support measures are needed to reduce such symptoms of post-traumatic stress in this population. A novel intervention to target intrusive memories, called an imagery-competing task intervention (ICTI), has been developed from the laboratory. The intervention includes a brief memory reminder cue, then a visuospatial task (Tetris® gameplay using mental rotation instructions for approximately 20 min) thought to interfere with the traumatic memory image and reduce its intrusiveness. The intervention has been adapted and evaluated in a randomized controlled trial (RCT) with Swedish HCWs (ClinicalTrials.gov identifier: NCT04460014).Objective: We aimed to explore how HCWs who worked during the COVID-19 pandemic experienced the use of a brief intervention to reduce their intrusive memories of work-related trauma.Method: Interpretative phenomenological analysis was used for in-depth understanding of the lived experiences of HCWs who used the intervention. Seven participants from the RCT were interviewed by an independent researcher without prior knowledge of the intervention. Interviews were conducted via telephone and transcribed verbatim.Results: Four general themes were generated: 'Triggers and troublesome images', 'Five Ws regarding support - what, when, why, by/with who, for whom', 'Receiving it, believing it, and doing it' and 'The intervention - a different kind of help'; the last two included two subthemes each. The results reflect participants' similarities and differences in their lived experiences of intrusive memories, support measures, and intervention impressions and effects.Conclusion: HCWs' experiences of the novel ICTI reflect a promising appraisal of the intervention as a potential help measure for reducing intrusive memories after trauma, and gives us a detailed understanding of HCWs' needs, with suggestions for its adaption for future implementation.Trial registration: ClinicalTrials.gov identifier: NCT04460014.

Many healthcare workers experience images or 'flashbacks' of traumatic experiences from their work during the COVID-19 pandemic.To ensure that individual needs are met, there is a need to tailor and refine current psychological support measures and their use for healthcare workers.The imagery-competing task intervention was perceived as acceptable, indicating its potential utility as a help measure to reduce intrusive memories after trauma.

[Incremental impact of population dispersion on health personnel resources in Primary Care]. / Impacto incremental de la dispersión poblacional sobre los recursos de personal sanitario en Atención Primaria.

OBJECTIVE: To quantify the incremental impact that population dispersion has on the number of health personnel in Primary Care in Alto Aragón, using a reproducible method. METHOD: Descriptive observational study that compares health the number of health personnel (family medicine, pediatrics and nursing) in EAP and PA emergencies in 2019 in an unpopulated and dispersed territory such as Huesca, with the number that would correspond to it by applying population ratios per professional of hypothetical constructs with different population densities. RESULTS: Huesca, with respect to the national average, has 39% more PA health personnel. There are 239 additional professionals (112 in family medicine, 2 in pediatrics and 115 in nursing), 130 in emergencies and 109 in EAP. With the average of the five most densely populated provinces, it would reduce this staff by 49%, and with the average of the five least densely populated provinces, it would increase it by 12%. CONCLUSIONS: There is a relationship between low population density and a greater number of family medicine and PC nurses, but not with pediatrics. The powerful incremental effect that dispersion has on health care spending gives it a relevant role in the regional financing system. Comparing PC health personnel in scenarios with different population density is a useful method for quantifying the impact of dispersion.

The independent and combined impact of moral injury and moral distress on post-traumatic stress disorder symptoms among healthcare workers during the COVID-19 pandemic.

Background: Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during the COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied in healthcare contexts. Moral Distress (MD), a related concept, may enhance understandings of MI and its relation to PTSD among HCWs. This study examined the independent and combined impact of MI and MD on PTSD symptoms in Canadian HCWs during the pandemic.Methods: HCWs participated in an online survey between February and December 2021, with questions regarding sociodemographics, mental health and trauma history (e.g. MI, MD, PTSD, dissociation, depression, anxiety, stress, childhood adversity). Structural equation modelling was used to analyze the independent and combined impact of MI and MD on PTSD symptoms (including dissociation) among the sample when controlling for sex, age, depression, anxiety, stress, and childhood adversity.Results: A structural equation model independently regressing both MI and MD onto PTSD accounted for 74.4% of the variance in PTSD symptoms. Here, MI was strongly and significantly associated with PTSD symptoms (ß = .412, p < .0001) to a higher degree than MD (ß = .187, p < .0001), after controlling for age, sex, depression, anxiety, stress and childhood adversity. A model regressing a combined MD and MI construct onto PTSD predicted approximately 87% of the variance in PTSD symptoms (r2 = .87, p < .0001), with MD/MI strongly and significantly associated with PTSD (ß = .813, p < .0001), after controlling for age, sex, depression, anxiety, stress, and childhood adversity.Conclusion: Our results support a relation between MI and PTSD among HCWs and suggest that a combined MD and MI construct is most strongly associated with PTSD symptoms. Further research is needed better understand the mechanisms through which MD/MI are associated with PTSD.

MI and MD were each independently associated with PTSD symptoms (including dissociation), when controlling for sex, age, childhood adversity, depression, anxiety and stress.Combining both MI and MD constructs into a single latent variable accounted for the greatest proportion of variance explained in PTSD symptoms among HCWs during the COVID-19 pandemic.Results suggest that expanding the construct of MI to include team and systemic organisational MD may be appropriate in the healthcare context.

Percepción del profesional sanitario sobre el paciente con síndrome de sensibilidad central-fibromialgia / Health personnel perception about central sensitivity syndrome-fibromyalgia patients

Antecedentes y objetivos: La fibromialgia se caracteriza por dolor musculoesquelético y astenia de curso crónico. Los pacientes con fibromialgia suelen ser todo un desafío para los sanitarios en su conjunto. Los estudios existentes suelen estar limitados a la opinión de médicos reumatólogos o de familia. Con este estudio buscamos conocer cuáles son las actuaciones, las percepciones y los conocimientos del conjunto de los profesionales sanitarios al atender pacientes con esta enfermedad. Materiales y métodos: Estudio descriptivo de corte transversal, mediante una encuesta autoadministrada y anónima, distribuida principalmente en plantas hospitalarias y centros de atención primaria. Se realizó análisis estadístico de las variables recogidas (p˂0,05). Resultados: Se recogieron 200 encuestas, la mayoría de médicos (63,5%; n=127) o de enfermeros (25,5%; n=51). El 71% de los médicos refirieron utilizar la escala analgésica de la OMS. El 53% (n=59) utilizan AINE o paracetamol. Los antidepresivos son el tercer fármaco de elección. La mayoría cree que los especialistas de referencia deben ser los reumatólogos o los médicos de atención primaria, y un porcentaje similar, que el manejo debe ser multidisciplinar. El 52% se sienten desanimados o molestos al abordar a estos pacientes. Los médicos tienen mayores connotaciones negativas y creen que la atención que el paciente recibe está mayormente influenciada por el diagnóstico de fibromialgia, frente a los enfermeros y otros profesionales. Conclusiones: Nuestro estudio demuestra que la falta de conocimiento y de herramientas terapéuticas genera en gran medida frustración y malestar en el personal sanitario. Es importante desarrollar nuevos enfoques sobre esta entidad.(AU)

Background and objectives: Fibromyalgia is characterized by musculoskeletal pain and asthenia of chronic course. Fibromyalgia patients are often a challenge for the health care community as a whole. Existing studies are often limited to the opinion of rheumatologists or family physicians. With this study we seek to know what are the actions, perceptions and knowledge of health professionals as a whole when caring for patients with this disease. Materials and methods: Descriptive cross-sectional study, by means of a self-administered and anonymous survey. Distributed mainly in hospital wards and primary care centers. Statistical analysis of the variables collected was performed (P˂.05). Results: Two hundred surveys were collected, most of them physicians (63.5%; n=127) or nurses (25.5%; n=51). 71% of physicians reported using the WHO analgesic scale. 53% (n=59) use NSAIDs or paracetamol. Antidepressants are the third drug of choice. Most believe that the referral specialists should be rheumatologists or primary care physicians, a similar percentage, that management should be multidisciplinary. Fifty two percent feel discouraged or annoyed when dealing with these patients. Physicians have more negative connotations and believe that the care that the patient receives is mostly influenced by the diagnosis of fibromyalgia, compared to nurses and other professionals. Conclusions: Our study shows that the lack of knowledge and therapeutic tools generates, to a large extent, frustration and discomfort in health personnel. It is important to develop new approaches to this entity.(AU)

Health personnel perception about central sensitivity syndrome-fibromyalgia patients.

BACKGROUND AND OBJECTIVES: Fibromyalgia is characterized by musculoskeletal pain and asthenia of chronic course. Fibromyalgia patients are often a challenge for the health care community as a whole. Existing studies are often limited to the opinion of rheumatologists or family physicians. With this study we seek to know what are the actions, perceptions and knowledge of health professionals as a whole when caring for patients with this disease. MATERIALS AND METHODS: Descriptive cross-sectional study, by means of a self-administered and anonymous survey. Distributed mainly in hospital wards and primary care centers. Statistical analysis of the variables collected was performed (p < 0.05). RESULTS: 200 surveys were collected, most of them physicians 63.5% (n = 127) or nurses 25.5% (n = 51). 71% of physicians reported using the WHO analgesic scale. 53% (n = 59) use NSAIDs or Paracetamol. Antidepressants are the third drug of choice. Most believe that the referral specialists should be rheumatologists or primary care physicians, a similar percentage, that management should be multidisciplinary. 52% feel discouraged or annoyed when dealing with these patients. Physicians have more negative connotations and believe that the care that the patient receives is mostly influenced by the diagnosis of fibromyalgia, compared to nurses and other professionals. CONCLUSIONS: Our study shows that the lack of knowledge and therapeutic tools generates, to a large extent, frustration and discomfort in health personnel. It is important to develop new approaches to this entity.

[Proposing a workload indicator for hospital at home patients in Osakidetza - Basque Public Health Service]. / Propuesta de un indicador de cargas de trabajo en la atención de pacientes en hospitalización a domicilio de Osakidetza ­ Servicio Vasco de Salud.

INTRODUCTION AND OBJECTIVES: The Hospital at Home (HaH) setting currently lacks adequate workload indicators. This study suggests an indicator that can help in improving professional resources allocation. MATERIALS AND METHODS: Prospective data was collected during May 2021 from patients treated in nine HaH units of Osakidetza-Basque Health Service (North of Spain). Direct care and travel times of healthcare staff was recorded. Data on inpatient days, number of visits, sociodemographic variables, health status, and patient pathologies, among others, were collected. The proposed indicator encompasses both the average visit time and the visit rates. It is called intensity and represents the average daily workload time per patient. RESULTS: A total of n = 1,171 users were included in the analyses. Their mean age was 69.8 years, 45.5% were women and 25% lived more than 12 km away from the corresponding HaH unit. Workload variations were observed for nursing-only and medical-nursing teams, depending on the type of day and patient classification group. The average nursing-only teams workload time on working days was 10.82 min and on non-working days it was 14.78 min. The average workload time for medical-nursing teams, during the same days, was 20.40 min and 4.59 min, respectively. It was observed that certain patient types, like those in palliative care, represented a high workload for medical-nursing teams on working days. CONCLUSIONS: The intensity indicator can help answering the question of how many patients can be assigned to a professional. It can also be used to adjust the staffing needs of the HaH units.

[Evolution of the perception of the safety culture of healthcare professionals in a pediatric emergency department]. / Evolución de la percepción de la cultura de seguridad de los profesionales sanitarios en una urgencia pediátrica.

BACKGROUND AND AIM: Safety culture (SC) is a fundamental tool for minimizing adverse events and improving safety and quality of care. Our objective, therefore was to analyze the evolution of the SC of healthcare professionals in a pediatric emergency department (PED) after the implementation of a risk management system for patient safety based on the UNE:EN:ISO 179003 Standard and the execution of new safe practices for Joint Commission International accreditation. At the same time describe the current strengths and weaknesses. METHODS: Quasi-experimental, single-center study. All PED professionals participated in the study. An initial measurement of SC was performed through the Hospital Survey on Patient Safety Culture (HSOPS) questionnaire of the Agency for Healthcare Research and Quality adapted to Spanish in 2014. Pro-patient safety strategies were implemented between 2015 and 2022. A subsequent measurement was performed in 2022. RESULTS: The response rate in 2014 was 55% and 78% in 2022. On both occasions the group with the highest participation was nurses with 35.1% and 34.8%, respectively. Five dimensions improved after the interventions: frequency of adverse events (25.2%, p<0.001), organizational learning (25%, p<0.001), feedback and communication about errors (22.3%, p<0.001), non-punitive response to errors (6.5%, p = 0.176), and management support (4%, p = 0.333). CONCLUSIONS: The actions carried out had a positive influence on organizational learning and the frequency of adverse events reported and communication within the team. In contrast, the perception of SC did not increase.

Mortalidade de profissionais de saúde pelo COVID-19 no Brasil: 2020 a 2022 / Mortality of healthcare professionals due to COVID-19 in Brazil: 2020 to 2022 / Mortalidad de profesionales de la salud por COVID-19 en Brasil: 2020 a 2022

Objetivo: Analisar a mortalidade de profissionais de saúde pelo COVID-19 no Brasil nos anos de 2020 à 2022. Metodologia: Estudo ecológico, exploratório, descritivo, comparativo e de abordagem quantitativa. Os dados foram adquiridos junto ao Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe) do Departamento de Informática do Sistema Único de Saúde (DATASUS) daSecretaria de Vigilância em Saúde e Ambiente (SVS) do Ministério da Saúde (MS). Resultados: Foi possível identificar o universo de 886 registros, com média e desvio-padrão (295,3±379). Foi verificado que a maior preponderância se constituiu de profissionais técnicos ou auxiliares de enfermagem com 26% (n=230), médicos 15% (n=133) e enfermeiros com 10% (n=89). O nível de formação educacional com maior preponderância foi o superior com 50% (n=443). Considerações finais: Foi possível verificar aumento na frequência de registros de mortalidade de profissionais de saúde pelo COVID-19 no recorte geográfico e histórico analisado.

Objective: To analyze the mortality of healthcare professionals due to COVID-19 in Brazil from 2020 to 2022. Methodology: Ecological, exploratory, descriptive, comparative study with a quantitative approach. The data were acquired from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) of the Department of Informatics of the Unified Health System (DATASUS) of the Secretariat of Health and Environmental Surveillance (SVS) of the Ministry of Health (MS). Results: It was possible to identify the universe of 886 records, with mean and standard deviation (295.3±379). It was found that the greatest preponderance was made up of technical professionals or nursing assistants with 26% (n=230), doctors with 15% (n=133) and nurses with 10% (n=89). The level of educational training with the greatest preponderance was higher education with 50% (n=443). Final considerations: It was possible to verify an increase in the frequency of mortality records of health professionals due to COVID-19 in the geographical and historical area analyzed.

Objetivo: Analizar la mortalidad de los profesionales de la salud por COVID-19 en Brasil en el período de 2020 a 2022.Metodología: Estudio ecológico, exploratorio, descriptivo, comparativo, con abordaje cuantitativo. Los datos fueron adquiridos del Sistema de Información de Vigilancia Epidemiológica de Influenza (SIVEP-Gripe) del Departamento de Informática del Sistema Único de Salud (DATASUS) de la Secretaría de Vigilancia en Salud y Ambiente (SVS) del Ministerio de Salud (MS).Resultados: Se logró identificar el universo de 886 registros, con media y desviación estándar (295,3±379). Se encontró que la mayor preponderancia la conformaron los profesionales técnicos o auxiliares de enfermería con un 26% (n=230), médicos con un 15% (n=133) y enfermeras con un 10% (n=89). El nivel de formación educativa con mayor preponderancia fue la educación superior con un 50% (n=443).Consideraciones finales:Se pudo verificar un aumento en la frecuencia de registros de mortalidad de los profesionales de la salud por COVID-19 en el área geográfica e histórica analizada.

Dificuldades enfrentadas pelos profissionais de saúde no atendimento de emergências em unidades básicas de saúde no Brasil / Difficulties faced by health professionals in emergency care in primary health care units in Brazil / Dificultades enfrentadas por los profesionales de salud en la atención de emergencias en unidades básicas de salud en Brasil

Objetivos: compreender as dificuldades enfrentadas pelos profissionais de saúde para o atendimento de casos de urgências/emergências em unidades básica de saúde e identificar as proposições de resolubilidade. Métodos: Pesquisa qualitativa, realizada com dez profissionais de saúde, em uma unidade básica de saúde do interior paulista. As entrevistas foram transcritas e analisadas utilizando-se a estratégia metodológica do Discurso do Sujeito Coletivo. Resultados: As dificuldades foram atreladas a fatores como despreparo da equipe, falta de infraestrutura, insumos e equipamentos, carência de profissional médico, pouca aproximação das unidades básicas de saúde com o setor de emergência hospitalar e escasso investimento do município para realização desses atendimentos. As proposições de melhorias destacaram a necessidade de capacitação dos profissionais de saúde, investimentos em recursos materiais e equipamentos, permanência de médico em período integral no serviço, implantação de protocolos de atendimento e empenho dos gestores. Conclusão: Os discursos evidenciaram que o serviço não tem condições de atender casos de urgência/emergência, em virtude do despreparo da equipe e da falta de recursos humanos e materiais. Além disso, não é prioridade do município oferecer condições mínimas para a realização deste atendimento nas unidades básicas de saúde, para que sejam integrantes da rede de atenção de Atenção às Urgências no Sistema Único de Saúde.

Objective: understand the difficulties health professionals face in urgency/emergency care at primary health care units and identify the propositions of problem-solving ability. Methods: Qualitative research, conducted with ten health professionals at a primary health care unit in the interior of São Paulo. The interviews were transcribed and analyzed using the methodological strategy of the collective subject discourse. Results: The difficulties were linked to factors such as unpreparedness of the team, lack of infrastructure, supplies and equipment, lack of medical professional, little cooperation between the primary health care units and the hospital emergency sector and scarce investment of the municipality to carry out these services. The proposals for improvements highlighted the need for training of health professionals, investments in material resources and equipment, full-time presence of physician at the service, implementation of care protocols and commitment of managers. Conclusion: The discourse showed that the service is not able to attend urgency/emergency cases, due to the unpreparedness of the team and the lack of human and material resources. In addition, the municipality does not prioritize the supply of minimum conditions for this care in primary health care units to make them part of the emergency care network in the Unified Health System.

Objetivo: comprender las dificultades enfrentadas por los profesionales de salud para la atención de casos de Urgencias/Emergencias en unidades básicas de salud e identificar las proposiciones de resolubilidad. Métodos: Investigación cualitativa, desarrollada con diez profesionales de salud, en una unidad básica de salud del interior paulista. Las entrevistas fueron transcritas y analizadas utilizando la estrategia metodológica del Discurso del Sujeto Colectivo. Resultados: Las dificultades fueron ligadas a factores como la falta de preparación del equipo, falta de infraestructura, insumos y equipamientos, carencia de profesional médico, poca aproximación de las unidades básicas de salud con el sector de emergencia hospitalaria y escasa inversión del municipio para realizar esas atenciones. Las propuestas de mejorías destacaron la necesidad de capacitación de los profesionales de salud, inversiones en recursos materiales y equipamientos, permanencia de médico a tiempo completo en el servicio, implantación de protocolos de atención y empeño de los gestores. Conclusión: Los discursos evidenciaron que el servicio no tiene condiciones de atender casos de urgencia/emergencia, en virtud de la falta de preparación del equipo y de la falta de recursos humanos y materiales. Además, no es prioridad del municipio ofrecer condiciones mínimas para la realización de esta atención en las unidades básicas de salud, para que sean integrantes de la red de atención de atención a las urgencias en el Sistema Único de Salud.

Programa especial de exámenes de salud en trabajadores con COVID-19 persistente del INGESA-Ceuta / Special program of health examinations for workers with persistent COVID-19 at INGESA-Ceuta

Introducción: El COVID-19 Persistente (CP) es una afección multisistémica que persiste tras una infección inicial por SARS-CoV-2. Nuestro objetivo es definir el perfil clínico del CP en trabajadores sanitarios mediante una consulta de vigilancia de salud específica de Medicina del Trabajo.Material y Métodos:Se estudiaron 645 trabajadores que padecieron COVID-19 desde el inicio de la pandemia hasta el 30/09/2022. Primero mediante entrevista telefónica y, posteriormente, en una consulta médica presencial.Resultados:Se recogieron más de 35 síntomas. Los síntomas más frecuentes fueron astenia, dolores osteomusculares, cefalea, dolores articulares, alteraciones del olfato y perdida del cabello en el grupo entrevistado telefónicamente. En los trabajadores vistos en consulta, la sintomatología más frecuente fue astenia, ojo seco, dolores articulares, pérdida de memoria, disnea y trastornos del sueño.Conclusión:Los trabajadores de atención a la salud han experimentado una sintomatología similar a la vista en otros estudios, pero en menor frecuencia y de menor gravedad. (AU)

Introduction: Persistent COVID-19 (PC) is a multisystem condition that persists after an initial SARS-CoV-2 infection. Our objective is to define the clinical profile of PC in health workers through a specific Occupational Medicine health surveillance consultation.Material and methods:A total of 645 workers who suffered from COVID-19 were studied from the start of the pandemic until 09/30/2022. First by telephone interview and, later, in a face-to-face medical consultation.Results:More than 35 symptoms were collected. The most frequent symptoms were asthenia, musculoskeletal pain, headache, joint pain, smell disturbances, and hair loss in the group interviewed by telephone. In the workers seen in the consultation, the most frequent symptoms were asthenia, dry eye, joint pain, memory loss, dyspnea and sleep disorders.Conclusion:Health care workers have experienced symptoms similar to those seen in other studies, but less frequently and with less severity. (AU)

Estilo de vida y síndrome metabólico en el personal de salud de un hospital, 2022 / Lifestyle and metabolic syndrome in hospital health personnel, 2022

Fundamentos: El síndrome metabólico es un conjunto de factores de riesgo cardiovascular que junto con unestilo de vida inadecuado puede generar una importante morbimortalidad en la población adulta, afectandosu salud y productividad. El objetivo fue determinar la relación entre el estilo de vida y el síndromemetabólico (SM) en el personal de la salud durante la pandemia por COVID-19 en un hospital en el distrito deAte, 2022.Métodos: Diseño no experimental, descriptivo, correlacional y transversal. Los participantes fueron 416trabajadores de un hospital en el distrito de Ate. El SM fue valorado según la definición la FederaciónInternacional de Diabetes (FID) y el estilo de vida mediante el cuestionario Fantástico. Para la asociación devariables se aplicó prueba de chi-cuadrado.Resultados: Participaron 304 (73,1%) mujeres y 112 (26,9%) hombres, con edades entre 30-59 años (n=395,94,9%) y mayores de 60 años (n=21, 5,1%). La prevalencia del SM fue del 52,2%. Se observó una relaciónentre estilos de vida y el SM. Al identificarse las características clínicas del personal de salud se encontrósegún los componentes del SM diferenciado por género, en mujeres y varones que además de presentarObesidad central, HTA, triglicéridos elevados y glicemia alterada.Conclusiones: La prevalencia de SM se presentó en más de la mitad de los participantes, siendo superior enlas mujeres; se encontró asociación entre la presencia de SM y los estilos de vida.(AU)

Background: The metabolic syndrome is a set of cardiovascular risk factors that together with an inadequatelifestyle can generate significant morbidity and mortality in the adult population, affecting their health andproductivity. The objective was to determine the relationship between lifestyle and metabolic syndrome (MS)in health personnel during the COVID-19 pandemic in a hospital in Ate district, 2022.Methods: Non-experimental, descriptive, correlational and cross-sectional design. The participants were 416workers from a hospital in Ate district. MS was assessed according to the definition of the InternationalDiabetes Federation (IDF) and lifestyle using the Fantastic questionnaire. For the association of variables, achi-square test was applied.Results: 304 (73.1%) women and 112 (26.9%) men participated, aged between 30-59 years (n=395, 94.9%)and over 60 years old (n=21, 5.1%). The prevalence of MS was 52.2%. A relationship was observed betweenlifestyles and MS. When the clinical characteristics of the health personnel were identified, it was foundaccording to the components of the MS differentiated by gender, in women and men who, in addition topresenting central obesity, HBP, elevated triglycerides and altered glycemia.Conclusions: The prevalence of MS was present in more than half of the participants, being higher in women;an association was found between the presence of MS and lifestyles.(AU)

GAD-7 Generalised Anxiety Disorder scale in Colombian medical professionals during the COVID-19 pandemic: Construct validity and reliability.

INTRODUCTION: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalised Anxiety Disorder (GAD-7) scale in Colombian doctors during the COVID-19 lockdown. METHODS: E-health study, in which cross-sectional data were collected online (n = 1030) from 610 COVID doctors and 420 non-COVID doctors, during the Colombian lockdown, between 20 April and 10 August 2020. Each subject was contacted, and they confirmed their participation, identity and professional role. RESULTS: A single factor factorial structure was found, made up of the 7 items of the instrument, which managed to explain 70% of the variance. The goodness of fit indices (RMSEA = 0.080; CFI = 0.995; SRMR = 0.053; p < 0.001) showed an "acceptable" unidimensionality and adequate factor loadings in each item of the GAD-7, >0.070. Finally, the internal consistency of the instrument was good, with a Cronbach's alpha of 0.920 (95%IC, 8.80-9.71). CONCLUSIONS: The GAD-7 is an instrument that presents adequate indicators of validity and reliability. It is an excellent tool that is reliable and easy and fast to use for the detection of generalised anxiety symptoms in medical personnel caring (or not) for patients infected with COVID-19.

Conhecimento dos profissionais da saúde de um hospital público em relação à afasia / Knowledge on aphasia held by health professionals of a public hospital / Conocimiento de los profesionales sanitarios de un hospital público sobre la afasia

Introdução: A compreensão da afasia é fundamental para os profissionais de saúde que prestam assistência a pacientes com AVC. No entanto, a informação disponível sobre a afasia ainda é limitada e insuficiente para uma abordagem eficaz. É de suma importância identificar o conhecimento dos profissionais de saúde a respeito da afasia, a fim de planejar o atendimento aos pacientes e suas famílias.Objetivo: Avaliar o nível de conhecimento dos profissionais de saúde de um hospital público em relação à afasia e analisar como eles lidam com pacientes com afasia durante o período de hospitalização. Método: Realizamos uma pesquisa com profissionais de saúde por meio de um questionário online para avaliar seu conhecimento sobre a afasia e suas estratégias de atendimento. Resultados: Os resultados indicam que profissionais de saúde com níveis de educação mais elevados tendem a possuir um entendimento mais sólido da afasia. No entanto, persistem lacunas de conhecimento em diversos aspectos da afasia. Embora a maioria dos profissionais se sinta adequadamente preparado para lidar com pacientes com afasia, eles reconhecem os desafios envolvidos e expressam o desejo de receber orientações para aprimorar suas habilidades de comunicação. Conclusão: Este estudo ressalta a necessidade de uma formação mais abrangente para os profissionais de saúde no que diz respeito à afasia e suas estratégias de comunicação. É fundamental o desenvolvimento de programas de treinamento e a elaboração de diretrizes específicas para os profissionais que atuam com esses pacientes, visando proporcionar um atendimento de alta qualidade. (AU)

Introduction: Understanding aphasia is crucial for healthcare professionals providing care to stroke patients. However, there is a need to enhance and refine the information available about aphasia for practical application. It is imperative to assess the knowledge of healthcare professionals regarding aphasia to facilitate effective care planning for patients and their families. Objective: This study aims to evaluate the level of knowledge among healthcare professionals in a public hospital concerning aphasia and their approach to patients with aphasia during their hospitalization. Method: An online questionnaire was administered to healthcare professionals to assess their understanding of aphasia and their caregiving strategies. Results: The findings indicate that healthcare professionals with higher education levels tend to have a better understanding of aphasia. Nevertheless, knowledge gaps persist in various aspects of aphasia. While most professionals feel adequately prepared to interact with patients experiencing aphasia, they acknowledge the challenges involved and express a desire for guidance to enhance their communication skills. Conclusion: This study underscores the necessity for comprehensive training of healthcare professionals in the realm of aphasia and effective communication strategies. The development of training programs and guidelines is crucial to better serve patients with aphasia, ensuring the provision of high-quality care. (AU)

Introducción: La comprensión de la afasia es importante para los profesionales de la salud que atienden a pacientes con ACV. Sin embargo, la información sobre la afasia sigue siendo limitada e insuficiente para un enfoque efectivo. Es importante identificar el conocimiento de los profesionales de la salud sobre la afasia para planificar la atención a los pacientes y sus familias. Objetivo: Evaluar el conocimiento de los profesionales de la salud de un hospital público sobre la afasia y cómo manejan a los pacientes con afasia durante el período de hospitalización. Método: Se realizó una encuesta a profesionales de la salud a través de un cuestionario en línea para evaluar su conocimiento sobre la afasia y sus tácticas de atención. Resultados: Se señala un mayor conocimiento sobre la afasia entre los profesionales de nivel superior, pero aún existen lagunas de conocimiento en varios aspectos de la afasia. La mayoría de los profesionales se sienten preparados para manejar a pacientes con afasia, pero reconocen que la atención es desafiante y les gustaría recibir orientación para mejorar sus habilidades de comunicación. Conclusión:Este estudio destaca la necesidad de una formación más amplia y completa para los profesionales de la salud sobre la afasia y su comunicación. Es fundamental desarrollar programas de capacitación y guías para atender mejor a estos pacientes y garantizar una atención de calidad. (AU)

Estrés post traumático en el personal sanitario de la Unidad de Emergencia de un hospital terciario en pandemia SARS COV-2 / Post traumatic stress in the health personnel of the Emergency Unit of a tertiary hospital in SARS COV-2 pandemic

Introducción: El personal sanitario de emergencia se encuentra extremadamente expuesto a situaciones estresantes. El trastorno de estrés post traumático es una patología emergente en el personal sanitario durante los últimos años y es reconocida únicamente como enfermedad mental de carácter laboral. Objetivos: Establecer la prevalencia y síntomas asociados al trastorno de estrés post traumático obtenidos del tamizaje con lista de verificación del trastorno de estrés post traumático para DSM-5 aplicado al personal sanitario de la unidad de emergencia de un hospital terciario durante la pandemia por SARS-CoV-2. Material y Métodos: Estudio retrospectivo, de cohorte observacional, transversal, unicéntrico en los (5) estamentos profesional y no profesional, entre el periodo abril 2021 a diciembre 2022. Resultados: Participaron 241 funcionarios (69.45% de esta unidad de emergencia). Donde, un 19.9% presentó síntomas de estrés post traumático, desagregados en; 36.0% auxiliar de servicio, 26.7% kinesiología, 26.1% técnico en enfermería nivel superior, 13.3% enfermería y un 9.8% médicos. La mayor sintomatología correspondió a recuerdos intrusivos, malestar psicológico intenso, comportamiento imprudente-autodestructivo e hipervigilancia. Asimismo, a mayor antigüedad laboral y los estamentos auxiliares, kinesiología incrementan la probabilidad de puntaje alto en el tamizaje (variables de riesgo), mientras que a mayor edad disminuye (variable protector). El 29.46% fue vinculado a una atención en salud mental posterior al tamizaje. Discusión y conclusión: El estudio identificó y caracterizó a un grupo representativo de la unidad de emergencia presentó síntomas de estrés post traumático durante la pandemia SARS-CoV-2. Una red de apoyo psicológico permanente podría ser una intervención efectiva de promoción en salud mental (AU)

Introduction: Emergency medical personnel are extremely exposed to stressful situations. Post-traumatic stress disorder is an emerging pathology in health personnel in recent years and is only recognized as a mental illness of an occupational nature. Objective: To establish the prevalence and symptoms associated with post-traumatic stress disorder obtained from the screening with the checklist of post-traumatic stress disorder for DSM-5 applied to health personnel from the emergency unit of a tertiary hospital during the SARS-CoV-pandemic. 2. Material and Method: Retrospective, observational, cross-sectional, single-center study in the (5) professional and non-professional levels, between the period April 2021 to December 2022. Results: 241 officials participated (69.45% of this emergency unit). Where, 19.9% presented symptoms of post-traumatic stress, broken down into 36.0% service assistant, 26.7% kinesiology, 26.1% higher level nursing technician, 13.3% nursing and 9.8% doctors. The greatest symptomatology corresponded to intrusive memories, intense psychological discomfort, reckless-self-destructive behavior and hypervigilance. Likewise, the higher the job seniority and the auxiliary levels, kinesiology increase the probability of a high score in the screening (risk variables), while at an older age it decreases (protective variable). 29.46% were linked to mental health care after the screening. Discussion: The study identified and characterized a representative group from the emergency unit who presented post-traumatic stress symptoms during the SARS-CoV-2 pandemic. A permanent psychological support network could be an effective promotion intervention in mental health. (AU)

Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad

Introducción: La detección de síntomas de ansiedad entre el personal sanitario que atiende a pacientes contagiados de COVID-19 es una prioridad actual. Se requieren instrumentos rápidos y válidos para esta población. El objetivo es establecer la validez de constructo y la confiabilidad de la Escala de Ansiedad Generalizada (GAD-7) en médicos colombianos durante la cuarentena por la COVID-19. Métodos: Estudio eSalud, en el que se recopilaron datos transversales en línea (n = 1.030) de 610 médicos de COVID y 420 no de COVID durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Se contactó con cada sujeto, que confirmó participación, identidad y función profesional. Resultados: Se encontró una estructura factorial de 1 solo factor, conformado por los 7 ítems del instrumento, que logró explicar el 70% de la varianza. Los índices de bondad de ajuste (RMSEA = 0,080; CFI = 0,995; SRMR = 0,053; p 0,07. Por último, la consistencia interna del instrumento fue buena, con alfa de Cronbach = 0,920 (IC95%,8,80-9,71). Conclusiones: El GAD-7 es un instrumento que presenta indicadores adecuados de validez y confiabilidad. Es un excelente instrumento, confiable, fácil y rápido de usar para la detección de los síntomas de ansiedad generalizada en personal médico, atienda o no a pacientes contagiados de COVID-19.

Introduction: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalized Anxiety Disorder (GAD-7) scale in Colombian doctors during the COVID-19 lockdown. Methods: E-health study, in which cross-sectional data were collected online (n = 1,030) from 610 COVID doctors and 420 non-COVID doctors, during the Colombian lockdown, between 20 April and 10 August 2020. Each subject was contacted, and they confirmed their participation, identity and professional role. Results: A single factor factorial structure was found, made up of the 7 items of the instrument, which managed to explain 70% of the variance. The goodness of fit indices (RMSEA = 0.080; CFI = 0.995; SRMR = 0.053; p 0.070. Finally, the internal consistency of the instrument was good, with a Cronbach's alpha of 0.920 (95%IC, 8.80-9.71). Conclusions:The GAD-7 is an instrument that presents adequate indicators of validity and reliability. It is an excellent tool that is reliable and easy and fast to use for the detection of generalised anxiety symptoms in medical personnel caring (or not) for patients infected with COVID-19.

Agresiones a personal adscrito a la Gerencia de Atención Primaria de Tenerife y pandemia por SARS-CoV2 / Attacks on personnel assigned to the Primary Care Management of Tenerife and the SARS-CoV2 pandemic

Objetivo Medir y caracterizar las agresiones sufridas por los profesionales sanitarios en el ámbito de la atención primaria de Tenerife entre el año 2018-2019 (prepandemia) y el 2020-2021 (pandemia). Secundariamente, analizar el grado de conocimiento de los profesionales en relación con el procedimiento de actuación frente a agresiones, las medidas de seguridad existentes y aspectos mejorables para su protección. Materiales y métodos Estudio observacional, descriptivo y transversal mediante un formulario autocumplimentado telemáticamente. Se difundió mediante los diferentes canales de comunicación con los profesionales sanitarios estando disponible entre marzo y abril del año 2022. Las variables cuantitativas se analizaron mediante medidas de tendencia central y de dispersión, y las cualitativas en porcentaje, realizando además un análisis bivariado utilizando el test χ2 y el test de la t de Student. Resultados De los participantes, 72,50% ha sufrido algún tipo de agresión en el ámbito laboral, siendo más frecuente en la zona metropolitana de Tenerife, las cuales se producen fundamentalmente por parte del paciente como de sus familiares. Estas agresiones son mayormente verbales y se producen en mayor cantidad hacia mujeres con la categoría de enfermera. Conclusiones La enfermería es la categoría que más sufre las agresiones en la atención primaria de Tenerife, de manera independiente a la zona de la isla donde desempeñe su trabajo (AU)

Objective To measure and characterize the aggressions suffered by health professionals in the field of primary care in Tenerife between 2018–2019 (pre-pandemic) and 2020–2021 (pandemic). Secondly, to analyze the degree of knowledge of the professionals in relation to the procedure for action against aggressions as well as the existing security measures and aspects that could be improved for their protection. Materials and methods Observational, descriptive and cross-sectional study using a self-completed form electronically. It was disseminated through the different communication channels with health professionals, being available between March and April 2022. The quantitative variables were analyzed using measures of central tendency and dispersion, and the qualitative variables in percentage, also performing a bivariate analysis using the Chi square and Student's T. Results 72.50% of the participants have suffered some type of aggression in the workplace and they are more frequent causes in the metropolitan area of Tenerife, which are produced fundamentally by the patient and their relatives. These aggressions are mostly verbal and occur in greater quantity towards women with the category of nurse. Conclusions Nursing is the category that suffers the most aggressions in primary care in Tenerife, regardless of the area of the island where they carry out their work (AU)

Evaluación de una intervención comunitaria para incrementar la cobertura vacunal de la gripe en mujeres embarazadas / Evaluation of a community-based intervention to increase influenza vaccination coverage in pregnant women

Objetivo: Conocer el impacto de la intervención educativa realizada sobre los profesionales de una zona básica de salud y su grupo de participación comunitaria, que conforman el grupo intervención (GI), y analizar su repercusión en la cobertura vacunal alcanzada para gripe en el grupo de riesgo (gestantes y puérperas) comparándola con su zona básica vecina, que conforma el grupo control (GC), durante la temporada vacunal 2019/20. Diseño: Estudio cuasiexperimental de intervención comunitaria. Emplazamiento: Dos zonas básicas de salud pertenecientes al departamento de salud Elche-Crevillente, España. Participantes: Gestantes y puérperas de 2 zonas básicas de salud y el grupo de participación comunitaria. Los profesionales de salud directamente relacionados con la campaña vacunal de gripe. Intervenciones: Sesión formativa al GI previa a la campaña de gripe 2019/20. Mediciones principales: Actitudes hacia la vacunación de gripe en profesionales sanitarios mediante el cuestionario validado CAPSVA y la cobertura vacunal de las gestantes y puérperas a través del Registro de Vacunas Nominal y su aceptación a la vacuna en la consulta de la matrona. Resultados: Los datos de cobertura vacunal en gripe registrados en el Registro de Vacunas Nominal para las mujeres gestantes y puérperas fue del 26,4% (n=207) en el GI y del 19,7% (n=144) en el GC (p=0,001), con una razón de incidencia del 1,34, lográndose así un 34% más de vacunación en el GI. La aceptación para la vacunación en las consultas de la matrona también fue elevada, inmunizándose en el GI el 96,5% vs. el 89,0% en el GC, con un RR=1,09 (IC 95% 1,01-1,62).Conclusiones: Estrategias de formación conjunta a profesionales y activos de la comunidad mejoran los resultados de cobertura vacunal.

Objective: To know the impact of the educational intervention carried out on the professionals of a basic health area and their community participation group, which make up the intervention group (IG), and to analyze its repercussion on the vaccination coverage achieved for influenza in the risk group (pregnant and puerperal women) comparing it with its neighboring basic zone, which makes up the control group (CG), during the 2019/20 vaccination season. Design: Quasi-experimental study of community intervention. SiteTwo basic health zones belonging to the Elche-Crevillente health department, Spain. Participants: Pregnant and postpartum women from 2 basic health areas and the community participation group. Health professionals directly related to the flu vaccination campaign. Interventions: Training session for the IG prior to the 2019/20 flu campaign. Main measurements: Attitudes towards influenza vaccination in health professionals through the validated CAPSVA questionnaire and the vaccination coverage of pregnant and postpartum women through the Nominal Vaccine Registry and their acceptance of the vaccine in the midwife's office. Results: The influenza vaccination coverage data recorded in Nominal Vaccine Registry for pregnant and puerperal women was 26.4% (n=207) in the IG and 19.7% (n=144) in the CG (p=0.001), with an incidence ratio of 1.34, thus achieving 34% more vaccination in the IG. Acceptance for vaccination in the midwife's office was also high, with 96.5% immunization in IG vs. 89.0% in CG, with a RR=1.09 (95% CI 1.01-1.62). Conclusions: Joint training strategies for professionals and community assets improve the results of vaccination coverage.(AU)

[Professional and psychological impact of second victims among hospital healthcare professionals]. / Impacto laboral y psicológico de las segundas víctimas entre los profesionales sanitarios hospitalarios.

OBJECTIVE: To analyze the occupational and psychological consequences suffered by healthcare workers who are considered second victims (SV). MATERIAL AND METHODS: Observational, descriptive and cross-sectional study among the healthcare workers of a university hospital. The answers collected in a specifically designed questionnaire about psychological consequences at work and the result of a post-traumatic stress scale, "Impact of Event Scale-Revised (IES-R, spanish version)" were evaluated. The variables between the groups were compared using the Chi square test (or Fisher's exact test) when both were qualitative and with the Student's T (or the Mann-Whitney U test for independent data), when one of them was quantitative. The level of statistical significance was P<.05. RESULTS: 75.5% (148/207) of the participants in the study suffered some adverse event (AE) and, of these, 88.5% (131/148) were considered SV. Physicians had a 2.2 times higher risk of feeling SV than nurses (95% CI: 1.88-2.52). The impact on the patient related to the AE explained why the professionals involved in it felt SV (P=.037). 80.6% (N=104) of the SVs presented post-traumatic stress. Women were 2.4 times more likely to suffer from it (OR: 2.4; 95% CI: 1.5-4.0). Intrusive thoughts in the SV were almost three times more frequent when the damage suffered by the patient was permanent or death (OR: 2.5; 95% CI: 0.2-3.6). CONCLUSIONS: Many healthcare workers, especially physicians, considered themselves to be SV, and many of them suffered from post-traumatic stress. The impact on the patient related to the AE was a risk factor for being SV and for suffering psychological consequences.