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2.
J Prim Care Community Health ; 12: 21501327211008437, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33840276

RESUMEN

BACKGROUND: Primary care physicians have been present on the frontline during the ongoing pandemic, adding new tasks to already high workloads. Our aim was to evaluate burnout in primary care physicians during the COVID-19 pandemic, as well as associated contributing factors. METHODS: Cross-sectional study with an online questionnaire disseminated through social media, applying the snowball technique. The target population was primary care physicians working in Portugal during the first outbreak of the COVID-19 pandemic. In addition to sociodemographic data, the questionnaire collected responses to the Copenhagen Burnout Inventory (CBI), the Resilience Scale and the Depression, Anxiety, and Stress Scales (DASS-21). Data were collected from May 9 to June 8, 2020, a period comprising the declaration of a national calamity and then state of emergency, and the subsequent ease of lockdown measures. Levels of burnout in 3 different dimensions (personal, work, and patient-related), resilience, stress, depression, and anxiety were assessed. Logistic regression analyses were conducted to identify factors associated with burnout levels. RESULTS: Among the 214 physician respondents, burnout levels were high in the 3 dimensions. A strong association was found between gender, years of professional experience, depression and anxiety, and burnout levels. CONCLUSIONS: Physician burnout in primary care is high and has increased during the pandemic. More studies are needed in the long term to provide a comprehensive assessment of COVID-19'simpact on burnout levels and how to best approach and mitigate it during such unprecedented times.


Asunto(s)
Agotamiento Psicológico/epidemiología , Médicos/psicología , Atención Primaria de Salud , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Portugal/epidemiología , Psicometría/instrumentación , Encuestas y Cuestionarios
3.
BMC Health Serv Res ; 21(1): 291, 2021 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-33789650

RESUMEN

BACKGROUND: This study aims to explore the experiences, beliefs, feelings, and challenges faced by Pakistani migrant doctors working in the United Kingdom in times of the COVID-19 pandemic. The qualitative study aims to explore the lived experiences, beliefs, feelings, and challenges faced by Pakistani migrant physicians working in the United Kingdom during the COVID-19 pandemic. METHODS: An exploratory phenomenological approach was used to collate data on experiences expressed during the COVID-19 pandemic. Purposive and snowball sampling was used to target participants, which were doctors of Pakistani origin involved in the direct care and management of COVID-19 patients in different NHS hospitals of the United Kingdom. Semi-structured, in-depth telephonic interviews were conducted with study participants in May 2020. Data analysis was done parallel with data collection by using an inductive qualitative approach. RESULTS: We recruited ten frontline physicians. Four theme categories emerged from the data analysis: 1) Working across borders and cultures, 2) Role of beliefs for coping with stress and fear, 3) Passion and profession, and 4) Scaffolding the Pakistani health system. Overall, the results show that the participants received limited professional support, in terms of counseling and psychological rehabilitation. Instead, they had to use self-management strategies to cope with the situation. CONCLUSION: The intensive work exhausted participants physically and emotionally. They were holding a lot of grief and hurt inside, but still, healthcare professionals showed the spirit of professional dedication to overcome difficulties. Although currently coping with their emotional problems, comprehensive professional support should be made available to cater to the wellbeing of frontline physicians.


Asunto(s)
Emigrantes e Inmigrantes , Médicos/psicología , Emigrantes e Inmigrantes/psicología , Humanos , Entrevistas como Asunto , Pakistán , Pandemias , Equipo de Protección Personal , Investigación Cualitativa , Reino Unido
4.
JCO Clin Cancer Inform ; 5: 394-400, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33822651

RESUMEN

PURPOSE: COVID-19 has infected more than 94 million people worldwide and caused more than 2 million deaths. Patients with cancer are at significantly increased risk compared with the general population. Telemedicine represents a common strategy to prevent viral spread. We sought to evaluate patient with cancer and physician perceptions of telemedicine during the COVID-19 pandemic. METHODS: A 16-question survey was e-mailed to 1,843 active e-mails of patients presenting to one of the six cancer clinics at a comprehensive cancer care center from January 1, 2020, to June 1, 2020. A six-question survey was e-mailed to attending physicians of those clinics. Specialties included Medical Oncology, Hematology-Oncology, Surgical Oncology, Urological Oncology, and Gynecologic Oncology. RESULTS: Three hundred seventy-four patients (20.3%) and 14 physicians (66.7%) responded. Most (68.2%) currently prefer in-person visits, and 80.4% prefer in-person visits following pandemic resolution. More than half (52.2%) of patients preferring virtual visits do so because of convenience. Most (63.1%) patients with cancer are comfortable with a complete physical examination. Surgical patients are more likely to prefer a complete examination (P = .0476). Physicians prefer in-person visits (64.2%) and believe that virtual visits maybe or probably do not provide comparable care (64.2%). 71.4% believe that virtual visits help prevent the spread of infectious disease. CONCLUSION: Given preferences for in-person visits, cancer care teams should be prepared to continue providing in-person visits for many of their patients. The discrepancy between patient and provider concern for spread of infectious disease represents an area where patients may benefit from increased education. Providers should feel comfortable performing physical examinations at their own discretion.


Asunto(s)
Actitud , Oncología Médica/métodos , Neoplasias/terapia , Telemedicina/métodos , Anciano , /virología , Humanos , Internet , Persona de Mediana Edad , Neoplasias/diagnóstico , Pandemias , Pacientes/psicología , Pacientes/estadística & datos numéricos , Médicos/psicología , Médicos/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Encuestas y Cuestionarios
5.
CMAJ Open ; 9(2): E400-E405, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33863798

RESUMEN

BACKGROUND: In March 2020, all levels of government introduced various strategies to reduce the impact of the COVID-19 pandemic. The purpose of this study was to document how the experience of providing medical assistance in dying (MAiD) changed during the COVID-19 pandemic. METHODS: We conducted a qualitative study using semistructured interviews with key informants in Canada who provided or coordinated MAiD before and during the COVID-19 pandemic. We interviewed participants from April to June 2020 by telephone or email. We collected and analyzed data in an iterative manner and reached theme saturation. Our team reached consensus on the major themes and subthemes. RESULTS: We interviewed 1 MAiD coordinator and 15 providers, including 14 physicians and 1 nurse practitioner. We identified 4 main themes. The most important theme was the perception that the pandemic increased the suffering of patients receiving MAiD by isolating them from loved ones and reducing available services. Providers were distressed by the difficulty of establishing rapport and closeness at the end of life, given the requirements for physical distancing and personal protective equipment. They were concerned about the spread of SARS-CoV-2, and found it difficult to enforce rules about distancing and the number of people present. Logistics and access to MAiD became more difficult because of the new restrictions, but there were many adaptations to solve these problems. INTERPRETATION: Providers and coordinators had many challenges in providing MAiD during the COVID-19 pandemic, including their perception that the suffering of their patients increased. Some changes in how MAiD is provided that have occurred during the pandemic, including more telemedicine assessments and virtual witnessing, are likely to remain after the pandemic and may improve service.


Asunto(s)
/psicología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Asistencia Médica/estadística & datos numéricos , Percepción/fisiología , Adulto , Anciano , Anciano de 80 o más Años , /epidemiología , Canadá/epidemiología , Muerte , Femenino , Humanos , Entrevistas como Asunto , Masculino , Asistencia Médica/tendencias , Persona de Mediana Edad , Enfermeras Practicantes/psicología , Aislamiento de Pacientes/psicología , Equipo de Protección Personal/efectos adversos , Médicos/psicología , Investigación Cualitativa , /genética
6.
BMC Infect Dis ; 21(1): 374, 2021 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-33882843

RESUMEN

BACKGROUND: The emerging threat of antibiotic resistance is growing exponentially and antibiotic stewardship programs are cornerstone to fight against this global threat. The study aimed to explore the knowledge, perspectives and practices of physicians regarding various aspects of antibiotic stewardship program including antibiotic stewardship activities, rational use of antibiotics, antibiotic resistance, prescribing practices and factors associated with these practices. METHODS: In this qualitative study, a total of 17 semi-structured, in-depth interviews with doctors of three tertiary care public sector hospitals in Bahawalpur and Rahim Yar Khan were conducted. The convenient sampling method was adopted to collect the data and the saturation point criterion was applied to determine the sample size. Thematic analysis approach was used to draw conclusions from the data. RESULTS: The analysis of data yielded five themes, 12 subthemes and 26 categories. The themes included, (i) perception about antibiotic use and antibiotic stewardship, (ii) antibiotic prescription practices, (iii) antibiotic resistance, (iv) limited strategies adopted by hospital administration to ensure quality and safe distribution of antibiotics, (v) implementation of antibiotic stewardship program: barriers, suggestion and future benefits. Doctors had misconceptions about the rational use of antibiotics. The perception regarding antibiotic stewardship programs was poor. Moreover, very few activities related to ASP existed. The participants gave many suggestions for successful implementation of ASP in order to reduce the burden of antibiotic resistance, including development of guidelines for the use of antibiotics, strict legislation regarding use of antibiotics, active participation of healthcare professionals and awareness program among general public about the use of antibiotics. CONCLUSION: This study concluded that poor knowledge of doctors regarding ASP, non-existence of antibiogram of hospital and lack of rules for the safe use of antibiotics were the main driving factors associated with irrational antibiotic prescription practices and development of AR.


Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos/métodos , Farmacorresistencia Microbiana , Conocimientos, Actitudes y Práctica en Salud , Percepción , Médicos/psicología , Antibacterianos/efectos adversos , Actitud del Personal de Salud , Prescripciones de Medicamentos , Femenino , Humanos , Masculino , Pakistán , Investigación Cualitativa
7.
J Coll Physicians Surg Pak ; 31(2): 182-187, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33645186

RESUMEN

OBJECTIVE: To find out various organizational, personal, and systemic factors influencing the performance of the postgraduate trainee doctors in managing COVID-19 pandemic. STUDY DESIGN: Analytical cross-sectional study. PLACE AND DURATION OF STUDY: Conducted in various medical institutions of Pakistan from 15th  April to 30th  June, 2020. METHODOLOGY: An analytical cross-sectional study was conducted on 11,656 postgraduate doctors. They were contacted through the e-log system of College of Physicians and Surgeons Pakistan. Semi-structured questionnaire was used consisting of demographic details, presenting symptoms, systemic involvements, clinical features, diagnostic tests, management of cases, authenticity of the  information used, telemedicine services, practice of preventive measures, training and interactive educational activities, performance-based tasks and details about workplace environment. Mean and standard deviation was reported for continuous variables. Bivariate and multivariate analyses were used to report p values. RESULTS: Among 11,656 postgraduate doctors, 3,193 (27.4%) were directly involved in the management of COVID-19 patients in designated special corona facilities. Multivariate analysis was performed to control confounders. The risk factors, found statistically significant with performance, were presence of comorbidity (OR 1.261; 95% C.I.1.06-1.50), allergic and autoimmune disorders (OR 1.18; 95% C.I.1.03-1.35), confirmed COVID-19 status due to exposure (OR 0.570; 95% C.I.0.41-0.81), and care provision to old parents (OR 1.299; 95% C.I.1.19-1.42). CONCLUSION: The effect of COVID-19 on performance of postgraduate doctors was multi-factorial. Significant risk factors were presence of a comorbidity, allergic and autoimmune disorders, and confirmed COVID-19 due to exposure. Key Words: COVID 19, Postgraduate trainee, Pandemic, Comorbidity, PCR.


Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Educación de Postgrado en Medicina/estadística & datos numéricos , Médicos/psicología , Adulto , Enfermedades Autoinmunes/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Pakistán/epidemiología , Pandemias , Factores de Riesgo , Encuestas y Cuestionarios
8.
J Infect Dev Ctries ; 15(2): 191-197, 2021 03 07.
Artículo en Inglés | MEDLINE | ID: mdl-33690199

RESUMEN

COVID-19 spread rapidly and jeopardised the physicians with not only treatment but also with limited resources and new working style. This study aimed to investigate the experience of physicians in Pakistan as frontline workers for the treatment of COVID-19 patients. The study employed a qualitative design and used Haas's adaptation of Colaizzi method for analysis. The respondents for the interview were selected based on purposive sampling and only those physicians were contacted who were treating COVID-19 patients in Lahore, Pakistan. The results of the study revealed many challenges faced by Pakistani physicians which included physical and psychological stress due to the treatment of COVID-19 patients. Moreover, infrastructural flaws have added in the vulnerabilities of the physicians. In developing countries, the fight is much harder for physicians as evidenced by their first-hand experience. The policymakers in developing countries especially in Pakistan can direct policies facilitating physicians to reduce their physical and psychological stress as well as increasing resources for the treatment of COVID-19 patients.


Asunto(s)
Médicos , Adulto , /transmisión , Femenino , Administración Hospitalaria , Hospitales , Humanos , Unidades de Cuidados Intensivos , Masculino , Pakistán , Equipo de Protección Personal , Médicos/psicología , Estrés Psicológico , Encuestas y Cuestionarios
10.
N Z Med J ; 134(1530): 12-20, 2021 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-33651773

RESUMEN

AIM: Burnout has a damaging effect on both the wellbeing of medical professionals and patients alike. Empathy is an important part of the therapeutic relationship and could be damaged by burnout. We aimed to describe the prevalence of burnout, assess levels of empathy and explore the relationship between burnout and empathy among senior medical officers (SMOs). We hypothesised that there would be a negative correlation between empathy and burnout. METHOD: This was a cross-sectional observational study involving SMOs from a variety of specialities. The focus is on SMOs with relatively prolonged contact times with patients. Email invitations were sent out requesting participation in an electronic survey on the QuestionPro platform. The survey comprised 42 questions enquiring about demographics, empathy (Jefferson Scale of Physician Empathy) and burnout (Copenhagen Burnout Inventory). Correlational analyses were performed. RESULTS: Three hundred and fourteen invitations were sent out and 178 responses were received (56.7% response rate). Forty-five percent of SMOs surveyed were experiencing high levels of personal burnout. There was a statistically significant negative correlation between empathy and patient-related burnout (p=0.018). CONCLUSIONS: The results show high levels of personal burnout among SMOs and suggest that empathy reduces as patient-related burnout increases. The nature of this relationship is a complex one, and other contributing variables should be considered.


Asunto(s)
Agotamiento Profesional/epidemiología , Empatía , Relaciones Médico-Paciente , Médicos/estadística & datos numéricos , Adulto , Agotamiento Profesional/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Médicos/psicología , Encuestas y Cuestionarios
11.
Mayo Clin Proc ; 96(3): 763-769, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33673923

RESUMEN

Physician burnout and other forms of occupational distress are a significant problem in modern medicine, especially during the coronavirus disease pandemic, yet few doctors are familiar with the neurobiology that contributes to these problems. Burnout has been linked to changes that reduce a physician's sense of control over their own practice, undermine connections with patients and colleagues, interfere with work-life integration, and result in uncontrolled stress. Brain research has revealed that uncontrollable stress, but not controllable stress, impairs the functioning of the prefrontal cortex, a recently evolved brain region that provides top-down regulation over thought, action, and emotion. The prefrontal cortex governs many cognitive operations essential to physicians, including abstract reasoning, higher-order decision making, insight, and the ability to persevere through challenges. However, the prefrontal cortex is remarkably reliant on arousal state and is impaired under conditions of fatigue and/or uncontrollable stress when there are inadequate or excessive levels of the arousal modulators (eg, norepinephrine, dopamine, acetylcholine). With chronic stress exposure, prefrontal gray matter connections are lost, but they can be restored by stress relief. Reduced prefrontal cortex self-regulation may explain several challenges associated with burnout in physicians, including reduced motivation, unprofessional behavior, and suboptimal communication with patients. Understanding this neurobiology may help physicians have a more informed perspective to help relieve or prevent symptoms of burnout and may help administrative leaders to optimize the work environment to create more effective organizations. Efforts to restore a sense of control to physicians may be particularly helpful.


Asunto(s)
Agotamiento Profesional/prevención & control , Neurobiología/métodos , Pandemias , Médicos/psicología , Lugar de Trabajo/psicología , Agotamiento Profesional/psicología , Humanos
14.
N Engl J Med ; 384(10): 891-893, 2021 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-33705618
15.
South Med J ; 114(4): 218-222, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33787935

RESUMEN

OBJECTIVES: Physician trainees in obstetrics and gynecology (OBGYN) experience unexpected outcomes similar to those of supervising physicians. A relative lack of experience and perspective may make them more vulnerable to second victim experience (SVE), however. The objectives of our study were to contrast the prevalence of SVE between supervising physicians and trainees and to identify their preferred methods of support. METHODS: In 2019, the Second Victim Experience and Support Tool, a validated survey with supplemental questions, was administered to healthcare workers caring for OBGYN patients at a large academic center in the midwestern United States. RESULTS: The survey was sent to 571 healthcare workers working in OBGYN. A total of 205 healthcare workers completed the survey, including 18 (43.9% of 41) supervising physicians and 12 (48.0% of 25) resident/fellow physicians. The mean scores for the Second Victim Experience and Support Tool dimensions and outcomes were similar between the two groups. Seven (58.3%) trainees reported feeling like a second victim after an adverse patient safety event at some point in their work experience compared with 10 (55.6%) of the supervising physicians. Five (41.7%) trainees identified as a second victim in the previous 12 months compared with 3 (16.7%) supervising physicians (P = 0.21). The most common form of desired support for both groups was conversations with their peers. CONCLUSIONS: Trainees and supervising physicians are both at risk of SVE after an unexpected medical event and prefer conversations with peers as a desired form of support. Because trainees commonly encounter SVEs early in their careers, program directors should consider implementing a program for peer support after an unexpected event.


Asunto(s)
Desgaste por Empatía/epidemiología , Ginecología/educación , Internado y Residencia , Obstetricia/educación , Médicos/psicología , Apoyo Social , Desgaste por Empatía/diagnóstico , Desgaste por Empatía/etiología , Desgaste por Empatía/terapia , Encuestas Epidemiológicas , Humanos , Relaciones Interprofesionales , Minnesota/epidemiología , Prevalencia , Factores de Riesgo
17.
J Prim Care Community Health ; 12: 21501327211000245, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33733901

RESUMEN

BACKGROUND: Health care workers (HCWs) are among the professionals at serious risk for the impact of the COVID-19 pandemic on their mental health. In this sense, the next public health challenge globally will be to preserving healthy HCWs during this pandemic. AIM: The present study has the aim of investigating the relationship among concerns, perceived impact, preparedness for the COVID-19 pandemic and the mental health of Italian physicians. METHODS: From March 29th to April 15th 2020, we conducted an online survey using snowball sampling techniques through Limesurvey platform. Data were analyzed using descriptive statistics and multiple binary logistic regressions. RESULTS: Multivariate analysis showed that the risk factors for perceived job stress were concerns about catching COVID-19 (OR = 3.18 [95% CI = 2.00-5.05] P < .001), perceived impact on job demands (OR = 1.63 [95% CI = 1.05-2.52] P < .05), perceived impact on job role (OR = 2.50 [95% CI = 1.60-3.90] P < .001), and non-working concerns (OR = 1.86 [95% CI = 1.15-3.03] P < .05). With respect to the risk factors for rumination about the pandemic emerged concerns about catching COVID-19 (OR 1.74, [95% CI = 1.12-2.71] P < .05), perceived impact on job role (OR = 1.68 [95% CI = 1.12-2.52] P < .05), and impact on personal life (OR = 2.04 [95% CI = 1.08-3.86] P < .05). Finally, the risk factors for crying at work were perceived impact on job role (OR = 2.47, [95% CI = 1.20-5.09] P < .05), rumination about the pandemic (OR = 3.027 [95% CI = 1.27-7.19] P < .01), watching colleagues crying at work (OR = 3.82 [95% CI = 1.88-7.77] P < .01), and perceived job stress (OR = 3.53 [95% CI = 1.24-10.07] P < .05). CONCLUSION: In general, our results highlighted that being concerned about being infected/infecting other people, carrying out new and unusual tasks, and witnessing colleagues crying at work were important risk factors for physicians' well-being. Additional data are necessary to advance understanding of these risk factors in a long-term perspective.


Asunto(s)
Salud Mental , Estrés Laboral/psicología , Médicos/psicología , Adulto , Anciano , Estudios Transversales , Análisis Factorial , Familia , Femenino , Humanos , Control de Infecciones , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Italia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Equipo de Protección Personal , Rol del Médico , Rumiación Cognitiva , Encuestas y Cuestionarios , Carga de Trabajo , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-33669828

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to the physical and mental well-being of doctors worldwide. Countries around the world introduced severe social restrictions, and significant changes to health service provision in the first wave of the pandemic to suppress the spread of the virus and prioritize healthcare for those who contracted it. This study interviewed 48 hospital doctors who worked in Ireland during the first wave of the pandemic and investigated their conceptualizations of their own well-being during that time (March-May 2020). Doctors were interviewed via Zoom™ or telephone. Interview transcripts were analyzed using structured thematic analysis. Five composite narratives are presented which have been crafted to illustrate themes and experiences emerging from the data. This study found that despite the risks of contracting COVID-19, many doctors saw some improvements to their physical well-being in the first wave of the pandemic. However, most also experienced a decline in their mental well-being due to anxiety, emotional exhaustion, guilt, isolation and poor support. These findings shed light on doctor well-being during COVID-19, and the ways in which they have been affected by the pandemic, both professionally and personally. The paper concludes by highlighting how doctors' work life and well-being can be better supported during and after the COVID-19 pandemic.


Asunto(s)
Pandemias , Médicos/psicología , Femenino , Estado de Salud , Hospitales , Humanos , Irlanda/epidemiología , Masculino , Salud Mental
20.
Transl Psychiatry ; 11(1): 169, 2021 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-33723233

RESUMEN

Lack of established knowledge and treatment strategies, and change in work environment, may altogether critically affect the mental health and functioning of physicians treating COVID-19 patients. Thus, we examined whether treating COVID-19 patients affect the physicians' mental health differently compared with physicians treating non-COVID-19 patients. In this cohort study, an association was blindly computed between physiologically measured anxiety and attention vigilance (collected from 1 May 2014 to 31 May 31 2016) and self-reports of anxiety, mental health aspects, and sleep quality (collected from 20 April to 30 June 2020, and analyzed from 1 July to 1 September 2020), of 91 physicians treating COVID-19 or non-COVID-19 patients. As a priori hypothesized, physicians treating COVID-19 patients showed a relative elevation in both physiological measures of anxiety (95% CI: 2317.69-2453.44 versus 1982.32-2068.46; P < 0.001) and attention vigilance (95% CI: 29.85-34.97 versus 22.84-26.61; P < 0.001), compared with their colleagues treating non-COVID-19 patients. At least 3 months into the pandemic, physicians treating COVID-19 patients reported high anxiety and low quality of sleep. Machine learning showed clustering to the COVID-19 and non-COVID-19 subgroups with a high correlation mainly between physiological and self-reported anxiety, and between physiologically measured anxiety and sleep duration. To conclude, the pattern of attention vigilance, heightened anxiety, and reduced sleep quality findings point the need for mental intervention aimed at those physicians susceptible to develop post-traumatic stress symptoms, owing to the consequences of fighting at the forefront of the COVID-19 pandemic.


Asunto(s)
Ansiedad/psicología , Atención , Estrés Laboral/psicología , Médicos/psicología , Reflejo de Sobresalto , Sueño , Trastornos por Estrés Postraumático/psicología , Adulto , Análisis por Conglomerados , Femenino , Humanos , Aprendizaje Automático , Masculino , Salud Mental , Persona de Mediana Edad
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