Retos y dificultades para los tomadores de decisiones del área de la salud durante la pandemia en Bogotá: perspectiva desde un abordaje fenomenológico interpretativo

Laura Sofía Amador-Perilla, Laura Daniela Forero-Cortés, Aneth Alvarado-Sarmiento, Luis Gonzalo Burgos-Ortiz, Mario Ávila-Daguer, Yazmín Cadena-Camargo
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Abstract

Introduction and objective

The health emergency caused by COVID-19 presented a context of limited scientific evidence, scarcity of resources, and changes in work routines, for which health workers had to adapt to a transformation of medical practice. This study seeks to know in depth the experiences lived by the health professionals and decision makers of the hospital facing the management of the situations posed by the health emergency of COVID-19.

Methods

We conducted qualitative research with a phenomenological interpretative approach. The target population were the decision-making physicians. The tool used was the in-depth open interview. A thematic analysis was carried out according to the author Steiner Kvale, inductive, where an approximation to the interviews was made, finding the preponderant themes in a repeated way, considering them as categories for the analysis. Finally, the information was grouped to carry out its analysis, relating it to the evidence found in the literature.

Results

Three emerging categories were identified, the first corresponds to organizational changes during the pandemic, the second was organizational culture and the third was mental health perceived by the participants. Our main results were that much of the stress felt by healthcare workers came from making difficult decisions in a context of uncertainty and scarcity of resources. Also, front line workers identify other risk factors that contributed to generate a negative effect on their mental health reflected in some symptoms of anxiety and depression. However, we also showed that these affectations were addressed with various institutional strategies.

Conclusions

Despite the limitation of the national context, collectively developed tools and plans were generated that allowed doctors to free themselves from the burden of situations posed by the health emergency, especially when making decisions, thus reducing risk factors that could threaten their mental health.
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波哥大大流行期间卫生决策者面临的挑战和困难:从现象学解释方法看问题
新冠肺炎引发的突发卫生事件的背景是科学证据有限、资源稀缺、工作惯例发生变化,卫生工作者必须适应医疗实践的转变。本研究旨在深入了解医院卫生专业人员和决策者在面对COVID-19卫生突发事件管理时的经验。方法采用现象学解释方法进行定性研究。目标人群是决策医生。使用的工具是深度公开面试。根据作者Steiner Kvale的归纳,进行了主题分析,其中近似于访谈,以重复的方式找到优势主题,将其视为分析的类别。最后,将信息分组进行分析,并将其与文献中发现的证据联系起来。结果确定了三个新类别,第一类对应于大流行期间的组织变化,第二类对应于组织文化,第三类对应于参与者感知的心理健康。我们的主要研究结果是,医护人员感受到的大部分压力来自于在不确定和资源稀缺的情况下做出艰难的决定。此外,一线工作人员还确定了其他风险因素,这些因素会对他们的心理健康产生负面影响,反映在一些焦虑和抑郁症状上。然而,我们也表明,这些影响是通过各种制度策略来解决的。结论:尽管国家背景有限,但集体开发了工具和计划,使医生能够摆脱卫生紧急情况造成的负担,特别是在做出决定时,从而减少了可能威胁其精神健康的风险因素。
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来源期刊
Revista Colombiana de Psiquiatria
Revista Colombiana de Psiquiatria Medicine-Psychiatry and Mental Health
CiteScore
2.50
自引率
0.00%
发文量
72
期刊介绍: Revista Colombiana de Psiquiatría (RCP) is a quarterly official publication of Colombian Psychiatry Association (March, June, September and December) and its purpose is to spread different the knowledge models that currently constitute the theoretical and practical body of our specialty. Psychiatrists, psychiatric residents, non psychiatric physicians, psychologists, philosophers or other health professionals or persons interested in this area can take part in the magazine. This journal publishes original works, revision or updating articles, case reports of all psychiatry and mental health areas, epistemology, mind philosophy, bioethics and also articles about methodology of investigation and critical reading.
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