La abrazoterapia como maniobra terapéutica en el contexto de la PCR

The medical emergency team working in the province of Zamora attended, in the last four years, 49 patients with diagnosis of cardiopulmonary arrest (CPA). After cardiopulmonary resuscitation (CPR) maneuvers, 26 patients resulted in return of spontaneous circulation. Psychological support to relatives was providded through emotional and physical closeness and they also were helped, when it was nececessary, with bureaucratic paperwork. A descriptive longitudinal observational study has been carried out with the variables of sex, age and survival in the population over 65 in Zamora who was attended by medical emergency team between 2016 and 2019, whose diagnosis was CPA. Assistance to patients with cardiorespiratory arrest is complex and variable, sometimes leading to death. After the death of a person a set of physical, emotional and social reactions occur, that can range from the feeling of sadness to complete desolation. When the words are left over or we don’t find the right ones, it is useful to use hug therapy. We must be prepared to be able to perform both advanced cardiopulmonary resuscitation (CPR) maneuvers and to provide psychological support in these situations. Being old does not mean that it hurts less to lose a loved one or that we are prepared. Helping to face this moment of loss both emotionally and bureaucratically should be part of all CPR protocols as one more maneuver.En los últimos cuatro años el Centro Coordinador de Emergencias de Castilla y León, a través del servicio telefónico 112, recibió un total de 766 llamadas para solicitar ayuda sanitaria con motivo de PCR. El personal de emergencias que trabaja en la provincia de Zamora, atendió 48 pacientes con motivo de PCR (Parada Cardiorrespiratoria). Recuperaron pulso tras realizar maniobras de RCP (Reanimación Cardiopulmonar) 26 pacientes y fueron trasladados al hospital. Ante la situación de fallecimiento, prestaron apoyo psicológico utilizando la cercanía emocional y física para acompañar a los familiares en esta situación y, orientaron cuando fue necesario, en el trámite burocrático.Se realizó un estudio descriptivo observacional longitudinal con las variables: sexo, edad y supervivencia de la población mayor de 65 años de Zamora durante el periodo entre 2016 y 2019 que atendió el servicio de emergencias médicas, cuyo diagnóstico de inicio y/o tras nuestra actuación fue de PCR. La asistencia a los pacientes en PCR es individualizada, dependiendo de varios factores que se suman llegando, en ocasiones, a situaciones potencialmente irreversibles. Tras el fallecimiento de una persona próxima se producen un conjunto de reacciones físicas, emocionales y sociales que pueden oscilar desde el sentimiento de tristeza hasta una desolación completa. Cuando sobran las palabras o no encontramos las adecuadas es útil la abrazoterapia y, les va a ayudar a afrontar mejor esta situación de duelo. Debemos estar preparados para realizar las maniobras de soporte vital avanzado de calidad y debemos prepararnos para prestar apoyo psicológico en estas situaciones. Ser anciano no implica que duela menos perder a un ser querido ni que estemos preparados para que ocurra en ese momento. Ayudar a afrontar este momento de pérdida tanto emocionalmente como burocráticamente debería formar parte de todos los protocolos de PCR como una maniobra más

Psychological impact of the COVID-19 pandemic on out-of-hospital health professionals: A living systematic review

Producción CientíficaHealth professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs

Percepción del nivel de autoeficacia en los profesionales sanitarios de la gerencia de emergencias sanitarias de Castilla y León durante la pandemia Covid-19

Health emergency personnel in Castilla y León have been part of the first line of care in the COVID-19 pandemic, being one of the groups most exposed to contagion. Determining the degree of self-efficacy that these workers perceive of themselves gives us an idea of their ability to adapt and cope with this adverse event. The aim of the study was to establish the level of self-efficacy perception in healthcare professionals of the Gerencia de Emergencias Sanitarias de Castilla y León during the COVID-19 pandemic, as well as the relationship of self-efficacy with other variables. The methodology used was quantitative and descriptive through surveys. The sample of volunteers is 253 participants. Out-of-hospital professionals obtain a mean score in their level of self-efficacy of 72.36 ± 15.80. A higher score is observed in older professionals, with greater professional experience in the extra-hospital setting, who work in direct care with patients, who have not previously received psychological treatment or who have received some dose of the SARS-CoV-2 vaccine Theself-efficacy of out-of-hospital professionalsis good, finding factorsrelated to a higher or lower level. These results show the ability of these professionals to adapt to adverse situations such as the COVID-19 pandemic.El personal de emergencias sanitarias de Castilla y León ha formado parte de la primera línea asistencial durante la pandemia por COVID-19, siendo uno de los grupos más expuestos al contagio. Determinar el grado de autoeficacia que estos trabajadores perciben de sí mismos nos da una idea de la capacidad de adaptación y afrontamiento que han tenido ante este evento adverso. El objetivo deestudio hasido establecerel nivel de percepción en autoeficaciaen los profesionales sanitarios de la Gerencia de Emergencias Sanitarias de Castilla y León durante la pandemia por COVID-19, así como su relación con otras variables. La metodología empleada es cuantitativa de tipo descriptiva a través de encuestas. La muestra de voluntarios es de 253 participantes. Los profesionales de extrahospitalaria obtienen una puntuación media en su nivel de autoeficacia, de 72.36 ± 15.80. Se observa una mayor puntuación en los profesionales de mayor edad (p=0.030), con una mayor experiencia profesional en el ámbito extrahospitalario (p<0.001), que trabajan en asistencia directa con pacientes (p=0.028), que no han recibido previamente tratamiento psíquico (p=0.014) o que han recibido alguna dosis de la vacuna contra el SARS-CoV-2 (p=0.002). La autoeficacia de los profesionales de extrahospitalaria es buena, existiendo factores que se relacionan con un mayor o menor nivel. Los resultados ponen de manifiesto la capacidad de adaptación de estos profesionales ante situaciones adversas como la vivida durante la pandemia por la COVID-19.

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (GSES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.This research was funded by Fundación ASISA and Sociedad Española de Urgencias y Emergencias (SEMES)

Papel de la emergencia en la gestión del problema social del anciano

Introducción.- Actualmente, en nuestra sociedad hay un aumento del porcentaje de la población mayor de 65 años. Zamora se sitúa en segundo puesto de España referente a este dato. El número de llamadas realizadas al centro 112 de Castilla y León, con diagnóstico final problema social, va aumentando según el registro desde 2016. A pesar de no ser una patología médica urgente, genera movilización de recursos sanitarios de urgencia y la situación va in crescendo de la misma forma; teniendo en cuenta que los recursos son limitados, ¿puede producirse un desequilibrio entre la demanda y los servicios ofertados? ¿En la gestión global del problema social es la UME la solución final? Objetivos.- 1. Analizar, en Zamora, que el incremento de esta población conlleva el aumento de diagnósticos finales: problema social; 2. Demostrar que la utilización de los recursos que existen en la actualidad para la gestión global del problema no es suficiente, genera sobrecarga de los Servicios de Urgencia y afecta a la sostenibilidad del Sistema Sanitario español; 3. Proponer soluciones alternativas. Método.- Estudio descriptivo observacional de la población mayor de 65 años de Zamora que realizó llamadas al 112 de Castilla y León cuyo diagnóstico fue considerado: problema social, desde enero de 2106 a septiembre de 2019. Resultados.- aumento de 52 incidentes con “problema social”. La frecuencia es mayor en hombres que en mujeres. De las 60 intervenciones de la UME, más de la mitad fueron dados de alta in situ. Conclusiones La sobredemanda de servicios de Urgencias y Emergencias, puede desembocar en el dilema “La tragedia de los comunes”, descrito por Garrett Hardin en 1968. Por tanto, una buena orientación, educación y formación sociosanitaria, y la elaboración de un Plan con recursos tipo servicio multidisciplinar de derivación: “Unidad Social”, aumentaría la eficiencia de la atención al anciano con problema social.Introduction: Currently, in our society there is an increase in the percentage of the population over 65 years of age. Zamora is in second place in Spain with regard to this data. The number of calls made to the 112 centre in Castilla y León, with a final diagnosis of a social problem, is increasing according to the register since 2016. Although it is not an urgent medical pathology, it generates the mobilization of emergency health resources and the situation is increasing in the same way; taking into account that resources are limited, can there be an imbalance between the demand and the services offered? Is the EMU the final solution in the global management of the social problem? To analyse, in Zamora, that the increase of this population, entails an increase of final diagnoses: social problem; 2. To demonstrate that the use of the resources that currently exist for the global management of the problem is not sufficient, generates an overload of the Emergency Services and affects the sustainability of the Spanish Health System; 3. Methods: Descriptive observational study of the population over 65 years of age in Zamora who made calls to 112 in Castile and Leon and whose diagnosis was considered a social problem from January 2106 to September 2019. Results: Increase of 52 incidents with “social problem”. The frequency is higher in men than in women. More than half of the 60 EMU interventions were discharged on site. Conclusions The over-demand of emergency services may lead to the dilemma “The tragedy of the commons”, described by Garrett Hardin in 1968. Therefore, good orientation, education and training in social and health care, and the development of a plan with resources such as a multidisciplinary referral service: “Social Unit”, would increase the efficiency of care for the elderly with social problems.peerReviewe

Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study

Abstract Background The COVID-19 pandemic had a major psychological impact on health care workers (HCWs). This study was embedded in a larger quantitative study on the mental health care of out-of-hospital HCWs in Spain. To better understand this, a qualitative study was conducted to explore the experiences, coping strategies, and influencing factors of out-of-hospital HCWs who scored high (> 25 points) on the Depression Anxiety Stress Scale (DASS-21) in a previous quantitative mental health study. Methods A qualitative study was conducted using six in-depth interviews with individuals who scored high on the depression scale and agreed to be contacted by email between May and June 2021, using the phenomenological approach. The data were analysed using Brawn and Clare’s method. Results The main results findings related to four themes. The emotional impact of assuming a professional role with high self-demands and responsibilities; Factors influencing the development of negative emotions such as the cruelty of the pandemic, the helplessness in relation to health management and policy, the changing role of the professional and the relationship with society; Personal protection through coping strategies to manage negative emotions such as support from colleagues and family; Good practices for the future looking for different management strategies that can influence individuals and their personal, professional, and social relationships. Conclusion The strong impact of the circumstances experienced points to the need to develop psychological support programmes that can protect people’s mental health from depression during a crisis and improve the relationship between workers and their managers

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (GSES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.Sin financiación4.964 JCR (2021) Q2, 55/172 Medicine, General & Internal1.040 SJR (2021) Q1, 438/2489 Medicine (miscellaneous)No data IDR 2021UE

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID-19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (G-SES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events