Martínez-Riera José Ramón, Gras-Nieto Elvira
Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, España; Asociación Enfermería Comunitaria (AEC), España.
Centro de Salud de Tomás Ortuño, Benidorm, Alicante, España; Asociación Enfermería Comunitaria (AEC), España.
Enferm Clin (Engl Ed). 2021 Feb;31:S24-S28. doi: 10.1016/j.enfcli.2020.05.003. Epub 2020 May 15.
In Spain, Home Care as a fundamental tool of Primary Health Care, has had uneven development both before and during the COVID-19 pandemic, although it initially played a relevant role in the control and monitoring of infected people and their families. However, at no time it was used the desirable community perspective and community participation throughout the process as it has been successfully done in other settings. Subsequently, with the closure of health centers, it ceased to be provided in some autonomous communities, when all the attention was transferred to the hospital setting. This exacerbated hospital-centrism, to the detriment of PHC and Home Care, is showing a high contagion in healthcare professionals. The circulation of professionals in the hospitals, where the main focus of infection is concentrated, and from these to their homes is a clear risk factor. In addition, we must not forget that Home Care is of special importance for the care of people with terminal illnesses or very advanced chronic diseases (dementia, COPD...), although always taking into account recommendations tending to extreme precautions for infection for professionals, family and caregivers. This can be adapted to the pandemic situation by using tools that digital health offers (telephone care, video calls...). Finally, it would be very interesting that, once the crisis was over, research was carried out that allowed the incorporation of people who have been treated by the health service during the pandemic, through the technique called public participation in research projects.
在西班牙,家庭护理作为初级卫生保健的一项基本工具,在新冠疫情之前及期间的发展并不均衡,尽管它最初在对感染者及其家人的管控和监测中发挥了重要作用。然而,在整个过程中,它从未像在其他地区那样采用理想的社区视角并实现社区参与。随后,随着健康中心的关闭,在一些自治区,家庭护理不再提供,所有注意力都转向了医院环境。这种加剧的以医院为中心的做法,对初级卫生保健和家庭护理造成了损害,在医护人员中呈现出高传染性。医院里医护人员的流动(感染主要集中于此)以及他们从医院回到家中,是一个明显的风险因素。此外,我们不能忘记,家庭护理对于绝症患者或患有非常严重慢性病(如痴呆症、慢性阻塞性肺疾病……)的患者的护理尤为重要,尽管始终要考虑到针对专业人员、家人和护理人员采取极端感染预防措施的建议。可以通过利用数字健康提供的工具(电话护理、视频通话……)来适应疫情形势。最后,非常有意思的是,一旦危机结束,开展研究,通过公众参与研究项目这种技术,将疫情期间接受过卫生服务治疗的人员纳入其中。