Mira José Joaquín, Cobos-Vargas Ángel, Astier-Peña Maria Pilar, Pérez-Pérez Pastora, Carrillo Irene, Guilabert Mercedes, Pérez-Jover Virtudes, Fernández-Peris Cesar, Vicente-Ripoll María Asunción, Silvestre-Busto Carmen, Lorenzo-Martínez Susana, Martin-Delgado Jimmy, Aibar Carlos, Aranaz Jesús
Alicante-Sant Joan Health Department, 03013 Alacant, Spain.
Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain.
Int J Environ Res Public Health. 2021 Nov 16;18(22):12010. doi: 10.3390/ijerph182212010.
: To describe lessons learned during the first COVID-19 outbreak in developing urgent interventions to strengthen healthcare workers' capacity to cope with acute stress caused by health care pressure, concern about becoming infected, despair of witnessing patients' suffering, and critical decision-making requirements of the SARS-CoV-2 pandemic during the first outbreak in Spain. : A task force integrated by healthcare professionals and academics was activated following the first observations of acute stress reactions starting to compromise the professionals' capacity for caring COVID-19 patients. Literature review and qualitative approach (consensus techniques) were applied. The target population included health professionals in primary care, hospitals, emergencies, and nursing homes. Interventions designed for addressing acute stress were agreed and disseminated. : There are similarities in stressors to previous outbreaks, and the solutions devised then may work now. A set of issues, interventions to cope with, and their levels of evidence were defined. Issues and interventions were classified as: adequate communication initiative to strengthen work morale (avoiding information blackouts, uniformity of criteria, access to updated information, mentoring new professionals); resilience and recovery from physical and mental fatigue (briefings, protecting the family, regulated recovery time during the day, psychological first aid, humanizing care); reinforce leadership of intermediate commands (informative leadership, transparency, realism, and positive messages, the current state of emergency has not allowed for an empirical analysis of the effectiveness of proposed interventions. Sharing information to gauge expectations, listening to what professionals need, feeling protected from threats, organizational flexibility, encouraging teamwork, and leadership that promotes psychological safety have led to more positive responses. Attention to the needs of individuals must be combined with caring for the teams responsible for patient care. : Although the COVID-19 pandemic has a more devastating effect than other recent outbreaks, there are common stressors and lessons learned in all of them that we must draw on to increase our capacity to respond to future healthcare crises.
描述在西班牙首次新冠疫情爆发期间吸取的经验教训,这些经验教训涉及制定紧急干预措施,以增强医护人员应对因医疗压力、对感染的担忧、目睹患者痛苦的绝望以及在首次爆发期间应对新冠疫情的关键决策要求所导致的急性应激的能力。:在首次观察到急性应激反应开始损害医护人员护理新冠患者的能力后,一个由医疗专业人员和学者组成的特别工作组被启动。采用了文献综述和定性方法(共识技术)。目标人群包括初级保健、医院、急诊科和养老院的卫生专业人员。商定并传播了针对急性应激的干预措施。:应激源与之前的疫情爆发有相似之处,当时设计的解决方案现在可能仍然有效。确定了一系列问题、应对干预措施及其证据水平。问题和干预措施分为:加强工作士气的充分沟通举措(避免信息封锁、标准统一、获取最新信息、指导新专业人员);从身心疲劳中恢复的适应力和恢复能力(简报、保护家庭、白天规定的恢复时间、心理急救、人性化护理);加强中级指挥的领导力(信息性领导、透明度、现实主义和积极信息,当前的紧急状态不允许对提议干预措施的有效性进行实证分析。分享信息以衡量期望、倾听专业人员的需求、感到免受威胁、组织灵活性、鼓励团队合作以及促进心理安全的领导力已带来更积极的反应。关注个人需求必须与关心负责患者护理的团队相结合。:尽管新冠疫情的影响比近期其他疫情爆发更为严重,但所有这些疫情都存在共同的应激源和吸取的经验教训,我们必须借鉴这些经验教训来提高应对未来医疗危机的能力。