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前线报告:卫生工作者描述巴西五个城市的 COVID-19 风险和担忧。

Reports from the frontline: health workers describe COVID-19 risks and fears in five cities in Brazil.

机构信息

School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.

Federal University of Ceará, Programa de Pós-Graduação Em Saúde Pública, Fortaleza, Brazil.

出版信息

BMC Health Serv Res. 2023 Mar 22;23(1):276. doi: 10.1186/s12913-023-09118-y.

Abstract

BACKGROUND

Health providers are under unprecedented pressures to perform in the COVID-19 health crisis and under unprecedented risks. We initiated a large mixed-method survey of health professionals in five large metropolitan areas in Brazil to document the risks and needs of health professionals. To initiate the study, we conducted formative research.

METHODS

We conducted 77 open-ended semi-structured interviews online in a convenience sample of physicians, nurses, nurse technicians, and physiotherapists in Belem, Fortaleza, Porto Alegre, Recife, and São Paulo, Brazil. Design, data collection, and analysis were informed by Rapid Ethnographic Analysis (REA).

RESULTS

Responses are organized into three themes that emerged in the interviews: the lack of preparation - both locally and nationally-for the pandemic and its effects on staffing and training; the overlap of personal, family, and professional risk and consequences; and inadequately addressed anxiety and suffering among health staff.

CONCLUSIONS

Our respondents were unprepared for the epidemic, especially the institutional sequelae and psychological cost. These consequences were exacerbated by both lack of leadership and sweeping changes undercutting the Brazilian health system noted by almost all participants.

摘要

背景

在 COVID-19 健康危机中,医疗服务提供者面临前所未有的压力和风险。我们对巴西五个大都市区的卫生专业人员进行了一项大型混合方法调查,以记录卫生专业人员的风险和需求。为了启动这项研究,我们进行了基础研究。

方法

我们在巴西贝伦、福塔莱萨、阿雷格里港、累西腓和圣保罗的医生、护士、护士技师和物理治疗师中进行了方便样本的 77 次在线开放式半结构式访谈。设计、数据收集和分析都受到快速人种学分析(REA)的启发。

结果

受访者的回答分为三个主题:对大流行及其对人员配备和培训的影响缺乏准备,无论是在地方还是在国家层面;个人、家庭和职业风险及后果的重叠;以及卫生人员的焦虑和痛苦没有得到充分解决。

结论

我们的受访者对疫情毫无准备,尤其是对机构后遗症和心理代价毫无准备。几乎所有参与者都注意到,领导层的缺乏和彻底的变革削弱了巴西卫生系统,这加剧了这些后果。

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