Public Health Department, Federal University of Maranhão, São Luís, MA, Brazil.
Fluminense Federal University, Niterói, RJ, Brazil.
PLoS One. 2023 Aug 29;18(8):e0290068. doi: 10.1371/journal.pone.0290068. eCollection 2023.
To analyze the experiences of maternal health workers in three Brazilian cities, located in the Northeast (São Luís), Southeast (Niterói), and South (Pelotas) regions during the first year of the COVID-19 pandemic.
Qualitative research carried out between December 2020 and February 2021. Interviews were conducted, in person or remotely, with 30 health workers, doctors and nurses, working in maternity hospitals of different degrees of complexity.
Sociodemographic characteristics, employment relationships and professional qualification of the interviewees were described. Two thematic axes were identified: 1) changes in hospital organization and dynamics in the pandemic; 2) Illness and suffering of health workers. The majority of respondents were women. Most physicians had work relationships in the public and private sectors. In Niterói, health workers had better professional qualifications and more precarious work relationships (as temporary hires), compared to São Luís and Pelotas. In the context of the uncertainties resulting from the pandemic, this situation generated even more insecurity for those workers. The statements at the beginning of the pandemic covered topics such as changes in the organizational dynamics of services, healthcare, telemedicine, and interaction between health workers and users. In the health workers' perception, the initial period of the health emergency, which resulted in intense changes in the provision of services, was marked by an increase in preterm births, perinatal mortality, and fetal losses. Work overload, fear of contamination, concern for family members and uncertainties regarding the new disease caused intense suffering in health workers who had little institutional support in the cities studied. The suffering experienced by health workers went beyond the work dimension, reaching their private life.
Changes caused by the pandemic required immediate adjustments in professional practices, generating insecurities in healthcare regardless of the location studied. The method of hiring health workers remained the same as the previously practiced one in each city. Due to the risk of disease transmission, measures contrary to humanization practices, and more restrictive in São Luís, were reported as harmful to obstetric care. The Covid-19 pandemic was a huge challenge for the Brazilian health system, aggravating the working conditions experienced by health workers. In addition to the work environment, it was possible to briefly glimpse its effects on private life.
分析巴西东北部（圣路易斯）、东南部（尼泰罗伊）和南部（佩洛塔斯）三个城市的孕产妇保健工作者在 COVID-19 大流行第一年的经历。
2020 年 12 月至 2021 年 2 月进行定性研究。采访了 30 名在不同复杂程度的产科医院工作的卫生工作者，包括医生和护士，他们通过面对面或远程的方式进行采访。
描述了受访者的社会人口特征、就业关系和专业资格。确定了两个主题轴：1）医院组织的变化和大流行中的动态；2）卫生工作者的疾病和痛苦。大多数受访者为女性。大多数医生在公共和私营部门都有工作关系。与圣路易斯和佩洛塔斯相比，尼泰罗伊的卫生工作者具有更好的专业资格和更不稳定的工作关系（作为临时工）。在大流行带来的不确定性背景下，这种情况给这些工人带来了更大的不安全感。大流行初期的陈述涵盖了服务组织动态、医疗保健、远程医疗以及卫生工作者和用户之间互动等方面的变化。在卫生工作者的认知中，卫生紧急情况的初始阶段导致服务提供发生了剧烈变化，表现为早产、围产期死亡率和胎儿损失增加。工作负荷过重、担心感染、担心家人以及对新疾病的不确定性，使卫生工作者感到强烈的痛苦，而这些城市的机构支持却很少。卫生工作者所经历的痛苦超出了工作层面，影响到了他们的私人生活。
大流行带来的变化要求专业实践立即进行调整，无论研究地点如何，都会导致医疗保健的不安全感。在每个城市，卫生工作者的招聘方式都与之前的做法相同。由于疾病传播的风险，与尼泰罗伊的人性化实践背道而驰、更为严格的措施被报道为对产科护理有害。Covid-19 大流行对巴西卫生系统来说是一个巨大的挑战，加剧了卫生工作者的工作条件。除了工作环境，还可以简要地看到它对私人生活的影响。
