Impacto de la pandemia por SARS-CoV-2 en Atención Primaria

Spanish healthcare workers' professional identity is intricately associated with the idea of vocation, among others values. This attitude has become even more marked during the current COVID-19 pandemic-during which these professionals have endured a gruelling workload that has tested the limits of their physical and mental strength. The objective of this study is to open a debate on the symbolic dimensions of identity and culture among healthcare professionals (mainly doctors and nurses), analysing the factors that, on the one hand, might reinforce this symbolic system or, on the other, might question it or cause it to be restructured. The study follows an an-thropological perspective, with the thematic content analysis of twenty-two in-depth interviews with primary healthcare professionals. The results show the need to dissect the symbolic and structural factors underpinning anxiety and fear in medical professional performance during the COVID-19 pandemic. These have a significant impact on the current model of medical practice and its most visible and worrying consequence, continuous occupational distress. The conclusions suggest that these models need to be reviewed since there is a notorious dissonance between their strengths and weaknesses. KEYWORDS: healthcare workers; professional identity; COVID-19 pandemic; occupational distress.

Background: The literature review shows that most studies on the psychological impact of COVID-19 on healthcare professionals have focused on hospital staff, with few specifically addressing the primary care workforce. This study aims to explore primary care workers' verbal accounts of the emotions they experienced. Methods: This is a qualitative study carried out between July and December 2020 in Spain. Semi-structured interviews and focus groups were conducted with primary care workers. Data were analysed through thematic content analysis. Participants were selected using purposive sampling. Results: A total of 53 primary care workers participated in the study, of whom 38 were individually interviewed, and 15 participated in three focus groups. Our analysis revealed themes in two categories: (1) from infection to affection; and (2) affected, but not patients-a discourse based on the acceptance of their experience as part of their work in primary care, creating an ideological construct or "shield" based on emotional self-management. Conclusions: Self-reflection on the emotional impact of COVID-19 is scarce. Examples of emotional affections include an obsessive focus on hygiene, the inability to establish clear boundaries between the personal and the professional spheres, and experiencing-and having to self-manage-emotional strain.

Background Pandemics and epidemics have represented public health emergencies with severe consequences at a global level. Primary care teams have played a crucial role in disease surveillance and monitoring during the COVID-19 pandemic through early detection, contact tracing, and isolation of positive cases. The objective of this study was to explore the impact of the COVID-19 pandemic on primary care teams regarding their internal dynamics and their professional performance. Methods Qualitative study carried out between July and December 2020 in two large central and southern Spanish regions (Castilla la Mancha and Madrid). Semi-structured interviews and focus groups were conducted with primary care workers. Data was analysed using thematic content analysis. Participants were accessed using purposive sampling. Results A total of 53 primary care workers participated in the study, of which 38 were individually interviewed, and 15 participated in three focus groups.The analysis of their experiences revealed two main themes regarding the impact of the COVID-19 pandemic on primary care teams: 1) The need to reorganise traditional roles: Primary care settings closed their doors to the public and their workers restructured their roles to ensure the delivery of essential services; 2) The need to implement a new primary care delivery model : Each primary care team had to self-organise, making sure their reference population was cared for and developing resource optimisation strategies. Conclusions Primary care teams have quickly adapted their roles and internal dynamics to respond to the demands generated by COVID-19. In the new delivery model, some positive aspects could be highlighted – such as increased communication between professionals and the use of telemedicine for some cases. However, it is important to address the negative impact that the COVID-19 crisis has had on of the main functions of primary care. These measures are necessary to promote well-being in primary care teams, and to provide quality care that addresses the complex and individual needs of each person and reduces inequalities in healthcare delivery.

Este trabajo se ubica en el marco del proyecto PRIMACOVID: Explorando el impacto de la pandemia por sars-CoV-2 en la Atención Primaria de la Salud, que ha sido financiado por el Fondo SUPERA-COVID. El Grupo de Etnografía y Estudios Sociales Aplicados (GEESA), ha sido el banco de ideas y motor de este proyecto. En consorcio con la Universidad Autónoma de Madrid, este proyecto ha explorado los efectos de la pandemia por sars-CoV-2 en el ámbito de la Atención Primaria desde la perspectiva de sus profesionales en dos comunidades autónomas: Castilla-La Mancha y Madrid. Los resultados que aquí se presentan se refieren a Castilla-La Mancha. Partimos de una propuesta con una metodología de investigación de recogida y análisis de los datos mixta, que pretende complementar los estudios epidemiológicos, privilegiando una mirada cualitativa y complementaria entre las ciencias sociales, sanitarias y de la salud pública