A Psychological Perspective Of The Health Personnel In Times Of Pandemic. Juan Moisés De La Serna

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СКАЧАТЬ this average is 3.6 per 1,000 inhabitants in 2019; while in the case of nurses, Spain is below the average, whose percentage in 2019 at the European level was 8.5 per 1,000 inhabitants.

      Greece, Austria and Portugal are the countries with a higher ratio of doctors in the European Union, and those with a lower ratio, Poland, Romania and England.

      Regarding the nursing community, among the countries with a higher ratio per 1,000 inhabitants are Norway, Iceland and Finland, while those with the lowest ratios in the European Union are Greece, Bulgaria and Lithuania.

      

Thus, Spain would be in the quadrant of more doctors and fewer nurses with respect to the European average (OECD / European Observatory on Health Systems and Policies, 2019) (see Illustration 2).

      Illustration 2 Health Personnel in Europe

      It is necessary to clarify, in order to offer a vision closer to reality, that in the specific case of Spain, where there is a lower ratio than the European average of nurses, that this is not due to a lack of personnel, but because there are not counted the nursing assistants, despite the fact that in other European countries they are equated in functions with nurses.

      It is also reported that in the case of Greece and Portugal, the number of doctors who are licensed to practice is counted, and not so those who work in health centres, hence their percentage is above the European average.

      With this first approach, it is wanted to offer a general overview of the Health Personnel that each country had, and specifically Spain, all of this prior to the appearance of COVID-19, an aspect that is relevant in terms of the human resources that are going to be fighting the advance of this disease, a panorama that, as will be explained, has changed rapidly in terms of availability and the need for new professionals.

      This reflects the enormous differences between countries of the European Union, which in first place could be counting for a greater or lesser workload that the said personnel will have to bear, thus, the more doctors and nurses per 100,000 inhabitants, the easier the attention to population will be, since it will be more human resources, at least that is what could be thought before learning about some events that have changed the reality of these personnel in weeks.

      But before proceeding, it is necessary to comment that there are also other indicators to take into account to know the “strength” of the health system of each country, so we can look at the number of hospital beds available, thus with data from 2014 the average of the European Union, there are 372 beds per 100,000 inhabitants, Spain being below the average with 242 beds (Eurostat, 2020) (see Illustration 3).

      The countries with the highest number of available beds between 2014 and 2015 were Bulgaria, Germany and Lithuania (with 616, 601 and 557 beds per 100,000 inhabitants respectively); while those with fewer beds were Sweden, England and Spain (with 203, 211 and 242 beds per 100,000 inhabitants respectively)

      

Illustration 3: Beds available per 100,000 inhabitants

       Therefore, and based on the previous data, it can be said that the countries of the European Union that have more personnel and material resources to face better a health crisis would be Greece, Austria and Portugal in number of doctors; Norway, Iceland and Finland in number of nurses; and Bulgaria, Germany and Lithuania in number of hospital beds.

      And on the contrary, those who are “worst” prepared to face a health crisis would be Poland, Romania and England in number of doctors; Greece, Bulgaria and Lithuania in number of nurses; and Sweden, England and Spain in number of beds available.

      In the specific case of Spain, with respect to the average of the European Union, there would be more doctors than the average and fewer nurses, taking into account the caveat indicating that auxiliary personnel who also perform their role in Health Centres are not included in this account (OECD / European Observatory on Health Systems and Policies, 2019).

      Regarding the criterion of available beds per 100,000 inhabitants, as of 2015, Spain was below the average in particular with 43% fewer beds available per 100,000 inhabitants (O.M.S., 2020a).

      Although the foregoing does not allow us to establish distinctions in terms of efficiency criteria, quality of the caring offered, ease of access or the users satisfaction with the hospital service in each country and specifically in Spain, it does offer an overview of the strength or weakness depending on the material and human resources available prior to the onset of the global health crisis.

       Regarding the quality of the caring, it must be taken into account that when a person is hospitalized, either for an upcoming operation or to recover from a trauma or intervention, in these cases patients usually spends days and even weeks in the hospital. In this “short” period of time, you will receive a “visit” from Healthcare Personnel, which includes the doctor who monitors the patient’s progress.

      While it is true that the caring can be good in the hospital, sometimes patients and relatives may complain about the “coldness” of its personnel, since they fulfil their function, but sometimes interacting as little as possible with the patient or the patient´s family members.

      A situation that has been seen as unnecessary and in some cases even detrimental for the proper functioning of the hospital, where aspects of the patient’s physical recovery are usually prioritized over emotional ones.

      Despite this, some Health Centres work closely with clinical psychologists, who train Health Personnel to properly relate and communicate with patients.

      Most of all, when “bad news” have to be given, where especially careful is needed in saying it, and it is necessary to know how to deal with the reactions from patients, which can range from a rapid decline in mood, to an outbreak of anger.

      But while it is true that knowing how to communicate is important, it is not enough for a quality doctor-patient relationship, so what should be done to improve patient caring?

      This is what has been tried to answer with a study carried out by the Nursing Care Research Center, the School of Nursing and Midwifery, together with the Firoozgar Hospital of the University of Medical Sciences of Iran; the Rajaie Center for Research and Cardiovascular Medicine of the University of Medical Sciences of Iran; and Tehran University of Medical Sciences (Iran) (Khaleghparast et al., 2016).

      The study was a qualitative one, in which 51 hospital users were interviewed, including patients, relatives and Health Personnel.

      The subject of the semi-structured interview was about the centre’s medical visit policies, paying special attention to the comparison between restrictive and open policies.

      The former, restrictive patient care policies are governed by a pre-established visit schedule for healthcare personnel, where both the time of the visit is set, as well as the duration of the visit.

      In the latter, in open patient care policies, there is no visiting schedule or restriction on the time spent with the patient.

       The answers of the three groups, patients, relatives and Health Personnel were categorized in order to analyse it. Thus, on restrictive policies, the results show the advantages that avoid chaos; guarantees medical visits even to patients who do not want visits; controls infections; offers regularity and stability to the personnel; and in disadvantages; lack of emotional “connection”; lack of information about the patient’s condition; and a limited professional visit time.

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