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      VIVÊNCIAS DE ENFERMEIROS E MÉDICOS DE UNIDADES DE PRONTO ATENDIMENTO NO ENFRENTAMENTO DA COVID-19 Translated title: EXPERIENCIAS DE ENFERMEROS Y MÉDICOS DE UNIDADES DE URGENCIAS EN EL ENFRENTAMIENTO DEL COVID-19 Translated title: EXPERIENCES OF NURSES AND DOCTORS OF EMERGENCY CARE UNITS IN COPING WITH COVID-19

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          Abstract

          Objetivo: descrever vivências de enfermeiros e médicos de Unidades de Pronto Atendimento no enfrentamento da pandemia da Covid-19. Método: estudo descritivo-exploratório de abordagem qualitativa, realizado com sete médicos e sete enfermeiros atuantes em duas Unidades de Pronto Atendimento, referência para Covid-19. As entrevistas ocorreram entre setembro e novembro de 2020 e foram guiadas por questionário semiestruturado. Os depoimentos foram gravados, transcritos e submetidos a Análise de Conteúdo. Resultados: surgiram duas categorias de análise: “A gente se sente esgotado”: a vivência de enfermeiros e médicos e Estratégias para enfrentar os percalços no contexto da pandemia. Considerações finais: os profissionais vivenciaram diversos desafios, como falta de protocolo institucional, falta de estrutura física, material, recursos humanos e capacitação, dificuldade para sensibilizar a população e preocupação de contaminar-se e contaminar a família. Entretanto, apoiaram-se em diferentes estratégias, como autoisolamento preventivo, apoio familiar, troca de experiências com outros profissionais e manter-se atualizado sobre a doença.

          Translated abstract

          Objetivo: describir las experiencias de enfermeros y médicos de Unidades de Urgencias en el enfrentamiento de la pandemia de Covid-19. Método: estudio descriptivo-exploratorio con abordaje cualitativo, realizado con siete médicos y siete enfermeros que trabajan en dos Unidades de Urgencias, referencia para Covid-19. Las entrevistas tuvieron lugar entre septiembre y noviembre de 2020 y se guiaron por un cuestionario semiestructurado. Las declaraciones fueron grabadas, transcritas y sometidas a Análisis de Contenido. Resultados: surgieron dos categorías de análisis: “Nos sentimos agotados”: la experiencia de enfermeros y médicos y Estrategias para enfrentar los percances en el contexto de la pandemia. Consideraciones finales: los profesionales experimentaron varios desafíos, como la falta de protocolo institucional, la falta de estructura física, material, recursos humanos y capacitación, la dificultad para sensibilizar a la población y la preocupación por contaminar a sí mismo y a la familia. Sin embargo, se apoyaron en diferentes estrategias, como el autoaislamiento preventivo, el apoyo familiar, el intercambio de experiencias con otros profesionales y mantenerse al día sobre la enfermedad.

          Translated abstract

          Objective: to describe experiences of nurses and doctors of Emergency Care Units in coping with the Covid-19 pandemic. Method: descriptive-exploratory study with a qualitative approach, conducted with seven doctors and seven nurses working in two Emergency Care Units, reference for Covid-19. The interviews took place between September and November 2020 and were guided by a semi-structured questionnaire. The statements were recorded, transcribed and submitted to Content Analysis. Results: two categories of analysis emerged: “We feel exhausted”: the experience of nurses and doctors and Strategies to face the mishaps in the pandemic context. Final considerations: the professionals experienced several challenges, such as lack of institutional protocol, lack of physical structure, material, human resources and training, difficulty in sensitizing the population and concern to contaminate oneself and the family. However, they relied on different strategies, such as preventive self-isolation, family support, exchange of experiences with other professionals and keeping up to date on the disease.

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          Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

          Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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            Early dynamics of transmission and control of COVID-19: a mathematical modelling study

            Summary Background An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to 95 333 confirmed cases as of March 5, 2020. Understanding the early transmission dynamics of the infection and evaluating the effectiveness of control measures is crucial for assessing the potential for sustained transmission to occur in new areas. Combining a mathematical model of severe SARS-CoV-2 transmission with four datasets from within and outside Wuhan, we estimated how transmission in Wuhan varied between December, 2019, and February, 2020. We used these estimates to assess the potential for sustained human-to-human transmission to occur in locations outside Wuhan if cases were introduced. Methods We combined a stochastic transmission model with data on cases of coronavirus disease 2019 (COVID-19) in Wuhan and international cases that originated in Wuhan to estimate how transmission had varied over time during January, 2020, and February, 2020. Based on these estimates, we then calculated the probability that newly introduced cases might generate outbreaks in other areas. To estimate the early dynamics of transmission in Wuhan, we fitted a stochastic transmission dynamic model to multiple publicly available datasets on cases in Wuhan and internationally exported cases from Wuhan. The four datasets we fitted to were: daily number of new internationally exported cases (or lack thereof), by date of onset, as of Jan 26, 2020; daily number of new cases in Wuhan with no market exposure, by date of onset, between Dec 1, 2019, and Jan 1, 2020; daily number of new cases in China, by date of onset, between Dec 29, 2019, and Jan 23, 2020; and proportion of infected passengers on evacuation flights between Jan 29, 2020, and Feb 4, 2020. We used an additional two datasets for comparison with model outputs: daily number of new exported cases from Wuhan (or lack thereof) in countries with high connectivity to Wuhan (ie, top 20 most at-risk countries), by date of confirmation, as of Feb 10, 2020; and data on new confirmed cases reported in Wuhan between Jan 16, 2020, and Feb 11, 2020. Findings We estimated that the median daily reproduction number (R t) in Wuhan declined from 2·35 (95% CI 1·15–4·77) 1 week before travel restrictions were introduced on Jan 23, 2020, to 1·05 (0·41–2·39) 1 week after. Based on our estimates of R t, assuming SARS-like variation, we calculated that in locations with similar transmission potential to Wuhan in early January, once there are at least four independently introduced cases, there is a more than 50% chance the infection will establish within that population. Interpretation Our results show that COVID-19 transmission probably declined in Wuhan during late January, 2020, coinciding with the introduction of travel control measures. As more cases arrive in international locations with similar transmission potential to Wuhan before these control measures, it is likely many chains of transmission will fail to establish initially, but might lead to new outbreaks eventually. Funding Wellcome Trust, Health Data Research UK, Bill & Melinda Gates Foundation, and National Institute for Health Research.
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              Defining the Epidemiology of Covid-19 — Studies Needed

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                Author and article information

                Journal
                rbaen
                Revista Baiana de Enfermagem
                Rev. baiana enferm.
                Universidade Federal da Bahia (Salvador, BA, Brazil )
                0102-5430
                2178-8650
                2021
                : 35
                : e43433
                Affiliations
                [02] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                [01] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                [05] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                [03] Salvador Bahia orgnameUniversidade Federal da Bahia Brazil
                [07] Mandaguari Paraná orgnameFaculdade de Filosofia, Ciências e Letras de Mandaguari Brazil
                [04] Maringá Paraná orgnameUniversidade Estadual de Maringá Brazil
                [06] Mandaguari Paraná orgnameFaculdade de Filosofia, Ciências e Letras de Mandaguari Brazil
                Article
                S2178-86502021000100349 S2178-8650(21)03500000349
                10.18471/rbe.v35.43433
                d437c8d8-5527-4d84-95f8-5764b43b6d63

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 13 February 2021
                : 18 May 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos Originais

                Infecções por Coronavírus,Pessoal de Saúde,Serviço Hospitalar de Emergência,Percepção Social,Infecciones por Coronavirus,Personal de Salud,Servicio de Urgencias Hospitalarias,Percepción Social,Coronavirus Infections,Health Personnel,Emergency Hospital Service,Social Perception

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