Impacto de la primera fase de la Pandemia por COVID-19 en el malestar psicológico de los trabajadores sanitarios del Ecuador y su asociación con el compromiso laboral, sentido de coherencia y ambiente laboral

Abstract

BACKGROUND: The pandemic produced by the new coronavirus has represented a real challenge for humanity, causing countless deaths, economic problems and destabilization in the human species. By the end of 2020, Ecuador registered more than 200 thousand positive cases of COVID-19 and around 14 thousand deaths from this same disease The stress caused by COVID-19 has been evident, and this phenomenon has been developing with greater force in health personnel, and mainly in those who have fought on the front line of the SARS-CoV-2 pandemic, creating a state of psychological distress (PD) on these workers. The PD represents a series of negative conditions on the worker and their performance, such as depression, anxiety, among others. OBJECTIVES: The general objective included in the current work was to evaluate the psychological impact during the first phase of the COVID-19 pandemic on health professionals in Ecuador, identifying scientific knowledge on the risk factors associated with psychological distress among health workers during the COVID-19 pandemic, and studying whether the sense of coherence (SOC) in health workers, during the first phase of the COVID-19 pandemic in Ecuador was associated with factors of work commitment (WE), psychological distress (PD) and work environment, or other risk factors associated with the PD. METHODOLOGY: To meet the proposed objectives, 3 stages were carried out. In the first, a systematic review was carried out in which electronic databases were used to find different works that evidence the PD psychological distress in health workers during the COVID-19 pandemic. In the second stage, a descriptive cross-sectional study was conducted to show whether the level of SOC (SCO-13 scale), the WE (UWES-9 scale) and the work environment are factors that are associated with the PD (GHQ-12 scale). A sample of 1235 health professionals from all provinces of Ecuador was taken. In the third stage, a quantitative, descriptive cross-sectional study design was carried out in which the level of PD during the COVID-19 pandemic in Ecuadorian health workers was analyzed. RESULTS: In the first phase, within the systematic review, a total of 59 articles were included showing that the prevalence of PD during the COVID-19 pandemic was high. It was evidenced that female sex, belonging to the nursing staff, being young, living alone / being single, having a chronic psychiatric disorder, having many years of experience, the presence of COVID-19 symptoms and contact history, not getting enough sleep, among others, were factors that influenced the development of PD during the pandemic. On the other hand, in the field study, it was found that health professionals in Ecuador had a perception that the quality of health care, working conditions and occupational health had worsened significantly during the health crisis compared to the previous stage (p<0.001). There was a statistically significant difference (p<.01) between the SOC and the WE in a positive way, and another negative difference with the DP. Likewise, a positive correlation (p<.01) was found between the SOC and the efficiency of the company to provide an effective and safe work. Similarly, there is a positive correlation (p<.01) between the SOC and age, and between the SOC and the psychological support needs of patients, health care personnel and other populations. In the third phase, it was observed that women developed a percentage of 71.7 PD, which is higher than the 55.4% of PD that appears in men (p<0.001). However, public employees have a higher PD status compared to private workers. CONCLUSIONS: The DP is a latent reality in health professionals in Ecuador, causing a series of negative effects on them. Mainly the emergence of the DP was seen in the hospital workers who participated fighting the COVID-19 pandemic on the front line. The factors that influence the development of PD are several, ranging from the perception of little biological protection, female sex, being part of the nursing staff, little family support, fear of personal and even family contagion, among others. This is a reality that was presented and is still lived in our health professionals, so it is recommended to enhance the mental health of this group of workers, which would generate better occupational health.