Psychological distress and associated factors related to COVID-19 pandemic among primary care physicians in Spain (STREPRIC study)

Abstract Background The COVID-19 pandemic is affecting people in all nations of the world. In Spain, the epidemic is being especially harsh. The lack of protective measures is a major concern and may have caused emotional stress to Primary Care Physicians (PCPs). The aim of the study was to address the sources of psychological distress among Spanish PCPs during the COVID-19 pandemic. Methods Observational, cross sectional study. A questionnaire consisting of 24 expressions was answered by PCPs working in their family health care centers in Spain during COVID-19 pandemic. A specific scale (EASE scale) was used to determine psychological distress, recently validated in the context of this pandemic. A Multivariate Linear Regression analysis was performed. Results 518 PCPs from different Spanish regions, participated in this survey. A total of 123 (23.7%) rated a high psychological distress score. Only half of PCPs received information about the appropriate use of Personal Protective Equipment (PPE). PCPs factors associated with higher levels of distress include female gender (1.69; CI 0.54, 2.84); Age (-0.43 (-0.61, 1.48)); working setting (rural) (0.84 (-0.34, 2.01)); lack of training in protective measures (1.96 (0.94, 2.99)). The absence of sick leave among colleagues, increased availability of PPEs, improved cleaning and hygiene conditions in health care centers facilities and the detection of COVID-19 RT-PCR for health care workers were associated with lower levels of distress. Conclusions One in four PCPs rated a high score for psychological distress. The availability of PEPs, training in their use, cleanliness and hygiene conditions in health care facilities and the availability of COVID-19 RT-PCR analyses for health workers, among others, are factors associated with the psychological distress of PCPs.

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Psychological distress and associated factors related to COVID-19 pandemic among primary care physicians in Spain (STREPRIC study)

10.21203/rs.3.rs-27476/v2 ◽

2020 ◽

Author(s):

Cebrián-Cuenca M Ana ◽

Jose Joaquin Mira ◽

Elena Caride-Miana ◽

Antonio Fernández-Jiménez ◽

Domingo Orozco-Beltrán

Keyword(s):

Primary Care ◽

Health Care ◽

Psychological Distress ◽

Primary Care Physicians ◽

Linear Regression Analysis ◽

Health Care Facilities ◽

Multivariate Linear Regression Analysis ◽

Rt Pcr ◽

Protective Measures ◽

Factors Associated

Abstract Background The COVID-19 pandemic is affecting people in all nations worldwide. In Spain, the epidemic has become especially severe. The lack of protective measures is a major concern and may have caused emotional stress to Primary Care Physicians (PCPs). This study aimed to address the sources of psychological distress among Spanish PCPs during the COVID-19 pandemic.Methods This observational, cross sectional study was conducted using a survey questionnaire that consisted of 24 expressions to be answered by PCPs working in family healthcare centres in Spain during the pandemic. A specific scale, the “Examination of Anomalous Self-Experience”, EASE scale was used to determine the distress related to the care of COVID-19 patients among Spanish PCPs. A multivariate linear regression analysis was performed.Results In all, 518 PCPs belonging to different regions of Spain participated in this survey, of which 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of personal protective equipment (PPE). PCPs factors associated with higher levels of distress include female gender (1.69; CI 0.54, 2.84); Age (-0.43 (-0.61, 1.48)); working setting (rural) (0.84 (-0.34, 2.01)); lack of training in protective measures (1.96 (0.94, 2.99)). The absence of sick leave among colleagues, increased availability of PPEs, improved cleaning and hygiene conditions in health care centers facilities and the detection of COVID-19 RT-PCR for health care workers were associated with lower levels of distress.Conclusions One in four PCPs rated a high score for psychological distress. The availability of PPEs, training on their use, cleanliness and hygiene conditions in health care facilities and the availability of COVID-19 RT-PCR analyses for health workers, among others, are factors associated with the psychological distress of PCPs.

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Sources of psychological distress among primary care physicians during the COVID-19 pandemic’s first wave in Spain: a cross-sectional study

Primary Health Care Research & Development ◽

10.1017/s1463423621000566 ◽

2021 ◽

Vol 22 ◽

Author(s):

Ana Cebrián-Cuenca ◽

José Joaquín Mira ◽

Elena Caride-Miana ◽

Antonio Fernández-Jiménez ◽

Domingo Orozco-Beltrán

Keyword(s):

Primary Care ◽

Psychological Distress ◽

Primary Care Physicians ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Multivariate Linear Regression Analysis ◽

Sectional Study ◽

Rt Pcr ◽

Cross Sectional ◽

Protective Measures

Abstract Background: The COVID-19 pandemic is affecting people worldwide. In Spain, the first wave was especially severe. Objectives: This study aimed to identify sources and levels of distress among Spanish primary care physicians (PCPs) during the first wave of the pandemic (April 2020). Methods: A cross-sectional study was conducted using a survey that included sociodemographic data, a description of working conditions related to distress [such as gaps in training in protective measures, cleaning, and hygiene procedures in work setting, unavailability of personal protective equipments (PPEs) and COVID-19 RT-PCR test, and lack of staff due to be infected] and a validated scale, the ‘Self-applied Acute Stress Scale’ (EASE). The survey was answered by a non-probability sampling of PCPs working in family healthcare centres from different regions of Spain. Analysis of variance and multivariate linear regression analysis were performed. Results: In all, out of 518 PCP participants, 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of PPE. PCP characteristics associated with higher levels of distress include female gender [1.69; 95% confidence interval (CI) 0.54, 2.84]; lack of training in protective measures (1.96; 95% CI 0.94, 2.99); unavailable COVID-19 RT-PCR for health care workers after quarantine or COVID-19 treatment (−0.77 (−1.52, −0.02). Reinforcing disinfection of the work environment (P < 0.05), availability of PPEs (P < 0.05), and no healthcare professional was infected (P < 0.05) were related to the lowest distress score. Conclusions: A better understanding of the sources of distress among PCPs could prevent its effect on future outbreaks.

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Likelihood of Normal ABI Increases With Physiologic Testing Referrals From Rural Primary Care Physicians

Journal for Vascular Ultrasound ◽

10.1177/1544316719870070 ◽

2019 ◽

Vol 43 (3) ◽

pp. 123-127

Author(s):

Robert P. Scissons ◽

Abraham Ettaher ◽

Sophia Afridi

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Care Physician ◽

Primary Care Physicians ◽

Bypass Graft ◽

Ankle Brachial Index ◽

Care Physician ◽

Health Care Facilities ◽

Rural Primary Care ◽

And Gender

Disparities in diagnostic capabilities have been noted between rural and urban health care facilities. We believe the clinical evaluation of peripheral arterial disease (PAD) by rural physicians may be similarly affected. Patients referred for arterial physiologic testing in an urban and rural regional health care network for a consecutive 7-month period were reviewed. Patients were classified into 3 groups based on referring physician specialty: (1) vascular surgeon or vascular medicine specialist (Vasc), (2) urban primary care physician (Urban), and (3) rural primary care physician (Rural). Normal patients were defined by a posterior tibial (PT) or dorsalis pedis (DP) ankle-brachial index (ABI) of ⩾0.90, bilaterally. Abnormal patients had both PT and DP ABI <0.90 in one or both extremities. Group comparisons were made for normal and abnormal patients, age (⩾65 years old), and gender. Patients with history of amputations, angioplasty, bypass graft, stent, calcification (PT or DP ABI ⩾1.30), and previous physiologic testing outside the designated period of analysis were considered a separate subclassification and analyzed separately. Emergency room referrals, inpatients, and patients with incomplete examination data were excluded from the analysis. A total of 430 patient exams were evaluated. Group-Rural had significantly greater numbers of normal ABI patients compared with Group-Urban ( P = .0028) and Group-Vasc ( P = .0000). No significant differences were noted between all groups for age and gender. Substantial disparities were noted in normal and abnormal ABI patients between rural health care physicians and their urban primary care and vascular specialist counterparts. Significantly greater numbers of normal ABI referrals by rural primary care physicians may warrant enhanced PAD diagnosis education or telemedicine alternatives.

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Do patients with and without a regular primary care physician have their psychological distress looked after differently?

Journal of Public Health ◽

10.1093/pubmed/fdy112 ◽

2018 ◽

Vol 41 (2) ◽

pp. 399-404 ◽

Cited By ~ 1

Author(s):

Kai Sing Sun ◽

Tai Pong Lam ◽

Kwok Fai Lam ◽

Tak Lam Lo ◽

David Vai Kiong Chao ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Psychological Distress ◽

Mental Health Care ◽

Continuity Of Care ◽

Primary Care Physicians ◽

Care Delivery ◽

Care Physician ◽

Psychological Problems

Abstract Background While qualitative studies suggested that continuity of care by primary care physicians (PCPs) facilitated consultations for psychological problems, there was limited quantitative evidence. This survey compared management of psychological distress between patients with and without a regular PCP. Methods A questionnaire survey was conducted with 1626 adult primary care attenders from 13 private and 6 public clinics in Hong Kong. Management of psychological distress between respondents with a regular PCP and those without were compared. Effects of demographic factors were adjusted for by multivariable logistic regression. Results Among the 1626 respondents, 650 (40.0%) reported that they had ever experienced psychological distress. Of the 650 respondents experienced distress, 307 (47.2%) had a regular PCP. A significantly higher proportion of patients with a regular PCP than those without reported: (i) their PCPs sometimes/often asked about psychological problems [37.7 versus 20.1%, adjusted OR = 2.241]; (ii) they sometimes/often mentioned their psychological problems to PCPs [45.2 versus 24.9%, adjusted OR = 2.503]; and (iii) their distress had been treated by PCPs [22.1 versus 13.4%, adjusted OR = 1.702]. Conclusion Patients with a regular PCP have around double odds of receiving mental health care. Continuity of care by PCPs should be emphasized in mental health care delivery.

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Metformin related adverse events: A prospective observational study in health care centers of western Odisha

Journal of Pharmacovigilance and Drug Research ◽

10.53411/jpadr.2020.1.2.5 ◽

2020 ◽

Vol 1 (2) ◽

pp. 32-34

Author(s):

Sanjeeb Kumar Kar ◽

Susovita Khuntia ◽

Shubhrata Nayak

Keyword(s):

Primary Care ◽

Health Care ◽

Adverse Events ◽

Observational Study ◽

Adverse Drug Reactions ◽

Primary Care Physicians ◽

Prospective Observational Study ◽

Drug Reactions ◽

Primary Health Care Centers ◽

Health Care Centers

Introduction: The most common adverse drug reactions were lactic acidosis followed by hypoglycemia, hypersensitivity reactions, nausea, decreased appetite, vomiting, weakness, and diarrhea. Objectives: The study was done to explore the management of the patients having diabetes by primary care physicians, and the adverse reactions associated with the dose regimens. This study provided information regarding the adverse drug reactions that could be developed in any patient and increases the risk to the patient. Methods: A qualitative In-Depth Interview study was conducted among the primary care physicians at ten primary health care centers at Sambalpur city of Odisha, India. The data were analyzed using content analysis. This was a prospective observational study (March 2019 - September 2019) among diabetes patients receiving metformin. Data were collected and analyzed to find out the demographic characteristics, causality, and severity of adverse events with metformin regimens. Results: It was seen that 8 % of cases could be assessed as certain and 24 % could be assessed as probable. Most (60 %) cases were assessed as possible. Severity assessment of ADRs by modified Hart wig and Siegel's severity Scale (n=143) indicates 64% of the case were mild and 34% of cases are moderately severe. Conclusions: Hence with an aim of patient safety quality of the drug formulations has to be improved that could ultimately improve drug safety.

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The scope of practice of primary health care physicians in rural and urban areas in Brazil

Cadernos de Saúde Pública ◽

10.1590/0102-311x00211520 ◽

2021 ◽

Vol 37 (9) ◽

Author(s):

Ana Cristina van Stralen ◽

Cristiana Leite Carvalho ◽

Sábado Nicolau Girardi ◽

Celia Regina Pierantoni ◽

Ilka Afonso Reis ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Urban Areas ◽

Primary Care Physicians ◽

Online Survey ◽

Scope Of Practice ◽

Factors Associated ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Main Factors

This study aimed to identify differences in the scope of practice of primary care physicians and find the main factors associated with expanded practice in rural and urban areas of Brazil. Data from an online survey with 2,277 primary care physicians, conducted between January and March 2016, were used. Differences regarding activities and procedures performed by physicians per area were verified using Kruskal-Wallis/Dunn’s post hoc and chi-square tests. Multivariate linear regression analyses were done using a bootstrap technique to identify the main factors associated with an expanded scope of practice. Regardless of the location, the results showed that the practices of the primary care physicians are below their competences. Rural physicians performed a higher number of procedures and activities compared with their peers from intermediate and urban municipalities. Within the overall sample, the variables related to a broader scope of practice included: male gender, work in rural municipalities, participation in training and continuing education programs and consultation of clinical protocols, articles and books. This study contributes with evidence that the medical scope of practice varies according to location. Recognizing and understanding the differences and associated factors for an expanded scope of practice is necessary to determine the skills and resources required for practice in rural and urban areas, collaborating in proposals of strategies to improve quality and access of health care services.

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