COVID-19 PANDEMIC IN URUGUAY AND THE NEED FOR A PERSON AND SOCIAL CENTERED MEDICINE

Nicolás Bagattini, Alejandra López-Gómez, Mario Luzardo, Denisse Dogmanas, N. Brunet, R. Bernardi
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Abstract

Background: During the COVID-19 pandemic, the Uruguayan government decided to call for an attitude of responsible freedom of the population and created an Honorary Scientific Advisory Group (GACH). The intention was to report the scientific evidence available on the health situation with transparency and technical independence and to recommended interventions. This paper aims (1) to analyze the strategy to combat the COVID-19 pandemic used in Uruguay from the perspective and principles of person-centered medicine (PCM), (2) to report and examine from a broad perspective the policy regarding health authorities, scientific evidence and population, and (3) to discuss the importance of mental health and behavioral monitoring for identifying vulnerable groups that require special attention and care. Methods: Retrospective and narrative analysis of the creation of a socioeconomic and behavioral observatory [OSEC], critical evaluation of key data collection on population mental health, and assessment of the influence of OSEC in the context of the pandemic in Uruguay. T-test was used to assess mean differences of mental health trends in the general population using GHQ-12 panel data. The article presents the results obtained on the country’s mental health data through the analysis of a helpline consultations and a digital panel survey of a representative sample of the Uruguayan population. Screening instruments were used, which allowed for an identification of risk groups. Results: The evidence shows the impact of the pandemic on the emotional distress of the population, indicating that the population discomfort decreased significantly when the pandemic situation began to improve. In addition, differences according to socioeconomic status and age groups were observed, showing that the most disadvantaged had significantly higher levels of emotional distress than those of the middle and upper class, at all times of analysis. Conclusions: Apparently, it is possible to extend the principles of beneficence, autonomy, and justice applied at the individual level to the level of collective health policies. This is essential to achieve the active participation of the population in their self-care and to promote greater and more transparent communication with the health and scientific fields. It is also necessary to adopt a holistic, biopsychosocial perspective, which makes it possible to identify the vulnerable sectors of society and the areas in which special attention is required.
乌拉圭的COVID-19大流行以及对以人为本和以社会为中心的医学的需求
背景:在2019冠状病毒病大流行期间,乌拉圭政府决定呼吁人们采取负责任的自由态度,并成立了荣誉科学咨询小组(GACH)。其目的是透明和技术独立地报告现有的关于卫生状况的科学证据,并提出建议的干预措施。本文旨在(1)从以人为本的医学(PCM)的角度和原则分析乌拉圭抗击COVID-19大流行的战略,(2)从广泛的角度报告和审查有关卫生当局、科学证据和人口的政策,以及(3)讨论心理健康和行为监测对确定需要特别关注和照顾的弱势群体的重要性。方法:对社会经济和行为观察站(OSEC)的建立进行回顾性和叙述性分析,对人口心理健康关键数据收集进行批判性评估,并评估OSEC在乌拉圭大流行背景下的影响。使用GHQ-12面板数据,采用t检验评估一般人群心理健康趋势的平均差异。本文介绍了通过对乌拉圭人口代表性样本的求助热线咨询和数字小组调查进行分析而获得的关于该国心理健康数据的结果。使用了筛选工具,从而可以确定风险群体。结果:有证据显示疫情对人群情绪困扰的影响,当疫情形势开始好转时,人群不适明显减少。此外,根据社会经济地位和年龄组的差异也被观察到,在分析的所有时间里,最弱势群体的情绪困扰水平明显高于中产阶级和上层阶级。结论:显然,有可能将适用于个人层面的仁慈、自主和正义原则扩展到集体卫生政策的层面。这对于实现人民积极参与自我保健和促进与卫生和科学领域更大和更透明的沟通至关重要。还必须采取一种整体的、生物心理社会的观点,这样才有可能确定社会中易受伤害的部门和需要特别注意的领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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