Efecto de acciones de equipos de Atención Primaria de Salud para proteger la salud mental después de desastres naturales

Abstract

Resumen Introducción Existe alta prevalencia de alteraciones emocionales en la población expuesta a desastres y los centros de atención primaria de salud (APS) podrían contribuir a su prevención. Objetivo Analizar asociaciones post-catástrofe entre variables de APS y variables de salud mental de la población. Método Estudio efectuado en Chile un año después de un terremoto de 8,8° Richter. Se aplicó un cuestionario de intensidad de acciones de salud mental en 16 centros APS y las escalas GHQ-12 y SF-36 para malestar psicológico y calidad de vida en una muestra basada en hogares y otra de consultantes a APS. Se efectuó un análisis de regresión lineal múltiple para las dos poblaciones y los dos instrumentos. Resultados Ninguna de las variables sobre intensidad de acciones de APS mostró relación con GHQ-12 o SF-36 en ambas muestras. Las variables asociadas significativamente a mayor puntaje en GHQ-12 y menor puntaje en SF-36 fueron sexo femenino, baja escolaridad, baja situación económica, menor apoyo social y daños producidos por el terremoto. Conclusión El equipo APS podría lograr un mayor efecto preventivo post-catástrofe trabajando con otros sectores que incluyan la dimensión salud mental en el abordaje de los problemas sociales críticos en situaciones de desastres, y reservando el trabajo preventivo directo para las personas con alta vulnerabilidad psicológica.

Primary Health Care Actions in Natural Disasters

“…Integrated health promotion actions must consider the resilience of the community to improve structural aspects, through educational strategies and dynamic awareness, relationships and responses to challenges in the communities. [13][14] For mitigation, considering Social Determinants of Health and intersectoral action can maximize the preventive potential of PHC in situations of disasters 15 and knowing socioeconomic aspects of families in the community influences the choice of assistance strategies at this stage of catastrophes.…”

“…Minoletti A, Alvarado R, Vitriol V, et al 15 Efecto de acciones de equipos de atención primaria de salud para proteger la salud mental después de desastres naturales.…”

“…The psychological vulnerability to traumas and stresses considering permanence in shelters and distancing of their support networks for a long period, after these events, imply an intersectoral action that includes PHC. 15 PHC actions for disaster preparedness are identified for the multidisciplinary dimension of PHC as the responsibility of health teams in preparing vulnerable families to deal with potential disasters14,18; promotion of continuing education for PHC professionals with the purpose of reducing deficiencies in the readiness of events [18][19] ; territory recognition, based on sociodemographic data to identify and prioritize needs and provide guidance to families in the community. 13,14,18 Specific recommendations about the risks to which the community is exposed must be raised in the territory and based on the population profile.…”

“…Moreover, it is important to know the dynamics of local actors, especially those who have civic and social representative responsibilities, in order to establish a relationship with disaster management. 15,20 The literature emphasizes the priority of community and family preparedness actions to disasters. 16,19 Contact by different means of communication between PHC teams with families and rapid mobilization for protective measures are fundamental actions in the first 24 hours of the alert to the event.…”

“…38 This must be foreseen by the teams and considered in training and contingency plans, including covering the structural components of health services, mental health care, as they minimize the consequences at the time of response for the professionals and families affected. 12,15 Studies in different countries show significant results related to mental health disorder prevalence in survivors after natural disasters. 39,40 This is an important indicator for PHC actions aimed at health promotion, prevention, recovery in affected communities or at risk of disasters.…”