Doctoring and mothering during the SARS-COV2 pandemic: Characteristics of physicians-mothers during COVID-19 and their impact on mental health
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Resumen
Objetivo. Analizar las características de un grupo de madres médicas, su impacto en la salud mental, y sus experiencias durante esta pandemia.
Método. Estudio de métodos mixtos mediante una encuesta en línea que indagó aspectos familiares, emocionales, profesionales y la experiencia personal de 537 madres médicas durante la primera etapa del COVID-19.
Resultados. Por la pandemia, las participantes cambiaron sus actividades diarias. Asimismo, incrementaron el número de horas dedicadas al trabajo profesional (HM = 5.08, p < .0001), el cuidado de niños (HM = 3.74, p < .0001) y la planificación y preparación de alimentos (HM = -6.96, p < .0001). Disminuyeron las horas dedicadas al ejercicio físico (MH = 8.67, p < .0001) y al cuidado personal (MH = 9.54, p < .0001). Señalaron que esta pandemia generó una falta de espacios definidos, lo que favoreció el multitasking. Miedo y culpa fueron dos palabras habituales en los discursos de las participantes. También miedo a enfermarse y morir, o miedo a contagiar a sus familias. Culpabilidad por sentir que no desempeñaron un buen papel ni como médicas ni como madres. Los síntomas psicológicos más comunes fueron insomnio, tristeza y tensión constante.
Discusión y conclusión. La pandemia evidenció y exacerbó las disparidades que enfrentan estas doctoras en el campo de la medicina y la inequidad en las tareas del hogar. La pérdida de los límites entre lo público y lo privado mostró a las médicas madres conciliando su vida personal y profesional, con repercusiones sustanciales para su salud mental.
Referencias
Adesoye, T., Mangurian, C., Choo, E. K., Girgis, C., Sabry-Elnaggar, H., & Linos, E. (2017). Perceived discrimination experienced by physician mothers and desired workplace changes: a cross-sectional survey. JAMA Internal Medicine, 177(7), 1033-1036. doi: 10.1001/jamainternmed.2017.1394
Amarís-Macías, M. (2004). Roles parentales y el trabajo fuera del hogar. Psicología desde el Caribe, (13), 15-28.
Berg, C. A., & Upchurch, R. (2007). A developmental-contextual model of couples coping with chronic illness across the adult life span. Psychological Bulletin, 133(6), 920-954. doi: 10.1037/0033-2909.133.6.920
Bohlken, J., Schömig, F., Lemke, M. R., Pumberger, M., & Riedel-Heller, S. G. (2020). COVID-19 Pandemic: Stress Experience of Healthcare Workers - A Short Current Review. Psychiatrische Praxis, 47(4), 190-197. doi: 10.1055/a-1159-5551
Cañongo León, G., & Palafox Luévano, I. N. (2020). Sobrecarga de trabajo para las madres en tiempos de COVID-19 - Mayo 9. Boletín UNAM-DGCS412. Retrieved from https://www.dgcs.unam.mx/boletin/bdboletin/2020_412.html
Chen, Q., Liang, M., Li, Y., Guo, J., Fei, D., Wang, L., … Zhang, Z. (2020). Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet Psychiatry, 7(4), e15-e16. doi: 10.1016/S2215-0366(20)30078-X
Chowdhry, S. M. (2020). Trying To Do It All: Being a Physician-Mother during the COVID-19 Pandemic. Journal of Palliative Medicine, 23(5), 731-732. doi: 10.1089/jpm.2020.0182
Cluver, L., Lachman, J. M., Sherr, L., Wessels, I., Krug, E., Rakotomalala, S., … McDonald, K. (2020). Parenting in a time of COVID-19. The Lancet, 395(10231), e64. doi: 10.1016/S0140-6736(20)30736-4
Cooney, C. I. (2020, April 8). The Parents Are Not All Right. Medium. Retrieved from https://gen.medium.com/parents-are-not-ok-66ab2a3e42d9
Duque, H., & Aristizábal Diaz-Granados, E. T. (2019). Análisis fenomenológico interpretativo. Una guía metodológica para su uso en la investigación cualitativa en psicología. Pensando Psicología, 15(25), 1-24. doi: 10.16925/2382-3984.2019.01.03
Eby, L., Casper, W., Lockwood, A., Bordeaux, C., & Brinley, A. (2005). Work and Family Research in IO/OB: Content Analysis and Review of the Literature (1980–2002). Journal of Vocational Behavior, 66(1), 124-197. doi: 10.1016/j.jvb.2003.11.003
Ganguli, I., Sheridan, B., Gray, J., Chernew, M., Rosenthal, M. B., & Neprash, H. (2020). Physician work hours and the gender pay gap—evidence from primary care. New England Journal of Medicine, 383(14), 1349-1357. doi: 10.1056/NEJMsa2013804
Goodman, S. H., & Garber, J. (2017). Evidence-Based Interventions for Depressed Mothers and Their Young Children. Child Development, 88(2), 368-377. doi: 10.1111/cdev.12732
Gorbalenya, A. E., Baker, S. C., Baric, R. S., Groot, R. J. de, Drosten, C., Gulyaeva, A. A., … Ziebuhr, J. (2020). Severe acute respiratory syndrome-related coronavirus: The species and its viruses – a statement of the Coronavirus Study Group. BioRxiv, 2020. doi: 10.1101/2020.02.07.937862
Guille, C., Frank, E., Zhao, Z., Kalmbach, D. A., Nietert, P. J., Mata, D. A., & Sen, S. (2017). Work-Family Conflict and the Sex Difference in Depression Among Training Physicians. JAMA Internal Medicine, 177(12), 1766-1772. doi: 10.1001/jamainternmed.2017.5138
Hamel, L., & Salganicoff, A. (2020, April 6). Is There a Widening Gender Gap in Coronavirus Stress?. Coronavirus (COVID-19). KFF. Retrieved from https://www.kff.org/policy-watch/is-there-widening-gender-gap-in-coronavirus-stress/
Jolly, S., Griffith, K. A., De Castro, R., Stewart, A., Ubel, P., & Jagsi, R. (2014). Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers. Annals of Internal Medicine, 160(5), 344-353. doi: 10.7326/M13-0974
Juengst, S. B., Royston, A., Huang, I., & Wright, B. (2019). Family Leave and Return-to-Work Experiences of Physician Mothers. JAMA Network Open, 2(10), e1913054. doi: 10.1001/jamanetworkopen.2019.13054
Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., Yang, B. X., … Liu, Z. (2020). The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. The Lancet Psychiatry, 7(3), e14. doi: 10.1016/S2215-0366(20)30047-X
Kvale, S. (1996). InterViews: An Introduction to Qualitative Research Interviewing. SAGE Publications, Inc.
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., … Hu, S. (2020). Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open, 3(3), e203976. doi: 10.1001/jamanetworkopen.2020.3976
Lancee, W. J., Maunder, R. G., Goldbloom, D. S., & Coauthors for the Impact of SARS Study. (2008). Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatric Services, 59(1), 91-95. doi: 10.1176/ps.2008.59.1.91
López-Atanes, M., Recio-Barbero, M., & Sáenz-Herrero, M. (2020). Are women still “the other”? Gendered mental health interventions for health care workers in Spain during COVID-19. Psychological Trauma: Theory, Research, Practice and Policy, 12(S1), S243-S244. doi: 10.1037/tra0000751
Mache, S., Bernburg, M., Groneberg, D. A., Klapp, B. F., & Danzer, G. (2016). Work family conflict in its relations to perceived working situation and work engagement. Work, 53(4), 859-869. doi: 10.3233/WOR-162257
Makino, M., Kanie, A., Nakajima, A., & Takebayashi, Y. (2020). Mental health crisis of Japanese health care workers under COVID-19. Psychological Trauma: Theory, Research, Practice and Policy, 12(S1), S136-S137. doi: 10.1037/tra0000819
Marchand, A., Bilodeau, J., Demers, A., Beauregard, N., Durand, P., & Haines, V. Y. (2016). Gendered depression: Vulnerability or exposure to work and family stressors? Social Science & Medicine, 166, 160-168. doi: 10.1016/j.socscimed.2016.08.021
Markham, A. N., & Buchanan, E. A. (2015). Internet Research: Ethical Concerns. In: Editor(s): James D. Wright (Eds.) International Encyclopedia of the Social & Behavioral Sciences (Second Edition). Elsevier, p. 606-613. doi: 10.1016/B978-0-08-097086-8.11027-X.
Martínez Miguélez, M. (2006). Validez y confiabilidad en la metodología cualitativa. Paradigma, 27(2), 07-33.
Michel, J., Kotrba, L., Mitchelson, J. K., Clark, M., & Baltes, B. (2011). Antecedents of work–family conflict: A meta‐analytic review. Journal of Organizational Behavior, 32(5), 689-725. doi: 10.1002/job.695
Mihailescu, M., & Neiterman, E. (2019). A scoping review of the literature on the current mental health status of physicians and physicians-in-training in North America. BMC Public Health, 19(1), 1363. doi: 10.1186/s12889-019-7661-9
Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901-907. doi: 10.1016/j.bbi.2020.05.026
Perry‐Jenkins, M., & Gerstel, N. (2020). Work and family in the second decade of the 21st century. Journal of Marriage and Family, 82(1), 420-453. doi: 10.1111/jomf.12636
Sandven-Thrane, S. (2020). Covid-19: Thoughts from a worried mother. Tidsskrift for Den Norske Legeforening. doi: 10.4045/tidsskr.20.0220
Shanafelt, T., Ripp, J., & Trockel, M. (2020). Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA, 323(21), 2133-2134. doi: 10.1001/jama.2020.5893
Staniscuaski, F., Reichert, F., Werneck, F. P., de Oliveira, L., Mello-Carpes, P. B., Soletti, R. C., … Parentin Science Movement. (2020). Impact of COVID-19 on academic mothers. Science, 368(6492), 724. doi: 10.1126/science.abc2740
Suarez, V., Suarez-Quezada, M., Oros-Ruiz, S., & Ronquillo-De Jesús, E. (2020). Epidemiology of COVID-19 in Mexico: From the 27th of February to the 30thofApril 2020. Revista Clínica Española, 220(8), 463-471. doi: 10.1016/j.rce.2020.05.007
Tawfik, D. S., Scheid, A., Profit, J., Shanafelt, T., Trockel, M., Adair, K. C., … Ioannidis, J. P. A. (2019). Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Annals of Internal Medicine, 171(8), 555-567. doi: 10.7326/M19-1152
Tayfur, O., Bayhan-Karapinar, P., & Metin-Camgoz, S. (2013). The mediating effects of emotional exhaustion cynicism and learned helplessness on organizational justice-turnover intentions linkage. International Journal of Stress Management, 20(3), 193-221. doi: 10.1037/a0033938
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. doi: 10.1093/intqhc/mzm042
Wenham, C., Smith, J., Morgan, R., & Gender and COVID-19 Working Group. (2020). COVID-19: The gendered impacts of the outbreak. The Lancet, 395(10227), 846-848. doi: 10.1016/S0140-6736(20)30526-2
World Health Organization [WHO]. (2020). Novel Coronavirus (2019-nCoV): Situation report, (No. 11). World Health Organization, WHO. Retrieved from https://apps.who.int/iris/handle/10665/330776
Yank, V., Rennels, C., Linos, E., Choo, E. K., Jagsi, R., & Mangurian, C. (2019). Behavioral Health and Burnout Among Physician Mothers Who Care for a Person with a Serious Health Problem, Long-term Illness, or Disability. JAMA Internal Medicine, 179(4), 571-574. doi: 10.1001/jamainternmed.2018.6411
Zhang, H., Tang, L., Ye, Z., Zou, P., Shao, J., Wu, M., … Mu, S. (2020a). The role of social support and emotional exhaustion in the association between work-family conflict and anxiety symptoms among female medical staff: A moderated mediation model. BMC Psychiatry, 20(1), 266. doi: 10.1186/s12888-020-02673-2
Zhang, W. R., Wang, K., Yin, L., Zhao, W.-F., Xue, Q., Peng, M., … Wang, H.-X. (2020b). Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China. Psychotherapy and Psychosomatics, 89(4), 242-250. doi: 10.1159/000507639
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., … China Novel Coronavirus Investigating and Research Team. (2020). A Novel Coronavirus from Patients with Pneumonia in China, 2019. The New England Journal of Medicine, 382(8), 727-733. doi: 10.1056/NEJMoa2001017