{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T10:58:14Z","timestamp":1782903494124,"version":"3.54.5"},"reference-count":58,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["RD21\/0016\/0027"],"award-info":[{"award-number":["RD21\/0016\/0027"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100025079","name":"FIIBAP","doi-asserted-by":"crossref","award":["COVID-1920-23"],"award-info":[{"award-number":["COVID-1920-23"]}],"id":[{"id":"10.13039\/501100025079","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Institut Catal\u00e0 de la RecercaI EstudisAvan\u00e7ats"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,3]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the experience of primary healthcare (PHC) professionals in their professional role during the pandemic and to describe collective coping strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a qualitative study using interviews, focus groups and photovoice techniques from February to September 2021. The qualitative data were transcribed, aggregated and analysed, from a hermeneutic perspective, using applied thematic analysis and ethnographic approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary Care Health Madrid region (Spain).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Convenience sampling was used to select 71 multidisciplinary primary care professionals who were working in 12 PHCs representing diverse socioeconomic, social vulnerability and COVID impact levels in the Madrid region (Spain).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings from this study show how lack of protection in the early days, uncertainty about how the disease would evolve and the daily challenges they faced have had an impact on the participants\u2019 perceptions of their professional role. Nuanced differences in impact were found between men and women, age groups, professional roles and territories. The questioning of the basic foundations of primary care and the lack of prospects led to a feeling of demotivation. They perceive a wide gap between their levels of involvement and commitment, the recognition they receive and the attention to resources they need to do their work to a high standard. The support of their colleagues was seen as the most valuable resource for coping with the crisis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The practitioners\u2019 discourses offer knowledge that could help to face new global health threats; they also identify an urgent need to restore the role and motivation of PHC professionals as part of a wider regeneration of health systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-090248","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T08:40:21Z","timestamp":1753346421000},"page":"e090248","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["From unconditionality to disenchantment among primary healthcare professionals during the COVID-19 pandemic: a qualitative study from Madrid, Spain"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3931-5304","authenticated-orcid":false,"given":"Isabel","family":"Cura-Gonzalez","sequence":"first","affiliation":[{"name":"Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain"},{"name":"Department of Medical Specialities and Public Health, Rey Juan Carlos University, Alcorc\u00f3n, Madrid, Spain"},{"name":"Research network on chronicity, primary care and health promotion, ISCIII, Madrid, Spain"},{"name":"Aging Research Center, Karolinska Institutet, Solna, Sweden"},{"name":"IIS Gregorio Mara\u00f1on, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Polentinos-Castro","sequence":"additional","affiliation":[{"name":"Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain"},{"name":"Department of Medical Specialities and Public Health, Rey Juan Carlos University, Alcorc\u00f3n, Madrid, Spain"},{"name":"Research network on chronicity, primary care and health promotion, ISCIII, Madrid, Spain"},{"name":"IIS Gregorio Mara\u00f1on, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Bola\u00f1os-Gallardo","sequence":"additional","affiliation":[{"name":"Independent Professional, FIIBAP, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Conde-Espejo","sequence":"additional","affiliation":[{"name":"Independent Professional, FIIBAP, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Martinez-Manrique","sequence":"additional","affiliation":[{"name":"Mostoles University Hospital, Mostoles, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Mart\u00ednez-Hern\u00e1ez","sequence":"additional","affiliation":[{"name":"Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"2025121514134039000_15.7.e090248.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m1090","article-title":"Covid-19: how doctors and healthcare systems are tackling coronavirus worldwide","volume":"368","author":"Tanne","year":"2020","journal-title":"BMJ"},{"key":"2025121514134039000_15.7.e090248.2","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(20)30739-X","article-title":"COVID-19 gives the lie to global health expertise","volume":"395","author":"Dalglish","year":"2020","journal-title":"Lancet"},{"key":"2025121514134039000_15.7.e090248.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31483-5"},{"key":"2025121514134039000_15.7.e090248.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-006422","article-title":"Inverse correlates of COVID-19 mortality across European countries during the first versus subsequent waves","volume":"6","author":"Villani","year":"2021","journal-title":"BMJ Glob Health"},{"key":"2025121514134039000_15.7.e090248.5","unstructured":"World Health Organization . 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