At the time of writing this paper,
the pandemic caused by the SARS-CoV-2 coronavirus and COVID-19 has infected 15
million, sickened 7 million, and caused 700,000 deaths worldwide [1]. In
Mexico, 400,000 infections and 40,000 deaths have been recorded [2]. Social
work intervenes in public policies and social programs aimed at vulnerable,
marginalized, or excluded people; its commitment must be analyzed considering
its relationship with the management of the treatment of the disease and the
rehabilitation of health sector institutions [3]. Policies to prevent COVID-19
were distinguished by confinement and social distancing derived from an
epidemiological traffic light that reduced or increased organizational
processes, such as work commitment. In the case of Mexico, the health culture
that inhibits disease prevention, as well as resistance to medical care until a
critical and irreversible stage, coupled with the discretionary and
non-selective recruitment of 50 thousand health professionals, hospitals
without equipment and the lack of ambulances; have caused the death of 40
thousand people and at least 80 thousand more deaths are projected [4].
However, as deaths increase due to the risks associated with the health crisis,
work commitment intensifies [5]. Mexico's anti-pandemic policies allowed the
hiring of health professionals in the midst of the health crisis [6]. In
addition to the hiring of health personnel recently graduated from universities
(Bermudez et al., 2021). In this complex scenario, work commitment, understood
as dispositions against or in favor of health policies, public assistance
services, self-care and social support, has been observed as a complex and
multidimensional variable, which explains the exposure of health workers, as
well as the prevalence of assuming greater risks expecting minimal benefits or
recognition. The health crisis, anti-COVID-19 policies and work commitment are
aligned by an epidemiological traffic light, which defines the strategies of
confinement, distancing and use of anti-pandemic devices (Abbas et al., 2022).
In this way, work commitment is a guiding axis of academic, professional and
work training in health crisis scenarios [7]. Consequently, the study of the
dimensions of work commitment will clarify the impact of the pandemic on the
training of health professionals. Theoretical frameworks on work engagement
highlight proposals that observe a balance between demands and resources, as
well as approaches that propose dispositions as predictors of performance [8].
A hybrid model is praised in which engagement indicators reflect and affect
performance [9].Within the framework of pandemic mitigation policies, scenarios
of confinement and violence prevail between the parties involved, as well as
between rulers and the governed, attributable to risk management and
communication [10]. In this sense, health professionals develop expectations
towards their authorities and users of public health services, as well as
towards the infrastructure of their work areas [11]. In this way, the
theoretical and conceptual frameworks that explain their degree of commitment
refer to their dispositions, intentions and actions in the face of scarcity,
lack, unhealthiness and famine. In this way, in the 1970s, explanatory theories
of the organizational and personal situation of health professionals were
designed and consolidated [12]. These are the Theory of Reasoned Action, the
Agenda Setting Theory, the Theory of Prospective Decisions, and the Theory of
Risk Amplification. In a context where health institutions and organizations
were considered as balanced environments of demands and resources, the Theory
of Reasoned Action contributed to the state of the art by relating beliefs of
abundance or scarcity with dispositions against or in favor of their
performance [13]. This is the case of health professionals who, when
interacting with their environment, developed self-management skills that
earned them the formation of associations such as "Doctors Without
Borders" or the "International Red Cross" itself [14]. From this
theoretical approach, commitment was the result of a deliberate, planned and
systematic process of biomedical, rather than social or organizational,
decisions in favor of the well-being of health professionals. In the same
decade of the sixties, the media achieved the status of fourth power, by
evidencing the political and institutional failures in the corruption scandals
associated with health policies, in the face of the impact of natural
disasters, the contamination of multinationals or nuclear accidents [15]. These
are environmental organizations that questioned the programs and strategies of
the State in the face of the extinction of animal and plant species [16].
Consequently, this theoretical approach demonstrated commitment as a product of
establishing axes and topics of discussion in the public agenda derived from
the political agenda, and this in turn, influenced by the scientific and health
research agenda [17]. Meanwhile, the Prospective Decision Theory focused on the
study of health promotion, the prevention of accidents or diseases, as well as
self-care and adherence to treatment of users of the public health service
[18]. This theoretical corpus linked decisions in risk situations with
expectations of high costs and maximum benefits, to explain risk behaviors in
the face of the appearance of sexually transmitted diseases.