Epidemiología de los episodios de hospitalización psiquiátricos en España

OBJETIVO: Analizar los episodios de hospitalización psiquiátricos en España y las variables sociodemográficas y clínicas asociadas. MATERIAL Y MÉTODO Estudio epidemiológico descriptivo, de la morbilidad en psicopatología hospitalaria, bajo un diseó ecológico. Hemos estudiado todos los ingresos de los hospitales de SNSS, analizando los datos, clínicos y administrativos, procendentes del CMBDAH (Conjunto Mínimo Básicos de Datos al Alta Hospitalaria) y GRD (Grupos Relacionados por el Diagnóstico). RESULTADOS Y CONCLUSIONES El 82% de los episodios son agrupados como trastorno mental (CDM 19) y el 18% como uso de drogas/alcohol y trastornos mentales orgánicos inbducidos (CDM20). La tasa de incidencia anual de hospitalizaciones en España para la CDM 19 es de 1,37 (IC 95% 1,37-1,39) y para la CDM 20, 0,30 (0,30-0,31). En la CDM 19, las Comunidades Autónomas de Baleares, Principado de Asturias y Aragón presentan las tasas más elevadas.Las tres entidades diagnósticas más frecuentes son: trastornos esquizofrénicos, psicosis afectivas y trastornos neuróticos, abarcando más del 50 % de los casos. Se producen más episodios de hospitalización masculino que femeninos. Existen diferencias tipológicas en función del sexo en ambas categorías diagnósticas. En los hombres predominan los trastornos esquizofrénicos y en las mujeres los cuadros ligados a la eesfera afectiva (Psicosis afectiva y trastornos neuróticos). En la mayoría de los episodios de hospitalización observamos un mismo patrön: mayor frecuencia de casos e incidencia para el género masculino, edad de ingreso y latencia de estancia superior en las mujeres. Se hace patente la necesidad de incorporar la mirada de género al estudio epidemiológico en salud mental. Se ha puesto en evidencia una cierta distribución desigual de los ingresos psicopatológicos en España. Existe una probabilidad diferente de ingresos por trastorno mental y de estancia hospitalaria según zona de residencia. La distribución de recursos, en las distintas CCAA, no se muestra acorde al volumen asistencial. La creación de índices multivariantes ha permitido establecer agrupaciones o clusters territoriales clasificando las diferentes áreas en función de un conjunto amplio de indicadores, la representación cartográfica facilita la visualización. En función de tales datos, debería plantearse la reorganización de los dispositivos sanitarios en salud mental posibilitando la distribución equitativa y racional de los recursos

Health Literacy, Misinformation, Self-Perceived Risk and Fear, and Preventive Measures Related to COVID-19 in Spanish University Students

The "infodemic" is one of the main obstacles in the fight against the COVID-19 pandemic. In order to face it, health literacy (HL) is essential since it allows for knowledge about COVID-19 and the practice of preventive measures to be fostered. This is especially relevant in university students due to their idiosyncrasy. This study aims to evaluate the level of HL related to COVID-19 (HLC), risk perception, misinformation, and the attitudes and behaviors adopted to prevent the spread of coronavirus in Spanish university students. An online questionnaire was administered to 499 Spanish university students. The HLC index presented a mean of 33.89 out of 50; a total of 63.8% had an inadequate level of HLC. They practiced a mean of 7.54 out of 9 preventive behaviors, and the mean knowledge score was 10.40 out of 13. The HLC showed significantly different scores for the degree, the practice of preventive measures, and some sources of information. The level of HL correlates with the adoption of preventive measures. The higher the severity and perceived susceptibility, the more preventive measures are taken by the students. Therefore, there is a need to strengthen the HL skills of university students and address the dissemination of misinformation. Although caution should be taken when generalizing these results due to the limitations inherent within a cross-sectional study and the convenience sampling, our results can guide the establishment of health education strategies and policies for the management of the infodemic in pandemic situations, according to this target population

Psychometric Assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) for Arabic/French-Speaking Migrants in Southern Europe

Improving health literacy (HL) is critical for addressing health inequalities. Low literacy rates are believed to be more prevalent in ethnic minorities, which may have an impact on people's health. For measures to be implemented in this regard, HL must be evaluated to obtain specific indicators. Our aim, therefore, was to develop a version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16), which is recommended to be used with vulnerable populations, suited to Arabic/French-speaking migrants who reside in south-eastern Spain, and to explore its psychometric properties for assessing health literacy in this population. A cross-sectional survey was carried out in a convenient sample of 205 migrants. The structural validity was calculated by a confirmatory factorial analysis (CFA), which suggested appropriate adjustment indicators, and which indicated that the three-dimensional model is adequately adjusted to the data obtained in the study. The coefficient omega showed high internal consistency in the three HL dimensions (health care, disease prevention, and health promotion). Concurrent validity presented a significant correlation with the Newest Vital Sign test (r = 0.390; p < 0.001). The multigroup CFA showed that the heterogeneity of the sample used was not a problem for establishing the structural validity of the scale. The Arabic/French version showed good construct validity

Assessment of health literacy among migrant populations in Southern Spain: A cross-sectional study

Aim: The aim of this study was to measure of health literacy in the migrant population and establish a type of immigrant profile with a higher risk of presenting low levels of health literacy. Design: A cross-sectional descriptive study. Methods: Health literacy was measured in a total of 278 immigrants using HLSEU-Q16. An inferential descriptive and multiple regression analysis was carried out. Results: 65.1% having inadequate and problematic health literacy. Significant correlations were found between health literacy and length of stay in Spain (r = .398), age (r = .178p) and perceived social status (r = .151). Participants with shorter length of stay (β = .405 1), without health sciences education (β = .205) and low education level (β = .182) had limited health literacy.11 página

Effectiveness of a Multifactorial Intervention in the First 1000 Days of Life to Prevent Obesity and Overweight in Childhood: Study Protoco

(1) Background: Obesity is a global health problem, and its prevention must be a priority goal of public health, especially considering the seriousness of the problem among children. It is known that fetal and early postnatal environments may favor the appearance of obesity in later life. In recent years, the impact of the programs to prevent obesity in childhood has been scarce. The aim of this research is to evaluate the effectiveness of an intervention based on the concept of early programming. (2) Methods: Non-randomized controlled trial design. Inclusion criteria are: two-year-old infants whose gestational period begins in the 14 months following the start of the intervention, and whose mothers have made the complete follow-up of their pregnancy in the same clinical unit of the study. The intervention will be developed over all the known factors that affect early programming, during pregnancy up to 2 years of life. Data will be collected through a data collection sheet by the paediatricians. A unibivariate and multivariate analysis of the data will be carried out. (3) Ethics and dissemination: The trial does not involve any risk to participants and their offspring. Signed informed consent is obtained from all participants. Ethical approval has been obtained. (4) Results: It is expected that this study will provide evidence on the importance of the prevention of obesity from the critical period of the first 1000 days of life, being able to establish this as a standard intervention in primary care

Self-management in heart failure using mHealth: A content validation.

AIM: To describe the development of a mobile health application -mICardiApp- designed by a multidisciplinary professional team and patients with heart failure and to evaluate its content validity. METHODS: Critical reviews of the literature, semi-structured interviews with patients, and user stories guided the development of the content of the mobile application. These contents were refined and validated through a modified Delphi process. An expert panel of healthcare and social care professionals together with patients and academics evaluated the content through two content validity indicators, relevance, and adequacy, and provided narrative feedback. The content validity of the app and each screen was determined by calculating the Content Validity Index (CVI). Similarly, the Adequacy Index (AI) was analyzed. RESULTS: The developed app is composed by 8 topics: (1) available resources, (2) cardiac rehabilitation, (3) control of signs and symptoms, (4) emotional support, (5) learning and having fun, (6) medication, (7) nutrition, and (8) physical activity. The results demonstrated high CVI of the screens and the full app. 57 of the 59 screens in the app reached an excellent CVI≥0.70 for both relevance and adequacy, except for 2 screens. The CVI Average Method of the app was 0.851. CONCLUSIONS: mICardiApp is presented as an application to improve health literacy and self-management of patients with multimorbidity and heart failure, with proven validation

Needs of patients with multi-morbidity and heart failure for the development of a mHealth to improve their self-management: A qualitative analysis

Objective: To provide practical information regarding needs, preferences of content and format of an app to assist the self-management in patients with multi-morbidity and heart failure (HF). Methods: The three-phase study was conducted in Spain. Six integrative reviews, a qualitative methodology based on Van Manen's hermeneutic phenomenology through semi-structured interviews and user stories were used. Data collection continued until data saturation was reached. All data were transcribed verbatim and analysed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes. Results: Integrative reviews conducted included practical recommendations to include in the content and format of the App and helped create the interview guide. Interviews revealed 15 subthemes that captured the meaning of narratives offering contextual insights into the development of the App. The main effective mechanisms of multicomponent interventions for patients with HF must contain (a) components that increase the patient's understanding of HF, (b) self-care, (c) self-efficacy and participation of the family/informal caregiver, (4) psychosocial well-being and (5) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), nutritional information (70%), type of exercises in order to improve their physical condition (75%) and information about food and drug interaction (60%). The importance of motivation messages (60%) was highlighted by transversal way. Conclusions: The three-phase process integrating theoretical basis, evidence from integrative reviews and research findings from target users has been considered a guide for future app development17 página

Simulación de debate de TV: Educación para la Salud sobre intolerancia a la lactosa

Todos los estudiantes participantes firmaron un documento de cesión de derechos audiovisuales.Simulación de debate de TV, en el que los estudiantes de 3º del Grado en Enfermería (Facultad de Enfermería) ejercieron diferentes tipos de rol (moderador, intervinientes y público). Los intervinientes asumieron diferentes tipos de rol relacionados con el problema de salud tratado (profesionales de enfermería, otros profesionales sociosanitarios, representantes de asociaciones de pacientes, cuidadores..., etc.), desarrollando y profundizando en la temática mediante el diálogo. El debate de TV se dividió en presentación, desarrollo y turno de preguntas.Duración - 28:49

Simulación de debate de TV: Educación para la Salud en la utilización de la píldora del día después

Todos los estudiantes participantes firmaron un documento de cesión de derechos audiovisuales.Simulación de debate de TV, en el que los estudiantes de 3º del Grado en Enfermería (Facultad de Enfermería) ejercieron diferentes tipos de rol (moderador, intervinientes y público). Los intervinientes asumieron diferentes tipos de rol relacionados con el problema de salud tratado (profesionales de enfermería, otros profesionales sociosanitarios, representantes de asociaciones de pacientes, cuidadores..., etc.), desarrollando y profundizando en la temática mediante el diálogo. El debate de TV se dividió en presentación, desarrollo y turno de preguntas.Duración - 26:26

Simulación de debate de TV: Educación para la Salud sobre intervenciones asistidas con animales

Todos los estudiantes participantes firmaron un documento de cesión de derechos audiovisuales.Simulación de debate de TV, en el que los estudiantes de 3º del Grado en Enfermería (Facultad de Enfermería) ejercieron diferentes tipos de rol (moderador, intervinientes y público). Los intervinientes asumieron diferentes tipos de rol relacionados con el problema de salud tratado (profesionales de enfermería, otros profesionales sociosanitarios, representantes de asociaciones de pacientes, cuidadores..., etc.), desarrollando y profundizando en la temática mediante el diálogo. El debate de TV se dividió en presentación, desarrollo y turno de preguntas.Duración - 27:32