Estudio exploratorio de relación entre la percepción de apoyo social instrumental y la modificación de roles familiares en mujeres con cáncer de mama

Objetivo: Explorar la relación entre las fuentes y el tipo de apoyo instrumental brindado a las mujeres con Cáncer de Mama (CM) con la modificación de roles y actividades cotidianas en las pacientes y sus allegados. Método: Se realizó un estudio cualitativo centrado en la etnografía de 9 pacientes con CM. A través del software MAXQDA v10, se hizo un análisis temático del discurso para posteriormente elaborar tablas cruzadas para el análisis de las variables en estudio. Resultados: Para estas mujeres, la familia nuclear constituye la principal fuente de apoyo instrumental, al mismo tiempo que son quienes suelen modificar más sus actividades cotidianas y roles sociales. Las mujeres con CM expresan dificultad para delegar principalmente actividades del hogar debido a 3 razones: la responsabilidad de madre, la sensación de utilidad y una ideología tradicional de género. Conclusiones: El impacto del cáncer en la mujer tiene consecuencias únicas, debido al papel central que ellas asumen en la vida familiar. Los movimientos funcionales, afectivos y relacionales que ocurren en la familia ante un diagnóstico de CM parece ser un hecho frecuente y de gran trascendencia, que ha sido poco estudiado en nuestra población. Estos aspectos deben ser considerados como un elemento importante en la comprensión y el soporte que se debe otorgar a las mujeres con CM y a sus familias

Internet-based self-administered intervention to reduce anxiety and depression symptomatology and improve well-being in 7 countries: protocol of a randomized control trial

BackgroundOnline psychological interventions have emerged as a treatment alternative because they are accessible, flexible, personalized, and available to large populations. The number of Internet interventions in Latin America is limited, as are Randomized Controlled Trials (RCTs) of their effectiveness and a few studies comparing their effectiveness in multiple countries at the same time. We have developed an online intervention, Well-being Online, which will be available to the public free of charge in 7 countries: Mexico, Ecuador, Peru, Chile, Brazil, Spain, and the Netherlands. We expect a reduction in depression and anxiety symptoms and an increase in well-being of the participants.MethodsA multi-country, randomized controlled trial will be conducted. The intervention is multicomponent (Cognitive Behavioral Therapy, Behavioral Activation Therapy, Mindfulness, Acceptance and Commitment Therapy, and Positive Psychology), with 10 sessions. In each country, eligible participants will be randomized to one of three groups: Enriched Intervention (interactive web design with videos, infographics, text, audio, and forum), Text Intervention (text on the website), and Wait List (control group). Repeated measures will be obtained at 5-time points. Our primary outcomes will be anxiety symptomatology, depressive symptomatology, and mental well-being. MANOVA analysis will be used for our main analysis.DiscussionThis protocol describes the design of a randomized trial to evaluate the efficacy of a web-based intervention to reduce anxiety and depression symptomatology and increase subjective well-being. The intervention will be made available in four languages (Spanish, Portuguese, Dutch, and English). Its results will contribute to the evidence of effectiveness in terms of randomized trials and Internet interventions, mainly in Latin America and Europe

Resiliencia asociada a factores de salud mental y sociodemográficos en enfermeros mexicanos durante COVID-19

Introduction: Nursing personnel are one of the groups which have been most affected by the current COVID-19 pandemic. Although mental health problems have been reported in this population, it is important to study resilience, in order to identify its strengths. The purpose was to study resilience in Mexican nurses and the mental health and sociodemographic factors associated with it. A cross-sectional study was used. Method: A sociodemographic and COVID-19 related questionnaire, the Resilience Inventory and the General Health Questionnaire-28, was sent via online. 556 nurses were included, the majority were women (80%), single (60.8%), aged between 26-35 years (38.3%). Results: Lower resilience was found among nurses who were younger (p<0.001, ɳ2=0.05), single (p<0.001, ɳ2=0.02) and with lower levels of education (p=0.001, ɳ2=0.02). Predictors of resilience included the search for mental health information (β =-0.152, p <0.001), higher education (β = 0.142, p<0.001), low levels of depression (β=-0.307, p<0.001) and low levels of social dysfunction (β =-0.261, p<0.001). Conclusion: This findings allowed to identify the factors which are associated with resilience among nurses and how this plays an important role in their mental. Likewise, this data allows for the identification of high psychosocial risk groups, to better guide mental health strategies aimed at increasing resilience.Introducción: El personal de enfermería es uno de los grupos más afectados por la actual pandemia por COVID-19. Se han reportado problemas de salud mental en esta población, sin embargo, también es importante estudiar la resiliencia, para identificar sus fortalezas. El objetivo de este estudio fue estudiar la resiliencia en enfermeros mexicanos y los factores sociodemográficos y de salud mental asociados a ella. Se llevó a cabo un estudio transversal.Método: Se envió vía online un cuestionario sociodemográfico y relacionado a COVID-19, así como el Inventario de Resiliencia y el Cuestionario General de Salud-28. Se incluyeron 556 enfermeros, la mayoría fueron mujeres (80%), solteras (60.8%) y con edades entre 26-35 años (38.3%).Resultados: Se encontraron niveles bajos de resiliencia en los enfermeros más jóvenes (p<0.001, ɳ2=0.05), solteros (p<0.001, ɳ2=0.02) y con menor nivel educativo (p=0.001, ɳ2=0.02). Los predictores de resiliencia fueron la búsqueda de información sobre salud mental (β =-0.152, p <0.001), nivel educativo más alto (β = 0.142, p<0.001), niveles bajos de depresión (β=-0.307, p<0.001) y bajos niveles de disfunción social (β =-0.261, p<0.001).Conclusión: Estos hallazgos permiten identificar los factores asociados a la resiliencia en los enfermeros y cómo estos juegan un rol muy importante en su salud mental. Asimismo, estos datos permiten la identificación de grupos con mayor riesgo psicosocial, con la finalidad de guiar estrategias en salud mental orientadas a aumentar la resiliencia.Resumo:Introdução:O pessoal de enfermagem é um dos grupos mais afetados pela atual pandemia de COVID-19. Problemas de saúde mental têm sido relatados nessa população, porém também é importante estudar a resiliência, para identificar seus pontos fortes. O objetivo deste estudo foi estudar a resiliência em enfermeiras mexicanas e os fatores sociodemográficos e de saúde mental a ela associados. Foi realizado um estudo transversal.Método:Um questionário sociodemográfico relacionado ao COVID-19 foi enviado online, assim como o Resilience Inventory e o General Health Questionnaire-28. Foram incluídos 556 enfermeiros, a maioria mulheres (80%), solteiros (60,8%) e com idade entre 26-35 anos (38,3%).Resultados:Baixos níveis de resiliência foram encontrados nos enfermeiros mais jovens (p <0,001, ɳ2 = 0,05), solteiros (p <0,001, ɳ2 = 0,02) e com menor escolaridade (p = 0,001, ɳ2 = 0,02). Os preditores de resiliência foram a busca por informações sobre saúde mental (β = -0,152, p <0,001), maior escolaridade (β = 0,142, p <0,001), baixos níveis de depressão (β = -0,307, p <0,001 ) e baixos níveis de disfunção social (β = -0,261, p <0,001).Conclusão:Esses achados permitem identificar os fatores associados à resiliência em enfermeiros e como eles desempenham um papel muito importante em sua saúde mental. Da mesma forma, esses dados permitem identificar grupos de maior risco psicossocial, a fim de nortear estratégias de saúde mental que visem aumentar a resiliência

Anxious depression in patients with Type 2 Diabetes Mellitus and its relationship with medication adherence and glycemic control

A relationship between anxious depression has been proposed in patients with diabetes, which may contribute to the lack of medication adherence. The aim of this study was to investigate if there is a relationship between depression and / or anxiety with medication adherence and glycemic control in patients with type 2 Diabetes Mellitus (DM2). An analytical, cross-sectional study was carried out in the internal medicine outpatient clinic of a Hospital in Mexico. Patients with DM2 participated over a period from November 2015 to January 2016. The Morisky scale for medication adherence, and the Goldberg anxiety and depression scale were conducted for each patient. Data was collected from a total of 179 patients. There was a significant difference between anxious depression and medication adherence (p < 0.001) using logistic regression with an R2 of 0.136. There was also a significant difference between anxiety and glycemic control (p < 0.001) with an R2 of 0.175, however no significant difference was found between glycemic control and anxious depression. Our findings demonstrate that patients who suffer from anxious depression also tend to have reduced medication adherence, and anxiety was associated with poor glycemic control in patients with DM2 within the Mexican population

Resilience associated to Mental Health and Sociodemographic factors in mexican nurses during COVID-19

Introducción: El personalde enfermería es uno de los grupos más afectados por la actual pandemia por COVID-19. Se han reportado problemas de salud mental en esta población, sin embargo, también es importante estudiar la resiliencia, para identificar sus fortalezas. El objetivo de este estudio fue estudiar la resiliencia en enfermeros mexicanos y los factores sociodemográficos y de salud mental asociados a ella. Se llevó a cabo un estudio transversal. Método: Se envió vía online un cuestionario sociodemográfico y relacionado a COVID-19, así como el Inventario de Resiliencia y el Cuestionario General de Salud-28. Se incluyeron 556 enfermeros, la mayoría fueron mujeres (80%), solteras (60.8%) y con edades entre 26-35 años (38.3%). Resultados: Se encontraron niveles bajos de resiliencia en los enfermeros más jóvenes (p<0.001, ɳ2=0.05), solteros (p<0.001, ɳ2=0.02) y con menor nivel educativo (p=0.001, ɳ2=0.02). Los predictores de resiliencia fueron la búsqueda de información sobre salud mental (β =-0.152, p <0.001), nivel educativo más alto (β = 0.142, p<0.001), niveles bajos de depresión (β=-0.307, p<0.001) y bajos niveles de disfunción social (β =-0.261, p<0.001). Conclusión: Estos hallazgos permiten identificar los factores asociados a la resiliencia en los enfermeros y cómo estos juegan un rol muy importante en su salud mental. Asimismo, estos datos permiten la identificación de grupos con mayor riesgo psicosocial, con la finalidad de guiar estrategias en salud mental orientadas a aumentar la resiliencia.Introduction: Nursing personnel are one of the groups which have been most affected by the current COVID-19 pandemic. Although mental health problems have been reported in this population, it is important to study resilience, in order to identify its strengths. The purpose was to study resilience in Mexican nurses and the mental health and sociodemographic factors associated with it. A cross-sectional study was used. Method: A sociodemographic and COVID-19 related questionnaire, the Resilience Inventory and the General Health Questionnaire-28, was sent via online. 556 nurses were included, the majority were women (80%), single (60.8%), aged between 26-35 years (38.3%). Results: Lower resilience was found among nurses who were younger (p<0.001, ɳ2=0.05), single (p<0.001, ɳ2=0.02) and with lower levels of education (p=0.001, ɳ2=0.02). Predictors of resilience included the search for mental health information (β =-0.152, p <0.001), higher education (β = 0.142, p<0.001), low levels of depression (β=-0.307, p<0.001) and low levels of social dysfunction (β =-0.261, p<0.001). Conclusion: This findings allowed to identify the factors which are associated with resilience among nurses and how this plays an important role in their mental. Likewise, this data allows for the identification of high psychosocial risk groups, to better guide mental health strategies aimed at increasing resilience

Evaluation of psychosocial aspects in participants of cancer genetic counseling

Abstract Background The instrument called “Hospital Anxiety and Depression Scale” (HADS) is frequently used to evaluate anxious and depressive symptomatology in patients who receive Cancer Genetic Counseling (CGC). However, this instrument cannot identify all of the psychosocial factors, such as the antecedents of the patients’ emotional states or their concerns. The objective of the present research was to compare cases detected with psychosocial alterations by means of HADS and a Psychological Health Interview (PHI). Methods A transversal analytical design was used. One hundred ten participants were included (97.3% females and 2.7% males). The average age was 45 years ±10 years. Results The PHI identified twice the amount of participants with psychosocial alterations than did HADS, which only detected 43% of these participants. Conclusions The results of our study suggest that the PHI should be applied in addition to HADS to identify participants who would require psychological support due to recurrent concerns

The Efficacy and Usability of an Unguided Web-Based Grief Intervention for Adults Who Lost a Loved One During the COVID-19 Pandemic: Randomized Controlled Trial

BACKGROUND: The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed. OBJECTIVE: The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system. METHODS: We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention. RESULTS: A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P<.001 to P=.006), with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at 3 months after the intervention. The results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist (P<.001), but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, the results indicated a high level of satisfaction with the Grief COVID. CONCLUSIONS: The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide risk, posttraumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional web-based psychological tools to help reduce clinical symptoms in people experiencing grief because of the loss of a loved one during a pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04638842; https://clinicaltrials.gov/ct2/show/NCT04638842