The mental health of patients with psychotic disorder from a positive, multidimensional and recovery perspective

Positive mental health (PMH) and mental illness are distinct, yet interrelated, constructs. However, this relationship has yet to be adequately established. We aimed to evaluate the level of PMH and its relationship with sociodemographic and clinical determinants as well as to explore the relationship between PMH and the positive constructs of recovery, subjective wellbeing (SWB), insight and functioning in patients with psychotic disorder. A multicenter, descriptive, cross-sectional and correlational study with a sample of 347 patients with psychotic disorder was conducted. The following assessment instruments were used: Positive Mental Health Questionnaire, Maryland Assessment of Recovery in Serious Mental Illness scale, Insight Scale, Personal Wellbeing Index-Adult version (PWI-A), Overall Life Satisfaction (OLS) and Global Assessment of Functioning scale. The mean global level of PMH was 116.16 (range of 39-156, SD = 19.39). Significant differences were found in PMH in relation to sociodemographic (sex, civil status and employment situation) and clinical variables (family history of mental disorders, number of prescribed antipsychotics, treatment with anxiolytics, treatment with antidepressants and suicide attempts). PMH was significantly and positively correlated with recovery (r = 0.760), SWB (PWI-A: r = 0.728 and OLS: r = 0.602) and functioning (r = 0.243), and negatively with insight (r = -0.335). These results can lead to a major change in mental health care. If actions are taken to increase PMH, then recovery, SWB and functioning will also increase. At the same time, interventions should be carried out to boost insight, since increasing PMH could decrease insight, all resulting in better quality of life for patients with psychotic disorder

Health promoting lifestyle and sense of coherence in young adult university students

Objetivo: la promoción de la salud permite poner en práctica fundamentos teóricos que pueden mejorar las conductas en salud de la población, para lo cual es necesario desarrollar un estilo de vida promotor de salud. Un enfoque positivo para generar salud en los adultos jóvenes es promover el enfoque salutogénico al incentivar el uso de recursos con los cuales cuenta la persona y desarrollar un sentido de coherencia. El objetivo del presente artículo es identificar el estilo de vida promotor de salud y su relación con el sentido de coherencia en adultos jóvenes universitarios en Sonora, México. Materiales y métodos: estudio descriptivo, correlacional en 300 estudiantes de carreras de pregrado. Previo consentimiento informado se aplicó cédula de datos sociodemográficos, el Cuestionario Estilo de Vida II y la Escala Sentido de Coherencia-13. Resultados: los adultos jóvenes mostraron estilo de vida promotor de salud general suficiente (51.0%), mayor incidencia en mujeres (52.1%). Los estudiantes de ciencias de la salud (55.2%) tuvieron un estilo de vida promotor de salud insuficiente, hubo diferencia estadísticamente significativa por carrera. El sentido de coherencia general fue alto (52.0%), predominó en hombres (58.0%) y estudiantes de ciencias de la salud (57.2%), no hubo diferencia estadísticamente significativa según sexo y carreras. Se evidenció que un estilo de vida promotor de salud suficiente promueve el desarrollo de un sentido de coherencia alto. Conclusiones: es imprescindible establecer programas para el desarrollo de habilidades para la vida al asegurar mejor salud y bienestar de las futuras generaciones de adultos jóvenes al promover el desarrollo del sentido de coherencia.Objective: Promotion of health allows to put into practice theoretical foundations that can improve health behaviors of the population, for which it is necessary to develop a health promoting lifestyle. A positive approach to generate health in young adults is to promote the salutogenic approach to health by encouraging the use of resources the person has and developing a sense of coherence. The main objective of this paper is to identify a health promoting lifestyle and its relationship with the sense of coherence in young adult university students in Sonora, Mexico. Materials and methods: descriptive, correlational study with 300 undergraduate students. Prior informed consent, a sociodemographic data card, the Life Style Questionnaire II and the Sense of Coherence-13 Scale were applied. Results: young adults showed enough general health promoting lifestyle (51.0%), with a higher incidence in women (52.1%). Health sciences students (55.2%) obtained an insufficient health promoting lifestyle and there was statistically significant difference by career. The general sense of coherence was high (52.0%), being predominant in men (58.0%) and in health sciences students (57.2%); there was no statistically significant difference according to gender and careers. It was evidenced that a sufficient health promoting lifestyle fosters the development of a high sense of coherence. Conclusions: it is essential to establish programs for the development of life skills to ensure better health and well-being of future generations of young adults by promoting the development of a sense of coherence

Health Literacy among Health and Social Care University Students

Health literacy has been defined by the World Health Organization as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Its importance in reducing inequalities makes health literacy a thematic area that should be addressed in the training of professionals in the fields of healthcare, Social Work and Education. The objective of this study was to define the health literacy levels of students from the Universities of Girona and Barcelona (Spain) and the Regional Institute of Social Work in Perpignan (France). A cross-sectional study was conducted among students of Nursing, Social Work, Primary Education and Special Education in the 2017-2018 academic year. Sociodemographic and academic variables were considered and the HLS-EU-Q16 questionnaire was used to study health literacy levels. In total, 219 students with an average age of 24.9 participated. Of these, 64.4% were studying Social Work, 23.7% Nursing, 5.9% Primary Education, and 5.9% Special Education. Of the total sample, 36.5% were classified as sufficient in health literacy. The total average score of the health literacy index was 11.1; 13.2 among Nursing students; 10.5 among Social Work students; 10.1 among Primary Education students, and 10.1 among Special Education students (p < 0.001). Nursing students obtained the best results and healthcare was the highest rated subdomain, more than disease prevention and health promotion

Resilience and job satisfaction among out‐of‐hospital emergency medical service professionals: a cross‐sectional multi‐centric study

Aim: We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals. Background: The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work. Methods: A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale. Results: Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73). Conclusion: There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. Implications for nursing management: Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals

La supresión de la educación especializada empeora el control metabólico en diabetes tipo 2

ResumenObjetivoEvaluar la posible relación entre la supresión de un programa de educación especializada en diabetes y el grado de control metabólico a largo plazo.DiseñoEstudio longitudinal prospectivo en una cohorte.EmplazamientoCentros de atención primaria en 3 comarcas de Cataluña.ParticipantesMuestra aleatorizada de 276 sujetos con diabetes mellitus tipo 2.Mediciones principalesLos pacientes se clasificaron, según el tipo de educación en diabetes (ED) recibida antes del comienzo del estudio, en 2 grupos: especializado (n=59) o convencional (n=217). En todos los sujetos se evaluó la hemoglobina glucosilada (HbA1C) en línea de base y a los 5 años de recibir únicamente educación convencional en diabetes.ResultadosEn la evaluación inicial, el grupo con educación especializada previa mostró mejores concentraciones de HbA1C (p=0,009). La evaluación final no mostró diferencias significativas entre ambos grupos (p=0,679). Comparados con la línea de base, los valores finales de HbA1C en toda la muestra aumentaron de manera significativa (p=0,001). Analizados separadamente, el grupo con educación convencional previa mostró un deterioro no significativo (p=0,058), mientras que el grupo especializado había empeorado significativamente (p=0,001).ConclusionesLos resultados indican que la supresión de niveles especializados de ED puede desempeñar un papel esencial en el deterioro del control metabólico y que la ED convencional no mejora los resultados. La política de salud en atención primaria debería considerar mejorar los niveles de ED mediante una organización más adecuada.AbstractAimsTo evaluate the possible relationships between a health policy decision, in relation to the diabetes education strategies and the metabolic control outcomes.DesignLongitudinal prospective cohort study.ParticipantsA random cohort sample of 276 type II diabetes mellitus subjects.LocationAll primary care centres in three regions of Catalonia.Principal measurementsPatients were classified as specialised (n=59) or non-specialised (n=217) groups, as regards whether having received previous diabetes education before the start of the study. HbA1c values were evaluated in all subjects at baseline and after 5 years after receiving only conventional education.ResultsBaseline evaluation showed a better metabolic control in the specialised group (P=0.009). The final evaluation showed no significant differences in outcomes between the two groups (P=0.679). When baseline and outcomes values were compared, significant differences were observed in all subjects (P=0.001), the specialised group showed significantly poorer metabolic control (P<0.001), but in the group with previous conventional education no significant differences were observed (P=0.058).ConclusionsOur results suggest that the withdrawal of higher levels of diabetes education may play a major role in poor metabolic control, and that conventional diabetes education does not improve outcomes. Health policy in Primary Care should consider improving the level of diabetes education

Evaluation of positive mental health and sense of coherence in mental health professionals

Background: the Sense of Coherence (SOC) of Antonowsky (1996) which is based on salutogenic theory and the multifactor Positive Mental Health (PMH) model of Lluch (1999) provide two constructs for comprehending, evaluating, and intervening in the promotion and maintenance of a good state of mental health. Aim: were assessed self-rated mental health of health professionals working in mental health services and relations between both constructs and sociodemographic, work, and health variables. Methods: the sample was made up of n=102 attending professionals at the mental health units of the Parc Hospitalari Martí i Julià, in Salt, Girona. The variables studied were sociodemographic work-related, health-related, and self-perception of mental health, evaluated by means of the Sense of Coherence questionnaire and the Positive Mental Health questionnaire. The questionnaires were self-administered. Results: overall, the sample studied scored high in the Sense of Coherence and the Positive Mental Health questionnaires. In terms of the relation between the overall scores of the SOC questionnaire and the PMH, analysis revealed a positive relation between the two. Conclusions: this positive relation between the two questionnaires may be of particular interest in future studies of the multifactor model of Positive Mental Health and the salutogenic model that underlies the Sense of Coherence, by generating a global conceptual framework for the study of mental health from a positive perspective

Control of Therapeutic Levels of Anticoagulation and Associated Factors: A Prospective Cohort Study

Teràpia anticoagulant; Vitamin K; Estudis de cohortsTerapia anticoagulante; Vitamin K; Estudios de cohortesAnticoagulant therapy; Vitamin K; Cohort StudiesMaintaining therapeutic levels of anticoagulation is essential to avoid health complications in people who take vitamin K antagonists. This study aimed to analyze the influence of people’s characteristics and the presence of changes in their lives in the control of therapeutic levels of anticoagulation. A longitudinal multicenter study with a 1-year follow-up of a cohort of 199 people receiving anticoagulant therapy was performed. The effect of biological, clinical, social, lifestyle, and changes in life on the international normalized ratio (INR) was analyzed. During the follow-up, 46.7% of participants presented good INR control. At baseline, a diagnosis of atrial fibrillation (P = .00), the lack of comorbidities (P = .03), absence of depression (P = .04), and not following a pharmacological treatment with hypoglycemia drugs (P = .01) were associated with good INR control. During the follow-up, the variable of making changes to the usual diet was associated with poor INR control (P = .05). In the binary multiple regression model, factors associated with poor control were taking hypoglycemia drugs (P = .02) and the presence of depression (P = .04), and only the diagnosis of atrial fibrillation was associated with good control (P = .03). People with a diagnosis of atrial fibrillation had good INR control. Having comorbidities, suffering depression, taking hypoglycemia drugs, and making changes to the diet have a negative effect on INR control

Detección y prevención de violencia contra la mujer en una muestra de estudiantes de enfermería

Justificación. Aunque la violencia durante el noviazgo ha sido poco estudiada, algunas investigaciones revelan que su incidencia puede ser elevada. Su detección precoz es fundamental para realizar una labor preventiva entre los jóvenes. Objetivo. El objetivo de este estudio fue identificar algunas conductas, actitudes y , valores que una muestra de mujeres estudiantes de enfermería atribuía a sus parejas masculinas y que podrían ser precursoras de violencia y abuso. Metodología. Se realizó un estudio descriptivo y transversal mediante encuesta autoadministrada a una muestra de estudiantes de 18 a 24 años, de cinco Escuelas de Enfermería de Cataluña. Se empleó una versión adaptada del Cuestionario de prevención y detección de la violencia durante el noviazgo de G. Ferreira. Las 48 preguntas se agruparon en 11 categorías por tratarse de formulaciones que exploraban cuestiones similares. Resultados principales. Se obtuvieron 390 respuestas. En el momento de la encuesta tenía pareja el 64% de la muestra. Los comportamientos en que el varón: 'Controla. Fiscaliza. Prohíbe', se confirmaron en el 13,9% de las encuestadas. Las 'Amenazas. Insultos' y las conductas en que él 'Aísla. Es antisocial', agruparon el mayor número (95%) de respuestas negativas. Conclusión. Según el estudio se descartan las conductas y actitudes que pueden considerarse precursoras de situaciones de mal trato contra la mujer. El cuestionario con preguntas cerradas puede que deba complementarse con otras técnicas (cualitativas) para obtener una información más fiable y válida

Caregivers' sense of coherence: Implications on direct and indirect costs of dementia care

Background: Dementia care is associated with physical, emotional, and monetary impact on the informal carers providing unpaid care. Differences in the personal characteristics of caregivers may help explain the variations in the costs of dementia care. Objective: The aim of this study was to analyze the effect of caregivers' sense of coherence (SOC) on direct and indirect costs in dementia care. Methods: A cross-sectional study was conducted in community dwelling caregivers of patients with Alzheimer's disease. Data of healthcare services were obtained from clinical registries, and information was collected from caregivers regarding their use of social care resources and time spent caregiving. The transformation of all costs into Euros was made assigning a fixed cost of 10.29€ /h and 16.24€ /h for assisting in instrumental and basic activities of daily living, respectively. Caregivers' SOC was assessed using the Orientation to Life Questionnaire (OLQ-13). Adjusted regression models were developed, with different types of costs as dependent variables. Results: A sample of 147 caregivers was recruited. The mean OLQ-13 score was 73.3 points (SD=11.6). The regression models showed a small association between caregivers' SOC and direct costs, mainly linked to the use of social care resources (r2=0.429; ß=-15.6€ /month), and a greater association between SOC and indirect costs (r2=0.562; ß=-222.3€ /month). Conclusion: Increasing caregivers' SOC could reduce dementia care costs by decreasing the use of social care resources and caregiving time