Social and health services offer in Primary Care attention of people older than 65

Rincón científico.La consolidación de poblaciones envejecidas en los países desarrollados, y concretamente en España, ha situado en primer plano la preocupación por la atención que recibe este grupo demográfico, tanto en lo que se refiere al aspecto social como al sanitario. El objetivo de este estudio es describir los servicios sociosanitarios y programas ofertados para la atención en domicilio de la población a partir de los 65 años. Este es un estudio descriptivo transversal realizado en 190 una muestra de conveniencia en las comunidades autónomas (CC.AA.) de Aragón, Baleares, Castilla y León, Navarra, Madrid y Cataluña durante el año 2004 a través de un cuestionario semiestructurado destinado a identificar servicios sanitarios y servicios sociales. En conjunto los programas y servicios sociosanitarios ofertados a esta población son muy similares en las CC.AA. estudiadas, pero existen diferencias en el grado de implantación de los mismos. Esto podría indicar que los cuidados llegan a la población de forma desigual según su lugar de residencia, con las consiguientes desigualdades en la atención recibida y por tanto con posibles desigualdades en salud, calidad de vida y bienestar.El presente trabajo forma parte del Proyecto Científico de la Red Temática de Investigación Cooperativa en Cuidados a Personas Mayores RIMARED (2003-2005) y financiado por el Fondo de Investigación Sanitaria. (G03/100).S

Influence of previous mental state on psychological outcomes of Spanish out-of-hospital professionals during the COVID-19 pandemic

Producción CientíficaThis study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student’s t-test for independent samples, one-way ANOVA, Pearson’s correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority

Psychological impact of the COVID-19 pandemic on out-of-hospital health professionals: A living systematic review

Producción CientíficaHealth professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs

Percepción del nivel de autoeficacia en los profesionales sanitarios de la gerencia de emergencias sanitarias de Castilla y León durante la pandemia Covid-19

Health emergency personnel in Castilla y León have been part of the first line of care in the COVID-19 pandemic, being one of the groups most exposed to contagion. Determining the degree of self-efficacy that these workers perceive of themselves gives us an idea of their ability to adapt and cope with this adverse event. The aim of the study was to establish the level of self-efficacy perception in healthcare professionals of the Gerencia de Emergencias Sanitarias de Castilla y León during the COVID-19 pandemic, as well as the relationship of self-efficacy with other variables. The methodology used was quantitative and descriptive through surveys. The sample of volunteers is 253 participants. Out-of-hospital professionals obtain a mean score in their level of self-efficacy of 72.36 ± 15.80. A higher score is observed in older professionals, with greater professional experience in the extra-hospital setting, who work in direct care with patients, who have not previously received psychological treatment or who have received some dose of the SARS-CoV-2 vaccine Theself-efficacy of out-of-hospital professionalsis good, finding factorsrelated to a higher or lower level. These results show the ability of these professionals to adapt to adverse situations such as the COVID-19 pandemic.El personal de emergencias sanitarias de Castilla y León ha formado parte de la primera línea asistencial durante la pandemia por COVID-19, siendo uno de los grupos más expuestos al contagio. Determinar el grado de autoeficacia que estos trabajadores perciben de sí mismos nos da una idea de la capacidad de adaptación y afrontamiento que han tenido ante este evento adverso. El objetivo deestudio hasido establecerel nivel de percepción en autoeficaciaen los profesionales sanitarios de la Gerencia de Emergencias Sanitarias de Castilla y León durante la pandemia por COVID-19, así como su relación con otras variables. La metodología empleada es cuantitativa de tipo descriptiva a través de encuestas. La muestra de voluntarios es de 253 participantes. Los profesionales de extrahospitalaria obtienen una puntuación media en su nivel de autoeficacia, de 72.36 ± 15.80. Se observa una mayor puntuación en los profesionales de mayor edad (p=0.030), con una mayor experiencia profesional en el ámbito extrahospitalario (p<0.001), que trabajan en asistencia directa con pacientes (p=0.028), que no han recibido previamente tratamiento psíquico (p=0.014) o que han recibido alguna dosis de la vacuna contra el SARS-CoV-2 (p=0.002). La autoeficacia de los profesionales de extrahospitalaria es buena, existiendo factores que se relacionan con un mayor o menor nivel. Los resultados ponen de manifiesto la capacidad de adaptación de estos profesionales ante situaciones adversas como la vivida durante la pandemia por la COVID-19.

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (GSES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.This research was funded by Fundación ASISA and Sociedad Española de Urgencias y Emergencias (SEMES)

Oferta de servicios sociosanitarios en Atención Primaria para la atención a mayores de 65 años Social and health services offer in Primary Care attention of people older than 65

La consolidación de poblaciones envejecidas en los países desarrollados, y concretamente en España, ha situado en primer plano la preocupación por la atención que recibe este grupo demográfico, tanto en lo que se refiere al aspecto social como al sanitario. El objetivo de este estudio es describir los servicios sociosanitarios y programas ofertados para la atención en domicilio de la población a partir de los 65 años. Este es un estudio descriptivo transversal realizado en 190 una muestra de conveniencia en las comunidades autónomas (CC.AA.) de Aragón, Baleares, Castilla y León, Navarra, Madrid y Cataluña durante el año 2004 a través de un cuestionario semiestructurado destinado a identificar servicios sanitarios y servicios sociales. En conjunto los programas y servicios sociosanitarios ofertados a esta población son muy similares en las CC.AA. estudiadas, pero existen diferencias en el grado de implantación de los mismos. Esto podría indicar que los cuidados llegan a la población de forma desigual según su lugar de residencia, con las consiguientes desigualdades en la atención recibida y por tanto con posibles desigualdades en salud, calidad de vida y bienestar.The consolidation of aged population in developed countries, specially in Spain, has located the preoccupation of the attention that this demographic group receives in first place, regarding social and health care.The objective of this study is to describe the social and health services programs supplied to attend the population of 65 years and older at home. This is a cross-sectional descriptive study made in a sample of convenience in autonomous communities (CC.AA.) of Aragon, Balearic Islands, Castile-Leon, Navarre, Madrid and Catalonia, during the year 2004, through a semistructured questionnaire destined to identify health and social services. Altogether the programs and health and social services offered to this population are very similar in the studied CC.AA., however, there are some differences in the degree of implantation of such services. This could indicate that the care that this population receives is unequal depending of their place of residence, with the consequent inequalities in the attention they receive regarding health, quality of life and well-being

Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study

Abstract Background The COVID-19 pandemic had a major psychological impact on health care workers (HCWs). This study was embedded in a larger quantitative study on the mental health care of out-of-hospital HCWs in Spain. To better understand this, a qualitative study was conducted to explore the experiences, coping strategies, and influencing factors of out-of-hospital HCWs who scored high (> 25 points) on the Depression Anxiety Stress Scale (DASS-21) in a previous quantitative mental health study. Methods A qualitative study was conducted using six in-depth interviews with individuals who scored high on the depression scale and agreed to be contacted by email between May and June 2021, using the phenomenological approach. The data were analysed using Brawn and Clare’s method. Results The main results findings related to four themes. The emotional impact of assuming a professional role with high self-demands and responsibilities; Factors influencing the development of negative emotions such as the cruelty of the pandemic, the helplessness in relation to health management and policy, the changing role of the professional and the relationship with society; Personal protection through coping strategies to manage negative emotions such as support from colleagues and family; Good practices for the future looking for different management strategies that can influence individuals and their personal, professional, and social relationships. Conclusion The strong impact of the circumstances experienced points to the need to develop psychological support programmes that can protect people’s mental health from depression during a crisis and improve the relationship between workers and their managers

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (GSES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.Sin financiación4.964 JCR (2021) Q2, 55/172 Medicine, General & Internal1.040 SJR (2021) Q1, 438/2489 Medicine (miscellaneous)No data IDR 2021UE

Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care

To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services. Design: Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February–30 April, 2021). The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health. The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care. Conclusions: Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality. The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). Patient or Public Contribution: ‘No patient or public involvement’This work was partially supported by Asistencia Sanitaria Interprovincial de Seguros - ASISA Foundation in Spain. The article is part of a transformative agreement between the University of Burgos and the publishing house Wile