Social inequalities in multimorbidity patterns in Europe: A multilevel latent class analysis using the European Social Survey (ESS)

Multimorbidity is associated with lower quality of life, greater disability and higher use of health services and is one of the main challenges facing governments in Europe. There is a need to identify and characterize patterns of chronic conditions and analyse their association with social determinants not only from an individual point of view but also from a collective point of view. This paper aims to respond to this knowledge gap by detecting patterns of chronic conditions and their social determinants in 19 European countries from a multilevel perspective. We used data from the ESS round 7. The final sample consisted of 18,933 individuals over 18 years of age, and patterns of multimorbidity from 14 chronic conditions were detected through Multilevel Latent Class Analysis, which also allows detecting similarities between countries. Gender, Age, Housing Location, Income Level and Educational Level were used as individual covariates to determine possible associations with social inequalities. The goodness-of-fit indices derived in a model with six multimorbidity patterns and five countries clusters. The six patterns were "Back, Digestive and Headaches", "Allergies and Respiratory", "Complex Multi -morbidity", "Cancer and Cardiovascular", "Musculoskeletal" and "Cardiovascular"; the five clusters could be associated with some geographical areas or welfare states. Patterns showed significant differences in the cova-riates of interest, with differences in education and income being of particular interest. Some significant dif-ferences were found among patterns and the country groupings. Our findings show that chronic diseases tend to appear in a combined and interactive way, and socioeconomic differences in the occurrence of patterns are not only of the individual but also of group importance, emphasising how the welfare states in each country can influence in the health of their inhabitants

Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic

Background: The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities. Methods: This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model. Results: We obtained a model with five patterns (entropy = 0.727): ‘Relative Healthy’, ‘Cardiometabolic’, ‘Musculoskeletal’, ‘Musculoskeletal and Mental’, and ‘Complex Multimorbidity’. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression. Conclusions: We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments17 página

Evolución del perfil del enfermo alcohólico durante los últimos veinte años

El estudio se ha llevado a cabo con una muestra de 386 pacientes atendidos en los servicios ambulatorios de alcoholismo de Cruz Roja de Cádiz. Se trata de un estudio descriptivo de la evolución del perfil, sociodemográfico del enfermo alcohólico en los últimos veinte años.La muestra la comprende dos grupos de enfermos: el primero está formado por pacientes que asistieron a consulta durante el trienio 1980-1982 y el segundo dos décadas después (1997-1999). El propósito era observar si variables como sexo, edad, estado civil, nivel de estudios, desempleo, etc. experimentaban algún cambio significati¬vo del primer al segundo periodo.La investigación se realizó mediante un estudio retrospectivo longitudinal extra¬yendo los datos de las historias clínicas de los pacientes y de las FI.B.A.T. (Ficha de Información Básica de Admisión a Tratamiento) utiliza por los servicios de drogodependencia del comisionado de droga de la Junta de Andalucía.La investigación reveló cambios importantes en el perfil del enfermo alcohólico de finales del siglo XX

The relationship between characteristics of nurses and their attitude toward nursing diagnosis: a cluster analysis

Aims and objectives To classify a sample of nurses into groups with similar attitude towards nursing diagnosis (ND), using the cluster analysis method, to explore differences in the characteristics between the identified profile groups. The characteristics tested included sociodemographic and professional aspects, and the degree of contact with ND. Methods A cross-sectional explorative design was used in a convenience sample of 548 registered nurses (RNs) was recruited through snowball sampling between the contacts of collaborators of the research group. It was used the Nursing Diagnosis Scale (PND): a 20-item scale that uses the semantic differential method to assess attitudes towards ND. Descriptive statistics were used to summarise data. A hierarchical cluster analysis was employed to categorise the participants into mutually exclusive clusters with similar attitude profiles based on their responses to the 20 items of the PND. Results A three-cluster solution was considered the most suitable. Clusters 1, 2 and 3 comprise RNs with positive, neutral and negative attitudes towards ND, respectively. Conclusion RNs who work in the management field show a better attitude. The increasing awareness of the Spanish managers regarding the benefits of the use of ND in practice could be related to this finding. Contact with ND appears to be a common factor among nurses with positive attitudes; the greater the interaction with ND by nurses, the better the attitudes

A forma abreviada da escala posições frente ao diagnóstico de enfermagem: desenvolvimento e avaliação psicométrica

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.El Position on Nursing Diagnosis (PND) es una escala que utiliza la técnica del diferencial semántico para medir las actitudes hacia el concepto diagnóstico enfermero. El estudio objetivó desarrollar una forma abreviada de la versión española de esta escala, evaluar sus propiedades psicométricas y eficiencia. Se utilizó un doble enfoque empírico-teórico para obtener una forma reducida del PND, el PND-7-SV, que fuera equivalente a la original. Mediante un diseño transversal a través de encuesta, se evaluó la fiabilidad (consistencia interna y fiabilidad test-retest), validez de constructo (análisis factorial exploratorio, técnica de grupos conocidos y validez discriminante) y de criterio (validez concurrente), sensibilidad al cambio y eficiencia del PND-7-SV en una muestra de 476 estudiantes de enfermería españoles. Los resultados avalaron la utilidad del PND-7-SV para medir las actitudes hacia el diagnóstico enfermero de manera equivalente a la forma completa de la escala y en un tiempo más reducido