Disability indicators in the Spanish Disability, Impairment and Health Survey

Fundamento: La medida y significado de la discapacidad dependen de los indicadores que se utilicen. El objetivo de este estudio es examinar los indicadores de dependencia y discapacidad residual severa en dos niveles: en cada una de las 14 actividades de la vida diaria (AVD) seleccionadas, y como puntajes sumarios de recuento de actividades. Métodos: Los datos proceden de la Encuesta de Discapacidades, Deficiencias y Estado de Salud (INE, 1999). La muestra se compone de los 8.779 registros correspondientes a las personas de 65 y más años con discapacidad en alguna de las 14 AVD seleccionadas. Se han creado tablas de proporciones y de contingencia, se han calculado estadísticos de asociación y concordancia, y se ha analizado la dimensionalidad de las medidas agregadas mediante el análisis factorial de información completa. Resultados: Las principales discrepancias entre los indicadores se concentran en las actividades de movilidad (los coeficientes Kappa oscilaron entre 0,50 y 0,71 en actividades de movilidad y entre 0,73 y 0,87 en actividades domésticas y autocuidados). La discapacidad residual severa (indicador seleccionado por el INE) frente a la dependencia más incapacidad incluye a más personas discapacitadas en movilidad y excluye a más personas discapacitadas en actividades domésticas y autocuidados. Dependencia más incapacidad es el indicador con mayor validez interna como medida agregada de discapacidad (dos autovalores: 8,37 y 1,91; 56,3 % varianza del primer factor, saturaciones del primer factor entre 0,58 y 0,87). Conclusiones: La dependencia más la incapacidad es un indicador más valido que la discapacidad residual severa como indicador principal de discapacidad.Background: The measurement and meaning of disability depend on the indicators used. In this study the indicators of dependency and severe residual disability are examined on two levels: in each of the 14 selected activities of daily living (ADL) and also as a summary score of the activities count. Methods: The data are extracted of the Disability, Impairment and Health Survey (INE, 1999). The sample is composed of 8.779 entries corresponding to people over 65 years old with disability in some of the 14 selected ADL. Tables of proportions and contingency have been elaborated, statistics of association and agreement has been calculated and the dimensionality of the aggregated measures had been analyzed through the full information factor analysis. Results: The main discrepancies between the indicators are concentrated on the mobility activities (kappa coefficients ranged between 0,50 to 0,75 for mobility activities and between 0,73 to 0,87 for domestic activities and self-care). Severe residual disability (indicator selected by the National Institute of Statistics) compared to dependency more inability includes more mobility disabled people and excludes more disabled people in domestic activities and self-care. Dependency more inability is the indicator with the highest validity as a summary measure of disability (two eigenvalues: 8,37 and 1,91, the first factor accounted for 56,3% of the variance, the saturations of the first factor ranged between 0,58 to 0,87). Conclusions: Dependency more inability is more valid than severe residual disability as main indicator of disability

Indicadores de discapacidad en la Encuesta de Discapacidades, Deficiencias y Estado de Salud

La medida y significado de la discapacidad depende de los indicadores que se utilicen. El objetivo de este estudio es examinar los indicadores de dependencia y discapacidad residual severa en dos niveles: en cada una de las 14 actividades de la vida diaria (AVD) seleccionadas, y como puntajes sumarios de recuento de actividades. Los datos proceden de la Encuesta de Discapadicades, Deficiencias y Estado de Salud (INE, 1999). La muestra se compone de los 8.779 registros correspondientes a las personas de 65 y más años con discapacidad en alguna de las 14 AVD seleccionadas. Se han creado tablas de proporciones y de contingencia, se han calculado estadísticos de asociación y concordancia, y se ha analizado la dimensionalidad de las medidas agregadas mediante el análisis factorial de información completa. Las principales discrepancias entre los indicadores se concentran en las actividades de movilidad (los coeficientes Dappa oscilaron entre 0.50 y 0.71 en actividades de movilidad y entre 0.73 y 0.87 en actividades domésticas y autocuidados). La discapacidad residual severa (indicador seleccionado por el INE) frente a la dependencia más incapacidad incluye a más personas discapacitadas en movilidad y excluye a más personas discapacitadas en actividades domésticas y autocuidados. Dependencia más incapacidad es el indicador con mayor validez interna como medida agragada de discapacidad (dos autovalores: 8.37, y 1.91; 56.3% varianza del primer factor, saturaciones del primer factor entre 0.58 y 0.87). La dependencia más la incapacidad es un indicador más valido que la discapacidad residual severa como indicador principal de discapacidad

La prevalencia del estrés laboral asistencial entre los profesores universitarios

El burnout, o estrés laboral asistencial, es un síndrome psicológico caracterizado por agotamiento emocional (CE), despersonalización (DP) e insatisfacción personal con los logros (RP). Se conoce poco acerca de la presencia de este síndrome en muestras representativas de profesores universitarios. Los objetivos del estudio son (a) conocer la prevalencia del burnout en un contexto universitario, (b) examinar la presencia del burnout en relación con la edad, género y categoría académica en un estudio transversal mediante cuestionario anónimo enviado por correo, y (e) explorar la relación entre el burnout y diversas variables de calidad de vida, satisfacción laboral y salud. Respondieron el cuestionario un total de 331 profesores en el contexto de un programa de calidad de vida de la Universidad de Alicante (España), lo que supone una tasa de respuesta del 56,2%. Se remitieron por correo a todos los profesores, seleccionados al azar del conjunto de todos los centros, un ejemplar del cuestionario junto con las instrucciones y sobre de devolución. El estrés laboral asistencial se midió a través del Maslach Burnout lnventory (MBI) estableciéndose una situación definida por altas puntuaciones en CE y DE, y bajas en RP. Este instrumento presenta un total de 22 ítems con siete alternativas de respuesta, desde 0 (nunca experimento este sentimiento) hasta 6 (todos los días experimento este sentimiento). Nuestros resultados muestran que un reducido porcentaje de profesores, el 1,8%, experimentan el síndrome de burnout. Cuando se analizan por separado las tres dimensiones que componen el burnout se observa que un 17,8% de los profesores se siente emocionalmente exhausto en su trabajo (puntuación e» 25), un 4,2% ha desarrollado una actitud negativa hacia los estudiantes puntuación e» 10), y un 42% se siente un escasa autorrealización personal en el trabajo (puntuación d»32). CE presenta unas correlaciones medias moderadas con las variables de salud (r= 0.42) y con calidad de vida (r=0.33). Un patrón relacional menos consistente se da en las restantes dimensiones del burnout. La edad, el género y la categoría académica de los profesores no se relacionan con los niveles de burnout. Se concluye que el burnout es un síndrome poco común en profesores universitarios.Burnout is a psychological syndrome of emotional exhaustation (EE), despersonalization (DP) and a sense of low personal accomplishment (PA). Little is known about burnout phenomenon in university professors. The purposes of the study were: (a) to provide an estimate of the prevalence of burnout within a university environment, (b) to examine the prevalence of burnout in relation to the age, gender and faculty rank in a cross-sectional study using an anonymous, mailed survey, and (e) to explore burnout's relationship to self-reported quality of life, job satisfaction and health variables. A total of 331 professors from a university-based quality of life program in University of Alicante (Spain) responded to the survey, which corresponds to a 56.2% response rate. For the university sample, professors were randomly selected from a master list comprising all faculties. Copies of the questionnaire, together with instructions and a return envelope were mailed to each faculty member. Burnout was measured using the Maslach Burnout lnventory (MBI) and was defined as scores in the high range on the emotional exhaustation and despersonalization subscales and scores in the low range on the personal accomplishment subscales. The 22-item instrument is structured on a 7-point fully anchored scale ranging from 0 (feeling has never experienced) to 6 (feeling is experienced daily). The university sample who met criteria for burnout is 1. 8%. The responding university professors had the following percentages on the MBI: for EE, 17.8% (a score e» 25 is considered high); for DE, 4.2% (a score e» 10 is considered high); for PA, 42% (this subscale has an inverse relationship to burnout and a score d» 32 is considered low). Findings were consistent in demonstrating a moderate correlation between EE and health (r mean= 0.42) or with quality of life (r mean= 0.33). Relationships between the other burnout dimensions exhibited a much less consistent pattern. Age, gender and faculty rank were not associated with burnout. As conclusion, burnout was uncommon among university professors

Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain

Purpose The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). Methods We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. Results GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53–31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42–17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. Conclusions GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Natur

What Is Privacy? Perceptions of Older Adults in the South of Spain About the Concept of Privacy and in Terms of Video-Based AAL Technologies

Privacy is a very complex concept that concerns all areas of human activity. Even more so, it has acquired whole new importance and has become a hot-button topic in the era of ubiquitous computing. The emergence of Active and Assisted Living (AAL) technologies is offering the improvement of the quality of life and maintaining the independence of older adults in their preferred environment. Especially with the advancement of computer vision, video-based technological solutions are giving us promising results but bring along significant risks of privacy violation. With this qualitative study, we aim to explore older adults’ understanding of privacy as a construct and their privacy considerations for technology-based monitoring applications in eldercare, for video-based systems among them. Exploratory interview sessions were conducted with 12 older adults 66 and plus of age living in care homes and in private households. Findings indicate that the concept of privacy is indeed difficult to understand and define for older adults. However, the context of video monitoring elicits clear privacy concerns. The nudity aspect of privacy was proved to be the most important among the participants, yet, the attitudinal shift in the perception of nudity was observed in older adults living in care homes. Eight out of 12 interviewed older adults did not like the idea of having a camera-based assistive technology, however, some of their worries were alleviated after explaining to them the possible technology’s inherent privacy-preserving techniques.This work is funded by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 861091 for the visuAAL project

The impact of volunteering in mental health settings on nursing students' attitudes

Nursing faculties are working to improve students’ attitudes towards mental illness and people with severe mental illness, given the repercussions a lack of knowledge and negative attitudes may have on the quality of care. Complementing undergraduate programmes with volunteering activities affords students the opportunity to interact with people with a severe mental illness, and allow them to develop positive attitudes and overcome prejudice. Aim: to explore and deepen in nursing students attitudes prior to and following volunteering on an Acute Mental Health Inpatient Unit. By means of mixed methods approach, students were assessed at two time points by questionnaires including “Community Attitudes to Mental Illness” and “Semantic Differential”, and by testimonies gathered from interviews. Positives changes in attitudes were identified and monitored over time capturing a destigmatizing tendency. The participation in educational strategies such as volunteering in Acute Mental Health Inpatient Unit, complementary to undergraduate programmes and clinical placements in mental health, allows nursing students to develop more diversified and positive attitudes towards mental illness and people with severe mental illness. The impact of an interventional education strategy is not as powerful in nursing students as it might be in students of other non-healthcare oriented university degrees due to their baseline attitudes.The present study received financial assistance via the ‘Programa de Redes-I 3CE’ research program for university training from the ‘Instituto de Ciencias de la Educación’ at the University of Alicante (2016-17); Reference No: 3720

Predictors of childbirth experience: Prospective observational study in eastern Spain

Background. In recent years, birth experience has been highlighted by national and international organisations as a relevant value in measuring maternal health care quality. According to a standardised tool, we aimed to assess which clinical indicators had the most significant influence on the birth experience. Methods. This prospective observational study was carried out in fourteen hospitals in eastern Spain. 749 women consented to the collection of birth variables at discharge, and subsequently, at 1-4 months, data were collected on the birth experience as measured by the Spanish version of the Childbirth Experience Questionnaire. Next, a linear regression analysis was performed to determine which clinical birth indicators greatly influence the birth experience measure. Result. The study sample (n = 749) was predominantly Spanish and primipara, with 19.5% vaginal births. The predictors that emerged in the linear regression model were to have a birth companion (B = 0.250, p = 0.028), drink fluids during labour (B = 0.249, p < 0.001), have early skin-to-skin contact (B = 0.213, p < 0.001) and being transferred to a specialised room for the second stage of labour (B = 0.098, p = 0.016). The episiotomy (B = -0.100, p < 0.015) and having an operative birth (B = -0.128, p < 0.008) showed a negative influence. Conclusion. Our study supports that intrapartum interventions recommended according to clinical practice guidelines positively influence the mother's birth experience. Episiotomy and operative birth should not be used routinely as they negatively influence the birth experience.This work has been funded by the Project PI11/02124 and PI14/01549 within the Government R&D&I plan 2013–2016 and co-funded by ISCIII General Sub-Directorate for Evaluation and Promotion of research the European Regional Development Fund (FEDER) "A way to make Europe"