Psychometric adaptation of the Spanish version of the Brief Pittsburgh Sleep Quality Index in adolescents.

OBJECTIVE: Good sleep quality is essential for adolescent health, yet sleep difficulties persist in this age group. The 6-item Brief Pittsburgh Sleep Quality Index (B-PSQI) was recently developed to improve sleep quality assessment, however, its validity in adolescents remains unexplored. This study examined the B-PSQI's psychometric properties in Spanish adolescents and adapted the scoring method to age-specific sleep recommendations. METHODS: A cross-sectional study involving 1,065 adolescents (15-17 years; 56.8% female) was conducted in public high schools. Sleep quality was measured using the B-PSQI, the Insomnia Severity Index (ISI), the short Patient-Reported Outcomes Measurement Information System (PROMIS), and the Epworth Sleepiness Scale (ESS). Additionally, depression and anxiety were assessed using the Depression, Anxiety, and Stress Scales. Reliability, validity, and measurement invariance were analyzed. RESULTS: The B-PSQI global scores were 4.5 (SD = 1.9) for the original scoring method and 5.4 (SD = 2.8) for the age-adjusted. The age-adjusted B-PSQI showed satisfactory reliability (ω = 0.84) and concurrent, convergent, and discriminant validity (ISI rS = 0.67; PROMIS rS = 0.71; anxiety rS = 0.40; depression rS = 0.42; ESS rS = 0.29). Adequacy for one-factor structure (χ2(4) = 53.9; CFI = 0.97; TLI = 0.92; RMSEA = 0.108; SRMR = 0.05) and invariance across sexes were supported. Both B-PSQI scoring methods showed similar psychometric properties, but the original yielded a higher percentage of poor sleepers (43.1%; cutoff ≥5) than the age-adjusted version (41.9%; cutoff ≥6). CONCLUSIONS: Findings suggest that the B-PSQI is a valid and reliable measure to assess adolescent sleep quality. Its scoring can be adjusted to provide age-specific criteria for good sleep. The B-PSQI has potential utility for screening sleep problems and facilitating overall health promotion in adolescents.

Effectiveness of the Brief Guided Self-Change Therapy Combined with Varenicline under "Real-Life" Conditions and Mediators for Smoking Cessation.

Background: Brief therapies have proven to reduce tobacco cost-effectively, however, unsuccessful quit attempts remain notable in real-life conditions, and the underlying mechanisms of treatment success are still unclear. Objectives: We aimed to analyze the effectiveness of the Guided Self-Change (GSC) therapy combined with varenicline (VAR+T) in public health services against varenicline alone (VAR), and to identify mediators of treatment outcomes. We conducted a two-arm quasi-experimental study with 126 treatment-seeking smokers (age=57.3±9.1 years; 59.5% women). Before treatment, and at weeks 12 and 24, we assessed tobacco use and five potential mediators: withdrawal, craving, motivation to quit, anxiety, and depression. Results: Only 25% of participants adhered to varenicline prescription, and 54% to GSC therapy. VAR+T group showed a greater proportion of abstainers compared to VAR group at week 12 (75% vs 57.4%; φc=0.21) and week 24 (62.9% vs 52.5%; φc=0.10). When controlling for weeks taking varenicline, motivation showed a significant indirect effect over abstinence rates in VAR+T compared with VAR (a1b1=1.34; 95%CI=0.04, 5.03). Conclusions: The GSC effectiveness seems to increase motivation which in turn contributes to reducing tobacco use. The implementation of GSC therapy in public health services could minimize treatment duration and increase smoking abstinence in 'real-life' conditions where varenicline adherence remains low.

Barriers for identification and treatment of problem drinkers in primary care.

OBJECTIVE: Due to the lack of studies in the Spanish population, this study aims to analyze the barriers perceived by health professionals from different Spanish health centers when attempting to identify and treat problem drinkers and the importance given to this aspect, as well as analyzing the possible differences as a function of the professionals' health teams. We also analyze the psychometric properties of the questionnaire used to assess these barriers. METHOD: The participants included 107 health professionals: 62.7% belonged to the medical team and 32.4% to the nursing team. After we had reviewed previous studies, collecting the main barriers referred to in them, participants completed an ad hoc questionnaire. RESULTS: The main barriers found were the belief that patients will lie about their actual consumption and will not identify its negative consequences, and the belief that they will reject participating in an intervention for their alcohol consumption. No significant differences between doctors and nurses were found in any of the barriers assessed. The results provide empirical evidence of the reliability of the test for the assessment by both teams of professionals. CONCLUSIONS: Studies are needed to examine in greater depth these conclusions, extending the number of variables studied to determine a more complete profile of the health professionals who are reluctant to incorporate the assessment and treatment of problem drinkers in their consultation. This could help to improve the design of programs to facilitate and encourage its implementation in primary care.