Effects of the COVID-19 pandemic on the mental health of rehabilitation area professionals: A systematic review.

Background: The role of the physiotherapist is vital in the recovery of post-COVID-19 patients, but fear of contagion is a possible feeling among healthcare professionals. The objective of this study is to assess the mental health effects that COVID-19 has had on healthcare workers, including rehabilitation care, in times of pandemic. Methods: A systematic review was conducted using the PRISMA format in the Pubmed, SCOPUS, and Web of Science databases between July and September 2022. Keywords included were "healthcare providers," "COVID-19," "Mental Health," and "Psychological Distress." Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: A total of 14 studies were included in this review. The study population was healthcare professionals including the rehabilitation services. In total, 4 studies reported exclusively on anxiety and stress levels in physiotherapists providing care during the pandemic. Conclusions: The mental health of healthcare professionals has been compromised during the pandemic. However, initially, research was only focused on physicians and nurses, so the need arises to include those professionals, such as physiotherapists, who are also in direct contact with COVID-19 patients. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367664, identifier: CRD42022367664.

Modulating factors of fibromyalgia in women during the COVID-19 pandemic: A protocol for systematic review.

BACKGROUND: Fibromyalgia is a disease that affects mostly women and is related to stressors. The aim of this study was to assess how the Coronavirus disease 2019 pandemic has affected women with fibromyalgia. METHODS: A systematic review was conducted in the PubMed, ScienceDirect, and Springer Link databases, following the recommendations of the preferred reporting items for systematic reviews and meta-analyses statement. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools for non-randomized studies. RESULTS: A total of 6 studies were included. Most results indicated a worsening in the mental health of women with fibromyalgia during the pandemic, and this in turn impacted on physical health. CONCLUSION: The mental health of women with fibromyalgia was more affected during the Coronavirus disease 2019 pandemic period than that of non-fibromyalgia sufferers. This was also reflected in the worsening of symptoms and weakness in performing daily activities.

[Ethical dimensions of prevention and planning in assisted-living facilities during the SARS-CoV-2 pandemic (Covid-19): a public health emergency.] / Dimensiones éticas de la prevención y planificación en los centros sociosanitarios durante la pandemia por SARS-CoV-2 (Covid-19): una emergencia de salud pública.

The SARS-CoV-2 pandemic (Covid-19) has had a major impact on residents of assisted-living facilities. While it is plausible that the characteristics of these patients and their special clinical fragility have contributed to their greater vulnerability to infection, other related factors cannot be ruled out, such as the quality of management at these centers and the lack of planning for actions taken before and during the health crisis. Both aspects pertain to the field of public health, where the ethics of the common good conflicts with the autonomy of the individual.

La pandemia por SARS-CoV-2 (Covid-19) ha tenido un gran impacto en los residentes de centros sociosanitarios. Es probable que las características de estos pacientes y su especial fragilidad clínica hayan contribuido a una mayor vulnerabilidad a la infección, pero no se pueden descartar otros factores asociados a la misma como son la gestión de los centros y la falta de planificación de las actuaciones antes y durante la crisis sanitaria. Ambos aspectos pertenecen al ámbito de la salud pública, donde la ética del bien común entra en conflicto con la autonomía de las personas.

[Perceived self-efficacy in patients after a cardiac rehabilitation programme in primary care: A new model of attention.] / Autoeficacia percibida en pacientes tras programa de rehabilitación cardíaca en Atención Primaria: un nuevo modelo de atención.

OBJECTIVE: The literature points to the possibility of carrying out an intervention, from primary prevention to rehabilitation after a cardiac event, towards decreasing the incidence of such cardiac events and facilitating the return to daily life. The objective was to determine the effect of a cardiac rehabilitation intervention over perceived selfefficacy for patients who have suffered a cardiac event. METHODS: A community clinical trial, open, controlled, and randomised, was designed, and performed in primary care. To determine the sample size, the research team used the General Self-Efficacy Scale by Baessler and Schwarzer. The mean difference between groups considered of clinical relevance was of at least 6 points in the aforementioned General Self-Efficacy Scale. A precision of 95% and a test power of 80% were accepted. The result proposed a sample of 44 subjects in each group. Over 12 months, all subjects of legal age (N = 104), both sexes, that had concluded phase II in the cardiac rehabilitation unit of the university Hospital Puerta del Mar (Cadiz) were offered to participate in the study. The patients were informed about the study development, asking for their participation and providing them with a written informed consent. The subjects were randomly assigned to the intervention or control group through blind allocation (in a sealed envelope to the researcher), on a pre-set 2:1 ratio (two patients assigned to the intervention group to one assigned to the control group). A non-response or rejection to participate in the study record was made for the non-response analysis. RESULTS: A total of 89 subjects were included in the statistical analysis (response rate of 85.57%), with an average age of 63.01 years (SD: 8.75). The main dependent variable was the scores difference between groups, comparing means before and after the intervention, through the General Self-Efficacy Scale by Baessler & Schwarner. A mean difference of 6.0972 points was obtained between the intervention and the control groups (p<0.0053; 95% CI -4.1950 to -10.29), as a result of a 3.3750 mean points increase (standard deviation: 7.01) in the intervention group and a 3.3750 mean points decrease (standard deviation: 7.19) in the control group. In relation to the possible changes to be detected through the Hamilton anxiety scale and the Beck's depression inventory, after finishing the intervention, an estimate and contrast of population means was made between groups for the scores difference in the Hamilton scale, determined on the final visit, with no significant differences found (t-student 0.1211; p <0.9 43). Similarly, no significant differences were found between the groups for the means obtained in the variable "Beck's depression inventory scores difference" (t-student -0.1281; p<0.8987). CONCLUSIONS: The inclusion in cardiac rehabilitation programmes carried out in primary care improves the general perceived self-efficacy of patients who have suffered cardiac events.

OBJETIVO: La literatura evidencia la posibilidad de intervención, desde la prevención primaria hasta la rehabilitación tras un evento cardiaco, y así disminuir su incidencia y facilitar la reincorporación a la vida cotidiana. El objetivo de este trabajo fue determinar el efecto sobre la autoeficacia percibida de una intervención en rehabilitación cardiaca a pacientes que han sufrido evento cardíaco. METODOS: Se diseñó un ensayo comunitario abierto, controlado y aleatorizado, realizado en atención primaria de salud. Para determinar el tamaño de muestra, el equipo de investigación utilizó la Escala General de Autoeficacia de Baessler y Schwarzer. La diferencia de medias entre grupos considerada como clínicamente relevante fue de al menos 6 puntos en la puntuación de la Escala General de Autoeficacia. Se aceptó una precisión del 95% y un poder del test del 80%. El resultado propuso una muestra de 44 sujetos en cada grupo. Se propuso participar, a lo largo de 12 meses, a todos los sujetos, mayores de edad (N= 104), de ambos sexos, que concluyeron la fase II en la unidad de RHC del Hospital Universitario Puerta del Mar (Cádiz). Se informó a los pacientes de la realización del estudio pidiéndoles su participación y ofreciendo consentimiento informado por escrito. De forma aleatoria, los sujetos fueron asignados aleatoriamente, siendo esta asignación de forma ciega (en sobre cerrado al investigador), al grupo de intervención o de control, mediante una proporción preestablecida 2:1 (dos pacientes a asignados a grupo intervención por uno a grupo control. Se realizó un registro de la no respuesta o rechazo a participar en el estudio para el análisis de la no respuesta. RESULTADOS: Un total de 89 sujetos fueron incluidos en el análisis estadístico (tasa de respuesta de 85, 57%), con una edad media de 63, 01 años, (DE 8, 75). La variable dependiente principal fue la diferencia de puntuación entre grupos, comparando medias, antes y después de la intervención, en la escala general de autoeficacia de Baessler & Schwarner. Se obtuvo diferencia de medias de 6.0972 puntos entre los grupos de intervención y de control (p<0.0053, IC 95% -4.1950 a -10.29), resultado de un aumento de 3.3750 puntos de media en el grupo de intervención (desviación estándar 7.01), y un descenso de 2.7222 puntos de media (desviación estándar 7.19), en el grupo de control. En relación a los posibles cambios a detectar en las escalas de ansiedad de Hamilton e inventario de depresión de Beck, tras finalizar la intervención, se realizó una estimación y contraste de medias poblacionales entre grupos para la diferencia de puntuaciones en la escala de Hamilton, determinadas en la visita final, no encontrándose diferencias significativas (t student 0.1211; p<0.9 43). De igual forma, no se encontraron diferencias significativas entre grupos para las medias obtenidas en la variable "diferencia de puntuación en inventario de Beck en depresión" (t student -0.1281; p<0.8987). CONCLUSIONES: La inclusión en los programas de rehabilitación cardiaca realizados en atención primaria mejora la autoeficacia general percibida de pacientes que han sufrido eventos cardíacos.