Attitudes of Spanish mental health professionals towards trans people: A cross-sectional study.

WHAT IS KNOWN ABOUT THE SUBJECT?: The trans community perceives barriers to the mental health services in the form of professionals' transphobia, lack of knowledge, and cultural sensitivity in healthcare. The attitudes of health professionals are mediated by their social context, which can determine their behaviour or attitude towards users. WHAT DOES THE ARTICLE ADD TO EXISTING KNOWLEDGE?: The attitudes of mental health professionals towards trans people are related to variables such as the professional's age, gender, political ideology and religious beliefs. Mental health nursing, psychology and social work are the professions that present more favourable attitudes towards trans people. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The inclusion of a professional perspective that understands sexual and gender diversity among mental health professionals is required. It is necessary to train professionals to promote socio-healthcare based on respect and free from prejudice, discrimination and stigma. ABSTRACT: Introduction The trans community perceives barriers to the mental health services in the form of professionals' transphobia, lack of knowledge and cultural sensitivity in healthcare. Aim Evaluation of the attitudes towards trans people of the professionals who work in the different Spanish mental health services. Method A cross-sectional design was used with a sample of professionals from different professional groups working in mental health units, hospitals and outpatient settings throughout Spain. Results Gender differences were found, with higher values in genderism and sexism among males. Negative attitudes and sexism have also been associated with age and religious beliefs. Mental health nursing, psychology and social work presented more favourable attitudes towards trans people than other mental health professionals. Discussion/Implications for Practice The inclusion of a professional perspective that understands sexual and gender diversity and the acquisition of professional attitudes based on evidence and patient-centred model are basic aspects to promote socio-healthcare based on respect and free from prejudices, discrimination and stigma.

Attitudes and behaviours of mental health professionals in the care of transgender people: A qualitative study.

WHAT IS KNOWN ON THE SUBJECT?: Mental health professionals' beliefs about transgender individuals vary, often influenced by stereotypes. There's recognition of healthcare needs, but limited knowledge impacts decision-making. Stereotypes persist regarding why transgender individuals seek mental health care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Professionals' attitudes show both positive support and negative, discriminatory views. Lack of training and knowledge gaps hinder effective care for transgender individuals. Pathologising attitudes exist, associating gender diversity with mental health conditions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Addressing training gaps is crucial for equitable care for transgender individuals. Challenging stereotypes and beliefs is necessary to reduce stigma and improve understanding. Enhancing knowledge and evidence-based tools will ensure safe and equal healthcare access. ABSTRACT: INTRODUCTION: Transgender people face against significant barriers in accessing mental health services due to, among other reasons, discrimination and a lack of expertise among professionals. AIM: To explore the beliefs and attitudes of professionals in the mental health network of the region of Murcia towards transgender people, focusing on aspects such as knowledge, perceptions, and prejudices about gender identity. METHOD: We carried out a qualitative study involving 14 participants, conducting semi-structured interviews based on prior knowledge of the topic. We asked the professionals about their experiences and challenges in their clinical interaction with transgender users and followed an inductive-deductive process to analyse the data. RESULTS: Two main themes were identified from the interviews, which were sub-categorised into different sub-themes: (a) beliefs about transgender people: underlying factors and origins of gender diversity, health needs, and stereotypes about the demand for health care; (b) attitudes and behaviours of professionals towards transgender people: pathologization and attitudes towards decision-making. DISCUSSION/IMPLICATIONS FOR PRACTICE: Our findings suggest that mental health professionals tend to oversimplify the factors underlying gender diversity and hold certain stereotypical beliefs about these users that oversimplify the complexity of their experiences.

Job satisfaction in midwives working in labour ward: A systematic review with meta-analysis.

PROBLEM: There is little documented evidence of job satisfaction in midwives who work in birthing rooms. BACKGROUND: Job satisfaction in midwives who work in birthing rooms may have changed in recent decades due to the medicalization of maternal health. AIM: To analyse job satisfaction levels among midwives working in birthing rooms. METHODS: We searched Web of Science, SCOPUS, MEDLINE, CUIDEN and CINAHL for observational and mixed method studies. The literature search was carried out from September to October 2022. FINDINGS: A total of 13 studies were included in the systematic review. A meta-analysis of the variable "midwives' job satisfaction" was performed on 12 of the studies. Midwives rated their job satisfaction positively: DME, CI (95%) = 1.24 [0.78, 1.69]. Subgroup 1: DME, CI (95%) = 2.41 [2.05, 2.76]); Subgroup 2: DME, CI (95%) = 0.76 [0.65, 0.86]; subgroup 3: DME, CI (95%) = 1.11 [0.95, 1.27]; subgroup 4: DME, CI (95%) = 0.10 [-0.11, 0.31]. DISCUSSION: Although midwives show high levels of satisfaction, the heterogeneity of instruments, lack of specificity and limited number of studies found restrict the outcomes. CONCLUSION: There are no specific measurement instruments for assessing job satisfaction among midwives working in labour wards, so it is possible that these data do not correspond to reality as they do not take into account specific professional aspects within this field of practice.

Influence of Laboring People's Mobility and Positional Changes on Birth Outcomes in Low-Dose Epidural Analgesia Labor: A Systematic Review with Meta-Analysis.

INTRODUCTION: Freedom of movement has been identified as a key issue for pregnant individuals during the birthing process, even if they opt for epidural analgesia, which has relegated people to more static positions during birth for many years. The aims of this systematic review were to evaluate the influence of mobility and positional changes on perinatal and neonatal outcomes in people in labor with epidural analgesia, describe the range of movement interventions used during the first and second stage of labor, and describe the level of motor blockade among people with low-dose epidural analgesia. METHODS: Bibliographic databases (Web of Science, Cochrane, CINAHL) were consulted from December 2020 to January 2021. The articles selected were clinical trials and observational or analytical studies, the subject of which was mobilization during labor in people with epidural analgesia. The outcome measures were mode of birth, duration of labor, and extrauterine adaptation after birth. A narrative synthesis was used to describe the types of movements interventions employed during the stages of labor and the level of motor blockade among people with low-dose epidural analgesia. RESULTS: Ten articles were selected (8 clinical trials, one cross-sectional study, and one quasiexperimental study), with a total sample of 6086 individuals. A meta-analysis showed nonsignificant results between groups for mode of birth (relative risk [RR], 1.00; 95% CI, 0.87-1.14), duration of labor (RR, 1.64; 95% CI, -34.57 to 37.86), and extrauterine adaptation after birth (RR, 0.86; 95% CI, 0.39-1.93). There was heterogeneity among studies in the type of movement interventions used during the first and second stage of labor. DISCUSSION: Although no clear benefit was observed for mobilization in epidural labor, no detrimental effects were found either, so perinatal care providers should encourage mobilization if the laboring person so desires, throughout the entire childbirth process.

Attitudes and Beliefs of Mental Health Professionals towards Trans People: A Systematic Review of the Literature.

A systematic review was conducted to assess and synthesize recent research on mental health professionals' attitudes towards trans people. The main objectives of our research were (a) to identify, synthesize, and analyze the scientific evidence available so far about the attitudes of mental health professionals towards the trans community, and (b) to determine the factors related to these professionals' attitudes, paying special attention to psychosocial and cultural aspects. A systematic search was carried out in the following electronic databases: Pubmed, Web of Science, PsycINFO, PsycARTICLES, Gender Studies Database, and Lilacs. A total of 32 articles of quantitative (n = 19), qualitative (n = 11), and mixed (n = 2) design, published up to March 2023, were included. Most studies used a cross-sectional or qualitative design, limiting the possibility of generalizing the results. The studies reviewed indicated mostly positive attitudes among the professionals, depending on their psychosocial characteristics. In line with the results of our review, we recommend that the training of professionals is important to improve their positive attitudes towards transgender and gender diverse people.

Violence in Dating Relationships: Validation of the CADRI Questionnaire in a Young Adult Population.

Dating violence in the young adult population is reaching alarming levels. However, the instruments used to measure it and their results are still heterogeneous. The main aim of this study was to validate the Conflict in Adolescent Dating Relationships Inventory questionnaire for a young adult Spanish university population aged between 19 and 25 years old, and to describe the types of violence perpetrated and suffered. MATERIAL AND METHODS: Observational, descriptive, cross-sectional study. A validity analysis was carried out through a confirmatory factor analysis. The relative frequencies for each type of violence and the Chi2 test for two dichotomous variables were used to describe the different types of violence perpetrated and suffered. RESULTS: The sample consisted of 976 young adults aged 19-25 years old (M = 21.7 years. SD = 1.8). The confirmatory factor analysis had an adequate structure and a good fit to the model. The types of violence perpetrated and suffered were described according to the sex of the participants, with significant differences found for verbal-emotional violence and physical violence exerted. CONCLUSIONS: The confirmatory factor analysis allowed us to consider the application of the questionnaire to be correct for the study population.

Serum Vitamin D, Folate and Fatty Acid Levels in Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis.

Vitamin and fatty acid deficiency in children diagnosed with autism has been linked to the etiology and course of the disease but the results have been inconsistent. In our work, we present a narrative review, which includes 20 observational studies that provide data on the blood levels of vitamin D, folate, or fatty acids of children diagnosed with ASD (Autism Spectrum Disorder-AG group), and of a control group (children without this disorder-CG group). The main characteristics and results are presented in a summary table. Of the 20 above-mentioned studies, a meta-analysis of vitamin D and folate levels was carried out in 14 of them, with a total of 2269 children (AG = 1159, CG = 1110). Vitamin D levels were lower in AG compared to CG: SMD, 95% CI = - 0.83 [- 1.15, - 0.50]. In terms of folate levels, a total of 299 children (AG = 148, CG = 151) were analyzed, finding no significant differences with the control group: SMD, 95% CI = - 0.16 [- 0.63, 0.32]. Only one study that provided data on fatty acids in children with ASD was included in the review although it was not possible to include it in the meta-analysis. We conclude that the nutritional status (vitamin and fatty acid levels) of patients diagnosed with ASD should be taken into account, as correct adjustment of these levels-may produce an improvement in the course of the disease and could also reduce the risk of its development.

User violence in mental health services: Adaptation of an instrument. Healthcare-workers' Aggressive Behavior Scale-Users-Mental Health Version (HABS-U-MH).

BACKGROUND/OBJETIVE: According to the World Health Organization, one out of every four violent workplace acts takes place in the health setting. The aims of the study are to adapt the Healthcare-workers' Aggressive Behavior Scale-Users (HABS-U) to mental health professionals, to establish the frequency of exposure to hostile indicators and to determine which professional group is most exposed. METHOD: Study through qualitative and quantitative methodology in MH professionals of the Region of Murcia (Spain). In the qualitative phase, 12 in-depth interviews were conducted, and during the quantitative phase, the instrument was applied to 359 professionals of Mental Health Services (MHS). RESULTS: Non-medical and nursing staff were found to be the professional group most exposed, as well as Brief Psychiatric Inpatient and Medium-Stay Inpatient Services. CONCLUSION: The resulting scale shows excellent psychometric properties. The distribution of user violence is not homogeneous among the different professional groups of MHS. The adaptation of the scale may be useful to detect user violence, as well as to evaluate the efficacy of intervention programs.

Vertical and lateral workplace bullying in nursing: development of the hospital aggressive behaviour scale.

Healthcare staff is one of the professional groups that suffers the highest exposure to sources of occupational stress such as hostility from coworkers and superiors. In order to contribute to the assessment of bullying behaviors in the healthcare sector and to obtain a brief and manageable instrument for the assessment of this psychosocial risk, we developed the Hospital Aggressive Behaviour Scale-version Co-workers-Superiors (HABS-CS). By means of thorough qualitative analysis, an initial pool of 166 items was obtained, which were reviewed according to precise criteria until concluding with a total of 57 items, which were administered to a sample of 1,484 healthcare professionals from 11 public hospitals. The analyses concluded with the selection of 17 items distributed in two subscales. The internal 5-factor structure is the result of exploratory and confirmatory factor analysis conducted in two samples. Both the resulting questionnaire and the factors identified present adequate psychometric properties: high-internal consistency (Cronbach's α of .86) and adequate criterion validity, analyzed by means of significant correlations between the HABS-CS and job satisfaction, burnout components, and psychological well-being. This instrument may be of great utility for the assessment and prevention of psychosocial risks.