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Resumen: Objetivo: Explorar el impacto del uso cotidiano de plataformas de videollamadas en las cogniciones, emociones y comportamientos relacionados con la autoimagen en pacientes con Trastornos del Comportamiento Alimentario (TCA) y personas de la población general, durante la pandemia por COVID-19. Métodos: Sesenta y ocho pacientes con TCA en tratamiento y 106 personas de la población general respondieron a un cuestionario diseñado para el estudio a través de Lime Survey; (98.5 y 79.2% respectivamente eran mujeres), con edad promedio de 17.6 (DE:3.47) y 33.5 (DE:9.35) respectivamente. Las pacientes discutieron y explicaron sus respuestas en cinco sesiones de terapia grupal presenciales dirigidas por un psiquiatra. Posteriormente, se realizó un análisis temático reflexivo con un enfoque inductivo para determinar las categorías. Resultados: Los pacientes reportaron una mayor incomodidad frente a la cámara, preocupación con la apariencia física, miedo a la crítica, vergüenza y sentimientos de vulnerabilidad, comparados con las personas de la población general. Predominaron los pensamientos negativos sobre la forma y el tamaño del rostro y otras partes del cuerpo y las conductas de chequeo y/o evitación de la imagen corporal, que interfirieron con la concentración y el rendimiento. Conclusión: además del impacto negativo de la pandemia de COVID-19 en la salud mental, la nueva virtualidad desafía a los clínicos a enfrentar dificultades adicionales con la imagen corporal en pacientes con TCA y alerta a la detección de nuevas preocupaciones dismórficas también en la población general.
Abstract: Objective: To explore the impact of video call platforms on physical appearance concerns (cognitions, emotions and behaviors) in Eating Disorders (ED) patients and in general population, during COVID 19 pandemic. Methods: Sixty-eight patients attending a treatment program for ED, and 106 people from the general population responded to a questionnaire designed for the study through Lime Survey; (98.5 and 79.2% respectively were women), with a mean age of 17.6 (SD:3.47) and 33.5 (SD:9.35) respectively. Patients discussed and explained their answers in five in vivo group therapy sessions directed by a psychiatrist. Then, a reflective thematic analysis with an inductive approach to determine the categories was performed. Results: Patients reported a higher discomfort in front of the camera, preoccupation with physical appearance, fear of criticism, embarrassment, and feelings of vulnerability, compared with general population. Negative thoughts about the shape and size of the face and other body parts predominated, as well as body image checking/avoidance behaviors that interfered with concentration and performance. Conclusion: In addition to the negative impact of the COVID-19 pandemic on mental health, the new virtuality challenges clinicians to face additional body image difficulties in ED patients and alerts on the detection of dysmorphic concerns in the general population as well.
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BACKGROUND: Lockdowns and social distancing as a result of the COVID-19 pandemic have brought about the need to continue treatment virtually in patients with Eating Disorders (ED). OBJECTIVE: To evaluate feasibility, acceptability and adherence to virtual treatment in patients, families and therapists. METHODS: Fourteen patients, 10 family members and eight therapists from an intensive outpatient program for ED answered online surveys and a SWOT analysis was performed with the responses. RESULTS: Virtual treatment during lockdown was considered feasible and useful by all respondents. Fear of contagion and the presence of parents in the home were identified as strengths. Parents reported problems with nutritional plan compliance, especially in anorexia patients. Therapists highlighted the importance of methodological adaptations in sessions to improve participation. Adherence to sessions was 100% for family members and 90% for patients. CONCLUSIONS: Adaptation to a virtual program is a valid and useful option during lockdowns. It improves family participation, but does not replace face-to-face treatment.
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COVID-19 , Transtornos da Alimentação e da Ingestão de Alimentos , Humanos , Estudos de Viabilidade , Pandemias , Controle de Doenças Transmissíveis , Pais , Transtornos da Alimentação e da Ingestão de Alimentos/terapiaRESUMO
BACKGROUND: Lockdowns and social distancing as a result of the COVID-19 pandemic have brought about the need to continue treatment virtually in patients with Eating Disorders (ED). OBJECTIVE: To evaluate feasibility, acceptability and adherence to virtual treatment in patients, families and therapists. METHODS: Fourteen patients, 10 family members and eight therapists from an intensive outpatient program for ED answered online surveys and a SWOT analysis was performed with the responses. RESULTS: Virtual treatment during lockdown was considered feasible and useful by all respondents. Fear of contagion and the presence of parents in the home were identified as strengths. Parents reported problems with nutritional plan compliance, especially in anorexia patients. Therapists highlighted the importance of methodological adaptations in sessions to improve participation. Adherence to sessions was 100% for family members and 90% for patients. CONCLUSIONS: Adaptation to a virtual program is a valid and useful option during lockdowns. It improves family participation, but does not replace face-to-face treatment.
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Harmful alcohol use is a public health problem worldwide, contributing to an estimated 5.1% of the global burden of illness. Screening and addressing at-risk drinking in primary care settings is an empirically supported health care intervention strategy to help reduce the burden of alcohol-use problems. In preparation for introducing screening and treatment for at-risk drinking in primary care clinics in Colombia, we conducted interviews with clinicians, clinic administrators, patients, and participants in Alcoholics Anonymous. Interviews were conducted within the framework of the Detección y Atención Integral de Depresión y Abuso de Alcohol en Atención Primaria (DIADA, [Detection and Integrated Care for Depression and Alcohol Use in Primary Care] www.project-diada.org) research project, and its qualitative phase that consisted of the collection of data from 15 focus groups, 6 interviews and field observations in 5 regional settings. All participants provided informed consent to participate in this research. Findings revealed the association of harmful alcohol use with a culture of consumption, within which it is learned and socially accepted practice. Recognition of harmful alcohol consumption includes a social context that influences its screening, diagnosis and prevention. The discussion highlights how, despite the existence of institutional strategies in healthcare settings and the awareness of the importance of at-risk drinking among health personnel, the recognition of the harmful use of alcohol as a pathology should be embedded in an understanding of historical, social and cultural dimensions that may affect different identification and care scenarios.
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Alcoolismo , Alcoolismo/diagnóstico , Colômbia/epidemiologia , Grupos Focais , Humanos , Atenção Primária à SaúdeRESUMO
BACKGROUND: The implementation of new technologies in medical research, such as novel big storage systems, has recently gained importance. Electronic data capture is a perfect example as it powerfully facilitates medical research. However, its implementation in resource-limited settings, where basic clinical resources, internet access, and human resources may be reduced might be a problem. METHODS: In this paper we described our approach for building a network architecture for data collection to achieve our objectives using a REDCap® tool in Colombia and provide guidance for data collection in similar settings. CONCLUSIONS: REDCap is a feasible and efficient electronic data capture software to use in similar contexts to Colombia. The software facilitated the whole data management process and is a way to build research capacities in resourced-limited settings.