Psychological responses to COVID-19 in a Mexican population: an exploratory study during second and third phases.

This work constitutes an exploratory study during the second and third phases of COVID-19 in Mexico, characterized by local transmission and untraceable cases, respectively, with an incidental sample of 666 participants. The 21-item Depression Anxiety Stress Scale was used to assess depression, anxiety and stress associated to COVID-19. Additionally, the Impact of the Event Scale-Revised was applied to assess the impact of the event, and the 10-item Connor-Davidson Resilience Scale was employed to assess resilience. Participants' levels of traumatic impact (21.7%), severe depression (7%), severe anxiety (9.4%) and severe stress (5.4%) were revealed to be lower than other populations. Comparison of means and effect size η2p of the data shows that women and young people (18-39 years) suffer the greatest negative effects. Individuals with higher levels of resilience experience fewer psychological consequences confirming its importance in the face of the adversities. These findings provide valuable information on the impact of COVID-19 pandemic in the Mexican population, allowing a comparative analysis at an international level which can be helpful in the development of appropriate sanitary policies.

Affective Comorbidity Associated with Symptoms, Lung Function, and Differences Between Patients with COPD for Biomass and Tobacco Smoke Exposure.

Anxiety and depression are common entities in patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD). This study aimed to determine the prevalence of affective comorbidity (depression and anxiety) associated with lung function, functional capacity, dyspnea, and quality of life; as well as the differences between groups of patients diagnosed with COPD associated with biomass (COPD-BE) and patients with COPD secondary to tobacco (COPD-TS). Comparative cross-sectional observational study. Multiple hierarchical regression models, analysis of variance, and covariance were carried out. A total of 291 COPD patients were evaluated, symptoms of depression were found to be higher in patients with COPD-BE than in patients with COPD-TS (5.3 ± 4.2 versus 4.2 ± 4, 1, p = 0.016), as well as anxiety complications (4.1 ± 3.8 versus 3.8 ± 3.3, p = 0.095), although with anxiety it was not statistically significant, being adjusted for age and FEV1. Patients with COPD-BE had higher prevalence of depression, compared to COPD-TS (41.2% versus 27.7%, p = 0.028). In the multivariate regression models, the variables of dyspnea and quality of life were associated with depression and anxiety, explaining 25% and 24% of the variability, respectively. Depression is higher in COPD-BE patients compared to COPD-TE patients, it is necessary to consider affective comorbidity in routine evaluation and provide a comprehensive intervention to prevent the effects on other clinical conditions of the disease.

Incivility at work, upset at home? Testing the cross-level moderation effect of emotional dysregulation among female nurses from primary health care.

Workplace incivility is a growing problem in nursing. However, most studies that explore this psychosocial risk and its consequences do so considering a single level and a between-person perspective. The aims of the study were to explore whether the effects of experiencing incivility during work-time could explain the daily levels of well-being of nurses at home; and to analyze if that relationship could be moderated by their levels of emotional dysregulation as a trait. This is a multilevel study with diary methodology. The study was carried out in 18 primary health-care centers belonging to Madrid and the Basque Country, in Spain. Ninety-four nurses completed a general questionnaire and 54 of them a diary booklet over five consecutive working days in two different moments, immediately after work and at bedtime. The results showed that nurses' emotional dysregulation moderated the relationship between daily workplace incivility and daily fatigue, and positive affect at night at home. However, there were no direct effects of daily incivility on these outcome variables. In conclusion, the presence of difficulties in emotional regulation among nurses can increase the negative effects of daily workplace incivility on their health and well-being.

Depression and Anxiety in Patients With Pulmonary Hypertension: The Role of Life Satisfaction and Optimism.

BACKGROUND: Pulmonary hypertension is a highly disabling condition characterized by a progressive increase in pulmonary arterial pressure. Even though pulmonary hypertension may cause great emotional distress, research examining the determinants of patients' emotional well-being has been scarce and has mostly focused on the role of disease-related factors. OBJECTIVES: This study examined whether patients' emotional well-being may be effected by their life circumstances. METHODS: Sixty-four patients with pulmonary hypertension completed measures of symptoms of pulmonary hypertension, functional disability, depression and anxiety symptoms, life satisfaction, optimism, and quality of life (QoL). RESULTS: Clinically-significant symptoms of depression and anxiety were only accurately predicted in 50.5% and 56.5% of patients, respectively, based on disease severity alone. However, the addition of life satisfaction and optimism to the models improved the prediction of depressive and anxiety symptomatology. Further, symptoms of anxiety were a significant predictor of QoL, above and beyond disease severity. CONCLUSIONS: Patients with considerably different levels of disease severity may develop clinically-significant depressive and anxiety symptomatology. This suggests that there is not a perfect correspondence between the level of disease severity and the repercussions thereof across patients. Accordingly, these results suggest that emotional well-being may be better explained by taking into consideration patients' life circumstances, as these may modulate the repercussions of having pulmonary hypertension. The results also showed that anxiety symptoms constituted an extra burden to patients' QoL. The higher prevalence in this sample of clinically-significant symptoms of anxiety, compared to that of depression, suggest that feelings of fear and uncertainty may require special attention among patients with pulmonary hypertension.

The relevance of experiential avoidance in breast cancer distress: insights from a psychological group intervention.

BACKGROUND: Research on the implication of experiential avoidance in the aetiology and maintenance of diverse forms of psychopathology has grown considerably over the last 10 years. However, the potential contribution of experiential avoidance to cancer-related distress has received limited attention. Accordingly, the objective of this study was to examine the association between experiential avoidance, symptoms of anxiety and depression, and quality of life (QoL) during the course of a psychological group intervention for women with breast cancer. METHODS: Fifty-four women with breast cancer participated in a psychological group intervention designed to reduce distress and improve QoL. Participants completed measures of experiential avoidance, anxiety and depressive symptoms, and QoL upon the first and last sessions. RESULTS: A path analysis revealed that, after controlling for baseline measures, smaller reductions in experiential avoidance during the course of the intervention predicted smaller reductions in anxiety and depressive symptoms. Also, experiential avoidance had a negative indirect effect on QoL via depressive symptoms. CONCLUSIONS: Experiential avoidance may perpetuate the emotional problems commonly found in women with breast cancer and attenuate improvements associated with participation in psychological interventions. Implications for clinical practice in psycho-oncology are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Factors influencing intention to help and helping behaviour in witnesses of bullying in nursing settings.

The role played by witnesses of bullying in nursing settings remains little studied, despite their potential relevance in explaining the onset and development of bullying. The objective of this study was to develop a model to account for witnesses' intention to help and helping behaviour in response to bullying in a nursing setting. Three hundred and thirty-seven witnesses completed self-report measures of variables predicting intention to help and helping behaviour. A full structural model was constructed using structural equation modelling. The intention to help victims was elicited by tension, group identity, support to peers' initiative to intervene and absence of fear of retaliation. However, engagement in helping behaviour was only predicted by the absence of fear of retaliation. This study shows that witnesses of bullying in nursing settings do not remain impassive, but their experienced discomfort and intention to help victims is not sufficient to predict helping behaviour. Fear of possible retaliation if intervening in favour of victims constitutes a crucial factor explaining witnesses' hesitation to help victims. Several implications for the implementation of policies directed at eradicating bullying in nursing settings are discussed.

Expanding the occupational health methodology: A concatenated artificial neural network approach to model the burnout process in Chinese nurses.

Artificial neural networks are sophisticated modelling and prediction tools capable of extracting complex, non-linear relationships between predictor (input) and predicted (output) variables. This study explores this capacity by modelling non-linearities in the hardiness-modulated burnout process with a neural network. Specifically, two multi-layer feed-forward artificial neural networks are concatenated in an attempt to model the composite non-linear burnout process. Sensitivity analysis, a Monte Carlo-based global simulation technique, is then utilised to examine the first-order effects of the predictor variables on the burnout sub-dimensions and consequences. Results show that (1) this concatenated artificial neural network approach is feasible to model the burnout process, (2) sensitivity analysis is a prolific method to study the relative importance of predictor variables and (3) the relationships among variables involved in the development of burnout and its consequences are to different degrees non-linear. PRACTITIONER SUMMARY: Many relationships among variables (e.g., stressors and strains) are not linear, yet researchers use linear methods such as Pearson correlation or linear regression to analyse these relationships. Artificial neural network analysis is an innovative method to analyse non-linear relationships and in combination with sensitivity analysis superior to linear methods.

Elucidating the role of recovery experiences in the job demands-resources model.

Based on the Job Demands-Resources (JD-R) model, the current study examined the moderating role of recovery experiences (i.e., psychological detachment from work, relaxation, mastery experiences, and control over leisure time) on the relationship between one job demand (i.e., role conflict) and work- and health-related outcomes. Results from our sample of 990 employees from Spain showed that psychological detachment from work and relaxation buffered the negative impact of role conflict on some of the proposed outcomes. Contrary to our expectations, we did not find significant results for mastery and control regarding moderating effects. Overall, findings suggest a differential pattern of the recovery experiences in the health impairment process proposed by the JD-R model.

Entrepreneurs and Burnout. How Hardy Personality works in this process.

BACKGROUND: Considering the importance of entrepreneurship and the impact of burnout on workers' health, this study aims to explore the presence of burnout in entrepreneurs and the interaction of hardy personality (HP) in this process. METHOD: The sample included 255 Spanish entrepreneurs. Occupational factors, working hours, labour immersion, HP, burnout syndrome (i.e. Emotional exhaustion, Depersonalization and Lack of accomplishment) and burnout consequences were assessed. RESULTS: Descriptive analysis showed that entrepreneurs had low levels of occupational factors, burnout syndrome and consequences. Hierarchical regression exploratory results indicated that working hours, labour immersion, and Emotional exhaustion were the most relevant predictors of the consequences. Besides, mediation models with PROCESS macro (v.3.0) highlighted the indirect effect of occupational factors and showed that emotional exhaustion was the only component of burnout that mediated in between the predictors and the consequences. As well, HP moderated the relationship between occupational factors and emotional exhaustion. CONCLUSIONS: Occupational factors are the main predictor of burnout in entrepreneurs and HP could prevent their effect on Emotional exhaustion. The results suggest the importance of training to promote HP for better health and performance of entrepreneurs.

Satisfied as professionals, but also exhausted and worried!!: The role of job demands, resources and emotional experiences of Spanish nursing home workers during the COVID-19 pandemic.

Nursing home workers have been exposed to great physical and mental burdens during the COVID-19 pandemic. Although this has generated high levels of exhaustion, it may also have contributed to feelings of professional satisfaction. The objective of this study was to explore the levels of satisfaction among nursing home workers during the COVID-19 pandemic, as well as the role of job demands, resources and emotional experiences in explaining their levels of satisfaction. This cross-sectional study was conducted in Spain between March and May 2020. Three hundred and thirty-five nursing home workers participated. A quantitative analysis was conducted, as was a content analysis of the responses to an open-ended question about the respondents' perceptions of job demands and resources during the crisis. The results showed that workers had very high levels of satisfaction. Social pressure from work, contact with death and suffering, and emotional exhaustion were negatively associated with satisfaction. Moreover, under conditions of extensive contact with suffering people and great fear of contagion, social support at work was shown to promote professional satisfaction. In conclusion, nursing home workers in Spain experienced high rates of satisfaction during the COVID-19 crisis despite the high job demands, lack of job resources, fear of contagion and exhaustion. The main practical implication of this study is the importance of ensuring optimal working conditions in the nursing home sector in order to guarantee professional satisfaction, prevent burnout, reduce turnover and promote post-crisis resilience.

The Moderating Effect of Resilience on Mental Health Deterioration among COVID-19 Survivors in a Mexican Sample.

Resilience has been reported to be a protective psychological variable of mental health; however, little is known about its role in COVID-19 survivors. Thus, in this study, we aimed to evaluate the levels of depression, anxiety, stress, traumatic impact, and resilience associated with COVID-19, as well as to investigate the role of resilience as a moderating variable. A sample of 253 participants responded to an online survey; all were previously diagnosed with COVID-19 by a nasopharyngeal swab RT-PCR test, were older than 18 years, and signed an informed consent form. Significant negative correlations were found between resilience and the mental health variables. Higher resilience was significantly related to a lower impact of the event, stress, anxiety, and depression when the number of symptoms was low. Only when the duration of COVID-19 was short and resilience levels were medium or high was psychological distress reduced. Moreover, resilience moderated the effects of COVID-19 on mental health, even if a relapse occurred. The results emphasize the need for interdisciplinary interventions aimed at providing COVID-19 patients with psychological and social resources to cope with the disease, as well as with probable relapses.

Factorial validity of the Job Expectations Questionnaire in a sample of Mexican workers.

The aim of this study was to examine the factorial validity of the Job Expectations Questionnaire (Cuestionario de Expectativas Laborales CEL) in a sample of Mexican workers. Following a cross validation approach, two samples were used in the study. The first sample consisted of 380 professionals who mainly performed administrative work in the Health Services in Puebla-Mexico. The second sample comprised 400 health professionals from the Hospital de la Mujer in Puebla-Mexico. Exploratory factor analysis yielded a three-factor solution, accounting for 51.8% of the variance. The results of confirmatory factorial analysis indicate that the three-factor model provided the best fit with the data (CFI = .96, GFI = .95, NNFI = .95, RMSEA = .04), maintaining the structure with 12 items. The reliability of the questionnaire and the diverse subscales showed high internal consistency. Significant correlations were found between job expectations and autonomy, vigor, dedication, and absorption, providing evidence of its construct validity. The evaluation of the psychometric qualities confirms this questionnaire as a valid and specific instrument to measure job expectations.

Maternal Psychological and Biological Factors Associated to Gestational Complications.

Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. We aimed to identify biopsychosocial risk and protective factors associated with the development of maternal and fetal complications. We enrolled 182 healthy pregnant women, and plasma melatonin and cortisol levels were measured in the first trimester by chemiluminescent immunoassays. At different time points along gestation, women answered several questionnaires (positive and negative affect schedule, hospital anxiety and depression scale, pregnancy concerns scale, life orientation test, resilience scale, life satisfaction scale and life-work conflicts scale). They were followed up until delivery and categorized as normal pregnancy, maternal or fetal complications. Maternal complications were associated with low melatonin (OR = 0.99 [0.98; 1.00]; p-value = 0.08) and life satisfaction (OR = 0.64 [0.41; 0.93]; p-value = 0.03) and fetal complications were associated with high cortisol (OR = 1.06 [1.02; 1.13]; p-value = 0.04), anxiety (OR = 2.21 [1.10; 4.55]; p-value = 0.03) and life-work conflicts (OR = 1.92 [1.04; 3.75]; p-value = 0.05). We conclude that psychological factors influence pregnancy outcomes in association with melatonin and cortisol alterations. High maternal melatonin and life satisfaction levels could be potential protective factors against the development of maternal complications during pregnancy. Low anxiety and cortisol levels and reduced work-life conflicts could prevent fetal complications.

The Job Demands and Resources Related to COVID-19 in Predicting Emotional Exhaustion and Secondary Traumatic Stress Among Health Professionals in Spain.

The current COVID-19 crisis may have an impact on the mental health of professionals working on the frontline, especially healthcare workers due to the increase of occupational psychosocial risks, such as emotional exhaustion and secondary traumatic stress (STS). This study explored job demands and resources during the COVID-19 crisis in predicting emotional exhaustion and STS among health professionals. The present study is a descriptive and correlational cross-sectional design, conducted in different hospitals and health centers in Spain. The sample consisted of 221 health professionals with direct involvement in treating COVID-19. An online survey was created and distributed nationwide from March 20 to April 15 which assessed: sociodemographic and occupational data, fear of contagion, contact with death/suffering, lack of material and human protection resources (MHRP), challenge, emotional exhaustion, and STS. Descriptive findings show high levels of workload, contact with death/suffering, lack of MHPR and challenge, and are moderately high for fear of contagion, emotional exhaustion, and STS. We found an indirect significant effect of lack of MHPR on predicting (1) emotional exhaustion through the workload and (2) on STS through fear of contagion, contact with death/suffering, and workload. To conclude, this study examines the immediate consequences of the crisis on health professionals' well-being in Spain, emphasizing the job demands related to COVID-19 that health professionals are facing, and the resources available in these health contexts. These findings may boost follow-up of this crisis among health professionals to prevent them from long-term consequences.

The Role of Healthcare Professionals' Passion in Predicting Secondary Traumatic Stress and Posttraumatic Growth in the Face of COVID-19: A Longitudinal Approach.

COVID-19 has increased the likelihood of healthcare professionals suffering from Secondary Traumatic Stress (STS). However, the difficulty of this crisis may lead these professionals to display personal resources, such as harmonious passion, that could be involved in posttraumatic growth. The goal of this study is to examine the STS and posttraumatic growth among healthcare professionals and the demands and resources related to COVID-19. A longitudinal study was carried out in April 2020 (T1) and December 2020 (T2). The participants were 172 health professionals from different health institutions and they reported their workload, fear of contagion, lack of staff and personal protection equipment (PPE), harmonious passion, STS and posttraumatic growth. The results revealed that workload and fear of contagion in T2 were positive predictors for STS, whereas harmonious passion was a negative predictor. Fear of contagion of both times seemed to positively predict posttraumatic growth, as well as harmonious passion. One moderation effect was found concerning the lack of staff/PPE, as posttraumatic growth was higher when the workload was high, especially in those with a high lack of staff/PPE. All in all, these findings pointed out the need for preventative measures to protect these professionals from long-term negative consequences.

Maternal Resources, Pregnancy Concerns, and Biological Factors Associated to Birth Weight and Psychological Health.

Cognitive maternal adaptation during pregnancy may influence biological variables, maternal psychological, and neonatal health. We hypothesized that pregnant women with numerous general resources and less negative emotions would have a better coping with a positive influence on neonatal birth weight and maternal psychological health. The study included 131 healthy pregnant women. A blood sample was obtained in the first trimester to assess biological variables (polyphenols, hematological and biochemical parameters). Psychological variables (negative affect, anxiety, optimism, resilience, family-work conflicts, pregnancy concerns, general resources, and life satisfaction) were evaluated at several time points along gestation, and birth weight was recorded. Hierarchical linear regression models were used to associate the above parameters with maternal psychological outcome at the end of gestation (depression, resilience, and optimism) and neonatal outcome (birth weight). Maternal depression was associated with leukocytes (ß = 0.08 ± 0.03, p-value = 0.003), cholesterol (ß = 0.01 ± 0.002, p-value = 0.026), and pregnancy concerns (ß = 0.31 ± 0.09, p-value = 0.001). Maternal resilience was associated with leukocytes (ß = -0.14 ± 0.09, p-value = 0.010) and life satisfaction (ß = 0.82 ± 0.08, p-value = 0.001), and maternal optimism was associated with polyphenol levels (ß = 0.002 ± 0.001, p-value = 0.018) and life satisfaction (ß = 0.49 ± 0.04, p-value = 0.001). Birth weight was associated with maternal resilience (ß = 370.2 ± 97.0, p-value = 0.001), red blood cells (ß = 480.3 ± 144.4, p-value = 0.001), and life satisfaction (ß = 423.3 ± 32.6, p-value = 0.001). We found associations between maternal psychological, blood variables, and birth weight and maternal depression. This study reveals the relevance of psychological health during pregnancy for maternal and neonatal outcome, and it emphasizes the need to consider it in preventive policies in the obstetric field.

Stressors, Job Resources, Fear of Contagion, and Secondary Traumatic Stress Among Nursing Home Workers in Face of the COVID-19: The Case of Spain.

This study aimed to analyze the psychological consequences of the COVID-19 pandemic on nursing home workers, as well as the influence of certain related stressors and job resources. Two-hundred twenty-eight nursing home workers in Spain participated in this cross-sectional study. High levels of workload, social pressure from work, contact with suffering, and fear of contagion were found. In nursing homes where cases of COVID-19 had been detected, workers experienced higher levels of secondary traumatic stress. Social pressure from work, high doses of exposure to suffering, lack of personnel and personal protective equipment, and minimal supervisor support were significant in explaining traumatic stress. Supervisor and coworker support moderated some of these relationships. The results are discussed in terms of the need to implement urgent psychosocial protection strategies and to provide personal protective equipment (PPE) to help prevent future psychological disorders in this worker population.

Precautionary Behaviors during the Second and Third Phases of the COVID-19 Pandemic: Comparative Study in the Latin American Population.

The population's behavioral responses to containment and precautionary measures during the COVID-19 pandemic have played a fundamental role in controlling the contagion. A comparative analysis of precautionary behaviors in the region was carried out. A total of 1184 people from Mexico, Colombia, Chile, Cuba, and Guatemala participated through an online survey containing a questionnaire on sociodemographic factors, precautionary behaviors, information about COVID-19, concerns, maintenance of confinement, and medical symptoms associated with COVID-19. Cubans reported the highest scores for information about COVID-19. Colombians reported less frequent usage of precautionary measures (e.g., use of masks), but greater adherence to confinement recommendations in general, in contrast to the low levels of these behaviors in Guatemalans. Chileans reported greater pandemic-related concerns and the highest number of medical symptoms associated with COVID-19. These findings allow a partial characterization of the Latin American population's responses during the second and third phases of the COVID-19 pandemic and highlight the importance of designing and managing public health policies according to the circumstances of each population when facing pandemics.

[Adaptation of the "Recovery Experience Questionnaire" in a Spanish sample]. / Adaptación del "Cuestionario de Experiencias de Recuperación" a una muestra española.

The aim of this work was to examine the psychometric properties of the Spanish version of the "Recovery Experience Questionnaire" developed by Sonnentag and Fritz. The sample was made up of 941 professionals from the security sector. Results from the exploratory factor analysis suggested the possibility of considering a four-factor structure. Confirmatory factor analysis showed that the four-factor model with three correlated items each provided the best fit to the data (CFI=0.97, GFI=0.96, NNFI=0.96, RMSEA=0.05 y AIC=171.76). Therefore, the questionnaire maintains the four recovery experiences -psychological detachment from work, relaxation, mastery experiences and control over leisure time--but with 12 items instead of 16 items as in the original scale. Reliability analysis showed good internal consistency for this scale with Cronbach alpha coefficients for the factors ranging from .75 to .88. Significant correlations were found between the recovery experiences and various external variables, providing evidence of construct validity. Thus, this Spanish version shows adequate psychometric properties and may help to achieve a better understanding of this topic.

[Vitality and inner resources as relevant components of psychological well-being]. / Vitalidad y recursos internos como componentes del constructo de bienestar psicológico.

Vitality and inner resources as relevant components of psychological well-being. The multidimensional model of well-being, created by Carol Ryff, proposes the following dimensions to study psychological well-being (PSWB): self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth. One of the main criticisms aimed at this proposal is that it is based on excessive ethnocentrism in the operationalization of the PSWB construct linked to contemporary individual societies. Because of this, the first aim of this study was to extend the PSWB model with two dimensions: inner resources and vitality. Through a cross-validation approach, exploratory and confirmatory factor analyses were performed. The results showed better psychometric data in reliability and validity for the scales of the extended model of PSWB. To examine the PSWB construct in depth, we conducted a second study to analyze the relationship between the extended version of PSWB and subjective well-being models, and their predictive capacity of positive and negative human functioning, i.e., self-esteem and depression. Results showed complementation and compensation effects from both models that denote their close connection and singularity.