From Anxiety to Hardiness: The Role of Self-Efficacy in Spanish CCU Nurses in the COVID-19 Pandemic.

Background and Objectives: Evidence shows that throughout the COVID-19 pandemic, nurses suffered from emotional symptoms, yet in spite of this, few studies within "positive psychology" have analyzed the emergence/promotion of positive traits, such as hardiness. In this context, the present study aimed to test a model regarding the mediating role of self-efficacy between anxiety experienced at the beginning of the COVID-19 pandemic and hardiness assessed six months later among nurses in critical care units (CCU) in Spain. Materials and Methods: An observational, descriptive, prospective longitudinal study with two data collection periods: (1) from the 1 to the 21 June 2020 (final phase of the state of alarm declared in Spain on 14 March) in which socio-demographic and occupational variables, anxiety (Depression, Anxiety and Stress Scale, DASS-21), self-efficacy (General Self-Efficacy Scale, GSES) and basal resilience (Resilience Scale-14, RS-14) were assessed, and (2) a follow-up 6 months later (January-March 2021) in which hardiness (Occupational Hardiness Questionnaire, OHQ) was evaluated. To analyze the data, multivariate regressions were performed using the PROCESS macro (simple mediation, model 4). Results: A total of 131 Spanish nurses from CCUs, with a mean age of 40.54 years (88.5% women) participated in the study. Moderate and severe levels of anxiety were observed in 19.1% of the sample. Significant and positive correlations were observed between self-efficacy, hardiness and resilience (all p < 0.001). Significant negative correlations were observed between anxiety and self-efficacy (p < 0.001), hardiness (p = 0.027) and resilience (p = 0.005). The indirect effect of anxiety on hardiness through self-efficacy was significant (Effect (SE) = -0.275 (0.100); LLCI = -0.487, ULCI = -0.097), contributing to 28% of the variance, including resilience (p = 0.015), age (p = 0.784), gender (p = 0.294) and years of experience (p = 0.652) as covariates. A total mediation was observed (non-significant anxiety-hardiness direct effect; Effect (SE) = -0.053 (0.215), t = 0.248, p = 0.804, LLCI = -0.372, ULCI = 0.479). Conclusions: The results suggest that in Spanish CCU nurses, anxiety experienced at the beginning of the COVID-19 pandemic may contribute to the development of hardiness through positive resources such as self-efficacy.

Revisiting the Mackey Childbirth Satisfaction Rating Scale: Spanish adaptation, factor analysis, and sources of construct validity.

BACKGROUND: Women's dissatisfaction with perinatal health care services is associated with poor postpartum outcomes for the mother and the baby. The Mackey Childbirth Satisfaction Rating Scale is a frequently used measure of women's childbirth satisfaction. However, its factor structure has been inconsistent across investigations. The goal of this study was to evaluate the psychometric properties of the scale (i.e., factor structure and sources of validity evidence). METHODS: This study is a descriptive prospective investigation. Participants included 106 pregnant women (mean age = 31.86, SD = 4.12) recruited from a public university hospital situated in South Madrid. Sources of construct validity of the Mackey were explored with the Women's View of Birth Labor Satisfaction Questionnaire. Sources of criterion validity were investigated with measures of pain (labor, delivery, and just after birth) and post-traumatic stress symptoms. RESULTS: Minor adaptations in item distribution resulted in an adequate fit of the original six-factor solution of the Mackey scale (i.e., oneself, the partner, the baby, the nurse, the physician, and overall satisfaction). Sources of validity evidence supported the construct and criterion validity of the scale. CONCLUSIONS: Obtaining a psychometrically and conceptually sound factor solution is fundamental when validating a scale. With the present study, researchers and clinicians (e.g., midwives) will be able to measure women's childbirth satisfaction in a more robust manner. Both antecedents and consequences of satisfaction were found to correlate with several satisfaction subscales, which might help guide prevention programs in mother care in a more efficient way.

Development and psychometric properties of the maternal ambivalence scale in spanish women.

BACKGROUND: maternal ambivalence, which refers to experiencing mixed emotions about motherhood, like happiness and sadness, is frequent during the perinatal period. AIM: Due to the relevance of this topic and the lack of psychometrically-sound instruments to measure it, this study aims to develop and test a measure of maternal ambivalence called the Maternal Ambivalence Scale (MAS). METHODS: in this cross-sectional, observational study, participants were 1424 Spanish women recruited online who were either pregnant (33%) or recent mothers of children under 2 years (67%). They responded to the MAS and measures of anxiety and depressive symptoms and life satisfaction. Analyses included exploratory and confirmatory factor solutions for the MAS, internal consistency estimates (Cronbach's α) for all scales, as well as bivariate correlations to investigate sources of validity evidence. Comparisons between pregnant and postpartum women were also examined. RESULTS: The assumptions for factor analysis about the relationship between items were met (Kaiser-Meyer-Olkin's [KMO] test = 0.90; Barlett's Chi-square sphericity test = 5853.89, p < .001). A three-factor solution (Doubts, Rejection, and Suppression) for the MAS showed a good model fit both in exploratory (Chi-square = 274.6, p < .001, Root Mean Square Error of Approximation [RMSEA] = 0.059, RMSEA 90% Confidence Interval [CI]=[0.052, 0.066], Comparative Fit Index [CFI] = 0.985, Tucker Lewis Index [TLI] = 0.974) and confirmatory analyses (Chi-square = 428.0, p < .001, RMSEA = 0.062, RMSEA 90% CI=[0.056, 0.068], CFI = 0.977, TLI = 0.971). Doubts (α = 0.83), Rejection (α = 0.70), and Suppression (α = 80) were associated with higher anxiety and depressive symptoms, as well as lower life satisfaction (all p < .001). Pregnant women presented greater Rejection (mean difference = 0.30, p = .037, 95% CI=[0.02, 0.58]) and less Suppression (mean difference=-0.47, p = .002, 95% CI=[-0.77,-0.17]) than mothers. CONCLUSION: with this study, we provide clinicians and researchers with a novel tool that successfully captures the complex nature of maternal ambivalence. Given the associations of maternal ambivalence with important outcomes in perinatal women, this tool could be important for the prevention of distress associated with chronic ambivalence and to evaluate the effectiveness of interventions addressing ambivalence.

Concern about contagion and distress in intensive care unit (ICU) nurses during the COVID-19 pandemic. Motherhood as moderator.

The aim of this research is to analyze the role that children play between fear of contagion and distress in intensive care unit (ICU) nurses during the COVID-19 pandemic, taking into account possible work stressors. Cross-sectional study using an online survey. The selection of the sample was carried out by means of a non-probabilistic sampling for convenience, sending the link to professionals of the Spanish healthcare system who had been in contact with COVID-19 patients. Social networks were also used. Data was collected from May to July 2020. Mothers were selected from among the female nurses for participation in this study. The sample was composed of 283 female nurses working in critical care during the COVID-19 pandemic. Distress levels were significantly lower (F = 2.372, p = .048) in women with children over the age of 16 (M = 8.26, SD = 4.44) than in those without them (M = 10.30;DT = 3.75) (cohabitants). No differences were observed in worries about contagion between nurses with children (either under or over 16 years of age) and without children at home. The regression analysis found significant direct positive contributions of worries about contagion (p = .025) and the presence of children living at home (p = .033) on distress levels. We found a moderating effect of having children over 16 years old living at home in this relationship (ß = 2.198, t = 2.422, p = .016, 95 percentCI = .406-3.992). Our results suggest higher levels of distress in ICU nurses who are working-mothers during COVID-19 pandemic. Living at home with children over 16 years of age has a moderating effect. Our study results point to the need to create action protocols that prepare the health system for outbreaks including early care actions with special emphasis on higher risk groups.

Why do some people with severe chronic pain adhere to walking prescriptions whilst others won't? A cross-sectional study exploring clinical and psychosocial predictors in women with fibromyalgia.

Fibromyalgia (FM) is a highly disabling condition characterized by widespread chronic pain. Physical exercise, such as walking, has been recommended as the treatment of choice for FM. However, adherence to physical exercise tends to be poor. Pain is one of the main inhibitors to adhere to walking in FM patients. The main objective of this study has been to determine whether there is a clinical and psychosocial profile to help predict individual differences in adherence to walking in a sample of patients with FM with severe pain levels. In this cross-sectional study, the sample was composed of 172 women with FM and severe pain levels (> 7 in an 11-point numerical scale). Women were classified into two groups: (1) those who walked regularly and (2) patients who rarely or never walked. Group differences regarding clinical outcomes (e.g., FM impact, anxiety, depression, cognitive fusion, catastrophizing, affect, and personality), sociodemographic variables, and medical history were analyzed. Patients who walked despite pain significantly reported less impact of FM, anxiety, depression, catastrophizing, cognitive fusion, negative affect, openness to experience, agreeableness, and conscientiousness. The unique predictors of group membership (walking versus no walking) in a binary regression were FM impact and negative affect. The results show that adherence to exercise might be influenced and predicted by the clinical profile of the patient, which suggests that personalized motivational interventions should be addressed to this at-risk subgroup.

Relationship Between Postpartum Depression and Psychological and Biological Variables in the Initial Postpartum Period.

Objectives The aims of this study were to evaluate the predictive relationship between psychological symptomatology 24 h postpartum and depression 4 months postpartum, and analyze the relationship between estradiol and postpartum mood. Methods Two hundred women participated in an assessment 24 h postpartum and gave a blood sample for estradiol analysis. One hundred eleven of these women completed the second assessment 4 months postpartum. The Beck Depression Inventory II and the Scale of State-Trait Anxiety were used to assess psychological symptoms. Results At 24 h postpartum, symptoms of depression, trait anxiety, and state anxiety were all significantly correlated with each other. Depression at 24 h postpartum was the only significant independent predictor of depression at 4 months postpartum, explaining 28.7% of the variance. No statistically significant relationship was found between levels of estradiol and mood. Symptoms of depression immediately postpartum thus appear to be a predictor of postpartum depression. Conclusions for Practice These results suggest that early postpartum psychological evaluation of the mother, and intervention as warranted, might prevent or lessen postpartum depression.

Evolution of childbirth expectations in Spanish pregnant women.

PURPOSE: To analyze the change of childbirth expectations over the course of pregnancy as well as their relation to socio-demographic and clinical variables. BACKGROUND: The study of expectations in pregnant women is gaining more interest from a biopsychosocial approach because of its consequences on pregnant women's wellbeing. To our knowledge there are no previous studies analyzing the evolution of childbirth expectations over the course of pregnancy. METHODS: Longitudinal study (first trimester and third trimester). Women were evaluated for childbirth expectations in their first trimester (n=285) and third trimester (n=122) of pregnancy. They also completed questionnaires collecting socio-demographic information. RESULTS: Childbirth expectations appear to remain more or less stable over the course of pregnancy, although they tend to become slightly negative at the end of gestation, specifically referring to personal control and delivery circumstances. Multiparity and planned pregnancy are associated with higher positive expectations. CONCLUSION: It seems essential to explore and to try to adjust childbirth expectations to more realistic ones, in order for them to be fulfilled. Midwives and other maternity healthcare providers play a key role in this regard.

Post-Partum Depression, Personality, and Cognitive-Emotional Factors: A Longitudinal Study on Spanish Pregnant Women.

In this study, our purpose was to examine whether personality and cognitive factors could be related to post-partum depression (PPD), mediated by anxiety, in Spanish women. Women were evaluated for personality and cognitive factors after the first trimester, for anxiety in the third trimester, and for PPD 4 months after childbirth. A structural equation model revealed that personality and cognitive factors were associated with anxiety and PPD as predictors. Neuroticism and extroversion proved to be the most relevant factors. Conscientiousness was associated with pregnancy anxiety. Pregnancy anxiety appeared as an independent predictor of PPD. The model presented here includes personality and cognitive and emotional factors as predictors of PPD. Comprehensive care for pregnant women should contemplate assessment and intervention on all these aspects. Special focus should be on cognitive factors and emotional regulation strategies, so as to minimize the risk of later development of emotional disorders during puerperal phases.

Self-efficacy and affect as mediators between pain dimensions and emotional symptoms and functional limitation in women with fibromyalgia.

The aim of this study was to investigate the role of self-efficacy and affect as mediators of the relationship between pain and several fibromyalgia (FM) symptoms (functional limitation, depression, and anxiety). We evaluated 144 women with FM for self-reported pain (numerical pain scale), pressure pain sensitivity (pressure pain thresholds), functional limitation (Fibromyalgia Impact Questionnaire), self-efficacy (Chronic Pain Self-Efficacy Scale), depression-anxiety (Hospital Anxiety and Depression Scale), and positive-negative affect (Positive-Negative Affect Scale). Mediating analyses were conducted with ordinary least squares multiple regression analysis. The results demonstrated that self-reported pain and pressure pain sensitivity exhibited significant relationships with functional limitation, anxiety, depression, self-efficacy, and affect. Affect mediated the relationship between pressure pain sensitivity and anxiety, whereas self-efficacy was the mediating variable between self-reported pain and functional limitation and depression. Our results support a complex nature of pain in women presenting with FM, as cognitive and emotional variables have different mediator relationships between pain dimensions and functional and emotional outcomes in women with FM.

Post-Pandemic Insomnia in Healthcare Workers: A Prospective Study including Sociodemographic, Occupational and Psychosocial Variables.

Background/Objectives: Previous research points to the prevalence of insomnia during the COVID-19 pandemic among healthcare workers (HCWs). However, longitudinal studies on its evolution, including the post-pandemic stage, are less abundant, with a special lack of research about possible psychosocial risk factors. The aim of the current study is to analyze the evolution of insomnia in Spanish HCWs from the beginning of the pandemic until two years later, examining the influence of sociodemographic, occupational and psychosocial variables. Methods: This was a prospective longitudinal design with three data collection periods in which insomnia was assessed using the Insomnia Severity Index (ISI), in addition to sociodemographic, occupational and psychosocial (i.e., social support, self-efficacy, resilience and cognitive fusion) variables in HCWs (n = 216) who were in direct contact with COVID-19 patients. Results: High scores were observed for insomnia, with a clear decrease throughout the periods studied (F = 30.198, p < 0.001). An association was observed between insomnia and certain sociodemographic and occupational variables (i.e., work category, p = 0.001; availability of Personal Protective Equipment (PPE), p < 0.001; workload, p < 0.001; worry about self or family contagion, p = 0.002, p = 0.003, respectively). Insomnia had negative relationships with social support (p = 0.014), self-efficacy (p < 0.001) and resilience (p < 0.001) and positive relationships with cognitive fusion (p < 0.001). Interaction effects between the evolution of insomnia and social support from friends (p = 0.024, ƞ2 = 0.34) and between the evolution of insomnia and cognitive fusion (p = 0.047; ƞ2 = 0.25) were found. Conclusions: Social support, self-efficacy and resilience act as buffers for insomnia. Cognitive fusion acts as a clear precipitator of insomnia as well as directly influencing its evolution. Social support from friends also affects the evolution of insomnia. Within the specific circumstances of the COVID-19 pandemic, a long-term effect of social support from friends and a short-term effect of cognitive fusion on the evolution of insomnia was observed. The findings emphasize the need to implement specific interventions to promote the mental well-being of HCWs, particularly in crisis contexts that involve an increase in occupational stress, emphasizing the role of certain psychosocial variables as protective factors.

Headache and Associated Psychological Variables in Intensive Care Unit Nurses during the COVID-19 Pandemic: A Prospective Study.

(1) Background: Headaches in health professionals have been studied over the years. This has become even more relevant during the COVID-19 pandemic, due to their link with the use of masks, being female or working in highly complex units. However, their association with different personality traits has not been studied in healthcare workers (HCWs). The aim of this study was to assess the prevalence and evolution of headaches throughout the pandemic in Intensive Care Unit (ICU) nurses and to analyze their association with sociodemographic, occupational and personality variables as well as with other symptoms. (2) Methods: This was an observational, descriptive, longitudinal, prospective study with two periods of data collection (at the end of the containment phase and six months thereafter). A non-probabilistic convenience sampling was performed (n = 131). (3) Results: A high percentage of ICU nurses reported headaches during the first (71%) or second (79.4%) time point; more than half of the sample (58.8%) reported headaches over time (chronic headache). Although a higher prevalence of headaches was observed in women at both assessment points, no significant gender-related relationships were observed for headaches maintained across the two time points. Regarding the symptoms and personality variables, positive relationships were found between headaches and anxiety (p = 0.005), insomnia (p = 0.030) and emotional exhaustion (p = 0.022), and a negative relationship was found between headaches and hardiness (p = 0.031). (4) Conclusions: Our study highlights the importance of assessing occupational, psychological and emotional aspects in order to decrease the prevalence of headaches and thus improve the quality of the work life of nurses in such demanding environments as the ICU.

Looking at the Mental Health of Children and Adolescents with Cleft Lip and/or Palate through Neuroticism and Emotional Regulation Strategies: A Case-Controlled Observational Study.

Background: Children and adolescents with cleft lip and/or palate (CL/P) are at an increased risk of developing emotional disorders. This study aims to explore this question in greater depth by addressing three objectives: (1) the presence of neuroticism as an indicator of emotional symptomatology, (2) the use of adaptive and non-adaptive emotional regulation strategies, and (3) the relationship between these strategies and neuroticism. Methods: A case-control correlational methodology was employed, with 60 children and adolescents with CL/P (mean age = 12.80 years; 33 females) and 60 non-clinical equivalent children and adolescents. Results: The CL/P group has higher scores on neuroticism (t = -7.74; p ≤ 0.001, d Cohen = 1.43) and lower scores in almost all emotional regulation strategies. The presence of CL/P moderated the relationship between neuroticism and self-blame (Beta = -0.46, t = -2.81, p = 0.005), rumination (Beta = -0.49, t = -3.73, p < 0.001), catastrophizing (Beta = -0.61, t = -4.26, p < 0.001), and blaming others (Beta = -0.45, t = -2.84, p = 0.005). This model predicted a significant variance of neuroticism (all p < 0.005), which ranged from 39% to 41%. Conclusions: The CL/P group has worse mental health indicators. Particularly novel results about the CL/P group are the lower scores on regulation strategies (both adaptive and non-adaptive) and the fact that non-adaptive strategies contribute, contrary to their effect in the general population, to a decrease in neuroticism. It supports the need to incorporate mental health indicators in the diagnosis and treatment of children and adolescents with CL/P.

A study on optimism as a psychological strength in nurses through a prospective study from the outbreak of the COVID-19 pandemic to two years later.

Aims and objectives: This study analyzes, in nurses, the influence of openness to experience and hardiness (assessed at baseline and one year after the COVID-19 pandemic respectively) on the development of optimism (assessed two years after the COVID-19 pandemic). Concerns about self-contagion were included as a moderating variable, given their relevance as a risk factor. Background: Nurses have been among the healthcare professionals most affected by the COVID-19 pandemic. Most previous studies have focused on the variables contributing to psychological symptoms, whilst the attention given to the variables adding to the well-being of these professionals has been much scarcer. Design: A prospective study was carried out. Methods: This study was carried out using three data collection periods: Period 1 (From May to June 2020), Period 2 (From January 2021 to April 2021), and Period 3 (From April 2022 to July 2022), with the participation of 151 Spanish nurses, using online self-reporting questionnaires. The study followed the STROBE statement. Results: The results showed that the proposed model was statistically significant. There was a positive effect of openness to experience (year 2020) on hardiness assessed one year later (year 2021). Similarly, hardiness had a positive effect on optimism assessed another year on (year 2022). Conclusions: Concerns about self-contagion behaved as a moderator in the relationship between openness to experience and hardiness (the relationship between openness and hardiness was statistically significant when contagion concern was higher). Relevance to clinical practice: In-depth understanding of the psychological processes that trigger psychological strengths (i.e. optimism) as a result of adverse situations (i.e. COVID-19 pandemic) is essential in promoting the mental health of healthcare professionals. Interventions targeting resilient personality traits and cognitive flexibility are key to this goal. No Patient or Public Contribution: The participants contributed exclusively to the collection of the sample.

Coping strategies of Spanish pregnant women and their impact on anxiety and depression.

The aims of this study were to analyze the coping strategies used by women in the first trimester of low-risk pregnancies, their relationships to sociodemographic and pregnancy variables, and their ability to predict anxiety and depression in the third trimester. Participants in the first trimester were 285 Spanish pregnant women, of whom 122 were followed into the third trimester. The use of problem-focused coping was stable, whereas variations occurred in emotion-focused coping. Age, educational level, employment, planned pregnancy, previous childbirth, and previous miscarriage were associated with adaptive coping. Coping strategies predicting anxiety and depressive symptoms were overt emotional expression and social support seeking. Coping through religion predicted anxiety. Coping is a complex process influenced by sociodemographic and obstetric factors that can contribute to the onset of psychological symptoms.

Psychopathological symptoms and locus of control in women with low-risk pregnancies.

This study investigated the role of locus of control in the development of psychopathological symptoms during pregnancy and postpartum in women with low-risk pregnancies. Pregnant women participated during the first trimester of pregnancy (n = 285), third trimester (n = 122), and in the postpartum (n = 116). Participants were assessed for locus of control (first and third trimesters) and psychopathological symptoms (first and third trimesters and postpartum). Sociodemographic and pregnancy variables (previous childbirth, previous miscarriage, and whether the pregnancy was planned) were also assessed. Significant differences were observed in the development of somatization and obsessive-compulsive symptoms during pregnancy and postpartum. Both increased in the third trimester and decreased after delivery. Previous births, planned pregnancy, having a job, and increasing age were protective variables. As pregnancy progressed, locus of control was significantly externalized. In the first trimester, significant differences were found for locus of control (internal vs. external) among almost all the psychopathological symptoms, but in the third trimester, significant differences were only found in obsessive-compulsiveness and interpersonal sensitivity. In two trimesters, internal locus of control was a protective health variable. Regression analysis showed that external locus of control was related only to phobic anxiety in the third trimester. Adoption of a bio-psycho-social model, such as internal locus of control, may increase personal resources in pregnant women.

Anxiety, depression and alexithymia in fibromyalgia: are there any differences according to age?

This article analyzes the evolution of alexithymia, anxiety, and depression associated with fibromyalgia (FM) in three age groups in comparison to how they evolve in the same age groups in healthy women. A total of 240 women participated in the study (120 diagnosed with fibromyalgia and 120 healthy women), divided into three age groups (≤35 years,>35 and <65 years, and ≥65 years old). Our analysis revealed that alexithymia, anxiety, and depression in FM patients showed increased levels compared to healthy controls. Also, young women with FM (under 35) show lower alexithymia, anxiety, and depression levels in comparison to older patients (≥65). Alexithymia in FM patients follows a similar pattern as in healthy women (although with significantly higher scores), increasing with age. Our results show that depression, anxiety, and alexithymia develop over age in a different way in FM patients than in healthy individuals, increasing over age.

Consideration of Psychosocial Factors in Acute Low Back Pain by Physical Therapists.

Clinical guidelines consistently recommend screening psychosocial (PS) factors in patients with low back pain (LBP), regardless of its mechanical nature, as recognized contributors to pain chronicity. However, the ability of physiotherapists (PTs) in identifying these factors remains controversial. This study aimed to assess the current identification of psychosocial risk factors by physical therapists (PTs) and which characteristics of PTs are associated with the identification of the main risk for chronicity (physical or psychosocial). A cross-sectional descriptive study surveying Spanish PTs in public and private health services was conducted, including questions on PT characteristics and three low back pain (LBP) patient vignettes with different biopsychosocial (BPS) clinical presentations. From 484 respondents, the majority of PTs agreed regarding the main risk for chronicity for each vignette (PS 95.7% for vignette A, PS and physical 83.5% for vignette B and PS 66% for vignette C). Female PTs were more likely to rate psychosocial compared with males (p < 0.05). PTs with higher levels of social and emotional intelligence (both, p < 0.05) were more likely to identify the main risk for chronicity. However, only gender and social information processing for vignette A (p = 0.024) and emotional clarity for vignette B (p = 0.006) were able to predict the identification of psychosocial and physical risk, respectively. The main risk for chronicity was correctly identified by a large majority of PTs through patient vignettes. Gender, social and emotional intelligence played a relevant role in the recognition of psychosocial risk and biopsychosocial factors.

Patient-reported outcome measurements (PROMs): Use during the physical therapy practice and associated factors.

OBJECTIVE: To assess the current level of routine use of psychosocial-related patient-reported outcome measurements (PROMs) in physical therapy practice and which physical therapist-level factors are associated with the use of these measurement instruments. METHODS: We conducted an online survey study among Spanish physical therapists involved in the treatment of LBP patients in Public Health Service, Mutual Insurance Companies, and private practice during 2020. Descriptive analyses were conducted for reporting the number and instruments utilized. Thus, sociodemographic and professional features differences between PTs using and not using PROM were analyzed. RESULTS: From 485 physiotherapists completing the questionnaire nationwide, 484 were included. A minority of therapists routinely used psychosocial-related PROMs (13.8%) in LBP patients and only 6.8% did so through standardized measurements instruments. The Tampa Scale for Kinesiophobia (28.8%) and the Pain Catastrophizing Scale (15.1%) were used most frequently. Physiotherapists working in Andalucía and País Vasco regions, in private practice environments, educated in psychosocial factors evaluation and management, considering psychosocial factors during the clinical practice and expecting patients' collaborative attitudes demonstrated significantly greater use of PROMS (p < 0.05). CONCLUSIONS: This study showed that the majority of physiotherapists in Spain do not use PROMs for evaluating LBP (86.2%). From those physiotherapists using PROMs, approximately the half use validated instruments such as the Tampa Scale for Kinesiophobia or the Pain Catastrophizing Scale while the other half limit their evaluation to anamnesis and non-validated questionnaires. Therefore, developing effective strategies to implement and facilitate the use of psychosocial-related PROMs would enhance the evaluation during the clinical practice.

The role of life satisfaction in the association between problematic technology use and anxiety in children and adolescents during the COVID-19 pandemic.

The main aim of this study is to explore problematic technology use among adolescents (Internet, video games, mobiles, and television) and its association with anxiety symptoms. Furthermore, we also analysed the possible moderating role of life satisfaction in this relationship during the COVID-19 pandemic in Spain. A cross-sectional survey of 4025 children and adolescents (52% females and 48% males) between 12 and 18 years old was carried out to explore problematic technology use and its correlation with anxiety and life satisfaction after pandemic lockdown. Four multivariate regressions containing the independent variable (problematic technology use), the moderator (life satisfaction), and their interaction were entered to predict the outcome (anxiety). The moderated models were examined using SPSS PROCESS macro software (Model 1). Analyses showed significant positive correlations with anxiety and negative correlations with life satisfaction regarding problematic technology use (mobile phone, television, and internet). Both gender and age had a significant direct effect on anxiety (showing that women and older participants had the greatest anxiety). In the moderation analysis, when life satisfaction was higher, the presence of anxiety symptoms depended to a greater extent on the problematic use of technology. Our results confirm that problematic technology use is related to higher levels of anxiety in adolescents, with differences by age and gender. The results also showed that life satisfaction mediated the relationship between technology abuse and anxiety, such that when life satisfaction was higher, the presence of anxiety symptoms was more dependent on problematic technology use. These findings have implications for health and education professionals.

Mother-Child Bond through Feeding: A Prospective Study including Neuroticism, Pregnancy Worries and Post-Traumatic Symptomatology.

Post-traumatic stress disorder (PTSD) is a common postpartum problem and influences maternal bonding with the infant. However, the relationship between this disorder, maternal personality, and the infant's emotional state during feeding is not clear. The aim of the present study was to explore the contribution of neuroticism on the infant's emotional state during feeding, by attending to the mediating role of postpartum PTSD (P-PTSD) symptoms and the moderating role of worries during pregnancy. A prospective design study was developed with 120 women with a low pregnancy risk. They responded to a questionnaire assessing maternal personality (first trimester), worries during pregnancy (third trimester), P-PTSD symptoms, and mother-baby bonding (4 months postpartum). The results showed a positive association among neuroticism, infant irritability during feeding, and P-PTSD symptoms, suggesting the latter plays a mediating role in the relationship between neuroticism and infant irritability (B = 0.102, standard error (SE) = 0.03, 95% coefficient interval (CI) [0.038, 0.176]). Excessive worries, related to coping with infant care, played a moderating role between neuroticism and P-PTSD symptoms (B = 0.413, SE = 0.084, p = 0.006, 95% CI [0.245, 0.581]). This relationship was interfered with by depressive symptoms in the first trimester (covariate) (B = 1.820, SE = 0.420, p = 0.016, ci [2.314, 0.251]). This study contributes to a better understanding of the role of neuroticism as an influential factor in the occurrence of P-PTSD symptoms, and in the impairment of infant bonding during feeding. Paying attention to these factors may favor the development of psychological support programs for mothers, with the aim of strengthening the bond with their child.