RESUMO
AIMS: Assess the prevalence of dual pathology in patients with alcohol dependence and describe the psychopathological profile of mental disorders, impulsiveness, ADHD presence and craving. METHOD: It is a cross-sectional study about dual pathology, carried out on 102 patients undergoing outpatient treatment. The presence of dual pathology is established by means of the MINI-5 interview and the MCMI-III test; DSM-IV being used as the alcohol abuse criteria. Impulsiveness, ADHD presence, craving and quality of life were measured through SIS, ASRSv1, MACS and SF-36. RESULTS: The prevalence of dual pathology ranges from 45.1% to 80.4% according to MCMI-III and MINI-5, respectively. The most frequent pathologies are current major depressive episodes, followed by current generalized anxiety disorders, suicide risk and current dysthymia disorders; 73.2% of dual patients present a moderate and intense global score according to MACS, 56.1% got a meaningful score in impulsiveness according to SIS and 41.5% has highly consistent symptoms with ADHD. As regards quality of life, 53.7% of the sample had bad mental health. In the case of dual patients consuming other substances, 30% had a history of bipolar disorders and 10% had a high suicide risk. CONCLUSIONS: The prevalence of psychiatric comorbidity in patients with alcohol dependence undergoing outpatient treatment varies depending on the detection method, MINI being the one identifying a greater number of cases. More than half of dual patients present impulsive behavior, a bad mental health state and high craving levels. Special attention should be paid to dual patients consuming other substances.
Assuntos
Alcoolismo/epidemiologia , Alcoolismo/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Adulto , Idoso , Assistência Ambulatorial , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students.A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbach's Alpha, the Kappa index, Spearman's correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence.Cronbach's alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD.
El objetivo de este trabajo fue determinar las propiedades psicométricas de los cuestionarios Alcohol Use Disorders Identification Test (AUDIT y AUDIT-C) para la detección de problemas por consumo de alcohol en universitarios. Participaron 1309 estudiantes, utilizando el Diario de consumo semanal como patrón de referencia y para el análisis de fiabilidad y validez el alfa de Cronbach, análisis exploratorio, índice kappa, coeficiente de correlación de Spearman y curvas ROC para los diferentes puntos de corte. Un 3,9% de hombres y un 4% de mujeres con consumo de riesgo bajo presentaba consumo intensivo de alcohol (BD).AUDIT identificó un 20,1% de Bebedor de riesgo y un 6,4% de Bebedor con problemas físico-psíquicos y probable dependencia alcohólica. El instrumento presentó un alfa-Cronbach de 0,75 demostrando buena consistencia interna. Los puntos de corte óptimos fueron ocho para Bebedor de riesgo en hombres y seis para mujeres; trece puntos para Bebedor con problemas físico-psíquicos y probable dependencia alcohólica en ambos sexos; con AUDIT-C, fueron para Consumo de riesgo cinco para hombres y cuatro para mujeres. La validez de criterio para detectar consumo intensivo de alcohol (BD) con ambas versiones presentó un valor K moderado. Los resultados indican que AUDIT cuenta con adecuadas propiedades psicométricas para detectar precozmente problemas de consumo de alcohol en universitarios, recomendándose reducir su punto de corte a ocho en varones. El AUDIT-C mejora su poder predictivo aumentando en una unidad el punto de corte. Se recomienda revisar los ítems 2 y 3 para aumentar el valor predictivo del BD.
Assuntos
Consumo de Álcool na Faculdade , Autorrelato , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Adulto JovemRESUMO
OBJECTIVE: This research delves into the intricate interplay between antipsychotic medications and neuroprotection focusing on the S100B protein-a central player in the regulation of neuroapoptotic activity. METHOD: Blood samples were collected to assess serum S100B protein levels using an immunoassay of immunoelectrochemiluminescence. The first two samples were collected with a 3-month interval between each, and the third sample was obtained 6â¯months after the previous one. Changes in S100B protein levels throughout the study were assessed using Friedman's ANOVA test. This was followed by the Wilcoxon signed-rank test with Bonferroni correction to account for multiple comparisons. RESULTS: This study involved 40 patients diagnosed with severe mental disorders (34 schizophrenia, 4 schizoaffective disorder, 1 bipolar disorder, and 1 borderline personality disorder). These patients had been receiving antipsychotic treatment for an average duration of 17â¯years. The results revealed that the S100B protein remained within physiological levels (median values 39.0â¯ng/L for the first sample, median values 41.0â¯ng/L for the second sample, and median values 40.5â¯ng/L for the third sample) with no significant changes (pâ¯=â¯0.287), with all anti-psychotic medicaments values consistently below 50â¯ng/L, a lower value compared to maximum range of 105â¯ng/L. Importantly, there were no significant differences in S100B protein levels between patients on monotherapy and those on combination antipsychotic therapy (pâ¯=â¯0.873), suggesting that combination therapy did not increase neuroapoptotic activity. CONCLUSIONS: These findings provide compelling evidence for the potential neuroprotective effects of long-term antipsychotic treatment in individuals with severe mental disorders. By maintaining physiological levels of the S100B protein, antipsychotic medications may help protect against neuronal damage and dysfunction. This research contributes valuable insights into the neuroprotective mechanisms of antipsychotic drugs, enhancing our understanding of their potential benefits in the treatment of severe mental disorders.
RESUMO
The COVID-19 pandemic was an unprecedented situation that raised concerns about the physical and mental health of adolescents. Several surveys demonstrated that post-lockdown, women reported more complaints and lower perceived quality of life compared to men. The aim of this study was to analyze gender differences in self-reported physical and mental health immediately after the second lock-down restrictions (July 2020 to December 2020) were suspended and physical exercise classes resumed after a break of several months. This was achieved using a comparative cross-sectional survey of over-18-year-old students from the faculties of Sports Science and Physical Therapy at the University of Cadiz (UCA) in Spain. Quality of life was assessed using two types of questionnaires. The first covered quality of nutrition (PREDIMED), and the second assessed emotional impact (SF12). Physical activity level was estimated using the International Physical Activity Questionnaire (IPAQ). Of the 166 participants in this study, about two-thirds were men. Men had a better perception of their overall health quality than women. In addition, men had significantly fewer limitations in performing activities of daily living than their female counterparts. In contrast, female university students had better coping strategies, that is, they were better able to handle the problems of daily life and did so with more composure, attention, and concentration. These findings highlight the differences in post-release recovery between men and women and can be used to develop programs to promote better living standards and services to reduce gender disparities, which can ultimately improve quality of life.
RESUMO
AIM: To report the adaptation into Spanish and psychometric testing of the Position on Nursing Diagnosis scale. BACKGROUND: The Position on Nursing Diagnosis is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. DESIGN: Methodological design. METHOD: The scale was cross-culturally adapted through a process including translation, comparison with versions in other languages, back-translation, review, and pre-testing. An opportunistic sample of 621 Spanish registered nurses was recruited from August-December 2011. Reliability was evaluated through internal consistency and test-retest reliability. Construct validity, using both exploratory factor analysis and the known-group technique, and concurrent validity were assessed. FINDINGS: The Position on Nursing Diagnosis-Spanish Version was obtained from the cross-cultural adaptation process. High internal consistency and satisfactory test-retest reliability over a two week period (n = 240) were found. In the principal component analysis, all items loaded strongly on a single-factor which accounted for adequate variance, supporting the unidimensionality of the scale. A statistically significant difference was found comparing the scores of nurses who were members of the Spanish Association of Nomenclature, Taxonomy and Nursing Diagnosis and those who were not. Concurrent validity was supported by the significant correlation found between the scores and the degree of nursing diagnosis utilization and attendance to training sessions. CONCLUSION: The findings support the validity and reliability of the Position on Nursing Diagnosis-Spanish Version for its use among Spanish registered nurses as a measurement of their attitude towards the nursing diagnosis concept.
Assuntos
Comparação Transcultural , Diagnóstico de Enfermagem , Psicometria , Tradução , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , EspanhaRESUMO
The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.
Assuntos
Atitude do Pessoal de Saúde , Diagnóstico de Enfermagem/estatística & dados numéricos , Enfermagem , Inquéritos e Questionários , Estudos Transversais , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Espanha , Estudantes de Enfermagem , Adulto JovemRESUMO
Multimorbidity is associated with lower quality of life, greater disability and higher use of health services and is one of the main challenges facing governments in Europe. There is a need to identify and characterize patterns of chronic conditions and analyse their association with social determinants not only from an individual point of view but also from a collective point of view. This paper aims to respond to this knowledge gap by detecting patterns of chronic conditions and their social determinants in 19 European countries from a multilevel perspective. We used data from the ESS round 7. The final sample consisted of 18,933 individuals over 18 years of age, and patterns of multimorbidity from 14 chronic conditions were detected through Multilevel Latent Class Analysis, which also allows detecting similarities between countries. Gender, Age, Housing Location, Income Level and Educational Level were used as individual covariates to determine possible associations with social inequalities. The goodness-of-fit indices derived in a model with six multimorbidity patterns and five countries clusters. The six patterns were "Back, Digestive and Headaches", "Allergies and Respiratory", "Complex Multimorbidity", "Cancer and Cardiovascular", "Musculoskeletal" and "Cardiovascular"; the five clusters could be associated with some geographical areas or welfare states. Patterns showed significant differences in the covariates of interest, with differences in education and income being of particular interest. Some significant differences were found among patterns and the country groupings. Our findings show that chronic diseases tend to appear in a combined and interactive way, and socioeconomic differences in the occurrence of patterns are not only of the individual but also of group importance, emphasising how the welfare states in each country can influence in the health of their inhabitants.
RESUMO
BACKGROUND: The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities. METHODS: This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model. RESULTS: We obtained a model with five patterns (entropy = 0.727): 'Relative Healthy', 'Cardiometabolic', 'Musculoskeletal', 'Musculoskeletal and Mental', and 'Complex Multimorbidity'. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression. CONCLUSIONS: We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments.
Assuntos
COVID-19 , Multimorbidade , Humanos , Pandemias , Determinantes Sociais da Saúde , COVID-19/epidemiologia , Fatores SocioeconômicosRESUMO
WHAT IS KNOWN ON THE SUBJECT?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people. There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties. There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The positive evolution of attitudes towards mental illness does not last over time. Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices. The design of any anti-stigma intervention must include the factor of "time". ABSTRACT: Introduction The stigma of health professionals is a contributing factor to morbi-mortality among people with mental health difficulties. There is a lack of research on long-term outcomes in nursing students. Objective To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self-education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti-stigma activities.
Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais , Enfermagem Psiquiátrica/educação , Estigma Social , Estudantes de Enfermagem , Adulto , Currículo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
AIM: To describe the alcohol drinking patterns and binge drinking episodes (BDE) in a sample of Health Science students, as well as identify associated factors. METHOD: It is a descriptive study, in which sociodemographic variables and a weekly alcohol consumption diary recording the number of standard drinking units consumed at different times of the day are collected by means of a self-administered questionnaire. RESULTS: 286 students (66.1% women) from Cadiz University (193 Medical students and 93 Nursing students), with a mean age of 21.1 (SD 2.8) years, took part in this study. Forty-four point 8percent of the students live with their families. Sixty-five point 7percent of the students drank alcohol in the previous week, this was more usual in the males. The weekly alcohol consumption pattern was 74.5% for low-risk alcohol consumption, 21% for moderate-risk and 4.5% for a high-risk consumption. Thirty-three point 9percent had 1-2 BDE over the previous week apart from their weekly consumption pattern. Twenty-six point 6percent of the students who were emancipated had moderate-risk consumption, 8.2% had a high-risk consumption and 41.8% had a binge drinking episode. There were statistically significant associations between the weekly consumption pattern regarding sex, habitual residence and BDE variables. CONCLUSIONS: More than half the students had taken alcohol the previous week, mainly at weekends. The high prevalence of BDE is highlighted. We propose enhancing early detection and prevention campaigns in this population.
Assuntos
Consumo de Álcool na Faculdade , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Prevalência , Risco , Fatores Sexuais , Espanha , Inquéritos e Questionários , Fatores de Tempo , Adulto JovemRESUMO
INTRODUCTION: A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. OBJECTIVE: To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. METHOD: A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. RESULTS: Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. CONCLUSIONS: Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem.
Assuntos
Suicídio/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Causas de Morte , Estudos de Coortes , Ética em Pesquisa , Humanos , Incidência , Estudos Longitudinais , Prevalência , Fatores de Risco , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos , Adulto Jovem , Prevenção do SuicídioRESUMO
Resumen: Objetivo: Identificar la posible influencia de los «estilos de la crianza¼ con la «actitud hacia el cambio¼ en pacientes diagnosticadas de trastorno de la conducta alimentaria según criterios DSM-IV-TR (American Psychiatric Association -APA-, 1994). Método: Fueron incluidas 166 pacientes de las cuales 66 (39.8%) recibieron el diagnóstico de bulimia nerviosa, 49 (29.5%) de anorexia nerviosa y 51 (30.7%) de trastorno de la conducta alimentaria no especificado. Todas las pacientes completaron una batería de cuestionarios para evaluar las relaciones familiares (APGAR familiar), los recuerdos de su crianza y su actitud hacia el cambio (ACTA) al año de seguimiento. Resultados: En el análisis de regresión múltiple realizado, se observó que la «sobreprotección¼ percibida en la infancia se relacionaba con mayores puntuaciones en «precontemplación¼ y menores puntuaciones en «acción¼ y «mantenimiento¼ . Por otra parte, el «rechazo¼ percibido en la crianza se relacionaba con puntuaciones más elevadas en «precontemplación ¼, independientemente del grado de disfunción familiar existente. Por último, el «afecto¼ percibido se relacionaba directamente con puntuaciones superiores en la fase de «acción¼ . Conclusiones: Estos resultados nos muestran la importancia de la crianza en aspectos tan relevantes del tratamiento como la motivación ante el cambio.
Abstract: Objective: To evaluate the relationships between "parental rearing styles" and "attitude towards change" in eating disorders patients according to DSM-IV-TR (American Psychiatric Association -APA-, 1994). Methods: A total of 166 patients was evaluated: 66 (39.8%) patients met criteria for bulimia nervosa, 49 (29.5%) patients met criteria for anorexia nervosa and 51 (30.7%) patients met criteria for an eating disorder not otherwise specified. All the patients completed a set of self-administered questionnaires to evaluate their family relationships (APGAR familiar), their memories of parental upbringing and their attitudes towards change (ACTA) after one year treatment. Results: A multiple regression analysis was performed. "overprotection " perceived during childhood was related to higher scores in "pre-contemplation " and lower scores in "action " and "maintenance ". On the other hand, "rejection " during upbringing was related to higher scores in "pre-contemplation " at one year follow-up regardless of family dysfunction. Finally, "warm " perceived was related to higher scores in "action" . Conclusions: These results show the relevance of breeding in treatment important aspects in eating disorders patients.
RESUMO
El Position on Nursing Diagnosis (PND) es una escala que utiliza la técnica del diferencial semántico para medir las actitudes hacia el concepto diagnóstico enfermero. El estudio objetivó desarrollar una forma abreviada de la versión española de esta escala, evaluar sus propiedades psicométricas y eficiencia. Se utilizó un doble enfoque empírico-teórico para obtener una forma reducida del PND, el PND-7-SV, que fuera equivalente a la original. Mediante un diseño transversal a través de encuesta, se evaluó la fiabilidad (consistencia interna y fiabilidad test-retest), validez de constructo (análisis factorial exploratorio, técnica de grupos conocidos y validez discriminante) y de criterio (validez concurrente), sensibilidad al cambio y eficiencia del PND-7-SV en una muestra de 476 estudiantes de enfermería españoles. Los resultados avalaron la utilidad del PND-7-SV para medir las actitudes hacia el diagnóstico enfermero de manera equivalente a la forma completa de la escala y en un tiempo más reducido.
O Position on Nursing Diagnosis (PND) é uma escala que utiliza a técnica do diferencial semântico para medir atitudes em relação ao conceito diagnóstico de enfermagem. O objetivo deste estudo foi desenvolver uma forma abreviada da versão em espanhol desta escala e avaliar suas propriedades psicométricas e eficiência. Foi utilizada uma dupla abordagem teórico-empírica para obter uma forma curta do PND, o PND-7-SV, que era equivalente à original. Usando um desenho transversal através de pesquisa, foi avaliada a confiabilidade (consistência interna e confiabilidade teste-reteste), validade de constructo (análise fatorial exploratória, técnica de grupos conhecidos e validade discriminante) e de critério (validade concorrente), sensibilidade à mudança e eficiência da PND-7-SV em uma amostra de 476 estudantes de enfermagem espanholas. Os resultados endossaram a utilidade do PND-7-SV para medir atitudes em relação ao diagnóstico de enfermagem de maneira equivalente à forma completa da escala e em um curto tempo.
The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.