Comparison of psychopathology, purpose in life and moral courage between nursing home and hospital healthcare workers during the COVID-19 pandemic.

The COVID-19 pandemic deeply affected healthcare workers, although the impact may have differed according to different workplace contexts. The aim of this current research was to compare the psychopathology presented by hospital versus nursing home healthcare workers during the COVID-19 pandemic and to analyse the predictive role of purpose in life and moral courage in the appearance of psychopathology. This was an observational, cross-sectional study carried out on a sample of 108 healthcare workers, 54 each from a hospital or nursing homes, who were recruited during the 5 and 6th waves of the COVID-19 pandemic in Spain. Various self-reported scales were used to assess anxiety, depression, acute/post-traumatic stress disorder, drug and alcohol abuse, burnout, purpose in life, and moral courage. Compared to the hospital healthcare workers, nursing home healthcare workers had higher scores and a higher prevalence of anxiety (74.1% vs. 42%), depression (40.7% vs. 14.8%), and post-traumatic stress disorder (55.6% vs. 25.9). In the overall sample, purpose in life was a protective factor against psychopathology (OR = 0.54) and burnout (OR = 0.48); moral courage was a protective factor against depression (OR = 0.47) and acute stress (OR = 0.45); and exposure of family/friends to SARS-CoV-2 was a risk factor for acute stress (OR = 2.24), post-traumatic stress disorder (OR = 1.33), and higher burnout depersonalisation subscale scores (OR = 1.84). In conclusion, the increased presence of psychopathology in nursing home healthcare workers may be influenced by workplace and occupational contexts, personal factors such as exposure of family/friends to SARS-CoV-2, or internal dimensions such as purpose in life and moral courage. This knowledge could be useful for understanding how a future epidemic or pandemic might affect the mental health of healthcare workers in different labour contexts.

Relationship of sociodemographic and clinical characteristics to mechanical restraint used in a psychiatric hospital in Spain.

BACKGROUND: Coercive measures have been applied in mental health fields throughout history, denying people with mental illness the ability to decide, even though there is increasing evidence that these measures bring few benefits to these individuals. OBJECTIVE: The objective of this study was to analyse the sociodemographic and clinical characteristics most likely associated with the use of mechanical restraints (MRs) in psychiatric hospital settings. DESIGN, SETTINGS AND PARTICIPANTS: This was a descriptive, comparative and analytical cross-sectional study in people with mental disorders who were hospitalized in two hospitals in the Autonomous Valencian Community (Spain). We included a total of 91 participants who completed the Scale to Assess Unawareness of Mental Disorder (SUMD), Positive and Negative Syndrome Scale (PANSS), Barrat's Impulsiveness Scale and the Hamilton Anxiety Scale. RESULTS: The results we collected indicated that the patients most likely to be mechanically restrained were younger people with less awareness of their symptoms and disease, previous admissions to a psychiatric hospital and cohabitation with parents and/or family. In addition, having been admitted involuntarily, previously having had MRs applied, presenting more positive psychotic symptoms and habitual caffeine consumption all predicted the use of MRs. CONCLUSIONS: The variables that were able to predict MR were involuntary admission, previous use of MR, the presence of positive psychotic symptoms and caffeine consumption. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Evaluation of the sociodemographic and clinical characteristics of patients can help health professionals, especially nurses, to recognize patients who are at risk of requiring MR. This allows mental health practitioners to take these factors into account during interventions or when implementing programmes designed to reduce the use of coercive measures in psychiatric hospital settings. IMPACT: What problem did the study address? Coercive measures have been applied in mental health fields throughout history, with no benefits to these patients. What were the main findings? There are studies that relate some variables to MR in psychiatric settings, but we have been able to find variables capable of predicting MR such as involuntary admission, previous use of MR, the presence of positive psychotic symptoms and caffeine consumption. Where and on whom will the research have an impact? The findings of this study allow for the reduction of MRs in psychiatric units. The sociodemographic and clinical characteristics found to be related to MR will help professionals identify when a patient is admitted in order to use specific interventions aimed at preventing the use of MRs during admission. This is the first study to indicate a relationship between caffeine consumption and the use of MRs. Further studies will be necessary to verify if controlled caffeine supplementation during admission to psychiatric units could become an additional strategy contributing to preventing the application of MR specifically in individuals who habitually consume coffee or caffeine-containing beverages daily. REPORTING METHOD: We have adhered to relevant EQUATOR guidelines using the STROBE reporting method. PATIENT CONTRIBUTION: No patient or public contribution.

Nutritional habits in patients with peripheral arterial disease: Adherence to the mediterranean diet. / Hábitos nutricionales en los pacientes con enfermedad arterial periférica: adherencia a la dieta mediterránea.

INTRODUCTION: Adherence to the Mediterranean diet (Dietmed) exerts protective effects on cardiovascular disease (CVD). In the Lower Extremity Peripheral Arterial Disease (PAD) there are fewer studies that analyze these data. OBJECTIVE: To determine adherence to Dietmed and dietary habits in patients with PAD, according to a history of CVD (coronary and/or cerebral ischaemic pathology) and according to the ankle-brachial index (ABI ≥ or <0,5). MATERIAL AND METHODS: Cross-sectional analytical study carried out in a tertiary hospital. The sample was collected consecutively. Sociodemographic and clinical history, ankle-brachial index (ABI) and a 14-point Dietmed adherence dietary questionnaire were included. The analysis of categorical variables was carried out using the Pearson's Chi-Square test, the T-Student's statistic test for independent samples was used for parametric variables and the U. Mann-Whitney test for non-parametric variables. RESULTS: Of the 97 patients, 87,6% had low adherence to Dietmed, with no differences according to the severity of PAD. However, when we analysed the data according to whether or not they had a history of CVD, we observed a high adherence to some items included in Dietmed, specifically, in the CVD group, the consumption of lean meat (95,5% vs 64%; P=.004). In addition, we observed a significant difference in the consumption in the group without a history of CVD (32% vs 9,1%; P=.033). CONCLUSION: In our population, patients with PAD, regardless of the stage of the disease and whether they had associated coronary or cerebral ischaemic pathology, had low adherence to Dietmed. Therefore, it is important to implement nutritional education programmes in patients with PAD in all stages, as well as in those patients who have already suffered a vascular event, so that they maintain adherence to healthy dietary habits in the long term.

Clozapine as a mood stabiliser for schizoaffective disorder: Effectiveness during a three-month follow-up.

Clozapine has shown signs of effectiveness in treating symptoms of schizoaffective disorder, although little research has been carried out to specifically assess this question. The objective of this current work was to analyse the mood-stabilising effectiveness and tolerability of clozapine in patients with schizoaffective disorder. This was a prospective, longitudinal, and quasi-experimental trial with three months of follow-up in patients with refractory schizoaffective disorder (PANSS score exceeding 80). Clinical response was evaluated through monthly visits using the YMRS, MADRS, CDSS, CGI-S and UKU. Twenty-seven participants (63% men, 37% women) with a mean age of 32.56 years were included. Clozapine significantly reduced the symptoms of mania, as measured by the YMRS (pre-treatment: 16.19, post-treatment: 0.67; p < 0.01) as well as the symptoms of depression, quantified with the CDSS (pre-treatment: 6.11, post-treatment: 0.67; p < 0.01), MADRS (pre-treatment: 9.56, post-treatment: 1.07; p < 0.01), and CGI-S (pre-treatment: 4.74, post-treatment: 1.15; p < 0.01). The prescription of clozapine significantly reduced the average daily dose of neuroleptics, measured in mg of chlorpromazine (pre-treatment: 1253.55, post-treatment: 742.59; p < 0.01) and hypnosedatives, measured in mg of diazepam (pre-treatment: 33.88, post-treatment: 5.74; p < 0.05) required in these patients. Patient-perceived tolerability, measured with the UKU, also improved during follow-up (pre-treatment: 12.89, post-treatment: 8.14; p < 0.01). The efficacy of clozapine was significant for the affective symptoms of schizoaffective disorder, thereby improving patient tolerability and permitting reductions in the other medications the patients used.

Inflammatory biomarkers and psychological variables to assess quality of life in patients with inflammatory bowel disease: a cross-sectional study.

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic gastrointestinal condition. While inflammatory biomarkers are valuable for diagnosing and monitoring the disease, their correlation with patients' quality of life (QoL) is not well-established. PURPOSE: This study aims to investigate the correlations between inflammatory biomarkers and the quality of life (QoL) variables of individuals diagnosed with IBD in clinical remission. METHODS: The sample of this cross-sectional study included 74 patients (80% women; 45 ± 11 years old) diagnosed with IBD. Outcome variables included faecal calprotectin (FC), C-reactive protein (CRP), cortisol levels from hair samples, and anxiety and depression assessed using the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), alongside QoL evaluated with the Inflammatory Bowel Disease Questionnaire 32 (IBDQ-32). Bivariate correlations were calculated using the Pearson correlation coefficient, and stepwise linear regression analyses were conducted to identify independent factors contributing to IBDQ-32 scores. RESULTS: The IBDQ-32 did not significantly correlate with any biomarkers. However, it exhibited a large and statistically significant negative correlation with HADS-A (r = -0.651) and HADS-D (r = -0.611) scores (p < 0.001). Stepwise linear regression analyses indicated that HADS-A was a significant and independent predictor for IBDQ-32 scores (Adjusted R2 = 0.41, ß = -0.65, p < 0.001). CONCLUSIONS: Inflammatory markers such as CRP, FC, or cortisol in hair do not play a decisive role in assessing the QoL of IBD patients. These findings emphasize the significance of considering psychological factors in evaluating and managing QoL in IBD patients in order to identify severity, suggesting that instruments like HADS should be integral to comprehensive patient assessments.

Mental Health in First- and Second-Division Soccer Players: A Cross-Sectional Study.

BACKGROUND: The benefits of sport in mental health have been broadly studied. However, few studies have examined these outcomes in high-performance athletes. We aimed to analyze the state of the mental health of the Villarreal Soccer Club's first- (FD) and second-division (SD) players and the possible mediating effects of sex and professional category. METHODS: This was a cross-sectional study with an initial sample of 108 soccer players (final sample n = 54). Data from MINI, HARS, HDRS, BARRAT-11 and SCSRQ questionnaires were analyzed. RESULTS: The mean age was 23.41 years (SD = 4.56) and 61.1% (n = 33) were men. A proportion of 24.1% (n = 13) stated that they had undergone mental health treatment, 7.4% (n = 4) had taken psychotropic drugs, and 2.1% (n = 1) had made a suicide attempt. Differences were observed between the FD and SD players in terms of the sensitivity to punishment (t = -2.2; p = 0.033), overall impulsivity (t = -3.1; p = 0.003), unplanned impulsivity (t = 3.4; p = 0.001), and the HDRS (U = -110.5; p = 0.004), HARS-Total (U = -104.0; p = 0.006) and HARS-Psychological subscale scores (U = -104.0; p = 0.001). Differences were also observed between the female and male SD players for the HARS-Somatic subscale (U = 136.5; p = 0.028). CONCLUSION: The low values obtained in the clinical scales, together with the reported psychopathological histories, suggested that the Villareal players showed better mental health than the general population.

Relationship of Gaming Disorder with parenting based on low affection-communication and personality trait of neuroticism in adolescents.

Background: Gaming Disorder is increasingly common in adolescents. We aimed to evaluate the relationship between parenting, personality traits, and Gaming Disorder. Methods: An observational and cross-sectional study in six secondary schools of Castelló, obtaining a final sample of 397 students. Results: Adolescents with Gaming Disorder had lower scores in Adolescent Affection-Communication (F = 8.201; p < 0.001), Father's Warmth (F = 3.459; p = 0.028), and Father's Acceptance/Involvement (F = 5.467; p = 0.003), and higher scores in Mother's Revoking Privileges (F = 4.277; p = 0.034) and Father's Indifference (F = 7.868; p = 0.002) than healthy participants. Male sex was a risk factor for Gaming Disorder (OR = 12.221; p = 0.004), while Adolescent Affection-Communication (OR = 0.908; p = 0.001) and Agreeableness (OR = 0.903; p = 0.022) were protective factors. Data modeling described the protective effect that Adolescent Affection-Communication had on Gaming Disorder, which was both directly (B = -0.20; p < 0.001) and indirectly mediated by Neuroticism (B = -0.20; p < 0.001), while Neuroticism itself was a risk factor for Gaming Disorder (B = 0.50; p < 0.001). Conclusion: These results reflect that Parental style with low affection and communication was directly and indirectly related to the Gaming Disorder, as well as male sex and personality trait of Neuroticism.

The effectiveness of a brief motivational nursing intervention to reduce psychoactive substance consumption in entertainment-sector workers: A transversal, observation, and semi-experimental study.

Checking whether changes in the perception of the quality of life related to health, after the nursing intervention, influence these patients' motivation to change. This was a two-staged study undertaken in entertainment-sector workers in Spain: the first part was transversal and observational, and the second was semi-experimental. First part undertook in 284 entertainment-sector workers, selected by non-probabilistic sampling, while second part undertook in 50 entertainment-business workers, selected by consecutive sampling from those who consumed substances. A short group-based motivational intervention session was implemented by nursing staff, and a before and after evaluation was completed. The EuroQol-5D and Test for the Evaluation of the Quality of Life in Addicts to Psychoactive Substances (TECVASP) were used. The patients' motivation to change was evaluated through the Stages of Change Readiness and Treatment Eagerness Scale. The results analysis showed that the nursing intervention reduced the participants' perceptions of their health-related quality of life (t = 4.23; P = 0.00009) and of their quality of life in addicts to psychoactive substances (t = 3.38; P = 0.00140). There was an increase in the motivation of 6 workers (12%) to seek treatment of their addiction (χ2  = 13.02; P = 0.0091). The post-test contemplation stage score was predicted (F = 6.56; P = 0.003; R = 0.46) with post-test TECVASP score and pre-post difference in TECVASP score. By reducing the patients' perception of their quality of life, this brief nursing intervention facilitated a favourable increase in the motivation for change among these workers and was effective in 12% of cases.