[Motivations for alcohol consumption in schooled adolescents: analysis of discussion groups]. / Motivaciones para el consumo de alcohol en adolescentes escolarizados: análisis de grupos de discusión.

OBJECTIVE: To find out the motivations of adolescents for alcohol consumption. DESIGN: Qualitative methodology with discussion groups. PARTICIPANTS AND CONTEXT: 131 adolescents (15-17 years old) enrolled in nine schools in Tarragona (Spain). METHOD: Systematic coding strategy, adapted to focus groups. Educational centers were selected through a stratified purposive sampling by educational levels (segmentation criterion) and ownership of the center (public or private). Participants within the educational levels were randomly selected for the groups. Content analysis was conducted using an open and flexible coding strategy. RESULTS: Motivations for alcohol consumption were identified, revolving around six fundamental dimensions: a) seeking fun and new sensations, b) alleviating discomfort, c) consumption due to social contagion and group pressure, d) consumption as a rite of passage into adulthood, e) environmental availability of alcohol, and f) low perception of risk. This motivation varied according to the adolescent's gender. In girls, drinking behavior appeared related to overcoming negative emotional states, while for boys, belonging to the peer group took precedence: drinking reinforces hegemonic masculinity and ensures complicity among peers. Adolescents considered that the information they receive from educational centers is sufficient, but it does not motivate change. CONCLUSIONS: Public health strategies focused on preventing alcohol consumption in adolescents should incorporate their motivations to achieve greater efficiency, paying due attention to sex/gender variables.

Family presence during invasive procedures: a pilot study to test a tool.

BACKGROUND: Family Presence During Invasive Procedures (FPDI) generates controversy among healthcare professionals. Twibell and her team designed an instrument that measured nurses' Risk-Benefit and Self-Confidence perceptions regarding family presence during resuscitation and was used in numerous studies. OBJECTIVES: Evaluate the new tool for Family Presence Risk-Benefit and Family Presence Self-Confidence during invasive procedures and find out the opinions of the medical and nursing staff on FPDIP. METHOD: Cross-sectional methodological pilot study. Online and paper questionnaires modified from a previous translation. A factor analysis was performed for the validity of the indices and bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards. RESULTS: One hundred twenty healthcare professionals (22.18%) answered the survey. Cronbach's α on the Family Presence Risk-Benefit scale was 0.877. Cronbach's α on the Family Presence Self-Confidence scale was 0.937. The correlation between the Risk-Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship. A lower predisposition to Family Presence During Invasive Procedures is observed. Physicians are more reluctant than nurses. CONCLUSIONS: The FPDI generates controversy as it alters health professionals' routines when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly physicians, do not favor FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favor of FPDI. The psychometric properties and internal consistency of the questionnaire indicate the validity and reliability of this tool.

Family presence during resuscitation: adaptation and validation into Spanish of the Family Presence Risk-Benefit scale and the Self-Confidence scale instrument.

BACKGROUND: Family Presence during Cardiopulmonary Resuscitation has been studied both to identify the opinions of health professionals, patients, and family members, and to identify benefits and barriers, as well as to design protocols for its implementation. R. Twibell and her team designed an instrument that measured nurses' perceptions of Risks-Benefits and Self-Confidence regarding Family Presence during Resuscitation. There are few studies in Spain on this practice. METHODS: The aim is to adapt and validate into Spanish the Family Presence Risk-Benefit scale and Family Presence Self-Confidence scale instrument. For this purpose, this instrument was translated cross-culturally, and administered in paper and online version. Statistical tests were carried out for the validity of the questionnaire. Five hundred forty-one healthcare professionals were invited to respond. The results were analyzed by the same statistical procedures as in the original scale. Ethical approvals and research permissions were obtained according to national standards. RESULTS: Two hundred thirty-seven healthcare professionals (43.8%) answered the survey (69% women), of whom 167 were nurses. Validation of instruments: Cronbach's α in Family Presence Risk-Benefit scale was 0.94. Cronbach's α in Family Presence Self-Confidence scale was 0.96. Factor Analysis Kaiser, Meyer and Olkin (KMO) was greater than 0.9. The correlation between the two measured scales, is significant and has a moderate intensity of the relationship (r = 0.65 and α < 0.001). A lower predisposition to Family Presence during Cardiopulmonary Resuscitation is observed, but the pure detractors are only 12%. Doctors are more reluctant than nurses. CONCLUSIONS: The psychometric properties of the questionnaire in Spanish indicate high validity and reliability. Risk-Benefit perception and Self-Confidence are related to the healthcare professionals who consider the Family Presence to be beneficial. More studies in different contexts are necessary to confirm the psychometric results and validity of this instrument in Spanish.

The significance of information variables in polydrug use by adolescents: insights from a cross-sectional study in Tarragona (Spain).

Substance use, especially among adolescents, is a significant public health concern, with profound implications for physical and psychological development. This study aimed to evaluate the quantity and sources of information available to adolescents regarding polydrug use. A cross-sectional survey was conducted in Tarragona involving adolescents with an average age of 16.44 years. This study assessed the number of substances used (alcohol, cigarettes, and cannabis) in the past month, along with information sources related to substance use. Monitored sources (e.g., schools, parents, and mass media) and unmonitored sources (e.g., peers, siblings, internet) were distinguished. In addition, four individual and four environmental control variables were considered. Multinomial logistic regression analysis revealed that incorporating variables related to adolescents' substance use information and its sources enhanced the explanatory model, surpassing control variables. The degree of information about substance use did not significantly explain consumption patterns, but the number of information sources, both monitored and unmonitored, did. The unmonitored sources were associated with increased polydrug use. Conversely, greater reliance on supervised sources for information was linked to reduced single-substance and polydrug use. This protective effect increased with an increase in the number of substances used. In conclusion, information obtained from monitored sources acts as a deterrent to substance consumption, consistent with findings suggesting that greater health literacy among adolescents discourages substance use. Conversely, this study suggests that information from more informal sources may encourage heavier polydrug use, aligning with reports indicating that adolescents with a more comprehensive understanding of substance use consequences tend to engage in heavier drug use.

Translation, Adaptation, and Validation of the Cultural Competence Assessment in Portuguese Nurses.

Background and Purpose: Previous research shows significant benefits resulting from improving culturally competent nursing care. Thus, the purpose of this study was to translate, adapt, and validate the Cultural Competence Assessment (CCA) in a sample of Portuguese nurses. Methods: A psychometric study of the CCA, after translation into European Portuguese, was performed with a snowball sample of 284 nurses. Participants were asked to fill in a sociodemographic questionnaire and the CCA. Results: The four-factor model of the CCA (Portuguese version) exhibited satisfactory indices of fitness without item nine. Cronbach's alpha was 0.85. Correlations between subscales and the total score scale were strong and statistically significant. Conclusions: These data add to the cultural competence knowledge of nurses to promote better practices and culturally competent care.

A Pilot Nurse-Administered CBT Intervention for Insomnia in Patients with Schizophrenic Disorder: A Randomized Clinical Effectiveness Trial.

Insomnia is a highly prevalent disorder among the population with schizophrenia and has a significant impact on their quality of life. Cognitive behavioural therapies (CBT) have shown effectiveness in the treatment of insomnia in the general population. The aim of this this pilot study was to evaluate the effectiveness of a group intervention led by nurses in an outpatient mental health centre. The group work combined cognitive behavioural and psychoeducational therapeutic interventions to improve insomnia in patients with schizophrenic disorder and their health-related quality of life. This randomized clinical trial included intervention and control groups with follow-up assessments at 6 and 9 months, using the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and EuroQol-5D (EQ-5D) scales. The inclusion criteria were as follows: over 18 years of age, diagnosis of schizophrenia, and a score of >7 on the ISI scale. The total sample was 40 participants. The ISI scale showed a mean difference of 3.63 (CI 95%: 2.02-5.23) (p = 0.000) and 4.10 (CI 95%: 2.45-5.75) (p = 0.000) and a large effect size (F: 28.36; p = 0.000; ηp2: 0.427). Regarding the PSQI scale, the mean difference was 3.00 (CI 95%: 1.53-4.49) (p = 0.000) and 2.30 (CI 95%: 0.85-3.75) (p = 0.000), with a medium effect size (F: 18.31; p = 0.000 ηp2: 0.325). The EQ-VAS scale showed a difference in mean scores between the groups of 10.48 (CI 95%: -19.66--1.29) (p = 0.027). CBT adapted for populations with mental disorders, carried out by nurses, is effective in improving insomnia and health-related quality of life.

Explaining Cannabis Use by Adolescents: A Comparative Assessment of Fuzzy Set Qualitative Comparative Analysis and Ordered Logistic Regression.

Background: This study assesses the relevance of several factors that the literature on the substance use of adolescents considers relevant. The factors embed individual variables, such as gender or age; factors linked with parental style; and variables that are associated with the teenager's social environment. Methods: The study applies complementarily ordered logistic regression (OLR) and fuzzy set qualitative comparative analysis (fsQCA) in a sample of 1935 teenagers of Tarragona (Spain). Results: The OLR showed that being female (OR = 0.383; p < 0.0001), parental monitoring (OR = 0.587; p = 0.0201), and religiousness (OR = 0.476; p = 0.006) are significant inhibitors of cannabis consumption. On the other hand, parental tolerance to substance use (OR = 42.01; p < 0.0001) and having close peers that consume substances (OR = 5.60; p < 0.0001) act as enablers. The FsQCA allowed for fitting the linkages between the factors from a complementary perspective. (1) The coverage (cov) and consistency (cons) attained by the explanatory solutions of use (cons = 0.808; cov = 0.357) are clearly lower than those obtained by the recipes for nonuse (cons = 0.952; cov = 0.869). (2) The interaction of being male, having a tolerant family to substance use, and peer attitudes toward substances are continuously present in the profiles that are linked to a risk of cannabis smoking. (3) The most important recipe that explains resistance to cannabis is simply parental disagreement with substance consumption. Conclusions: On the one hand, the results of the OLR allow for determining the strength of an evaluated risk or protective factors according to the value of the OR. On the other hand, the fsQCA allows for the identification not only of profiles where there is a high risk of cannabis use, but also profiles where there is a low risk.

Fear and Attitude towards SARS-CoV-2 (COVID-19) Infection in Spanish Population during the Period of Confinement.

In January 2020, the WHO classified SARS-CoV-2 infection as a public health emergency and it was declared a pandemic on 11 March 2020. The media warned about the danger of infection, fuelling the population's fear of the new situation and increasing the perception of risk. This fear can cause behaviour that will determine the course of the pandemic and, therefore, the purpose of this study was to analyse the fear of infection from COVID-19 among the Spanish population during the state of emergency. A cross-sectional, descriptive observational study was conducted with 16,372 participants. Data on sociodemographic factors, health factors, risk perception and fear were collected through an online survey. Level of fear is associated with older age, a lower level of education, having a person infected with SARS-CoV-2 in the immediate surroundings and living with and belonging to the most socioeconomically vulnerable group of people. Risk perception is associated with increased preventive behaviour. This paper provides relevant information for the public health sector since it contributes first-hand knowledge of population data that is highly useful in terms of prevention. Understanding the experiences of people in this pandemic helps to create more effective future intervention strategies in terms of planning and management for crisis situations.

Compliance with COVID-19 Prevention Measures in the Spanish Population during the New Normal: Will the Need for Greater Community Involvement Be One of the Lessons Learned?

Throughout the pandemic, national and international health authorities have called on the population to collaborate and contribute with their behavior to control the problem. The aim of this study is to analyze the implementation of the protective measures against COVID-19 and to determine the factors involved in their compliance. To respond to the objectives, a cross-sectional study was performed involving a total of 5560 individuals. An ad hoc online questionnaire was created and shared through social networks, scientific societies, and various health institutions. The probability of high or total compliance with the protective measures was higher in women (OR = 1.401) and as age increases, with an OR = 2.524 in the interval between 31 and 64 years old and an OR = 2.896 in the oldest interval (65 and over). This study shows the characteristics of the population that considers it more likely to be infected by SARS-CoV-2, thus adopting greater adherence to prevention measures. Knowing which factors are associated with adherence to protective measures is essential for establishing effective pandemic control measures. Our findings may be useful for designing future awareness campaigns adapted to different socio-demographic characteristics in settings affected by COVID-19.

The Experience of Insomnia in Patients With Schizophrenic Disorder: A Qualitative Study.

BACKGROUND: Insomnia is a health problem that particularly affects people with schizophrenia. Its repercussions go beyond the disorder itself and affect many areas of life. The aim of the present study is to explore the clinical symptoms and consequences of insomnia in patients diagnosed with schizophrenic disorder and the perceptions of these patients regarding the care they receive. METHODS: The study takes a qualitative approach and uses semi-structured interviews to conduct a descriptive and interpretive analysis of 3 clinically different clusters of patients. These 3 clusters have been defined by using two-step cluster analysis based on the results of the ISI (Insomnia Severity Index) and EQ-5D scales (EuroQol-5D) and the presence of certain diagnostic symptoms in a sample of 170 patients. The final sample was 31 subjects. The analysis was based on a hermeneutic analysis of the patients' narratives regarding their experiences of insomnia. RESULTS: The patients' narratives show differences in the intensity and experience of insomnia depending on the severity, as well as its impact on their quality of life. Insomnia has a huge emotional impact. Participants describe ruminations and obsessive thoughts as a key factor hindering falling asleep. Some of the everyday actions they perform encourage the chronicity of insomnia. The desired health response must include interventions that are effective, such as cognitive-behavioural therapy, and powerful, such as pharmacological solutions. Psychoeducation and advice on sleep hygiene are highly valued tools as preventive strategies. CONCLUSIONS: To know the experience of users gives us a more comprehensive understanding of insomnia complexities and brings some new intervention strategies in patients with mental disorders. It is important that health professionals intervene preventively to stop the disorder from becoming chronic.

Results of Mentoring in the Psychosocial Well-Being of Young Immigrants and Refugees in Spain.

This study examined the change processes associated with the Nightingale project, a community-based mentoring programme whose aim is to promote the social inclusion of minors of immigrant origin. A pre-test-post-test study was conducted on a group of 158 young immigrants between the ages of 8 and 15, in which the influence of the mentoring programme on the youths' psychosocial well-being was measured. Non-parametric tests were used to calculate the results before and after mentoring, comparing the results over a six-month period and controlling for sex and age. The analyses reflected associations between mentoring and improvements in specific aspects of the emotional well-being of young immigrants and highlighted the potential of mentorships to cushion the stressful events they are subjected to in the process of adapting to a new social reality.

Compulsive Internet and Prevalence Substance Use among Spanish Adolescents.

This paper analyses compulsive Internet use among Spanish adolescents as measured by the Compulsive Internet Use Scale (CIUS) of the ESTUDES 2016 survey (national survey on drug use in secondary schools), which was recently added to the statistical programme of the Spanish National Plan on Drugs. We examined two subsamples of Spanish adolescents (those who suffer from compulsive Internet use and those who do not) while taking into account gender and age. Our general hypothesis was that adolescents who suffer from compulsive Internet use have a greater prevalence of alcohol, tobacco, cannabis, sedative, and new substance consumption as well as a greater prevalence of modes of consumption such as getting drunk, drinking with friends in public places (botellón), and binge drinking. While our results confirm these assumptions, they also suggest that gender and age play an ambivalent role in these associations.

Substance Use among Spanish Adolescents: The Information Paradox.

This aim of this paper is to determine the relationship between the consumption of tobacco, cannabis, and alcohol (including drunkenness and binge drinking consumption patterns) in the previous 30 days by Spanish adolescents and the information that is available to adolescents on drug consumption. This cross-sectional study employed data from the Survey on Drug Use in Secondary Education in Spain (ESTUDES 2016), which was conducted on students aged 14 to 18 (n = 35,369). Contingency tables, mean comparison tests, and logistic regression analyses were conducted and prevalence ratios (PR) were obtained. The results show that the probability that an adolescent will smoke tobacco is associated with whether their mother and/or father smoke (PR: 1.30), whether some of their friends smoke (PR: 14.23), whether the majority of their friends smoke (PR: 94.05) and how well informed they perceive themselves to be (PR: 1.30). Cannabis use is mainly associated with whether most of their friends also use cannabis (PR: 93.05) and whether they are sufficiently informed regarding this consumption (PR: 1.59). Alcohol consumption is associated with whether their mothers drink regularly (PR: 1.21), whether most of their friends drink (PR: 37.29), and whether they are well informed (PR: 1.28). Getting drunk and binge drinking are associated with whether their friends have these behaviors (PR: 44.81 and 7.36, respectively) and whether they are sufficiently informed (PR: 1.23 for both behaviors). In conclusion, the consumption of these substances is more frequent among Spanish adolescents who believe that they are better informed and whose friends have similar patterns of consumption.

Insomnia in Schizophrenia Patients: Prevalence and Quality of Life.

Sleep disorders are often not regarded as an important health problem, despite their impact on heath. Insomnia is the most frequent sleep disorder in mental health. The aim is to quantify the prevalence of insomnia in a population with schizophrenic disorder and assess its influence on quality of life. This is a descriptive, analytical and cross-sectional study conducted in a sample of 267 schizophrenic patients over 18 years of age using consecutive non-probabilistic sampling. The variables of interest were collected by means of the "Cuestionario Oviedo de Sueño," "Insomnia Severity Index" and EuqoQol-5D. The estimation of insomnia in our schizophrenic population according to the International Classification of Disease (ICD-10) criteria was 23.2%. The likelihood of insomnia when there are problems in the quality of life is significant in all its dimensions: mobility OR: 3.54 (95% CI 1.88- 6.65), self-care OR: 2.69 (95% CI 1.36-5.32), usual activities OR: 3.56 (95% CI 1.97-6.44), pain/discomfort OR: 4.29 (95% CI 2.37-7.74) and anxiety/depression OR: 3.01 (95% CI 1.61-5.65). The prevalence of insomnia fluctuates depending on the diagnostic criteria; however, the schizophrenic population shows high prevalence in some clinical characteristics. People with insomnia have a lower quality of life.

Risk Perception of COVID-19 Community Transmission among the Spanish Population.

On 11 March 2020 the SARS-CoV-2 virus was officially declared a pandemic and measures were set up in various countries to avoid its spread among the population. This paper aims to analyse the perception of risk of COVID-19 infection in the Spanish population. A cross-sectional, descriptive observational study was conducted with a total of 16,372 Spanish participants. An online survey was used to gather data for 5 consecutive days over the compulsory lockdown period which was established after the state of emergency was declared. There is an association between socio-demographic variables and risk perception, and a very strong relationship between this perception and contact and direct experience with the virus in a family, social or professional setting. We also found that compared to working from home, working outside the home increased the perception of risk of infection and the perception of worsening health. Understanding the public perception of the risk of COVID-19 infection is fundamental for establishing effective prevention measures.

[Impact on success rates among drugdependent men and women treated in separate therapeutic groups.] / Impacto en el éxito terapéutico de hombres y mujeres drogodependientes en grupos separados.

OBJECTIVE: The incorporation of gender variable in drug addiction studies provides information about the presence of differences in the therapeutic success rates between men and women. Is therefore essential to carry out studies to analyse the efficacy of differentiated treatments to improve their success. The objective of this study is to observe differences in success rates among women and men undergoing therapy for drug dependence at an addiction centre during two different periods, before 2005, in which they are treated together and after 2005, in which they are treated in separate groups. METHODS: The method was as follows: profiling of the individuals in treatment, analysis of the relationship between successful therapy and the independent variables, T-tests of independent samples and, finally, a logistic regression analysis of the period after 2005 when women and men were separated. RESULTS: Improved success rates were observed among women after 2005 compared with the previous period (Odds of success in women before 2005=2,00; after 2005=7,08). Success rates among men did not change significantly (Odds of success in men before 2005=2,78; after 2005=2,75). Women's success rates were higher than men's (24,4 times more probable on average) for all types of substance abuse and increased for shorter types of treatment, whereas success rates with longer treatments tended to be similar for both men and women (20,5 more likely). CONCLUSIONS: The study shows improved success rates for drug-dependent women when they are treated separately from men, once the specific problems of drug addiction in women are taken into account.

OBJETIVO: La incorporación de la variable sexo en los estudios sobre drogodependencia ofrece información sobre la existencia de diferencias en el éxito terapéutico entre hombres y mujeres, advirtiéndose la necesidad de realizar estudios que analicen la eficacia de los tratamientos diferenciados para la mejora del éxito de los mismos. El objetivo de este estudio fue observar las diferencias en el éxito terapéutico en mujeres y hombres drogodependientes de un centro en dos períodos diferentes: antes de 2005, cuando son tratados conjuntamente; y a partir de 2005, cuando son tratados separadamente. METODOS: La secuencia de análisis fue la siguiente: elaboración de un perfil de las personas tratadas, análisis de asociación entre éxito terapéutico y variables independientes, realización de pruebas T para muestras independientes y, finalmente, un análisis de regresión logística para el período posterior a 2005 en el que se separan mujeres y hombres. RESULTADOS: Se observaron mejoras del éxito en mujeres a partir de 2005 respecto al éxito en las mismas en el período anterior (Odds de éxito en mujeres antes 2005=2,00; después de 2005=7,08). Las probabilidades de éxito en los hombres no se modificaron sustancialmente (Odds de éxito en hombres antes 2005=2,78; después de 2005=2,75). El éxito en las mujeres respecto al de los hombres fue mayor (24,4 veces más probable de media), independientemente de la sustancia consumida, en los tratamientos más cortos de tiempo, mientras que los tratamientos más largos tendieron a igualar el éxito en hombres y mujeres (20,5 más probable). CONCLUSIONES: El estudio muestra mejoras del éxito en mujeres drogodependientes al presentarse tratamientos separados, una vez atendidas las problemáticas específicas de la drogadicción en las mujeres.

The Spanish version of the Cultural Competence Assessment (CCA-S): Transcultural validation study and proposed refinement.

BACKGROUND: Cultural competence (CC) is becoming an essential component of healthcare professionals. There is a gap in the research evaluating CC in order to develop competency-based approach programs. Spain has become a multicultural society and it is necessary to evaluate and promote CC attitudes to reduce the disparity of care for vulnerable and minority groups. OBJECTIVES: To adapt and validate the Cultural Competence Assessment (CCA) of Schim et al. (2003), to get evidence-based data of CC in Spanish healthcare professionals. METHOD: A process of translation/back-translation and cultural adaptation was carried out in accordance with international standards. An on-line cross-sectional survey questionnaire was used. Statistical and metrical analysis was based in a sample of 568 healthcare professionals who worked daily with patients in a health care institution in South Catalonia in 2018. RESULTS: The results of the exploratory factorial analysis and subsequent confirmatory analysis showed that the data had an adequate fit for a four-factor model. The reliability analysis results confirm an acceptable consistency for each subscale: active behaviour (0.86), seeking information (0.86), awareness (0,94), and sensitivity (0.69). ANOVA showed no differences between healthcare professionals, age and gender. The scores showed a normal distribution and it was proposed a standardization of scores. CONCLUSIONS: The translation and transcultural-validation process of the CCA resulted in a Spanish-language for the 25 items, like the original. The psychometric analysis proved that the Spanish version is a reliable and valid instrument. This scale is going to be useful to analyze healthcare professional's attitudes to create effectiveness training programs focused on specific needs. The four-factor model and the standardization of the scores will be useful to achieve future objectives about research in cultural competence in healthcare professionals.

Risk of Exclusion in People with Disabilities in Spain: Determinants of Health and Poverty.

In this paper, we analyze data from the 2012 Encuesta de Integración Social y Salud (Social Integration and Health Survey) of the Instituto Nacional de Estadística (Spanish National Institute of Statistics) to obtain profiles created by combining disability, poverty and social exclusion. We hypothesize that the probability that people will experience social exclusion increases if they have a disability, chronic illness or limitation in conducting everyday activities, and that this probability is greater for women than for men. To conduct our analysis, we constructed a social exclusion model based on a series of social determinants that acts as a dependent variable. In this context, social exclusion is understood to go beyond the concept of financial poverty. We performed bivariate analyses, in which we calculated the Odds Ratios (OR) for certain variables considered to be predictors of social exclusion. We also performed a means comparison test and an ANOVA test to observe differences between individuals with recognized disability and those without. Finally, we conducted logistic regression analysis to determine which vulnerability profiles are most likely to experience a situation of social exclusion. We also discuss the limitations of our study, and suggest areas in, which the relationships between health, social exclusion and disability can be further investigated.