The emotional well-being of Long COVID patients in relation to their symptoms, social support and stigmatization in social and health services: a qualitative study.

BACKGROUND: Long COVID patients have experienced a decline in their quality of life due to, in part but not wholly, its negative emotional impact. Some of the most prevalent mental health symptoms presented by long COVID patients are anxiety, depression, and sleep disorders. As such, the need has arisen to analyze the personal experiences of these patients to understand how they are managing their daily lives while dealing with the condition. The objective of this study is to increase understanding about the emotional well-being of people diagnosed with long COVID. METHODS: A qualitative design was created and carried out using 35 patients, with 17 participants being interviewed individually and 18 of them taking part in two focus groups. The participating patients were recruited in November and December 2021 from Primary Health Care (PHC) centers in the city of Zaragoza (Northern Spain) and from the Association of Long COVID Patients in Aragon. The study topics were emotional well-being, social support networks, and experience of discrimination. All an inductive thematic content analyses were performed iteratively using NVivo software. RESULTS: The Long COVID patients identified low levels of self-perceived well-being due to their persistent symptoms, as well as limitations in their daily lives that had been persistent for many months. Suicidal thoughts were also mentioned by several patients. They referred to anguish and anxiety about the future as well as a fear of reinfection or relapse and returning to work. Many of the participants reported that they have sought the help of a mental health professional. Most participants identified discriminatory situations in health care. CONCLUSIONS: It is necessary to continue researching the impact that Long COVID has had on mental health, as well as to provide Primary Health Care professionals with evidence that can guide the emotional treatment of these patients.

Gender Differences in the Incidence of Depression Among Immigrants and Natives in Aragón, Spain.

Knowledge of depression among immigrants within Spanish primary care is limited. This database study investigates the incidence of depressive disorders among immigrants and natives within primary care in Aragón (Spain). Participants were patients registered in an electronic record register, aged above 20 years diagnosed with depression. Incidence of depression was calculated and compared per continent of origin, gender and age with the Mann-Whitney U test and the Kruskal-Wallis test. The population consisted of 11,088 patients with depression of whom 93.0 % natives and 7.0 % immigrants. Incidence of depression amongst male immigrants was lower than amongst male natives (OR 0.80). Eastern European males showed the lowest incidence 4.1 (3.5-5.3). The gender difference in incidence was larger in immigrants than in natives (OR 3.4 vs. 2.7). Due to male immigrants the incidence of depression within primary care is lower among immigrants. Equal care should be provided to patients of both genders and all origin.

Conocimientos acerca de la vitamina D y hábitos de prevención de su déficit en las consultas de atención primaria / Knowledge and prevention management of vitamin D deficiency in primary care

Objetivos. Determinar los conocimientos y el manejo de la vitamina D (VD) en atención primaria (AP). Diseño. Estudio observacional. Emplazamiento. Cincuenta y siete centros de AP de Barcelona y 12 de Huesca. Participantes. Todos los médicos y diplomados de enfermería de estos centros. Mediciones principales. Se elaboró un cuestionario diseñado específicamente para recoger los conocimientos acerca de las acciones de la VD (sobre el metabolismo óseo, cardiovascular e inmunitario), conocimientos acerca de su déficit (HVD) y hábitos de prevención del mismo. Resultados. Del total de 2.100 profesionales, 785 contestaron la encuesta (37,78%). 79,9% fueron mujeres. La edad media fue 47 años (DE: 9,7). El 4,8% conocían globalmente las acciones de la VD, aunque la mayoría (66%) conocía solo sus efectos sobre el metabolismo óseo. El 62,4% desconocían si su déficit era un problema frecuente y el 54,9% creían que la fotoprotección eficaz no lo favorecía. El 73,6% no determinaban niveles de VD a sus pacientes nunca o casi nunca. Una minoría (23%) ofrecía consejos para mantener un nivel adecuado de VD, siendo el más frecuente la exposición solar (16,8%). Los pediatras tenían más conocimientos (p < 0,001) y ofrecían más consejos para mantener niveles adecuados de VD en sangre (p < 0,001). Conclusiones. La mayoría de los profesionales no conocían globalmente las acciones de la VD, ni que su carencia es frecuente, ni los factores que la favorecen. El consejo que más se ofrecía para evitar su déficit no es el más seguro. Los pediatras están más sensibilizados en prevenir la HVD (AU)

Objectives: To determine the knowledge and management of vitamin D (Vit D) in primary care (PC). Design: Observational study. Location: A total of 69 primary care centres, with 57 in Barcelona and 12 in Huesca. Participants: All medical and nursing graduates of these centres. Main measurements: A specifically designed questionnaire was used to collect knowledge on the actions of Vit D (on bone metabolism, cardiovascular and immune systems), its deficiency and prevention measures. Results: Of the total of 2100 professionals, 785 completed the survey (37.78%), of whom 79.9% were women. Their mean age was 47 years (SD: 9.7). Only 4.8% knew the overall actions of Vitamin D, although the majority (66%) knew only its effects on bone metabolism. Almost twothirds (62.4%) were unaware that its deficiency was a common problem, and 54.9% believed that photoprotection was contraindicated. Almost three-quarters of those surveyed (73.6%) never or almost never determined Vit D levels in their patients. A minority (23%) offered advice to maintain an adequate level of Vit D, with the most frequent being sun exposure (16.8%). Pediatricians were more knowledgeable (p < .001) and offered more advice for maintaining adequate levels of Vit D in blood (p < .001). Conclusions: Most of the professionals were unaware of the overall actions of Vit D, or that its deficiency was common, or the factors contributing to this. The advice that was more often offered to avoid its deficiency was not the safest. Paediatricians are more aware of how to prevent Vit D deficiency (AU)

[Knowledge and prevention management of vitamin D deficiency in primary care]. / Conocimientos acerca de la vitamina D y hábitos de prevención de su déficit en las consultas de atención primaria.

OBJECTIVES: To determine the knowledge and management of vitamin D (Vit D) in primary care (PC). DESIGN: Observational study. LOCATION: A total of 69 primary care centres, with 57 in Barcelona and 12 in Huesca. PARTICIPANTS: All medical and nursing graduates of these centres. MAIN MEASUREMENTS: A specifically designed questionnaire was used to collect knowledge on the actions of Vit D (on bone metabolism, cardiovascular and immune systems), its deficiency and prevention measures. RESULTS: Of the total of 2100 professionals, 785 completed the survey (37.78%), of whom 79.9% were women. Their mean age was 47 years (SD: 9.7). Only 4.8% knew the overall actions of Vitamin D, although the majority (66%) knew only its effects on bone metabolism. Almost two-thirds (62.4%) were unaware that its deficiency was a common problem, and 54.9% believed that photoprotection was contraindicated. Almost three-quarters of those surveyed (73.6%) never or almost never determined Vit D levels in their patients. A minority (23%) offered advice to maintain an adequate level of Vit D, with the most frequent being sun exposure (16.8%). Pediatricians were more knowledgeable (p<.001) and offered more advice for maintaining adequate levels of Vit D in blood (p<.001). CONCLUSIONS: Most of the professionals were unaware of the overall actions of Vit D, or that its deficiency was common, or the factors contributing to this. The advice that was more often offered to avoid its deficiency was not the safest. Paediatricians are more aware of how to prevent Vit D deficiency.

Differences in the use of primary care services between Spanish national and immigrant patients.

UNLABELLED: Knowing what real use is made of health services by immigrant population is of great interest. The objectives are to analyze the use of primary care services by immigrants compared to Spanish nationals and to analyze these differences in relation to geographic origin. Retrospective observational study of all primary care visits made in 26 urban health centers. Main variable: total number of health centre visits/year. DEPENDENT VARIABLES: type of clinician requested; type of attention, and origin of immigrants. The independent variable was nationality. Statistics were obtained from the electronic medical records. The 4,933,521 appointments made in 2007 were analyzed for a reference population of 594,145 people (11.15% immigrants). The adjusted annual frequency for nationals was 8.3, versus whereas 4.6 for immigrants. The immigrant population makes less use of primary care services than national population. This is evident for all age groups and regardless of the immigrants' countries of origin. This result is important when planning health care resources for immigrant population.

[Users-physicians: in search of new ways of detecting problems of quality]. / Usuarios-médicos: a la búsqueda de nuevas técnicas de detección de problemas de calidad.

OBJECTIVE: 1) To develop experimentally a method of detecting quality problems in primary care, based on the patient's analysis of his/her overall health-care experience. 2) To perceive and assimilate, from the point of view of the providers, aspects of care related to patients' expectations. DESIGN: A descriptive concurrent study in which "user-doctors" visit their general practitioners as patients. SETTING: Health centres, located in Aragón and Rioja. PARTICIPANTS: Thirty-two doctors doing a doctorate. INTERVENTION: Filling-out of a semi-structured questionnaire and individual elaboration of a report analysing the different care stages: appointment, waiting, visit and referrals. Main variables of the study: accessibility, waiting time, comfort, doctor's interest, quality of information, satisfaction, treatment received. For each stage, in line with prior expectations, the detection of problems, the search for positive aspects and the analysis of the care situation with corrective measures were proposed. MEASUREMENTS AND MAIN RESULTS: Problems detected: difficulty of telephone contact, uncomfortable and lengthy wait, health staff smoking, scant interest from the doctor, no greeting on entry, interruptions during the visit, insufficient information. Positive aspects: facilities in choice of appointment, cordiality of treatment, personal call by the doctor, punctuality. CONCLUSIONS: The method is simple, economical, sensitive in detecting problems felt by the users, and feasible as a complement to other systems used in our ambit.

[An epidemiological study on mental health in a health area]. / Estudio epidemiológico en salud mental en una zona de salud.

To identify the prevalence of psychological abnormalities in the adult population of the Valdefierro Health Area, we carried out an epidemiological study following the methodology of the cross sectional two-phase study. A random sample of 400 individuals, stratified for age and sex, was selected from the population over 15 years of age. In a first phase, the GHQ positive individuals underwent the semistructured interview Clinical Interview Schedule (CIS). The prevalence of psychological distress detected by the GHQ questionnaire was 13.4%. There was a significant association between psychological distress and female gender, educational level, working status, marital status and use of health care services. 42 of the 51 GHQ positive cases (82%) were considered as psychiatric conditions by the CIS. This represents a 11% prevalence of psychiatric disorders in the evaluated sample.