Mexican Quality of Work Life Scale in healthcare personnel: development and validation / Escala Mexicana de Calidad de Vida Laboral en personal sanitario: desarrollo y validación

Existe poca evidencia de escalas de medición con propiedades psicométricas adecuadas respecto a la Calidad de Vida Laboral en el personal sanitario, por lo que el objetivo fue desarrollar y examinar las propiedades psicométricas de la Escala Mexicana de Calidad de Vida Laboral (EMCVL). Se realizó un estudio instrumental y transversal. Fase 1) desarrollo de la escala y validez de contenido; Fase 2) validación con dos muestras diferentes [n = 293] y [n = 300] a través de un cuestionario en línea. Se obtuvo validez de contenido para 60 ítems (V de Aiken > .90); los análisis factoriales exploratorio y confirmatorio arrojaron una estructura de seis dimensiones; los índices de ajuste de la escala final con 24 ítems fueron aceptables (χ2[257] = 540.277; CMIN/DF = 2.102; NFI = .914; CFI = .953; GFI = .877, AGFI = .845; SRMR = .047; RMSEA = .061 [.054-.069] p <.001), con buenos índices de confiabilidad (α = .949, ω = .982). La EMCVL demostró confiabilidad en la consistencia interna, varias evidencias de validez y una invarianza configuracional y métrica aceptable con un modelo que confirma la existencia de seis dimensiones que explican el constructo a través de 24 ítems.(AU)

There is little evidence of measurement scales with appropriate psychometric properties regard Quality of Work-Life in health personnel, so the objective was to develop and examine psychometric properties of Mexican Quality of Work Life Scale (MQWLS). An instrumental, cross-sectional study was conducted. Phase 1) development of the scale and con-tent validity; Phase 2) validation with two different samples [n= 293] and [n = 300] through an online questionnaire. Content validity was obtained for 60 items (Aiken's V>.90); exploratory and confirmatory factor analyz-es yielded a six-dimension structure; the fit indexes from the final scale with 24 items were acceptable (χ2[257]=540.277; CMIN/DF=2.102; NFI=.914; CFI=.953; GFI=.877, AGFI=.845; SRMR=.047; RMSEA=.061 [.054-.069] p <.001), with good reliability indices (α =.949,ω=.982). MQWLS proved internal consistency reliability, several ev-idences of validity and acceptable configurational and metric invariance with a model that confirms the existence of six dimensions that explain the construct through 24 items.(AU)

Assessing HIV knowledge in Mexican people living with HIV: development and validation of CC-VIH questionnaire.

The level of knowledge that people living with human immunodeficiency virus (HIV) have about their disease can impact their adherence to treatment. The aim of this study was to develop a tool to assess the knowledge about HIV among people receiving treatment at a specialized clinic in Mexico City. To establish content validity, expert judges were invited to conceptualize the tool and propose items for the defined dimensions. A total of 490 individuals living with HIV completed the 91-item questionnaire, with 82.2% being male and a mean age of 36.1 years. We conducted an exploratory factor analysis, resulting in a reduced questionnaire of 45 questions. A three-factor solution explained 36.2% of the variance in HIV knowledge. The total scale had a reliability coefficient of 0.937, and each subscale had reliabilities of 0.828, 0.856 and 0.859. Lower educational level (F(336) = 8.488, p < 0.001) and female gender (t(399) = 2.003, p = 0.046) were associated with lower scores on the HIV knowledge questionnaire. This tool appears suitable for measuring HIV knowledge in people living with HIV, although future studies are required to confirm its structure and reduce its extension.

Anxiety and Depression in Family Members of Critically Ill Covid-19 Inpatients: Brief Psychological Interventions via Telephone, an Exploratory Study.

Purpose: This study aimed to assess the level of anxiety and depression in relatives of critically ill COVID-19 patients admitted to the intensive care unit (ICU), and to perform an exploratory pilot study on the implementation of telephone psychological interventions to reduce the initial levels of anxiety and depression in this population. Patients and Methods: Family members of COVID-19 inpatients at ICU answered GAD-7, PHQ-9 and questions on socio-demographic data. A brief psychological intervention was applied via telephone based on the needs of the participants (with adequate adaptation, with symptoms of anxiety, depression, or both). After intervention, participants completed the Patient Global Impression of Change Scale. Results: A total of 1307 relatives were included (66.5% female), 34% and 29% had anxiety and depressive symptoms, respectively. These symptoms were associated with female gender, unemployment, and being the parent or partner of the patient. After intervention, 57.9% reported felt better, 31.3% a little better and 6.6% much better; and with emotional regulation techniques and psychoeducation, higher percentages of feeling better or much better were reported. Conclusion: Brief interventions to reduce the psychological impact of inpatient family members could be effective but will need to be explored further in future studies.

Mental health and adherence to antiretroviral therapy among Mexican people living with HIV during the COVID-19 pandemic.

BACKGROUND: The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). METHODS: We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. RESULTS: 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p < 0.001). Vulnerable patients were more likely to be women, with low educational level and unemployed (p < 0.001). CONCLUSIONS: It is important to address mental health of PLWH during the COVID-19 pandemic, with special attention to the most vulnerable individuals. Future studies are needed to understand the relationship between mental health and ART adherence.

Measuring confidence in physician: Adaptation and validation of TPS in HIV individuals from Mexico / Evaluar confianza en el médico: Adaptación y validación del Trust in Physician Scale (TPS) en personas mexicanas que viven con VIH

Abstract Introduction Patient-physician relationship is associated with ART adherence and medical follow-up in people living with HIV (PLWH). Patient's trust in their doctor is a key component of patient-physician relationship, so adequate and reliable instruments to measure this component are important to evaluate its impact on health outcomes. Objective To evaluate the psychometric properties of a translated and adapted version of Trust in Physician Scale (TPS) in Mexican PLWH. Method A cross-sectional study was carried out in PLWH. Scale was translated to Spanish and culturally adapted. Sociodemographic and TPS data were collected online due to COVID-19 pandemic. Exploratory (EFA) and confirmatory (CFA) factor analysis were carried out in two different samples. Results Data from 215 participants was used to EFA. Five items were eliminated due to low correlation with total scale. Final Cronbach's alpha was .93. A single-factor structure explained 68.8% of the variance. CFA in a sample of 140 participants confirmed adequate fit indices (χ2[7] = 13.015 p = .072, CFI = .997, RMSEA = .057, SMRS = .0015). Discussion and conclusion The final scale was unifactorial and it is made up of six items instead of 11. It seems to be a valid and reliable scale to measure patient's trust in doctors in Mexican PLWH. Further studies are recommended to provide evidence of convergent validity to the instrument.

Resumen Introducción La relación médico-paciente está asociada a la adherencia al tratamiento antirretroviral y al seguimiento médico en las personas que viven con VIH (PVVS). La confianza de los pacientes en sus médicos es un componente clave de la relación médico-paciente, por lo que es importante disponer de instrumentos adecuados y fiables para medir este componente y evaluar su impacto en los resultados de salud. Objetivo Evaluar las propiedades psicométricas de una versión traducida y adaptada de la Trust in Physician Scale (TPS) en PVVS mexicanas. Método Se realizó un estudio transversal en adultos con VIH. La escala fue traducida al español y adaptada culturalmente. Los datos sociodemográficos y de la TPS se recogieron en línea debido a la pandemia de COVID-19. Se realizaron análisis factoriales exploratorios (AFE) y confirmatorios (AFC) en dos muestras diferentes. Resultados Se utilizaron los datos de 215 participantes para el AFE. Se eliminaron cinco ítems debido a la baja correlación con la escala total. El alfa de Cronbach final fue de .93. Una estructura unifactorial explicó el 68.8% de la varianza. El AFC en una muestra de 140 participantes confirmó la adecuación del modelo mostrando índices de ajuste adecuados (χ2[7] = 13.015 p = .072, CFI = .997, RMSEA =.057, SMRS = .0015). Discusión y conclusión La escala final fue unifactorial y se compuso de seis ítems en lugar de 11. Parece ser una escala válida y fiable para medir la confianza del paciente en los médicos en PVVS mexicanas. Se recomiendan más estudios para buscar evidencia de validez convergente del instrumento.

Clinical Follow-Up in People Living with HIV During the COVID-19 Pandemic in Mexico.

Clinical follow-up in people living with HIV (PLWH) has individual and public health implications. The objectives of this study were to measure variables related to follow-up failures, identify self-reported reasons to maintain adequate follow-up or for having follow-up failures, and know how the pandemic influenced patients' clinical follow-up. Participants were PLWH receiving HIV-health care at a hospital-based clinic in Mexico City which became an exclusive COVID-19 health service. Participants completed a telephone semi-structured interview and online psychological questionnaires. Lower educational and socioeconomic level, longer times of transportation to the clinic, being attended by different doctors, detectable viral load, having previous dropouts, inadequate antiretroviral adherence, and less HIV knowledge were related to follow-up failures. COVID-19 had a significant negative impact, but it also had positive repercussions for patients with adequate follow-up. These results could help develop effective psychosocial programs and improve healthcare in institutions to facilitate patient retention.

RESUMEN: El seguimiento clínico en las personas que viven con VIH (PVV) tiene implicaciones individuales y de salud pública. Los objetivos de este estudio fueron medir las variables relacionadas con las fallas en el seguimiento, identificar las razones reportadas para mantener un seguimiento adecuado o para tener fallas en el seguimiento, y conocer cómo la pandemia influyó en el seguimiento clínico de los individuos. Los participantes eran PVV que recibían atención médica para el VIH en una clínica hospitalaria de Ciudad de México que se convirtió en un servicio exclusivo para COVID-19. Los participantes completaron una entrevista semiestructurada por teléfono y cuestionarios psicológicos en línea. El nivel educativo y socioeconómico más bajo, mayor tiempo de transporte a la clínica, falta de continuidad del médico, carga viral detectable, tener abandonos previos, inadecuada adherencia al tratamiento antirretroviral y menor conocimiento del VIH se relacionaron con las fallas en el seguimiento. La pandemia demostró tener un importante impacto negativo, pero también tuvo repercusiones positivas para los pacientes con un seguimiento adecuado. Estos resultados son importantes para desarrollar programas psicosociales eficaces y mejorar la atención sanitaria en las instituciones para facilitar la retención de los pacientes.

Assessment of anxiety in Mexican persons living with HIV using a culturally-adapted version of the GAD-7 test.

Our aim was to assess the severity of anxiety in PLWHA in Mexico City and obtain the psychometric properties of the culturally-adapted Spanish version of GAD-7. Thirteen percent of participants presented moderate to severe symptoms. Reliability (α = 0.82) and construct validity (single-factor explained 48.9% of variance) were evaluated in 411 participants. Confirmatory Factor Analysis was performed in a second sample of 527 participants. Model fit adequately (CFI = 0.991; CMIN/DF = 1.924; RMSEA = 0.042; and SRMR = 0.026). The adapted version of GAD-7 was adequate for the assessment of anxiety in Mexican PLWHA.

Identifying risk factors for HIV-positive test results in walk-in and hospitalized patients in a Mexico City HIV clinic: a descriptive study.

The objective of this study was to analyze risk factors for HIV-positive tests in walk-in users and in hospitalized patients in a Mexico City hospital. We undertook a cross-sectional study based on routine HIV testing and counseling service data in adults undergoing an HIV test from January 2015 to July 2017. Multivariate analysis was performed to determine risk factors for walk-in and hospitalized patients. The results showed that 2040 people tested during the period; hospitalized patients were more likely to test HIV-positive than walk-in users (18 versus 15%; p < 0.05). HIV risk factors for hospitalized patients included being men who have sex with men (MSM) (adjusted odds ratio [aOR] 7.2, 95% CI 2.0-26.5), divorced (aOR 4.4, 95% CI 1.3-14.4), having 3-5 lifetime sexual partners (aOR 2.7, 95% CI 1.0-7.4), and being in the emergency room (aOR 3.6, 95% CI 1.1-11.3), intensive care (aOR 27.2, 95% CI 3.4-217.2), or clinical pneumology wards (aOR 33.4, 95% CI 9.7-115.2). In the walk-in group, HIV risk factors included being male (aOR 2.8, 95% CI 1.3-5.9), being MSM (aOR 4.3, 95% CI 2.0-9.5), having sex while using drugs (aOR 2.3, 95% CI 1.3-4.0), being referred by a physician for testing (aOR 3.2, 95% CI 1.6-6.3), and perceiving oneself at risk (aOR 3.8, 95% CI 2.3-6.3). Differential risk factors found among hospitalized patients and walk-in testers can be helpful in designing better HIV testing strategies to increase early diagnosis and linkage to care.