Evaluación de la consistencia interna y dimensionalidad de la Escala de Capital Social Cognitivo en adultos colombianos

Introducción: durante las últimas dos décadas, el concepto de capital social se ha utilizado con creciente frecuencia en las ciencias de la salud debido a las relaciones directas e indirectas entre el capital social y la salud física y mental de las poblaciones. Por tanto, es necesario construir un instrumento para cuantificar este concepto con seguridad y confiabilidad. Objetivo: analizar la consistencia interna y dimensionalidad de una escala de siete ítems para medir el capital social en adultos de la población general de Colombia. Metodología: se realizó un estudio de validación en línea, que incluyó una muestra de 700 adultos de entre 18 y 76 años, el 68 % eran mujeres. Los participantes completaron una escala de siete ítems llamada Escala de Capital Social Cognitivo (ECSC). El alfa de Cronbach y el omega de McDonald se calcularon para probar la consistencia interna. Se realizaron análisis factoriales exploratorios y confirmatorios para explorar la dimensionalidad de la ECSC. Resultados: la ECSC presentó una consistencia interna baja (alfa de Cronbach de 0,56 y omega de McDonald de 0,59) y pobre dimensionalidad. Seguidamente, se probó una versión de cinco ítems (ECSC-5). La ECSC-5 mostró una alta consistencia interna (alfa de Cronbach de 0,79 y omega de McDonald de 0,80) y una estructura unidimensional con indicadores de bondad de ajuste aceptables. Discusión: la ECSC-5 presenta alta consistencia interna y una estructura unidimensional para medir el capital cognitivo social en adultos colombianos. Se recomienda la ECSC-5 para la medición del capital social en la población general colombiana. Futuras investigaciones deben corroborar estos hallazgos en aplicaciones de lápiz y papel y explorar otros indicadores de confiabilidad y validez.

Introduction: During the last two decades, the concept of social capital has been used increasingly frequently in health sciences due to the direct and indirect relationships between social capital and populations' physical and mental health. Therefore, it is necessary to build an instrument to quantify this concept confidently and reliably. Objective: The study aimed to internal consistency and dimensionality of a seven-item scale to measure social capital in Colombia's general population of adults. Methods: An online validation study included a sample of 700 adults aged between 18 and 76 years; 68% were females. Participants completed a seven-item scale called the Cognitive Social Capital Scale (CSCS). Cronbach's alpha and McDonald's omega were computed to test internal consistency. The authors explore the internal consistency and dimensionality of the CSCS. Results: The CSCS presented a low internal consistency (Cronbach's alpha of 0.56 and McDonald's omega of 0.59) and poor dimensionality. Then, the researchers tested a five-item version (CSCS-5). The CSCS-5 showed high internal consistency (Cronbach's alpha of 0.79 and McDonald's omega of 0.80) and a one-dimension structure with acceptable goodness-of-fit indicators. Discussion: The CSCS-5 presents high internal consistency and a one-dimensional structure to measure cognitive capital social in the Colombian sample. Authors can recommend measuring social capital in the general Colombian population. Further research should corroborate this pencil and paper application findings and explore other reliability and validity indicators.

Depression among COVID-19 survivors in Colombia.

The COVID-19 survivors are at high risk of meeting the criteria for depression. However, few studies have explored its prevalence and associated factors. The study aimed to know the frequency and variables associated with depression among COVID-19 survivors in Santa Marta, Colombia. A sample of COVID-19 survivors was included. Depression was quantified with the Patient Health Questionnaire (PHQ-9, α = 0.85). Three hundred and thirty survivors participated in the research. They were aged between 18 and 89 years, 61.5% were women, and 49.7% of participants scored above the cut-off point for depression. Depression was associated with female gender, younger age, COVID moderate or severe, and having presented symptoms for more than three weeks. In conclusion, depression occurs in half of the COVID-19 survivors and is higher in younger, women and who report more severe symptoms. Longitudinal studies can provide further information on the long-term impact on the mental health of COVID-19 survivors.

SPANISH VERSION OF THE ATTITUDE TOWARDS COVID-19 VACCINES SCALE: RELIABILITY AND VALIDITY ASSESSMENT.

Background and Purpose: The negative attitude towards vaccines for coronavirus disease (COVID-19) has motivated the adaptation of instruments for this specific purpose. However, details of the reliability and validity of these scales are unknown. The study aimed to evaluate some indicators of the reliability and validity of the Spanish version of the Attitude towards COVID-19 Vaccines Scale. Methods: A validation study was carried out with 1,136 students of emerging age (18 and 29 years) from a Colombian university; 65.5% were female. Cronbach's alpha and McDonald's omega were calculated for reliability, and exploratory and confirmatory factor analyzes for validity. Additionally, the gender differential item functioning (DIF) was estimated with Kendall's tau b. Results: The Spanish version of Attitude towards COVID-19 Vaccines Scale showed high internal consistency (Cronbach's alpha of .94 and McDonald's omega of .95), a one-dimensional structure with acceptable goodness-of-fit indicators (CFI = .94, TLI = .91, and SRMR = .04), and non-gender DIF (Kendall's tau b between .02 and .06). Conclusions: The Spanish version of the Attitude towards COVID-19 Vaccines Scale presents some appropriate reliability and validity indicators among university emerging adults. These findings should be explored in samples with other characteristics.

A Cross-Sectional Study on Prescription Patterns of Short-Acting ß2-Agonists in Patients with Asthma: Results from the SABINA III Colombia Cohort.

Purpose: Overuse of short-acting ß2-agonists (SABAs) for asthma is associated with a significant increase in exacerbations and healthcare resource use. However, limited data exist on the extent of SABA overuse outside of Europe and North America. As part of the multi-country SABA use IN Asthma (SABINA) III study, we characterized SABA prescription patterns in Colombia. Patients and Methods: This observational, cross-sectional cohort study of SABINA III included patients (aged ≥12 years) with asthma recruited from seven sites in Colombia. Demographics, disease characteristics (including investigator-defined asthma severity guided by the 2017 Global Initiative for Asthma report), and asthma treatments prescribed (including SABAs and inhaled corticosteroids [ICS]) in the 12 months preceding the study were recorded using electronic case report forms during a single study visit. Results: Of 250 patients analyzed, 50.4%, 33.2%, and 16.4% were enrolled by pulmonologists, general medicine practitioners, and allergists, respectively. Most patients were female (74.0%) and had moderate-to-severe asthma (67.6%). Asthma was partly controlled or uncontrolled in 57.6% of patients, with 15.6% experiencing ≥1 severe exacerbation 12 months before the study visit. In total, 4.0% of patients were prescribed SABA monotherapy and 55.6%, SABA in addition to maintenance therapy. Overall, 39.2% of patients were prescribed ≥3 SABA canisters in the 12 months before the study visit; 25.2% were prescribed ≥10 canisters. Additionally, 17.6% of patients purchased SABAs over the counter, of whom 43.2% purchased ≥3 canisters. Maintenance medication in the form of ICS or ICS/long-acting ß2-agonist fixed-dose combination was prescribed to 36.0% and 66.8% of patients, respectively. Conclusion: Our findings suggest that prescription/purchase of ≥3 SABA canisters were common in Colombia, highlighting a public health concern. There is a need to improve asthma care by aligning clinical practices with the latest evidence-based treatment recommendations to improve asthma management across Colombia.

Assessment of validity and reliability of the tuberculosis related stigma scale in Colombian patients.

OBJECTIVE: To know the dimensionality and internal consistency of the Tuberculosis-Related Stigma Scale in patients living with tuberculosis in Santa Marta, Colombia. METHOD: One hundred and twenty-two patients between the ages of 18 and 75 participated (M = 40.3, SD = 14.9), 63.9% were men, 44.3% were single, 69.7% had low income, 80.3% had pulmonary tuberculosis, and 13.1% had co-infection with HIV. The Tuberculosis-Related Stigma Scale was applied; it comprises perceived and internalised stigma subscales. The internal structure was explored by confirmatory factor analysis (EFA). Internal consistency was measured with Cronbach's alpha and McDonald's omega. Besides, the differential functioning of the scales according to gender was explored with Kendall's tau-b coefficient. RESULTS: CFA did not show excellent goodness-of-fit indicators for the perceived stigma scale (Satorra-Bentler's chi-square of 184.48, degree of freedom of 44, p = .001, RMSEA of 0.16, 95%CI 0.14-0.19, CFI of 0.77, TLI of 0.72, and SRMR of 0.08) and internalised (Satorra-Bentler's chi-square of 189.14, degree of freedom of 54, p = .001; RMSEA of 0.14, 95%CI 0.12-0.17, CFI of 0.82, TLI of 0.78, and SRMR of 0.07). The alpha and omega coefficients were 0.89 and 0.91 for both scales. Non-gender differential functioning was observed; Kendall's tau-b was between 0.00 and 0.15. CONCLUSIONS: The Tuberculosis-Related Stigma Scale has an excellent internal consistency but poor goodness-of-fit indicators of unidimensionality. Evaluating the scale's psychometric performance is recommenced in future research.

Prevalence and variables associated with insomnia among COVID-19 survivors in Colombia.

BACKGROUND AND AIM OF THE WORK: The prevalence of insomnia is higher in COVID-19 survivors. However, there is little information about his associated variables. The aimed to know the prevalence and variables associated with insomnia among COVID-19 survivors in Colombian adults. METHOD: Three hundred and thirty COVID-19 survivors participated in a cross-sectional study. Insomnia was quantified with the Athens Insomnia Scale (cut-off score ≤ 6, Cronbach's alpha of 0.90). RESULTS: COVID-19 survivors were between 18 and 89 years (Mean = 47.7, SD = 15.2); the majority were women (61.5%), university-educated (62.4%), low income (71.2%), married or free union (66.1%), not healthcare workers (85.8%), without comorbidities (63.0%), asymptomatic or mild COVID-19 (66.1%), duration of COVID-19 symptoms in less than three weeks (80.0%) and remission of symptoms less two months by the day of study participation (73.0%). Scores on the Athens Insomnia Scale were observed between 0 and 24 (M = 7.3, SD = 5.1, Me = 7, IQR = 3 - 10), 60% presented insomnia. Insomnia was associated with post-traumatic stress symptoms (OR = 8.8, 95%CI 2.7 - 29.5), COVID-19 symptoms for more than three weeks (OR = 2.1, 95%CI 1.1 - 3.9), female gender (OR = 1.9, 95%CI 1.2 - 3.2) and married or free union marital status (OR = 1.8, 95%CI 1.1 - 3.0). CONCLUSION: The frequency of insomnia in COVID-19 survivors is high and mainly related to post-traumatic stress, symptoms of COVID-19 for more than three weeks, and the female gender. It is necessary to implement follow-up studies over time to evaluate the persistence of insomnia.

COVID-19 vaccine distrust in Colombian university students: Frequency and associated variables.

BACKGROUND AND AIM OF THE WORK: The frequency of distrust towards the COVID-19 vaccine varies widely depending on the context, way of measurement, and pandemic stage. However, little information is available about Colombian populations. The study aimed to know the frequency and variables associated with COVID-19 vaccine distrust in students of a Colombian university. METHODS: A cross-sectional study was carried out which participated emerging adult students of a Colombian university. RESULTS: A total of 1,136 students between 18 and 29 years (M= 22.0, SD = 3.0); most of participants were female (66.0%), non-health students (82.8%), low-income (79.0%), and residents of urban areas (84.9%). It was frequent low institutional trust (74.8%), low cognitive, social capital (27.9%), low fear of COVID-19 (49.5%), low perceived stress related to COVID-19 (83.5%), and high COVID-19 vaccine distrust (78.9%). Non-health carrier (Adjusted OR = 3.63, 95%CI 2.58-5.10), rural residence (AOR = 1.85, 95%CI 1.13-3.04), low income (AOR = 1.84, 95%CI 1.31-2.57), and perceived stress related to COVID-19 (AOR = 1.74, 95%CI 1.20-2.54) were related to high COVID-19 vaccine distrust. CONCLUSIONS: COVID-19 vaccine distrust is high among emerging adult Colombian university students. The COVID-19 vaccine distrust is related to non-health science carriers, rural residents, low-income, and low-perceived stress related to COVID-19. The COVID-19 related health literacy should be improved in students of this university considering socio-cultural background.

Relation of perceived discrimination with depression, insomnia and post-traumatic stress in COVID-19 survivors.

The study's objective was to study the association of perceived discrimination with depression, insomnia and post-traumatic stress in people recovered from coronavirus disease (COVID-19) in Santa Marta, Colombia. COVID-19 survivors were invited to participate. The authors measured perceived discrimination related to COVID-19 (COVID-19 Perceived Stigma Scale), depression (PHQ-9), insomnia (Athens Insomnia Scale), and post-traumatic stress (Brief Davidson Trauma Scale). Three hundred thirty COVID-19 survivors participated in the research; the participants were between 18 and 89 years; 61.52% were females. 32.12% of the participants reported high perceived discrimination; 49.70%, depression; 60.61%, insomnia; and 13.33% post-traumatic stress. After adjusting for age, gender, and income, depression, insomnia, and post-traumatic stress were associated significantly with discrimination perceived by COVID-19. Perceived discrimination is a social stressor that affects the psychological well-being of people recovered from COVID-19. In the follow-up of this group of patients, it is important to consider the impact of perceived discrimination on psychological well-being.

Confirmatory factor analysis of the brief Spanish Zung Self-Rating Depression Scale in patients with chronic pulmonary obstructive disease.

PURPOSE: To corroborate the factor structure of the brief Spanish Zung Self-Rating Depression Scale among patients with chronic pulmonary obstructive disease at Santa Marta, Colombia. DESIGN AND METHODS: A psychometric study was done in which 409 patients with the chronic obstructive pulmonary disease were included, aged between 40 and 102 years. Participants completed the 10 items on the brief Spanish Zung Self-Rating Depression Scale. Confirmatory factor analysis was performed. FINDINGS: The two-dimensional structure was confirmed. The goodness of fit indicators was acceptable. PRACTICAL IMPLICATION: The brief Spanish Zung scale for depression has a clear two-dimensional structure for evaluating depressive symptoms in patients with chronic obstructive pulmonary disease. New studies should prove this dimensionality in patients with other clinical conditions.

Anxiety and depression among patients with chronic obstructive pulmonary disease / Ansiedad y depresión en pacientes con enfermedad pulmonar obstructiva crónica

Abstract Objective: to establish some variables associated with anxiety and depression with clinical importance in patients with COPD from the outpatient clinic in Santa Marta, Colombia. Design: a cross-sectional analytical study. Background: chronic obstructive pulmonary disease (COPD) is a chronic disease that affects approximately one in ten people in the general Colombian population. COPD is often associated with anxiety and depression. However, information on the variables associated with anxiety and depression in patients with COPD is limited. Participants: adult COPD patients were included. The patients were classified according to the GOLD initiative and the combined assessment. Interventions: none. Measurements: clinically important anxiety and depression were assessed with the 10-item versions of the Zung scales. Results: 409 patients between 40 and 102 years of age participated, mean of 73.0 years (SD=10.2 years), 58.7% male, 88.8% married (or in free union), 73.6% residents in low stratum (I, II or III), 92.7% exposed to cigarettes or wood smoke (biomass), 44.5% in GOLD 3 or 4, 22.2% classified in the combined evaluation C or D, 19.1% presented clinically significant anxiety and 27.9% clini cally significant depression. Clinically important anxiety showed a significant association with the combined assessment C or D (OR=2.08, 95%CI 1.19-3.63) and female sex (OR=1.80, 95%CI 1.10 2.99) and depression with clinical importance showed a significant relationship with female sex (OR=2.35, 95%CI 1.50-3.70) and the combined C or D evaluation (OR=2.04, 95%CI 1.22-3.42). Conclusions: The prevalence of clinically important anxiety and depression is high in COPD patients. Anxiety and depression are associated with female gender and the severity of COPD. Anxiety and depression must be evaluated in all patients with COPD evaluated in an outpatient clinic, particularly in women and in patients classified C or D in the combined evaluation. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1644).

Resumen Objetivo: establecer algunas variables asociadas a ansiedad y depresión con importancia clínica en pacientes con EPOC de la consulta externa de Santa Marta, Colombia. Diseño: estudio analítico transversal. Marco de referencia: la enfermedad pulmonar obstructiva crónica (EPOC) es un padecimiento crónico que afecta aproximadamente a una de cada diez personas de la población general colombiana. La EPOC con frecuencia se asocia a ansiedad y depresión. Sin embargo, es limitada la información sobre las variables asociadas a ansiedad y depresión en pacientes con EPOC. Participantes: se incluyeron pacientes adultos con EPOC. Los pacientes se clasificaron según la iniciativa GOLD y la evaluación combinada. Intervenciones: ninguna. Mediciones: la ansiedad y la depresión con importancia clínica se evaluaron con las versiones de 10 ítems de las escalas de Zung. Resultados: participaron 409 pacientes entre 40 y 102 años, media de 73.0 años (DE=10.2 años), 58.7% de sexo masculino, 88.8% casado (o en unión libre), 73.6% residentes en estrato bajo (I, II o III), 92.7% expuesto a cigarrillo o humo de leña (biomasa), 44.5% en GOLD 3 o 4, 22.2% clasificados en la evaluación combinada C o D, 19.1% presentaron ansiedad con importancia clínica y 27.9% depresión con importancia clínica. La ansiedad con importancia clínica mostró asociación significativa con la evaluación combinada C o D (OR= 2.08; IC95% 1.19-3.63) y sexo femenino (OR=1.80; IC95% 1.10-2.99) y la depresión con importancia clínica mostró relación significativa con sexo femenino (OR=2.35; IC95% 1.50-3.70) y la evaluación combinada C o D (OR=2.04; IC95% 1.22-3.42). Conclusiones: la prevalencia de ansiedad y depresión con importancia clínica es alta en pa cientes con EPOC. Ansiedad y depresión se asocian a sexo femenino y a la gravedad de la EPOC. Es necesario evaluar ansiedad y depresión en todos los pacientes con EPOC evaluados en consulta externa, particularmente, en mujeres y en pacientes clasificados C o D en la evaluación combinada. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1644).

Quality of life and depression in COPD patients in the Colombian Caribbean.

OBJECTIVE: To establish the association between quality of life and depression among COPD patients of the Colombian Caribbean. METHOD: A cross-sectional study was carried out with the participation of adult COPD patients. COPD-related quality of life was quantified with the COPD Assessment Test (CAT) and depression using the Zung 10-item Self-rating Depression Scale (SDS-10). The relationship between COPD-related quality of life and depression with odds ratios (OR), crude and adjusted, was determined. RESULTS: 408 patients participated in the study. They were aged between 40 and 102 years (mean = 72.9, SD = 10.2) and 58.8% men. Two hundred eighty-four patients (69.6%) reported worse health status (CAT ≥10), and 114 patients (27.9%) scored for depression (SDS-10). Patients with worse health status presented more depression (OR = 5.85, 95% CI 3.01-11.36) and after adjusting for gender (OR = 5.70, 95% CI 2.92-11.13). CONCLUSIONS: In patients with COPD and CAT ≥10, there is a five times greater risk of depression than patients with CAT <10. However, the relationship may be bidirectional. It is essential to specify the direction of causality in future investigations.

Risk of a Major Depressive Episode in Asthma and COPD Patients Amidst Colombian SAR-CoV-2 Confinement.

BACKGROUND: Chronic non-communicable diseases, such as asthma (AS) and chronic obstructive pulmonary disease (COPD), are a public health problem that compromises patients' quality of life and is highly comorbid with medical and psychological conditions. The present study's objective was to know the variables associated with the risk of major depression during confinement due to SAR-CoV-2 in patients with AS and COPD in the Colombian Caribbean. SUBJECTS AND METHODS: An online cross-sectional observational study was done with the participation of patients diagnosed with AS or COPD. AS and COPD patients completed the Patient Health Questionnaire (PHQ-9) to identify a major depressive disorder risk. RESULTS: Two hundred seventy-seven patients diagnosed with AS or COPD aged 18 to 69 (M=60.4, SD=17.6) participated. The risk of major depression was assessed using the PHQ-9 sent online after telephone contact with the participants. 30.7% of the patients during the last month reported a risk of major depression, and it was associated with a history of major depressive disorder (OR=4.39, 95% CI 1.53-12.67) and medical comorbidity (OR=1.69, 95% CI 1.00-2.86). CONCLUSIONS: The depression risk is associated with a history of depressive disorder and medical comorbidity in patients with AS and COPD. Medical history is the leading risk factor for depression during confinement. It is recommended to carry out studies with many participants and study other variables that may mediate said associations during confinement by SAR-CoV-2 in the Colombian Caribbean.