Long-Term Emotional Impact of the COVID-19 Pandemic and Barriers and Facilitators to Digital Mental Health Tools in Long-Term Care Workers: Qualitative Study.

BACKGROUND: The overall pandemic created enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. Despite this, most of the available evidence on professional well-being during COVID-19 has exclusively focused on frontline health care workers. OBJECTIVE: This study aimed to identify the long-term psychological needs of LTCWs derived from the COVID-19 pandemic and to explore barriers and facilitators related to digital mental health tools. This is part of a project that seeks to develop a digital mental health intervention to reduce psychological distress in this population group. METHODS: We performed a qualitative study with a rapid research approach. Participants were LTCWs of the autonomous community of Catalonia. We conducted 30 semistructured interviews between April and September 2022. We used a qualitative content analysis method with an inductive-deductive approach. RESULTS: The period of the pandemic with the highest mental health burden was the COVID-19 outbreak, with almost all workers having experienced some form of emotional distress. Emotional distress persisted over time in more than half of the participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, the feeling that pandemic times are not over, and poor working conditions that have remained since then have been the most frequently expressed determinants of such emotions. Potential barriers and facilitators to engagement with digital tools were also identified in terms of previous experience and beliefs of the target population, possibilities for the integration of a digital tool into daily life, preferences regarding the level of guidance, the possibility of social connectedness through the tool, and privacy and confidentiality. The identified factors may become especially relevant in the context of the pandemic remission phase. CONCLUSIONS: More than 2 years after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees' well-being. Considering factors that act as barriers and facilitators for the use of digital mental health tools, it is important to develop tailored tools that could offer valuable support to this population during and after a pandemic.

Anxiety and depression played a central role in the COVID-19 mental distress: A network analysis.

INTRODUCTION: Psychological, socio-demographics, and clinical factors play an important role in patients with COVID-19, but their relationship is complex. The network approach might be used to disentangle complex interactions in different systems. Using data from a multicentre, cross-sectional, survey among patients with COVID-19 in Spain (July-November 2020), we investigated the network structure of mental disorders symptoms, social support, and psychological resilience, and changes in network structures according to the presence of a pre-existing mental disorder or hospitalization for COVID-19. METHODS: Subjects completed a survey to evaluate sociodemographic characteristics, COVID-19 infection status, resilience, social support, and symptoms of depression, anxiety disorders, post-traumatic stress disorder, panic attacks, and substance use disorder. 2084 patients with COVID-19 were included in the analysis. Network analysis was conducted to evaluate network and bridge centrality, and the network properties were compared between COVID-19 patients with and without a history of lifetime mental disorder, and between hospitalized and non-hospitalized patients. LIMITATIONS: Generalization of our findings may be difficult since differences in network connectivity may exist in different populations or samples. RESULTS: Anxiety and depression showed high centrality in patients with COVID-19 and anxiety showed the highest bridge influence in the network. Resilience and social support showed a low influence on mental disorder symptoms. Global network estimations show no statistically significant changes between patients with and without pre-existing mental disorders or between hospitalized and non-hospitalized patients. CONCLUSIONS: Anxiety might be a key treatment target in patients with COVID-19 since its treatment might prevent other mental health adverse outcomes.

Tratamiento psicológico grupal para pacientes con sintomatología de Covid persistente: protocolo para un ensayo controlado aleatorizado / Psychological group treatment for patients with long covid Symptoms: randomized controlled trial’s protocol

La sintomatología de Covid persistente aparece en 1-2 de cada 10 personas infectadas por el virus SARS-CoV-2 y pueden presentar severas dificultades de adaptación a su nueva condición de salud. Por un lado, este artículo presenta nuestra propuesta de tra-tamiento psicológico grupal basada en la ya conocida terapia de aceptación y compromiso. Se ha descrito brevemente el contenido de la psicoterapia sesión a sesión y se han detallado los aspectos formales para su correcta implementación y posibilidad de repli-cación. Por otro lado, se describen las particularidades metodológicas de un ensayo controlado aleatorizado: diseño experimental pre-post con asignación aleatoria a dos modalidades de tratamiento; criterios de inclusión y exclusión de la muestra; proceso de reclutamiento y aleatorización, procedimiento, variables e instrumentos de evalua-ción y análisis y contraste estadístico de los resultados. El protocolo que hemos elaborado pretende evaluar, de forma metodológicamente rigurosa, la efectividad de un tratamiento espe-cíficamente dirigido a mejorar la calidad de vida y el funcionamiento psicosocial de las personas que sufren síntomas persistentes de Covid-19. Los resultados permitirán saber si dicho tratamiento es realmente eficaz.(AU)

Long Covid symptoms appear in 1-2 out of 10 people infected by the SARS-CoV-2 virus. They may well present severe difficulties when it comes to adapting to their new health condition.On the one hand this article presents a Psychological group treatment for patients with Long Covid symptoms based on the well-known acceptance and commitment therapy. The content of psychotherapy session after session has been briefly described. What’s more, the formal aspects for both its correct implementation and the possibility of replication have also been detailed.On the other hand, the methodological characteristics of a randomized controlled trial are described. This includes: pre-post experimental design with two treatment modalities assigned ran-domly; sample inclusion and exclusion criteria; patient recruitment and randomisation; procedure and instruments of evaluation and analysis and statistical contrast of the results.The developed protocol aims to evaluate, in a methodologically rigorous manner, the effectivity of an intervention that specifically aspires to improve psychosocial functioning and life quality of people suffering from Long Covid symptoms. The results will allow us to know if this treatment has been objectively successf.(AU)

La mejoría de la calidad de vida de las personas con fibromialgia requiere promover creencias de control propio del dolor y un afrontamiento activo / Improving the quality of life of people with fibromyalgia requires promoting beliefs of self-control of pain and active coping

Introducción: Las personas con fibromialgia refieren una notable interferencia de la enfermedad en su calidad de vida. A pesar de que los síntomas de la fibromialgia suelen seguir un curso crónico, la calidad de vida de las pacientes puede mejorar. Por consiguiente, la mejoría de la calidad de vida debería ser un objetivo terapéutico prioritario. El objetivo de este estudio longitudinal fue evaluar los determinantes de la calidad de vida en las pacientes con fibromialgia seis meses después de haber recibido un tratamiento multidisciplinario. Método: En 40 pacientes seleccionadas consecutivamente se analizaron las variables previamente descritas como sólidos determinantes de la calidad de vida antes y seis meses después de realizar un tratamiento multidisciplinario. Se realizó un análisis de componentes principales del cambio observado en cada uno de estos determinantes y se analizó su relación con la mejoría de la calidad de vida mediante análisis de regresión multivariante. Resultados: El análisis de los componentes principales observó 7 factores independientes que explicaron el 76.4% de la varianza entre sujetos del cambio en las variables clínicas evaluadas. Los análisis de regresión multivariantes mostraron que la mejoría en las distintas facetas de la calidad de vida dependió principalmente de las creencias favorables a la posibilidad de disminuir el dolor mediante recursos propios y de un afrontamiento activo que conllevara un incremento de la capacidad funcional subjetiva.Conclusiones: Dada la cronicidad de los síntomas de la fibromialgia, la mejoría de la calidad de vida de las pacientes debería basarse en la promoción de las creencias de control del dolor y el incremento de la autoeficacia teniendo, no obstante, en cuenta el efecto a la vez negativo y positivo de la ayuda externa.(AU)

Introduction: People with fibromyalgia report a significant interference of the disease in their quality of life. Although the symptoms of fibromyalgia usually follow a chronic course, the quality of life of patients can improve. Therefore, improving quality of life should be a priority therapeutic goal. The objective of this longitudinal study was to assess the determinants of quality of life in patients with fibromyalgia six months after receiving multidisciplinary treatment. Method: In 40 consecutively selected patients, the variables previously described as solid determinants of quality of life were analyzed before and six months after receiving a multidisciplinary treatment. A principal component analysis of the change observed in each of these determinants was performed and their relationship with improvement in quality of life was analyzed using multivariate regression analysis. Results: Principal component analysis of change found 7 independent factors that explained 76.4% of the between-subject variance of change in clinical variables assessed. The multivariate regression analysis showed that the improvement in the different facets of quality of life depended mainly on the promotion of perceived ability to control pain through one’s own resources and on active coping that would lead to an increase in subjective functional capacity. Conclusions: Given the chronicity of fibromyalgia symptoms, improvement of patients’ quality of life should be based on the promotion of pain control beliefs and the increase of self-efficacy considering, however, the effect both negative and positive of significant others’ assistance.(AU)

Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia.

INTRODUCTION: There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain. METHODS: We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription. RESULTS: Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)=2.83), older age (IRR=25.43), and lower socio-economic status (IRR=1.35) were significantly associated with increased risk of being prescribed an AD. CONCLUSIONS: Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.

Nuevas controversias en psicología sanitaria: un análisis libre de ruido / New controversies in Health Psychology: A noise free analysis

Durante los últimos años hemos asistido a la regulación del ejercicio sanitario de la Psicología. Nuevas figuras profesionales, como el Psicólogo General Sanitario, precipitan la confusión en competencias respecto a otras profesiones ya existentes en el ámbito, como el Psicólogo especialista en Psicología Clínica. Esta circunstancia ha motivado conflictos e incluso difusión de información distorsionada (o ruido) desde los sectores académico y colegial. El presente trabajo intenta realizar un análisis, libre de ruido, de las controversias actuales no resueltas que afectarán de forma inminente a la evolución de la Psicología Sanitaria. Entre ellas, los límites entre ambas profesiones, su articulación dentro del ámbito sanitario, la acreditación de nuevas especialidades sanitarias y la regulación del Grado en Psicología. Más allá del ruido generado desde intereses particulares, este trabajo pretende analizar las opciones, oportunidades y consecuencias de la toma de decisiones respecto a estas cuestiones aún inconclusas. Finalmente, se apuesta por el debate abierto y transparente entre todas las partes de la Psicología, como única solución a la encrucijada actual de la disciplina

Practice in health related issues in psychology has been increasingly regulated over the past few years in Spain. New professional profiles such as General Health Psychologist have caused confusion over skills and competences with other existing professionals such as Clinical Psychologists. This circumstance has sometimes caused conflicts among psychology professionals due to misinformation (noise) from academic and professional bodies (COP) over recent legal discussions. Our manuscript tries to carry out a noiseless analysis of the current unresolved controversies surrounding psychology in the health sector that would inevitably affect the development of psychology in this area in Spain. Issues such as the boundaries between both professions, their role and functions in the health sector, the accreditation of new health specialties and the regulation of the Psychology Degree arise. Leaving aside the noise generated by particular interests, this article tries to analyze the options, opportunities and consequences of decision making about these yet to be solved matters. Finally, we encourage all psychology sectors to engage in an open and transparent debate as the only way to achieve a real solution for the critical position of psychology in Spain