Positive mental health and sense of coherence among emergency medical service professionals.

Background: Positive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment. Objective: This study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service. Methods: A descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale. Results: High scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background. Conclusion: Healthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.

Building community engagement with caregivers through online interaction and a salutogenic approach in a period of isolation.

Background: Informal caregivers are essential figures that deal with the effects of dependence in the elderly. However, they suffer from poorer health-related quality of life, particularly regarding mental health. Social support is crucial, but this was suspended or dramatically reduced during the Covid-19 pandemic. Salutogenesis theory explores the contributing factors for the promotion and maintenance of health. Considering all these, we offered caregivers the opportunity to join a participatory project aimed at creating communication spaces where they could share experiences, think together about potential solutions, and explore which salutogenic actions they used in their daily basis and how they had changed during Covid-19 restrictions. Methods: We used a qualitative methodology with a socio-constructivist and phenomenological approach and purposive sampling. We organized two focus groups consisting of online semi-structured discussions with seven participants in total. Conversations were videotaped and transcribed and we conducted content thematic analyses using the NVivo software. Results: Caregiving in our setting are primarily women with high levels of education that do not always feel comfortable with this load because it interferes with their personal and professional lives. The pandemic increased caregivers feelings of loneliness, resignation, and burden, directly affecting their mental health. Furthermore, the disappearance of prevention programs and the difficulties to access healthcare services produced negative consequences on the already fragile elderly and their family caregivers. Conclusion: The pandemic and its restrictions exacerbated the problematics affecting informal caregivers. Although these people are aware of their situation and have valued knowledge of how to improve their health, they cannot always put it into practice. We call policymakers to reframe interventions aimed at caregivers by introducing the voice of the community in the planning and to rethink the management of vulnerable people and their carers in other potential health crises.

Mapping health promotion practices across key sectors and its intersectoral approach at the local level: Study protocol.

AIMS: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions. DESIGN: A complementary multi-method study combining survey methods and qualitative interviews will be adopted. METHODS: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a 'framework analysis' will be performed. DISCUSSION: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building. IMPACT: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts. STAKEHOLDER ENGAGEMENT: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.

Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of the health services and mortality (DESVELA cohort): qualitative study protocol for a prospective cohort study in a hybrid analysis.

Introduction: Maintaining or acquiring healthier health-oriented behaviours and promoting physical and mental health amongst the Spanish population is a significant challenge for Primary Health Care. Although the role of personal aptitudes (characteristics of each individual) in influencing health behaviours is not yet clear, these factors, in conjunction with social determinants such as gender and social class, can create axes of social inequity that affect individuals' opportunities to engage in health-oriented behaviours. Additionally, lack of access to health-related resources and opportunities can further exacerbate the issue for individuals with healthy personal aptitudes. Therefore, it is crucial to investigate the relationship between personal aptitudes and health behaviours, as well as their impact on health equity. Objectives: This paper outlines the development, design and rationale of a descriptive qualitative study that explores in a novel way the views and experiences on the relationship between personal aptitudes (activation, health literacy and personality traits) and their perception of health, health-oriented behaviours, quality of life and current health status. Method and analysis: This qualitative research is carried out from a phenomenological perspective. Participants will be between 35 and 74 years of age, will be recruited in Primary Health Care Centres throughout Spain from a more extensive study called DESVELA Cohort. Theoretical sampling will be carried out. Data will be collected through video and audio recording of 16 focus groups in total, which are planned to be held in 8 different Autonomous Communities, and finally transcribed for a triangulated thematic analysis supported by the Atlas-ti program. Discussion: We consider it essential to understand the interaction between health-related behaviours as predictors of lifestyles in the population, so this study will delve into a subset of issues related to personality traits, activation and health literacy.Clinical trial registration: ClinicalTrials.gov, identifier NCT04386135.

Health promotion practices in primary care: comparison between florianópolis-brazil and girona-spain / Prácticas de promoción de la salud en atención primaria: comparación entre florianópolis-brasil y girona-espanha / Práticas de promoção da saúde na atenção primária: comparativo entre florianópolis-brasil e girona-espanha

ABSTRACT Objective: to understand the health promotion practices developed by nurses in the Primary Care context in Florianópolis and Girona. Method: this is a comparative study with a qualitative approach and of the descriptive exploratory type, carried out with eight nurses between June 2021 and April 2022 in health units that developed health promotion practices. The data, collected by means of semi-structured interviews, were analyzed through thematic analysis based on the health promotion framework. Results: four categories related to health promotion practices emerged from the data, namely: Training actions for health professionals in health promotion; Health promotion activities in individual consultations; Health education group activities; and Community health promotion actions. Conclusion: it is concluded that, in both municipalities, nurses develop individual and collective health promotion practices through groups and community actions, focusing on lifestyle changes. In Florianópolis they are grounded on the National Health Promotion Policy and, in Girona, health promotion actions are based on actions involving specific groups aimed at preventing diseases.

RESUMEN Objetivo: comprender las prácticas de promoción de la salud desarrolladas por enfermeros en el contexto de Atención Primaria de Florianópolis y Girona. Método: estudio comparativo de enfoque cualitativo y del tipo exploratorio-descriptivo, realizado entre junio de 2021 y abril de 2022 con ocho enfermeros en unidades de salud que desarrollaban prácticas de promoción de la salud. Los datos, recolectados por medio de entrevistas semiestructuradas, fueron analizados a través de análisis temático sobre la base del referencial de la promoción de la salud. Resultados: cuatro categorías relacionadas con las prácticas de promoción de la salud surgieron de los datos, a saber: Acciones para la formación de profesionales de la salud en promoción de la salud; Actividades de promoción de la salud en consultas individuales; Actividades grupales de educación en salud; y Acciones comunitarias de promoción de la salud. Conclusión: se concluye que, en ambos municipios, los enfermeros desarrollan prácticas individuales y colectivas de promoción de la salud por medio de grupos y acciones comunitarias, con énfasis en modificar estilos de vida. En Florianópolis se fundamentan en la Política Nacional de Promoción de la Salud y, en Girona, las acciones de promoción de la salud se basan en actividades relacionadas con grupos específicos dirigidos a prevenir enfermedades.

RESUMO Objetivo: compreender as práticas de promoção da saúde desenvolvidas por enfermeiros no contexto da Atenção Primária de Florianópolis e Girona. Método: trata-se de um estudo comparativo, de abordagem qualitativa, do tipo exploratório descritivo, realizado em unidades de saúde que desenvolviam práticas de promoção da saúde, com oito enfermeiros, no período entre junho de 2021 a abril de 2022. Os dados, coletados por entrevistas semiestruturadas, foram analisados por meio de análise temática com base no referencial da promoção da saúde. Resultados: emergiram dos dados quatro categorias relacionadas às práticas de promoção da saúde: Ações de formação de profissionais de saúde em promoção da saúde; Atividades de promoção da saúde na consulta individual; Atividades grupais de educação em saúde; Ações comunitárias de promoção da saúde. Conclusão: conclui-se que em ambos os municípios os enfermeiros desenvolvem práticas de promoção da saúde individuais e coletivas por meio de grupos e ações comunitárias, com enfoque na mudança de estilos de vida. Em Florianópolis estão fundamentadas na Política Nacional de Promoção da Saúde e, em Girona, as ações de promoção da saúde estão baseadas nas ações envolvendo grupos específicos voltados para a prevenção da doença.

Control of Therapeutic Levels of Anticoagulation and Associated Factors: A Prospective Cohort Study.

Maintaining therapeutic levels of anticoagulation is essential to avoid health complications in people who take vitamin K antagonists. This study aimed to analyze the influence of people's characteristics and the presence of changes in their lives in the control of therapeutic levels of anticoagulation. A longitudinal multicenter study with a 1-year follow-up of a cohort of 199 people receiving anticoagulant therapy was performed. The effect of biological, clinical, social, lifestyle, and changes in life on the international normalized ratio (INR) was analyzed. During the follow-up, 46.7% of participants presented good INR control. At baseline, a diagnosis of atrial fibrillation (P = .00), the lack of comorbidities (P = .03), absence of depression (P = .04), and not following a pharmacological treatment with hypoglycemia drugs (P = .01) were associated with good INR control. During the follow-up, the variable of making changes to the usual diet was associated with poor INR control (P = .05). In the binary multiple regression model, factors associated with poor control were taking hypoglycemia drugs (P = .02) and the presence of depression (P = .04), and only the diagnosis of atrial fibrillation was associated with good control (P = .03). People with a diagnosis of atrial fibrillation had good INR control. Having comorbidities, suffering depression, taking hypoglycemia drugs, and making changes to the diet have a negative effect on INR control.

The Mental Health of Patients With Psychotic Disorder From a Positive, Multidimensional and Recovery Perspective.

Positive mental health (PMH) and mental illness are distinct, yet interrelated, constructs. However, this relationship has yet to be adequately established. We aimed to evaluate the level of PMH and its relationship with sociodemographic and clinical determinants as well as to explore the relationship between PMH and the positive constructs of recovery, subjective wellbeing (SWB), insight and functioning in patients with psychotic disorder. A multicenter, descriptive, cross-sectional and correlational study with a sample of 347 patients with psychotic disorder was conducted. The following assessment instruments were used: Positive Mental Health Questionnaire, Maryland Assessment of Recovery in Serious Mental Illness scale, Insight Scale, Personal Wellbeing Index-Adult version (PWI-A), Overall Life Satisfaction (OLS) and Global Assessment of Functioning scale. The mean global level of PMH was 116.16 (range of 39-156, SD = 19.39). Significant differences were found in PMH in relation to sociodemographic (sex, civil status and employment situation) and clinical variables (family history of mental disorders, number of prescribed antipsychotics, treatment with anxiolytics, treatment with antidepressants and suicide attempts). PMH was significantly and positively correlated with recovery (r = 0.760), SWB (PWI-A: r = 0.728 and OLS: r = 0.602) and functioning (r = 0.243), and negatively with insight (r = -0.335). These results can lead to a major change in mental health care. If actions are taken to increase PMH, then recovery, SWB and functioning will also increase. At the same time, interventions should be carried out to boost insight, since increasing PMH could decrease insight, all resulting in better quality of life for patients with psychotic disorder.

La toma de decisiones en salud comunitaria a través del mapeo de activos en salud / Community health decision-making through the assets mapping

Se presenta la experiencia de redefinición de la metodología de mapeo de activos en salud, que tuvo como objetivo hacer posible el análisis según desigualdades de salud, así como su utilización como herramienta en procesos participativos de toma de decisiones en el ámbito de la Administración local. Para ello se diseñó un procedimiento replicable y apto para todas las edades y todos los colectivos. A su vez, se estableció una extensa clasificación de los activos no solo en el plano geográfico, sino también según el perfil de la persona y las características de los activos. El volcado de los datos en un sistema de información geográfica y la gran cantidad de activos recogidos permitieron ampliar la interpretación habitual de los datos obtenidos y presentar la información de forma dinámica. (AU)

This is a report about the experience on redefining the health asset mapping methodology. The aim of this experience consisted of making an analysis on health inequalities, as well as of using it as a tool in decision-making participative processes in the local administration area. Thus, a replicable procedure for all ages and groups was designed. Besides this, assets have been widely classified, in accordance with the territorial distribution, people's profiles and asset features. Both the upload of data to a geographical information system and the large amount of data gathered allowed us to enlarge the common interpretation of data and present the information in a dynamic way. (AU)

Evaluation and perceptions of a nursing discharge plan among nurses from different healthcare settings in Spain.

PURPOSE: The exchange of information between different healthcare settings through a nursing discharge plan is essential for safe care. However, the factors contributing to achieving the most efficient exchange have not been well studied. This study aimed to evaluate and explore the perceptions of a nursing discharge plan from the perspective of nurses in different healthcare settings. METHODS: A mixed methods approach comprising a specifically designed ad hoc questionnaire (n = 437) and a focus group session (n = 8). FINDINGS: Overall, 66.1% out of 437 nurses, and especially those working in nursing homes, were satisfied with the nursing discharge plan. Lack of time to complete the report and poor information about both nursing diagnoses and patients' social assessment were identified as problem areas. Some proposals emerged from the focus group: providing sufficient time for its completion, giving the nursing discharge plan a more flexible structure permitting more open-ended responses, requiring more information to be provided about the social and psychological situation of the patients, training nurses to use standardized language to avoid possible misinterpretations, and getting nurses from the different health care settings to work together in designing continuity of care plans. Elderly and low-income patients are found to need greater attention when filling out nursing discharge plans. CONCLUSIONS: The study has revealed key aspects that need to be improved and some recommendations in implementing the nursing discharge plan in our health area. These include that there should be more time provided to complete the NDP, and also specific details regarding the format, structure, content of the information that is communicated, and the prioritization of the patient profile.

Pain, Anxiety, and Depression in Patients Undergoing Chronic Hemodialysis Treatment: A Multicentre Cohort Study.

BACKGROUND: Pain is a considerable health concern that interferes with hemodialysis treatment outcomes and can lead to a patient developing anxiety and depression. AIMS: To examine the perception of pain in patients on chronic hemodialysis therapy, and to analyze the relationship between their pain, anxiety, depression, and sociodemographic data. METHOD: The research was conducted using a quantitative, observational, cross-sectional design. The study recruited 138 patients from multicentered hemodialysis units. A battery of questionnaires, including the visual analog scale (VaS) as pain intensity scale, the Hospital Anxiety and Depression Scale (HADS), and an ad hoc sociodemographic data questionnaire, were given to patients to answer during their hemodialysis sessions. A linear regression analysis was conducted to obtain the results. RESULTS: The mean of pain to all participants was generally low, as per AVS scale (0-10) it was 3.6 (stanard deviation [SD] = 3.07). Women manifested lower levels of pain than men (p = .015). One in five participants in both sexes suffered from clinical anxiety and one in six participants in both sexes suffered from clinical depression. Women scored higher on both the anxiety (4.8 versus 4.2) and depression scale (6.8 versus 6.5). Those participants who manifested clinical anxiety were younger compared with those who did not (aged 56.8 versus 66.8 years). Finally, older patients (aged 68.5 years) manifested higher levels of depression. CONCLUSIONS: The level of pain perceived by patients undergoing chronic hemodialysis therapy was generally low, especially in women. The study also demonstrated a positive association between levels of pain and anxiety and depression.

The Influence of Doing Shift Work on the Lifestyle Habits of Primary Care Nurses.

Nurses' lifestyle habits play a key role in promoting healthy lifestyles; although, they may not always be entirely healthy and can be influenced by working conditions. This paper aims to analyze the influence of doing shift work on nurses' lifestyle habits. Participants (n = 219) were recruited from 27 primary health care centres in Spain. Data were collected on socio-demographic characteristics, working conditions and lifestyle behaviour, assessed by use of an adhoc questionnaire including validated measures. Descriptive analysis and logistic regression models were performed. A total of 95% of the nurses reported having an adequate diet; 45.2% did not engage in any type of physical activity; and 85.8% did not smoke, especially women. A total of 60.3% did shift work, especially the younger ones (80.8%; p < 0.001), these nurses being the ones with the worst food habits (81.8%). In contrast, nurses who did shift work, exercised more days a week (69.5%; p < 0.001). The dietary habits of the nurses were adequate. Low tobacco consumption and low adherence to physical activity were observed, especially among women. Shift work harmed eating habits and obesity rates, but was a protective factor in terms of adherence to physical exercise.

Resilience and job satisfaction among out-of-hospital emergency medical service professionals: A cross-sectional multi-centric study.

AIM: We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals. BACKGROUND: The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work. METHODS: A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale. RESULTS: Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73). CONCLUSION: There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals.

Online breast-feeding support groups as a community asset in Lebanon after Beirut explosion.

OBJECTIVE: Breast-feeding rates are unsatisfactory in Lebanon. Social media groups could play an important role in promoting breast-feeding in normal conditions and post crisis. The aim of this study is to identify breast-feeding challenges, facilitators and assets and to describe how community assets via social media could build community resilience to pandemic's and disaster's effects. DESIGN: A two-phase qualitative content analysis was performed on posts and comments collected from a Facebook breast-feeding support group. Data were categorised into themes, categories and subcategories. SETTING: Posts and comments retrieved from a Facebook breast-feeding support group in Lebanon during the month of August 2020. PARTICIPANTS: Group members: mothers who breastfed, breast-feeding mothers and group admins that are lactation consultants. RESULTS: In phase one, breast-feeding 'Challenges' identified were lack of support from peers and family, lack of supportive policies, lack of knowledge and maternal stress related to political instability, COVID-19 and economic crisis. 'Assets and facilitators' included community support and donations. In phase two, analysis revealed how assets were being used on social media platform to build community resilience post crisis, through access to social support in challenging times, community engagement, material resources and transformative potential. CONCLUSION: Challenges faced during breast-feeding were diminished due to the support and assets received on a Facebook breast-feeding support group, and social media has been shown to be an important community asset implicated in empowering women to breastfeed and to build community resilience in moments of crisis.

[Community health decision-making through the assets mapping]. / La toma de decisiones en salud comunitaria a través del mapeo de activos en salud.

This is a report about the experience on redefining the health asset mapping methodology. The aim of this experience consisted of making an analysis on health inequalities, as well as of using it as a tool in decision-making participative processes in the local administration area. Thus, a replicable procedure for all ages and groups was designed. Besides this, assets have been widely classified, in accordance with the territorial distribution, people's profiles and asset features. Both the upload of data to a geographical information system and the large amount of data gathered allowed us to enlarge the common interpretation of data and present the information in a dynamic way.

The Impact of a Peer Social Support Network from the Perspective of Women with Fibromyalgia: A Qualitative Study.

BACKGROUND: Fibromyalgia is a chronic and complex disease whose management by patients requires a high level of commitment. Patient empowerment therefore represents an important milestone in chronic disease treatment and control. We explored the impact of a peer social support network from the perspective of women with fibromyalgia. METHODS: A generic qualitative design was proposed for the study, for which women who had been diagnosed with fibromyalgia were purposefully selected. Six semi-structured interviews were conducted, and the collected data were thematically analysed. RESULTS: Three key themes emerged regarding the peer social support network: (1) empowerment (facilitating acceptance of the diagnosis and acting as a source of information); (2) effects on well-being and quality of life (attenuated the stigma, improved physical well-being, provided emotional support and was a socialization medium); and (3), valuable aspects (transmitted feelings of being understood and listened to and increased personal feelings of satisfaction). CONCLUSIONS: A peer social support network for women with fibromyalgia exerts positive effects on their physical, mental, and social well-being and empowers them to better manage their disease. Healthcare for women with fibromyalgia should include strategies that connect them through peer social support networks.

Assessing Nurses' Satisfaction with Continuity of Care and the Case Management Model as an Indicator of Quality of Care in Spain.

Chronic diseases are treated and cared for in different healthcare settings. Continuity of care and the case management model facilitate the integration of processes and care levels. However, there is little evidence regarding the satisfaction of nurses with this model. The purpose of this study was to examine nurses' satisfaction with continuity of care and the case management model. A cross-sectional study was conducted. An ad hoc questionnaire was administrated to 437 Spanish nurses from the three health care settings that responded. This included items on socio-demographics, employment relationship, and satisfaction with continuity of care and case management. Descriptive analysis and linear regression models were performed. In total, 96.1% of the nurses expressed a high level of satisfaction with continuity of care and 80.7% with the case management model. Nurses in a primary care setting reported the greatest satisfaction with the case management model (B = 0.146, 95% CI = 0.139-0.694, p = 0.003). The nurses' higher perception of patient satisfaction was associated with greater satisfaction with continuity of care (B = 0.466, 95% CI = -0.367-0.533, p < 0.000). Nurses identified the case management model as an optimal facilitator of continuity of care. While satisfaction with continuity is high, strategies are needed to improve it in primary care centers and aged care homes.

Individual, social and national coping resources and their relationships with mental health and anxiety: A comparative study in Israel, Italy, Spain, and the Netherlands during the Coronavirus pandemic.

Employing the salutogenic model, we asked how individuals in different countries cope with the COVID-19 crisis and stay healthy. We were interested in exploring the individual (i.e. sense of coherence) as well as the social and national resources (i.e. social support, sense of national coherence, and trust in governmental institutions) that could explain levels of mental health and anxiety during the outbreak of the pandemic. Data collection was conducted via convenience sampling on online platforms, during the end of March and the beginning of April 2020. The data included four samples: 640 Israeli participants (319 males), 622 Dutch participants (177 males), 924 Italian participants (338 males) and 489 Spanish participants (117 males); age range of 18-88 years. The questionnaires included standard tools (MHC-SF, GAD-7, SOC, SONC). Several questions were adapted to the context of coronavirus and measured levels of exposure to COVID-19, trust in governmental institutions, and social support. The results significantly confirmed the suggested salutogenic model regarding the contribution to individual and national coping resources to anxiety levels and mental health. The patterns of the coping resources in explaining anxiety and mental health were similar in the four samples, and SOC was the main predictor these outcomes. Despite these similarities, a different pattern and also different magnitudes of the predictive value of the coping resources were found for the two different reactions: anxiety vs. mental health. While SOC and situational factors (like financial threat) were significant in explaining anxiety levels, the SOC and national resources were found as significant in explaining mental health levels. The findings support the salutogenic approach in studying reactions during pandemic time. They also shed some light on the difference between pathogenic and salutogenic measures in studying psychological reactions to stressful situations.

Análisis descriptivo de la formación en participación comunitaria en salud en España / Descriptive analysis of training in community health engagement in Spain

OBJETIVO: Describir las actividades formativas en participación comunitaria en salud que se realizan en España. MÉTODO: Identificación y análisis descriptivo de las acciones formativas en el periodo 2017-2018 en los ámbitos de la universidad, la Administración pública y las unidades docentes de medicina y enfermería familiar y comunitaria. RESULTADOS: Se incluyeron 28 actividades formativas en el análisis descriptivo de ocho comunidades autónomas diferentes y dos de ámbito nacional. La mayoría de las actividades formativas son presenciales e impartidas por unidades docentes de formación especializada para profesionales de medicina y enfermería de atención familiar y comunitaria, con una duración de entre 10 y 25 horas, y sin coste de matriculación. CONCLUSIÓN: Existe un vacío formativo en la mayoría de las comunidades autónomas que evidencia que la formación en participación comunitaria en salud es escasa y está poco integrada. Las actividades formativas analizadas están incluidas principalmente en la formación de especialistas de medicina y enfermería de familia y comunitaria, si bien esta formación no está unificada ni se incorpora en todos los planes docentes. Para una mirada integral sobre la salud de las personas es esencial incluir la participación comunitaria en salud en la formación de grado y posgrado, tanto del ámbito sanitario como de otras disciplinas. Las instituciones responsables de la formación en los diferentes niveles deben incluir la participación comunitaria en salud en los itinerarios formativos de los profesionales

OBJECTIVE: To describe the professional training health professionals receive in community health engagement in Spain. METHOD: The identification and descriptive analysis of trainings developed between 2013-2018 offered by public universities, public administrations and the teaching units for the specialization of family and community health doctors and nurses. RESULTS: Twenty eight trainings were included in the descriptive analysis. Most of them had been organized during 2018 in eight Autonomous Communities. Two of them were organized at a national level. Most trainings were attendance based and have been developed by teaching units in charge of training doctors and nurses specializing in family and community health, with an average duration of 10-25hours and no enrolment costs. CONCLUSION: There is a lack of training in community health engagement in the majority of autonomous communities in Spain which shows that it is scarce and not yet fully integrated in the training of health professionals. The trainings that have been analyzed are mainly part of wider specialization programs for doctors and nurses specializing in family and community health, and even so this training is not standardized and included in the specialization programs of all the Spanish regions. To develop a comprehensive health approach it is key to include community health engagement as part of the trainings professionals receive during their University degree, and to extend it to other health professions. The institutions responsible for the training of health professionals should include community health engagement as part of the different training itineraries of professionals