Occupational Therapy in Severe Mental Disorder-A Self-Controlled Quasi-Experimental Study.

Severe mental disorder (SMD) produces a significant functional limitation that affects the performance of daily activities. The occupational therapist intervenes on this limitation by seeking greater autonomy of these patients through specific activities. This study aims to identify the main limitations of people with SMD and to examine whether an occupational intervention has any effect in helping to overcome or ameliorate these limitations. A quasi-experimental study including 103 participants was carried out. An evaluation using the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire was performed before and after the intervention. Within the activity program, those with a higher attendance rating during cognitive stimulation, cooking workshop, therapeutic walks, relaxation, and creative activities were mainly men. Both patients and professionals indicated that Understanding and Communicating, Participation in Society, and Activities of Daily Living were the main perceived limitations. Upon discharge, patients and professionals reported positive outcomes. The intervention programs carried out by occupational therapy, along with the other aspects of the treatment that SMD patients received, played an important part in improving the performance and occupational interests of these patients.

Reliability and Validity of a Stress Scale in Public Employees from Murcia (Spain).

Stress is common in all work environments. Technostress and the difficulty of separating the family arena from the work environment are some of the new and emerging risks faced by companies, employees and society in general. Most of the available instruments for measuring stress in workers have been focused on education professionals and healthcare workers. Therefore, it is necessary to validate simple and friendly-use tools to detect stress levels in public workers. The aim of this study was to determine the internal consistency of an adapted version of the Student Stress Inventory-Stress Manifestations (SSI-SM) for public employees and to determine if high-stress levels are related to personal and work-related factors. A cross-sectional and descriptive study was conducted from October 2016 to February 2019 including 468 Spanish public workers based in Murcia. An adapted version of the SSI-SM was administered and data on personal and work-related factors were collected. Results showed that all of the factors had Cronbach's α over 0.700, and no items need to be deleted due to correlations with the factor exceeding 0.300. Factor 1, "Self-concept", has a Cronbach's α of 0.868, with values of 15.62 ± 4.99; factor 2, "Sociability", Cronbach's α: 0.853, with mean values of 13.33 ± 4.17; factor 3, "Somatization", Cronbach's α: 0.704, mean value of 5.35 ± 1.90 and: factor 4, "Uncertainty", Cronbach's α: 0.746, with a mean value of 8.19 ± 2.51. In conclusion, the internal consistency of the adapted SSI-SM for public employees with different work positions and shifts has been validated and determined. This study provides a useful tool for the early detection of stress in public employees and may be potentially useful for preventing the harmful consequences of stress.

The COVID-19 Pandemic and Its Impact on Homebound Nursing Students.

University students are predisposed to stress, which could be even higher in Nursing students since they are directly related to the COVID-19 pandemic given their health training and area of knowledge. Our purpose was to assess the stress levels of Nursing students before and during lockdown due to the COVID-19 pandemic in Murcia (Spain), its influence on taking an online exam and how it was affected by physical exercise. This was an observational and prospective study including Nursing students from the second year of the Nursing Degree from 3 February to 23 April 2020. Three measurements were performed: one before lockdown and two during lockdown. Stress increased substantially during lockdown. Financial, family or emotional problems, as well as physical exercise, also increased. Indeed, at 40 days of lockdown, those students with financial, family or emotional problems, and less physical exercise reported significantly higher stress levels. In addition, those who passed the online exam had lower stress levels compared to those who failed. In conclusion, during lockdown, stress in Nursing students increased. This could be triggered by students' personal problems, and physical exercise may be used as a way to reduce stress. Academic performance was better in those students reporting less stress.

Work Shift and Circadian Rhythm as Risk Factors for Poor Sleep Quality in Public Workers from Murcia (Spain).

The purpose of this study was to determine the prevalence of sleep quality and to investigate variables predicting the risk of poor sleep quality in public workers from Murcia (Spain). A cross-sectional and prospective study was conducted from October 2013 to February 2016 in 476 public workers. The Pittsburgh Sleep Quality Index was used to measure the quality of sleep, and the reduced scale of the Horne and Österberg Morningness-Eveningness Questionnaire was applied to analyze the circadian typology. The predictive variables of self-reported poor sleep quality were identified by multivariate logistic regression. No significant differences were found according to sex in the overall sleep quality scores (5 ± 2.9 versus 5.1 ± 3, p = 0.650), but there were in the duration of sleep. Three percent of females slept <5 hours compared to 2% of men (p = 0.034). Fixed morning shifts (OR = 1.9, 95% CI 1.3-3.1; p = 0.007) and evening chronotypes (OR = 1.6, 95% CI 1.0-2.3; p = 0.017) were independent predictors of suffering from poor sleep quality. In conclusion, the frequency of self-reported poor sleep quality among public workers from Murcia was 37.4%. Being a public worker with a fixed morning shift and having an evening chronotype demonstrated to be associated with the quality of sleep.

A new tool to assess patients' comfort during hospitalization: The Hospital Discomfort Risk questionnaire.

AIM: We aimed to develop a tool for the assessment of the risk of patient discomfort in Spanish hospital wards. BACKGROUND: Several studies described tools to assess comfort but most are long and complex. METHODS: Cross-sectional study performed in three phases ((a) initial design; (b) refinement and psychometric testing; and (c) internal validation of the Hospital Discomfort Risk [HDR] questionnaire). RESULTS: A voluntary expert panel proposed the HDR questionnaire. Internal consistency and factorial analysis were investigated in 270 (53.7% men, mean age 57.33 ± 18.7 years) inpatients. Based on the Cronbach's α, three items were removed to the final 8-item version of the questionnaire. The HDR questionnaire showed a good predictive ability for identifying the risk of discomfort (c-index: .897, 95% CI 0.854-0.930; p < .001). CONCLUSIONS: The HDR questionnaire could be useful for identifying inpatients at risk of discomfort, but further prospective studies should externally validate these results. IMPLICATIONS IN NURSING MANAGEMENT: Nurses are the healthcare professionals with better access to patients and the first in identifying complications of hospitalization. Patients' discomfort could be routinely assessed during hospitalizations using the HDR questionnaire. Nurse managers should play an important role in this accomplishment, by promoting its use and knowledge among the nurse staff.

Risk factors for mental workload: influence of the working environment, cardiovascular health and lifestyle. A cross-sectional study.

OBJECTIVES: Mental workload is a condition which can negatively influence the overall health of workers. In this study, we aimed to investigate the risk factors for the onset of mental workload, including working conditions, cardiovascular comorbidities and lifestyle habits, in a working population. METHODS: This is a cross-sectional study including 408 workers from a risk prevention service of small/medium companies in Murcia (Spain). Workers from the secondary and tertiary sectors or primary/secondary sectors with administrative management tasks who underwent a routine medical examination between 1 January 2017 and 31 April 2017 were included. Workers from the primary sector and construction were excluded to avoid a sex and age bias. RESULTS: From 408 workers, 206 (50.5%) were females; with mean age 36.8±10.4 years. 164 (40.2%) workers had a moderate to significant risk of mental workload. Based on multivariate logistic regression analyses, independent predictors of mental workload were age ≥30 years (OR 2.42, 95% CI 1.22 to 4.80; p=0.012), working in tertiary (OR 7.89, 95% CI 3.59 to 17.31; p<0.001) or administrative sectors (OR 87.57, 95% CI 35.22 to 217.79; p<0.001) and alcohol consumption (OR 2.08, 95% CI 1.16 to 3.73; p=0.014). Smoking habit (OR 0.47, 95% CI 0.26 to 0.85; p=0.012) was found as a protective variable so non-smoking was considered as a risk factor. CONCLUSION: In the present study from a risk prevention service including workers of small/medium companies from the secondary and tertiary sectors and workers with administrative tasks, the labour sector, age, alcohol consumption and smoking habits, are independently associated with a higher risk of developing moderate to significant mental workload.