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.

Work-family conflict among hotel housekeepers in the Balearic Islands (Spain).

The massive incorporation of women to the labour market has increased academic and applied interest on work-life issues throughout the years. This article aims to describe the domestic burden and difficulties in work-life balance (WLB) and to understand the intersection of work and family spheres among hotel housekeepers (HHs). A cross-sectional study was conducted through Primary Health Care in the Balearic Islands (Spain); 1,043 HHs were enrolled. 56.7% reported difficulties in WLB. Risk factors for perceiving difficulties in WLB were: living with someone else (regardless of the number of co-habitants), having difficulties making ends meet, being the main person in charge of domestic tasks, having a dependant, having an external locus of control, presenting higher levels of stress at work, working more hours a week and being younger. Protective factors from experiencing work-family conflict (WFC) were job and wage satisfaction. WFC is strongly influenced by individual, economic, labour and domestic factors: these relationships show that labour and domestic spheres are non-separate worlds.

Workplace bullying and sexual harassment at work among hotel housekeepers in the Balearic Islands (Spain).

Introduction: Hotel housekeepers are close to being a 100% feminized occupational group in Spain. This fact, coupled with some features of the job, places them at high risk of sexual harassment at work and bullying in the workplace. This study aims to explore experiences of sexual harassment at work and workplace bullying among hotel housekeepers in the Balearic Islands. Second, it aims to describe and estimate the prevalence of both phenomena. Methods: This is a mixed-methods study. Ten semi-structured interviews were conducted with key informants, and six focus groups were held with hotel housekeepers. Additionally, a quantitative cross-sectional study (n = 1,043) was undertaken. Results: Most participants in focus groups had been sexually harassed at work. However, they had normalized this kind of situations, not labeling themselves as victims of sexual harassment; and harassment events were seen as unimportant, normal, and unquestioned, as well as being part of their daily work. Hotel housekeepers who were sexually harassed indicated high levels of stress at work and low social support. The prevalence of different workplace bullying behaviors was quite high among hotel housekeepers working in the Balearic Islands. Some were associated with poorer self-rated health, less satisfaction with the job and the salary, lower social support, and higher levels of stress. Despite this, qualitative methods informed us that less severe behaviors were normalized and perceived by hotel housekeepers as intrinsic to their job. Discussion: The results show the high tolerance to less severe expressions of sexual harassment at work and workplace bullying, as well as difficulties in or reluctance to labeling this kind of experiences as such.

Hotel housekeepers and occupational health: experiences and perceived risks.

Background: Hotel housekeepers are one of the most important occupational group within tourism hotel sector; various health problems related to their job have been described, above all musculoskeletal disorders. The objective of this study is to understand the experiences and perceptions of hotel housekeepers and key informants from the Balearic Islands (Spain) regarding occupational health conditions and the strategies employed to mitigate them. Methods: A qualitative study was carried out. Six focus groups with hotel housekeepers and 10 semi-structured interviews with key informants were conducted. Next, we carried out a content analysis. Results: Hotel housekeepers reported musculoskeletal disorders, anxiety and stress as main occupational health problems; health professionals underscored the physical problems. Hotel housekeepers perceived that their work (physically demanding and with repetitive movements) caused their health conditions. To solve health issues, they used medication (anti-inflammatory agents, painkillers, sedatives and anxiolytics), which allowed them to continue working; health public services, generally rated as satisfactory; individual protective equipment; ergonomics (with difficulties due to high work pace and hotel facilities) and physical activity. Two contrasting attitudes were identified regarding sick leave: HHs who refused to accept a doctor-prescribed sick leave (due to fear of being fired, sense of responsibility, ...), and those who accepted it (because they could not continue working, they prioritised health before work). Conclusions: Our results might contribute to plan improvement strategies and programs to address health problems among hotel housekeepers. These programs should include interventions, such as coping strategies for the work-related risk factors (i.e., stress) and strategies to reduce medicine consumption. Additionally, hotel facilities should adopt policies focused on making workplaces more ergonomic (i.e., furniture) and to diminish the work pace.

Impacto de la drepanocitosis en las familias de los afectados. Estudio cualitativo sobre sus experiencias, percepciones y necesidades / Impact of sickle cell disease on the families of affected patients. Qualitative study of their experiences, perceptions and needs

Introducción: la drepanocitosis o enfermedad de células falciformes es una enfermedad genética que afecta mayoritariamente a población de origen africano. Requiere ingresos largos y repetidos, afectando a la calidad de vida. Si la situación socioeconómica es vulnerable, el efecto de la enfermedad en su vida se agrava. Este estudio pretende conocer las preocupaciones, creencias y necesidades de las familias de los menores afectados de drepanocitosis, los conocimientos previos sobre la enfermedad, las repercusiones psicosociales, la satisfacción con la asistencia sanitaria y el posible estigma que rodea esta enfermedad. Material y métodos: estudio cualitativo mediante entrevistas a familiares de los afectados Resultados: se realizaron 20 entrevistas. Se exploró la relación de las familias con la enfermedad, el entorno sociofamiliar, las preocupaciones, emociones y estrategias de afrontamiento, los recursos deseados y no deseados y la satisfacción con la atención recibida. Al analizarlas, destacó el impacto del diagnóstico, un buen conocimiento de los síntomas y tratamiento, y diferencias en el conocimiento de las causas de la enfermedad. El rol de cuidador está ligado al género femenino. La organización familiar y laboral es causa frecuente de estrés. Se detectan preocupaciones por la enfermedad y el día a día, emociones y sentimientos negativos y positivos, así como diferentes estrategias de afrontamiento. Expresan recursos deseados como ayudas por hijo/a enfermo/a. Valoran positivamente la atención sanitaria recibida. Conclusiones: las entrevistas en profundidad con las familias de las personas afectadas ayudan a conocer mejor su realidad y sus necesidades, mejorando así la atención a los menores con drepanocitosis (AU)

Introduction: sickle cell disease is a genetic disease that mainly affects the population of African ancestry. It requires repeated and protracted hospitalizations thereby impairing quality of life. The impact of the disease in life is worse in socially vulnerable individuals. This study aimed to establish the concerns, beliefs and needs of the families of children and adolescents affected by sickle cell disease, their knowledge of sickle cell disease, the psychosocial impact of the disease, the satisfaction with health care services and the potential stigma surrounding the disease.Material and methods: qualitative study through interviews with relatives of affected individuals.Results: we conducted 20 interviews. We explored how families dealt with the disease; the social and family environment; concerns, emotions, and coping strategies; which resources were wanted versus not, and the satisfaction with the care received. The most salient results of the analysis were the impact of the diagnosis, the good level of knowledge about the symptoms and treatment and differences in the knowledge about the causes of the disease. The caregiver role was associated with female sex. Organizing family life and work was a frequent source of stress. We identified concerns about the disease and everyday life, negative and positive emotions and feelings and different coping strategies. Participants expressed the resources they wished for, such as aid for the sick child. They expressed a positive perception of the care received.Conclusions: in-depth interviews with families of affected individuals help improve our understanding of their experiences and needs, and therefore also improve the care provided to paediatric patients with sickle cell disease. (AU)

Anxiety, Depression, and Concern About Employment Status of Hotel Housekeepers in the Balearic Islands During the COVID-19 Pandemic: A Longitudinal Study.

Tourism is a crucial economic sector in the Balearic Islands (Spain). COVID-19 pandemic might severely impact hotel housekeepers (HHs) due to their already precarious employment situation. The purpose is to assess the evolution of the concern about employment status, anxiety, and depression of HHs. This is a longitudinal study conducted with a subset of participants from a primary care, health promotion intervention study. Two additional visits were added (March-April and October-December 2020) for the purpose of this study. We recruited 290 HHs in March-April 2020; 237 were again interviewed during October-December 2020. In the first visit, high level of concern about employment was associated with age under 50, temporary contracts and external locus of control (LOC). Moderate-severe anxiety was associated with low social support and external LOC; moderate-severe depression was associated with low social support. Regarding the second visit, age, years working as HH, type of contract, social support, and LOC were not associated with concern about employment status, anxiety, and depression. There was a larger proportion of HHs with moderate-severe anxiety and depression among HHs with high degree of concern. Concern increased significantly among HHs: over 50 years of age; with more than 15 years in the job, a recurring seasonal contract and normal social support. After adjusting by age, type of contract, LOC, and social support, we found a statistically significant increase (12.0%) of HHs highly concerned about their job situation: compared to the first visit, HHs were 2.3 more likely to have a high degree of concern in December 2020. In contrast, increases in moderate-severe anxiety (0.3%) and depression (4.3%) between the two periods were not significant. In HHs, the COVID-19 pandemic has caused significant concern about employment status and symptoms of depression and anxiety. In the uncertain times of the pandemic, mental wellbeing benefits from variables that confer stability, such as internal LOC, perception of social support, and a stable job. Longitudinal results point at long lasting effects of the COVID-19 pandemic on mental health. It is crucial to allocate additional resources in primary care to adequately address the anticipated influx of needs.

Chronic Pain and Work Conditions of Hotel Housekeepers: A Descriptive Study.

OBJECTIVES: To estimate the prevalence of musculoskeletal pain of hotel housekeepers (HHs) and to describe the work conditions and perception of health in this occupational group in the Balearic Islands, Spain. METHODS: Cross-sectional descriptive study with HHs of the Balearic Islands, performed in primary care. Random sample of HHs who worked during the 2018 season. We collected information on sociodemographic variables, job characteristics, workload, pain, perceived health, and physical activity. After participants signed the informed consent form, we conducted a face-to-face interview in the primary care centre and accessed the participants' electronic health records. RESULTS: 1043 HHs aged 43.3 ± 10 years and with 10.7 ± 9.1 years worked as HHs were included. 51% (95% CI: 48-54%) reported chronic pain, mainly in the lower back 28.7% (95% CI: 25.9-31.5%), hands/wrists 23.7% (95% CI: 21.1-26.4%), neck 21.6% (95% CI: 19.1-24.3%), shoulders 19.9% (95% CI: 17.4-22.4%), and back 17.8% (95% CI: 15.4-20.2%). Pain was associated with older age, more years worked, more beds made/day and difficulty in pushing the housekeeping cart. More than half HHs reported that they did not incorporate occupational risk prevention measures (ORPMs) into their routine; 17.3% (95% CI: 15.1-19.7%) HHs considered their health as poor or very poor. Perception of health was worse in HHs with chronic pain. CONCLUSIONS: A high percentage of HHs of the Balearic Islands reported chronic pain, a low compliance with ORPMs and compared to women of the same sociodemographic profile they perceive a worse health status.

Perceived Factors of Stress and Its Outcomes among Hotel Housekeepers in the Balearic Islands: A Qualitative Approach from a Gender Perspective.

Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands, e.g., work overload, time pressure, physical burden…, lack of enough resources and little control, derived from role conflict, unexpected events…, were the most important factors explaining HHs' stress. Additionally, this imbalance was perceived as leading to health problems, mainly musculoskeletal disorders. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict, preventing them from enjoying leisure time. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.