Professional quality of life and fear of COVID-19 among Spanish nurses: A longitudinal repeated cross-sectional study.

AIM AND OBJECTIVES: To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign. BACKGROUND: The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential. DESIGN: A repeated cross-sectional design was carried out with a time-lapse of 12 months. METHODS: A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies. RESULTS: The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = - .16, p = .001; r = - .22, p ≤ .001). RELEVANCE TO CLINICAL PRACTICE: Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care. PATIENT OR PUBLIC CONTRIBUTION: The nurses collaborated by participating in the present study anonymously and disinterestedly.

Experiences of Self-Stigma in People with Chronic Psychosis: A Qualitative Study.

We present the results of a phenomenological study understanding the personal meaning of self-stigma in people with chronic psychosis. Self-stigma is a frequent phenomenon in the lives of people with psychosis and their families and it functions as a barrier to recovery. Semi-structured in-depth interviews were conducted with fourteen outpatients that suffer from chronic psychosis during January 2020. Data analysis was carried out using an inductive approach as described by Graneheim and Lundman through the MAXQDA 2022 program. The themes observed were: "Contextual Stigma", "Components of Self-Stigma", "Skills Loss" and "Coping with Self-Stigma". The main categories and subcategories were avoidance and escape behaviours from their social environment, labelling, loss of social relationships, negative impact and self-concealment of the diagnosis. Our results revealed influence on each other, forming a looping effect that explains and amplifies the lived experience of self-stigma. These findings highlight the need to implement strategies in nursing practice aimed at training the acceptance and distancing necessary to minimize the impact of self-stigma on people with chronic psychosis. This study adheres to the EQUATOR guidelines for the Consolidated Criteria for Reporting Qualitative Research (COREQ).

The role of nurses' professional values during the COVID-19 crisis.

BACKGROUND: The COVID-19 pandemic has produced high stress in nurses, affecting their professional quality of life. Different variables affect psychological stress response and professional quality of life. In this context, the role of professional values represents an interesting object of research. OBJECTIVES: To analyze the relationship between professional values, perceived stress, and professional quality of life among nurses during the COVID-19 crisis. RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT: Descriptive cross-sectional study. Participants were 439 registered nurses from the public health system. Perceived stress, professional quality of life, and professional values were evaluated by using measuring instruments adapted and validated in the geographic context of research. Data were collected online in December 2020 during the second wave of the COVID-19 pandemic in Spain. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee on Clinical Research of the Principality of Asturias. FINDINGS: Within professional values, ethics obtained higher scores showing the primacy of ethical values among nurses. Moderate correlations between ethics, mastery, expertise, and compassion satisfaction were found. Frontline nurses informed high perceived stress. The correlations between professional values and compassion satisfaction were higher in non-frontline nurses. A moderate negative correlation between perceived stress and compassion satisfaction was found in both groups, which implies that the higher the stress, the lower the satisfaction in the helping relationship. CONCLUSION: Professional values positively influence compassion satisfaction during the COVID-19 pandemic. Compassion satisfaction presents a negative correlation with fatigue compassion and burnout in frontline and non-frontline nurses. Given the functionality of values both to guide clinical practice professionally and ethically, and prevent dissatisfaction with one's professional quality of life by reinforcing compassion satisfaction, it is necessary to reinforce them with an intensive and cross-sectional learning during the university training.

Psychological Inflexibility in People with Chronic Psychosis: The Mediating Role of Self-Stigma and Social Functioning.

Psychosis is associated with self-stigmatization and loss of social functioning that increase the severity of the disorder. Psychological inflexibility (PI)-an individual's tendency to suppress undesirable private events-plays a fundamental role in the emergence and worst prognosis of psychosis. The main objective of this study was to analyze whether self-stigma and social functioning mediate the association of PI with the severity of psychosis in adults with chronic schizophrenia. The study was carried out with a sample of 103 outpatients. The Acceptance and Action Questionnaire, the Internalized Stigma of Mental Illness Scale, and the Social Functioning Scale were used for clinical assessments. Data analyses were performed by using the PROCESS macro for SPSS. Results showed that the link between PI and the severity of psychosis is not direct, but is better explained by mediation of the self-stigma and social functioning of those assessed. PI also predicts worse social functioning without the need to take self-stigma into account. Moreover, self-stigma alone does not predict the severity of psychotic symptoms; this relationship has to be mediated by social functioning. These findings suggest that interventions designed to increase psychological flexibility, such as Acceptance and Commitment Therapy (ACT), may offer an alternative to attenuate the negative impact of self-stigma and to improve the social functioning.

[Evidence-Based Psychological Treatments for Adults: A Selective Review]

Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.

Transdiagnóstico: origen e implicaciones en los cuidados de salud mental / Transdiagnosis: origin and implications for mental health care

El enfoque transdiagnóstico representa una innovación en salud mental de gran calado teórico de la que se derivan importantes implicaciones a nivel interdisciplinar. Se presentan los antecedentes del modelo referidos a tres problemas interrelacionados: insatisfacción con el diagnóstico psicopatológico, riesgo de medicalización de la vida normal y elevada comorbilidad psicopatológica. El transdiagnóstico surge al constatarse la existencia de un número reducido de procesos comunes a muy diversos trastornos. Este planteamiento permite reconsiderar de forma radical los cuidados de salud mental, desde la propia comprensión de los trastornos a su terapéutica, incluyendo la prevención y promoción de la salud mental. Los cuidados transdiagnósticos se basan en principios generales que implican la posibilidad de intervenir sobre factores comunes a distintos trastornos, ofreciendo una visión más integrada y eficiente de la atención. Se exponen las ventajas de organizar los cuidados de salud mental bajo un planteamiento transdiagnóstico, abordando problemas a nivel de los núcleos psicopatológicos subyacentes. El interés retorna a la vivencia subjetiva y a la relación terapéutica como focos de atención clínica. Esta forma de concebir los problemas mentales enlaza con la fenomenología y permite fortalecer una visión humanista del cuidado, representando una vuelta a los orígenes de la enfermería de salud mental. El énfasis en los núcleos psicopatológicos y en las relaciones interpersonales implica tender hacia una perspectiva más convergente y unificada de las intervenciones, avanzando hacia una práctica clínica más satisfactoria, integrada y menos estigmatizante

Transdiagnosis represents an innovation in mental health of great theoretical depth, with important interdisciplinary implications. The background of the model regarding three interrelated problems (dissatisfaction with psychopathological diagnosis, risk of medicalization of everyday life, and high rates of psychopathological comorbidity) is shown. Transdiagnosis emerges at the beginning of the 21st century, when a number of common processes underlying a variety of disorders were found. This approach allows a radical reconsideration of mental health caring, including the understanding of the disorders, their treatment, and the prevention and promotion in mental health. Transdiagnostical care is based on general principles that affect common factors shared by different disorders, offering a more integrated and efficient vision of mental health care. The advantages of organizing nursing care under a transdiagnostic approach are exposed and discussed. The interest is focused on subjective experience and the therapeutic relationship, which implies a return to the origins of mental health nursing. This conception is linked with phenomenology and allows strengthening a humanistic approach to caregiving. The emphasis on common psychopathological processes and interpersonal relationships involves moving towards a more convergent and unified perspective of our interventions, and towards a more integrated and less stigmatizing clinical practice

Diminished emotional expression in schizophrenia: an interdisciplinary approach based on behavioral interventions / Expresión emocional disminuida en la esquizofrenia: un abordaje interdisciplinar basado en intervenciones conductuales

Background: Negative symptoms represent the main cause of disability in schizophrenia, having recently been grouped into two general dimensions: avolition and diminished emotional expression, which includes affective flattening and alogia. The aim of this study was to explore the response of these two symptoms to a set of behavioral interventions based on contingency management, performed in an interdisciplinary context. Method: Behaviors of interest were monitored and evaluations before and after the treatment were performed on 9 schizophrenic inpatients with persistent negative symptoms. The program included 12 group double sessions aimed at developing facial expression and verbal communication, and a nursing care plan to generalize and strengthen these behaviors synergistically. Results: there were appreciable differences in facial expression, which were less clear for alogia. The clinical evaluation using PANSS-N did not find notable differences at group level, but the nursing assessment using NOC indicators did. Conclusions: although difficult to modify, negative symptoms are not insensitive to the influence of behavioral interventions. Specific psychological interventions that address negative symptoms as a priority focus of attention and care need to be promoted and developed, particularly when considering the crucial role of context in their progression (AU)

Antecedentes: los síntomas negativos representan la principal causa de discapacidad en la esquizofrenia, habiendo sido agrupados recientemente en dos dimensiones: avolición y expresión emocional disminuida, que incluye el aplanamiento afectivo y la alogia. El objetivo del estudio fue explorar la respuesta de estos dos síntomas a un conjunto de intervenciones conductuales basadas en el manejo de contingencias en un contexto interdisciplinario. Método: se monitorizaron conductas de interés y realizaron medidas pre y post a 9 participantes con esquizofrenia negativa persistente ingresados en dispositivos de rehabilitación. El programa incluyó 12 sesiones grupales dobles dirigidas a trabajar la expresión facial y la comunicación verbal, y un plan de cuidados para fortalecer y generalizar estas conductas. Resultados: se obtuvieron diferencias relevantes en la expresión facial, que fueron menos claras para la alogia. La evaluación clínica mediante la PANSS-N no obtuvo diferencias notables a nivel de grupo, pero sí la valoración mediante indicadores NOC. Conclusiones: aunque difíciles de modificar, los síntomas negativos no son insensibles a la influencia de intervenciones conductuales. Resulta necesario potenciar intervenciones psicológicas específicas que aborden estos síntomas como un foco prioritario de atención y cuidado, considerando el papel crucial del contexto en su evolución (AU)

Diminished emotional expression in schizophrenia: an interdisciplinary approach based on behavioral interventions.

BACKGROUND: Negative symptoms represent the main cause of disability in schizophrenia, having recently been grouped into two general dimensions: avolition and diminished emotional expression, which includes affective flattening and alogia. The aim of this study was to explore the response of these two symptoms to a set of behavioral interventions based on contingency management, performed in an interdisciplinary context. METHOD: Behaviors of interest were monitored and evaluations before and after the treatment were performed on 9 schizophrenic inpatients with persistent negative symptoms. The program included 12 group double sessions aimed at developing facial expression and verbal communication, and a nursing care plan to generalize and strengthen these behaviors synergistically. RESULTS: there were appreciable differences in facial expression, which were less clear for alogia. The clinical evaluation using PANSS-N did not find notable differences at group level, but the nursing assessment using NOC indicators did. CONCLUSIONS: although difficult to modify, negative symptoms are not insensitive to the influence of behavioral interventions. Specific psychological interventions that address negative symptoms as a priority focus of attention and care need to be promoted and developed, particularly when considering the crucial role of context in their progression.

Explorando el potencial de aprendizaje de personas con esquizofrenia en distintas condiciones psicopatológicas / Exploring learning potential in schizophrenic inpatients in different psychopathological conditions

En el presente trabajo tratamos de explorar empíricamente el potencial de aprendizaje de personas con esquizofrenia en condiciones opuestas de estabilidad psicopatológica. Con este objetivo se realizó un experimento de equivalencia de estímulos o procedimiento general de aprendizaje de discriminaciones condicionales, estudiando seguidamente la formación de clases de equivalencia. La muestra incluyó 8 adultos en tratamiento en el programa de atención a trastornos mentales severos, con edades comprendidas entre 20 y 53 años. Debido a los abandonos, el procedimiento inicial fue modificado para reducir la duración y el esfuerzo atencional de la tarea. Los resultados mostraron que personas con esquizofrenia pueden adquirir la equivalencia de estímulos tanto en condiciones psicopatológicas de estabilidad como de descompensación en presencia de sintomatología positiva intensa. Este hallazgo es relevante para la terapia, concebida como aprendizaje, así como para el diseño de programas en el contexto de la rehabilitación y recuperación en la esquizofrenia

The aim of this paper is to explore empirically the learning potential of people with schizophrenia in opposite conditions of psychopathological stability. For this purpose, a general procedure of conditional discrimination learning was introduced by conducting a study on the formation of equivalence classes. The sample consisted of 8 inpatient adults included in the program of Severe Mental Disorders, aged between 20 and 53 years. Because of dropouts, the initial procedure was modified in order to reduce the duration and attentional effort of the task. The results showed that people with schizophrenia can acquire stimulus equivalence with standard procedure both in terms of stability and psychopathological decompensation, in the presence of strong positive symptoms. This finding is relevant both for therapy, conceived in terms of learning, and for designing programs in the context of rehabilitation and recovery in schizophrenia